Taylor J L, Dwyer D M, Coffman T, Groves C, Patel J, Israel E
Division of Outbreak Investigation, Maryland Department of Health and Mental Hygiene, Baltimore 21201.
Infect Control Hosp Epidemiol. 1992 Feb;13(2):93-7. doi: 10.1086/646479.
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.
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%).
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.
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.
描述甲型（H3N2）流感暴发情况；分析疫苗效力；测定流感3种临床病例定义的敏感性、特异性和阳性预测值。
马里兰州华盛顿县的一家疗养院。此次暴发涉及52名居民（罹患率=47.7%）和140名员工中的至少10人（最低罹患率=7.1%）。
25名居民对甲型/四川/2/87流感病毒的抗体滴度呈4倍或更高倍数增长。疫苗效力测定为-7.1%，这表明1988/1989年的流感疫苗未为机构内老年人提供针对甲型流感感染的最佳保护。
此次暴发明确表明需要进行快速诊断。通过使用快速诊断检测，本可及时检测出甲型流感以便使用金刚烷胺。
