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Nursing Home Outbreak of Influenza A (H3N2): Evaluation of Vaccine Efficacy and Influenza Case Definitions

Published online by Cambridge University Press:  21 June 2016

Jean Lin Taylor*
Affiliation:
Division of Outbreak Investigation, Epidemiology and Disease Control Program
Diane M. Dwyer
Affiliation:
Division of Outbreak Investigation, Epidemiology and Disease Control Program
Thelma Coffman
Affiliation:
Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, and the Washington County Health Department
Carmela Groves
Affiliation:
Division of Outbreak Investigation, Epidemiology and Disease Control Program
Jagdish Patel
Affiliation:
Laboratories Administration
Ebenezer Israel
Affiliation:
Division of Outbreak Investigation, Epidemiology and Disease Control Program
*
Division of Outbreak Investigation, Epidemiology and Disease Control Program, Maryland Department of Health and Mental Hygiene, 201 West Preston Street, Baltimore, MD 21201

Abstract

Objectives:

Describe an outbreak of influenza A (H3N2); provide an analysis of vaccine efficacy; measure the sensitivity specificity, and positive predictive value of 3 clinical case definitions of influenza.

Setting:

A nursing home in Washington County, Maryland. The outbreak involved 52 residents (attack rate = 47.7%) and at least 10 of 140 employees (minimum attack rate = 7.1%).

Results:

Twenty-five residents exhibited a 4-fold or greater increase in titer to influenza A/Sichuan/2/87. Vaccine efficacy was measured at -7.1%, suggesting that the influenza vaccine in 1988/1989 did not offer optimal protection against influenza A infection for the institutionalized elderly.

Conclusions:

The outbreak was a clear indicator of the need for rapid diagnosis. With the use of rapid diagnostic tests, influenza A could have been detected in time to use amantadine.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992

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