MMWR Morb Mortal Wkly Rep. 2010 Jan 29;59(3):74-7.
Hospitalization and death from seasonal influenza are more common among older adults and in long-term--care facilities (LTCFs). Early data from the 2009 pandemic influenza A (H1N1) outbreak indicated that attack rates among persons aged >or=65 years were lower than in other age groups, and anti-influenza A antibodies that cross-react with 2009 H1N1 could be detected in up to one third of healthy adults aged >60 years. Based on these early data and anticipation of limited initial supplies of 2009 H1N1 vaccine, the Advisory Committee on Immunization Practices (ACIP) identified priority groups for vaccination, which did not include persons aged >or=65 years who did not have higher risk for influenza or its complications. During October and November 2009, CDC received reports of 2009 H1N1 outbreaks in LTCFs in Colorado, Maine, and New York. This report summarizes the three outbreaks, which involved facilities primarily housing older patients. These outbreaks illustrate that, despite the lower risk for infection with 2009 H1N1 among persons aged >or=65 years compared with seasonal influenza, 2009 H1N1 outbreaks still can occur in LTCFs. These outbreaks also underscore the importance of respiratory illness surveillance and recommended infection-control procedures in LTCFs. All health-care personnel should be vaccinated against seasonal influenza and 2009 H1N1. LTCF residents should receive seasonal influenza vaccination, and should be vaccinated against 2009 H1N1 after assessment of vaccine availability at the local level indicates that demand for vaccine among younger age groups is being met.
季节性流感导致的住院和死亡病例在老年人和长期护理机构（LTCF）中更为常见。2009 年甲型 H1N1 大流行的早期数据表明，年龄≥65 岁者的发病率低于其他年龄组，并且在多达三分之一的年龄≥60 岁的健康成年人中可检测到与 2009 年 H1N1 交叉反应的抗流感 A 抗体。基于这些早期数据和对 2009 年 H1N1 疫苗初始供应有限的预期，免疫实践咨询委员会（ACIP）确定了疫苗接种的优先人群，其中不包括没有更高流感或其并发症风险的年龄≥65 岁者。2009 年 10 月至 11 月，CDC 收到了科罗拉多州、缅因州和纽约州 LTCF 发生 2009 年 H1N1 暴发的报告。本报告总结了这三起暴发事件，这些暴发事件涉及主要收容老年患者的机构。这些暴发事件表明，尽管与季节性流感相比，年龄≥65 岁者感染 2009 年 H1N1 的风险较低，但 2009 年 H1N1 暴发仍可能在 LTCF 中发生。这些暴发事件还强调了在 LTCF 中进行呼吸道疾病监测和推荐感染控制程序的重要性。所有卫生保健人员均应接种季节性流感和 2009 年 H1N1 疫苗。LTCF 居民应接种季节性流感疫苗，并且应在当地评估疫苗供应情况后接种 2009 年 H1N1 疫苗，如果表明年轻年龄组对疫苗的需求已得到满足。
