Epidemiology and Surveillance Unit, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
J Am Geriatr Soc. 2011 Dec;59(12):2301-5. doi: 10.1111/j.1532-5415.2011.03715.x. Epub 2011 Oct 31.
To describe the epidemiological, virological, and institutional characteristics of influenza-like illness (ILI) in nursing homes (NHs).
Continuous clinical surveillance of ILI and virological surveillance of ILI and other acute respiratory infections (ARIs) during four influenza seasons.
National sentinel NH surveillance network.
National sentinel residents.
Weekly registration of ILI cases (influenza seasons 2008/09-2009/10), influenza virus detection (influenza seasons 2006/07-2009/10), and collection of institutional characteristics of NHs at start of participation.
During the 2008/09 influenza season, ILI incidence started to rise in Week 49 of 2008, peaked in Week 3 of 2009 (158 cases per 10,000 resident weeks), and flattened out by Week 16 of 2009 (mean ILI incidence during epidemic: 73 cases per 10,000 resident weeks). During the 2009/10 influenza pandemic, there was no epidemic peak. Influenza virus type and subtype varied throughout virological surveillance but was limited to influenza A(H3N2) and B viruses. Higher staff vaccination coverage (>15%) was associated with lower ILI-incidence in the 2008/09 influenza season in a univariate negative binomial regression analysis (incidence rate ratio = 0.3, 95% confidence interval = 0.1-0.8)).
Neither seasonal nor pandemic influenza A(H1N1) viruses were detected in the network, despite widespread community transmission of seasonal and influenza A(H1N1) virus. ILI incidence trends corresponded to virological trends. Sentinel surveillance of ILI combining clinical and virological data in NHs increases understanding of transmission risks in this specific vulnerable population.
描述流感样疾病（ILI）在养老院（NH）中的流行病学、病毒学和机构特征。
在四个流感季节连续进行 ILI 临床监测和 ILI 及其他急性呼吸道感染（ARI）的病毒学监测。
国家哨点 NH 监测网络。
国家哨点居民。
每周登记ILI 病例（2008/09-2009/10 流感季节）、流感病毒检测（2006/07-2009/10 流感季节）以及参与时 NH 机构特征的收集。
在 2008/09 流感季节，ILI 发病率于 2008 年第 49 周开始上升，于 2009 年第 3 周达到高峰（每 10000 居民周 158 例），并于 2009 年第 16 周趋于平稳（流行期间平均 ILI 发病率：每 10000 居民周 73 例）。在 2009/10 流感大流行期间，没有出现流行高峰。病毒学监测中病毒的类型和亚型各不相同，但仅限于甲型 H3N2 和 B 病毒。在单变量负二项回归分析中，较高的工作人员疫苗接种率（>15%）与 2008/09 流感季节较低的 ILI 发病率相关（发病率比=0.3，95%置信区间=0.1-0.8）。
尽管季节性流感病毒和甲型 H1N1 流感病毒在社区广泛传播，但该网络并未检测到季节性流感 A(H1N1)病毒和甲型 H1N1 病毒。ILI 发病率趋势与病毒学趋势相符。在 NH 中结合临床和病毒学数据进行 ILI 哨点监测，增加了对这一特定脆弱人群传播风险的了解。
