Nicholson K G, Baker D J, Farquhar A, Hurd D, Kent J, Smith S H
Infectious Diseases Unit, Groby Road Hospital, Leicester.
Epidemiol Infect. 1990 Dec;105(3):609-18. doi: 10.1017/s0950268800048251.
Occupants of 482 long-stay and 33 short-stay beds in 11 Leicester City Council homes for the elderly were studied during a 30-week period from September 1988 to March 1989 to determine the incidence, aetiology, morbidity, and mortality of acute upper respiratory tract viral infections and the use of influenza vaccine. Influenza immunization rates by home ranged from 15.4 to 90% (mean 45%). There were no differences in the distribution of medical conditions by home. The highest immunization rates were seen in people with chest disease (77%), heart disease (60%), diabetes (56%), and those with three medical conditions (75%). There was an average of 0.7 upper respiratory episodes per bed per annum with a mortality of 3.4% (6/179). Half of all episodes were seen by a general medical practitioner and 81 of 90 (90%) referrals were prescribed antibiotics costing approximately 7.50 pounds per patient. Lower respiratory tract complications developed during 45 (25%) of 179 episodes including 3 of 12 coronavirus infections, 3 of 9 respiratory syncytial virus infections, 2 of 4 adenovirus infections, 1 of 11 rhinovirus infections, but none of 5 influenza infections. Respiratory infections were caused mostly by pathogens other than influenza virus during the influenza period documented nationally. This highlights the role of coronaviruses, respiratory syncytial virus, and unidentified agents in the elderly, and questions the assumptions made in American estimates on the impact of influenza and the value of influenza vaccines.
1988年9月至1989年3月的30周期间，对莱斯特市议会11所养老院中482张长期床位和33张短期床位的居住者进行了研究，以确定急性上呼吸道病毒感染的发病率、病因、发病率和死亡率以及流感疫苗的使用情况。各养老院的流感免疫接种率在15.4%至90%之间（平均45%）。各养老院的医疗状况分布没有差异。胸部疾病患者（77%）、心脏病患者（60%）、糖尿病患者（56%）以及患有三种疾病的患者（75%）的免疫接种率最高。每张床位每年平均有0.7次上呼吸道发作，死亡率为3.4%（6/179）。所有发作中有一半由普通医生诊治，90例转诊中有81例（90%）被开了抗生素，每位患者的费用约为7.50英镑。179次发作中有45次（25%）出现下呼吸道并发症，包括12例冠状病毒感染中的3例、9例呼吸道合胞病毒感染中的3例、4例腺病毒感染中的2例、11例鼻病毒感染中的1例，但5例流感感染中无一例出现并发症。在全国记录的流感期间，呼吸道感染大多由流感病毒以外的病原体引起。这突出了冠状病毒、呼吸道合胞病毒和不明病原体在老年人中的作用，并对美国关于流感影响的估计以及流感疫苗价值的假设提出了质疑。
