This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stevenson, C. G.
Right arrow Articles by McGeer, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stevenson, C. G.
Right arrow Articles by McGeer, A. J.
Related Collections
Right arrow Other epidemiology
Right arrow Long-term care
Right arrow Vaccination
Right arrow Other respiratory infections
Right arrow Influenza
CMAJ • May 15, 2001; 164 (10)
© 2001 Canadian Medical Association or its licensors

Research
Recherche

Prevention of influenza and pneumococcal pneumonia in Canadian long-term care facilities: How are we doing?

Colin G. Stevenson*, Margaret A. McArthur*, Monika Naus{dagger}, Erika Abraham{dagger} and Allison J. McGeer*

From *the Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ont., and {dagger}the Ontario Ministry of Health and Long Term Care, Toronto, Ont.

Background: Influenza and pneumococcal pneumonia are serious health problems among elderly people and a major cause of death in long-term care facilities. We describe the results of serial surveys of vaccination coverage and influenza outbreak management in Canadian long-term care facilities over the last decade.

Methods: Cross-sectional surveys consisting of questionnaires mailed to all Canadian residential long-term care facilities for elderly people in 1991 and to a random sample of respondents in 1995 and 1999.

Results: The response rates were 83% (430/515) in 1995 and 75% (380/506) in 1999. In 1999 the mean reported rates of influenza vaccination were 83% among residents and 35% among staff, and the mean rate of pneumococcal vaccination among residents was 71%; all 3 rates were significantly higher than those in 1991. The rates were also higher in facilities with an infection control practitioner than in those without such an individual (88% v. 82% for influenza vaccination among residents [p < 0.001], 42% v. 35% for influenza vaccination among staff [p = 0.008] and 75% v. 63% for pneumococcal vaccination among residents [p < 0.001]). Obtaining consent for vaccination on admission to the facility was associated with higher influenza and pneumococcal vaccination rates among residents (p = 0.04 and p < 0.001 respectively). Facilities with higher influenza vaccination rates among residents and staff reported lower rates of influenza outbreaks (p = 0.08 and 0.03 respectively). Despite recommendations from the National Advisory Committee on Immunization, only 50% of the facilities had policies for amantadine prophylaxis during influenza A outbreaks. Amantadine was judged effective in controlling 76% of the influenza A outbreaks and was discontinued because of side effects in 3% of the residents.

Interpretation: Influenza and pneumococcal vaccination rates among residents and staff in Canadian long-term care facilities have increased over the last decade but remain suboptimal. Vaccination of residents and staff against influenza is associated with a reduced risk of influenza outbreaks. Amantadine is effective in controlling influenza outbreaks in long-term care facilities.




This article has been cited by other articles:


Home page
 CMAJHome page
G. S. Ogilvie MD MSc, V. P. Remple PhD, F. Marra PharmD, S. A. McNeil MD, M. Naus MD MHSc, K. L. Pielak MSN, T. G. Ehlen MD, S. R. Dobson MD, D. M. Money MD, and D. M. Patrick MD MHSc
Parental intention to have daughters receive the human papillomavirus vaccine
Can. Med. Assoc. J., December 4, 2007; 177(12): 1506 - 1512.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
J. Johnstone, T. J. Marrie, D. T. Eurich, and S. R. Majumdar
Effect of Pneumococcal Vaccination in Hospitalized Adults With Community-Acquired Pneumonia
Arch Intern Med, October 8, 2007; 167(18): 1938 - 1943.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
A. C. Kimura, C. N. Nguyen, J. I. Higa, E. L. Hurwitz, and D. J. Vugia
The Effectiveness of Vaccine Day and Educational Interventions on Influenza Vaccine Coverage Among Health Care Workers at Long-Term Care Facilities
Am J Public Health, April 1, 2007; 97(4): 684 - 690.
[Abstract] [Full Text] [PDF]

Home page
 Evid. Based Med.Home page
A. McGeer
Oseltamivir was safe and effective for prophylaxis of influenza in the frail elderly
Evid. Based Med., January 1, 2002; 7(1): 10 - 10.
[Full Text] [PDF]

Home page
 CMAJHome page
E. Rea and R. Upshur
Semmelweis revisited: the ethics of infection prevention among health care workers
Can. Med. Assoc. J., May 1, 2001; 164(10): 1447 - 1448.
[Full Text] [PDF]