Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Infect Control Hosp Epidemiol. 2011 Oct;32(10):990-7. doi: 10.1086/661916. Epub 2011 Aug 17.
Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation.
The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds.
Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]).
High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.
与居民有接触的长期护理机构（LTCF）员工应每年接种流感疫苗，以降低居民中流感的发病率。本调查估计了这一建议的受益程度。
新墨西哥州卫生署在 2006-2007 年和 2007-2008 年流感季节在其所有 75 个 LTCF 中实施了主动监测。每月收集每个机构中实验室确诊的流感病例数以及居民和直接护理员工的疫苗接种比例信息。将报告至少 1 例居民实验室确诊的流感（分别通过实验室确诊或流感样疾病[ILI]的症状定义）的 LTCF 与未报告流感病例的 LTCF 进行比较。使用回归建模获得员工疫苗接种覆盖率与流感暴发发生之间的关联的调整比值比（aOR）和 95％置信区间（CI）。协变量包括居民疫苗接种覆盖率、员工与居民的比例以及床位占有率。
在这 2 年的监测期间，报告了 17 次流感暴发。其中 11 次为实验室确诊（n = 21 名居民），6 次为 ILI 定义（n = 40 名居民）。暴发报告机构中直接护理员工的流感疫苗接种覆盖率平均为 51％，而未暴发报告机构中的接种率为 60％（P =.12）。直接护理员工的疫苗接种覆盖率增加与报告的实验室确诊流感暴发（aOR，0.97 [95％CI，0.95-0.99]）和 ILI（aOR，0.98 [95％CI，0.96-1.00]）减少相关。
直接护理员工的高疫苗接种覆盖率有助于预防 LTCF 中的流感。
