Masse S, Minodier L, Heuze G, Blanchon T, Capai L, Falchi A
EA 7310, Laboratory of Virology, University of Corsica-Inserm, Corte, France.
CIRE-SUD Paca Corse, InVS, Saint-Maurice Cedex, Paris, France.
Springerplus. 2016 Aug 11;5(1):1338. doi: 10.1186/s40064-016-2957-z. eCollection 2016.
To study the molecular epidemiology of the influenza outbreaks in nursing homes (NHs) to determine whether multiple influenza strains were involved.
From September to December 2014, NHs in Corsica were invited to participate in an ongoing daily epidemiological and microbiological surveillance for influenza-like illness (ILI) among residents and health care workers (HCWs).
The study involved 12 NHs. Respiratory illness meeting the ILI case definition was observed among 44 residents from whom 22 specimens were collected. Of the 22 residents with a nasopharyngeal sample, 13 (59 %) were positive for at least one of the 11 pathogens analysed. Among these 13 patients, 11 (92 %) presented a confirmed influenza (A/H3N2) and two had another respiratory virus: one human metapneumovirus and one human coronavirus. Of patients with a confirmed influenza A(H3N2), 10 (91 %) were vaccinated against influenza during the 2014-2015 season. Two influenza outbreaks were reported in two NHs, caused by influenza A(H3N2) strains belonging to cluster 3C.3 and 3C.2a. Although antivirals were available, prophylaxis was not used.
Phylogenetic analysis seems to suggest no multiple introduction into the two NHs reporting the two influenza A(H3N2) outbreaks. A number of factors could have contributed to transmitting influenza in NHs including, the absence of administration of antiviral treatment for prophylaxis of all residents/staff regardless of immunization status because of the poor vaccine match during each outbreak, the intensive contacts with incompletely protected residents and HCWs, and the low adherence of NHs to notification of ILI outbreaks to the health authorities.
研究养老院流感暴发的分子流行病学，以确定是否涉及多种流感毒株。
2014年9月至12月，邀请科西嘉岛的养老院参与一项针对居民和医护人员中流感样疾病（ILI）的持续每日流行病学和微生物学监测。
该研究涉及12所养老院。在44名居民中观察到符合ILI病例定义的呼吸道疾病，从中采集了22份标本。在22名采集了鼻咽样本的居民中，13名（59%）对所分析的11种病原体中的至少一种呈阳性。在这13名患者中，11名（92%）确诊为流感（A/H3N2），另外两名感染了另一种呼吸道病毒：一名感染人偏肺病毒，一名感染人冠状病毒。在确诊为甲型H3N2流感的患者中，10名（91%）在2014 - 2015季节接种了流感疫苗。两所养老院报告了两起流感暴发，由属于3C.3和3C.2a簇的甲型H3N2流感毒株引起。尽管有抗病毒药物可用，但未进行预防用药。
系统发育分析似乎表明，在报告两起甲型H3N2流感暴发的两所养老院中，没有多次引入流感病毒。许多因素可能导致了流感在养老院中的传播，包括：由于每次暴发期间疫苗匹配性差，无论免疫状态如何，未对所有居民/工作人员进行抗病毒治疗以预防；与未得到充分保护的居民和医护人员密切接触；以及养老院向卫生当局报告ILI暴发的依从性低。
