Merritt Tony, Hope Kirsty, Butler Michelle, Durrheim David, Gupta Leena, Najjar Zeina, Conaty Stephen, Boonwatt Leng, Fletcher Stephanie
Hunter New England Local Health District, New South Wales, Australia .
Health Protection New South Wales, North Sydney, New South Wales, Australia .
Western Pac Surveill Response J. 2016 Feb 19;7(1):14-20. doi: 10.5365/WPSAR.2015.6.3.005. eCollection 2016 Jan-Mar.
There was a record number ( = 111) of influenza outbreaks in aged care facilities in New South Wales, Australia during 2014. To determine the impact of antiviral prophylaxis recommendations in practice, influenza outbreak data were compared for facilities in which antiviral prophylaxis and treatment were recommended and for those in which antivirals were recommended for treatment only.
Routinely collected outbreak data were extracted from the Notifiable Conditions Information Management System for two Local Health Districts where antiviral prophylaxis was routinely recommended and one Local Health District where antivirals were recommended for treatment but not routinely for prophylaxis. Data collected on residents included counts of influenza-like illness, confirmed influenza, hospitalizations and related deaths. Dates of onset, notification, influenza confirmation and antiviral recommendations were also collected for analysis. The Mann-Whitney U test was used to assess the significance of differences between group medians for key parameters.
A total of 41 outbreaks (12 in the prophylaxis group and 29 in the treatment-only group) were included in the analysis. There was no significant difference in overall outbreak duration; outbreak duration after notification; or attack, hospitalization or case fatality rates between the two groups. The prophylaxis group had significantly higher cases with influenza-like illness ( = 0.03) and cases recommended antiviral treatment per facility ( = 0.01).
This study found no significant difference in key outbreak parameters between the two groups. However, further high quality evidence is needed to guide the use of antivirals in responding to influenza outbreaks in aged care facilities.
2014年，澳大利亚新南威尔士州老年护理机构中流感暴发数量创纪录（n = 111）。为确定抗病毒预防建议在实际中的影响，对推荐抗病毒预防和治疗的机构与仅推荐抗病毒治疗的机构的流感暴发数据进行了比较。
从法定传染病信息管理系统中提取两个常规推荐抗病毒预防的地方卫生区以及一个仅推荐抗病毒治疗而非常规预防的地方卫生区的常规收集的暴发数据。收集的居民数据包括流感样疾病、确诊流感、住院和相关死亡的病例数。还收集了发病日期、报告日期、流感确诊日期和抗病毒建议以进行分析。采用曼-惠特尼U检验评估关键参数组中位数之间差异的显著性。
共有41起暴发（预防组12起，仅治疗组29起）纳入分析。两组在总体暴发持续时间、报告后的暴发持续时间、发病率、住院率或病死率方面无显著差异。预防组的流感样疾病病例数（P = 0.03）和每个机构推荐抗病毒治疗的病例数显著更高（P = 0.01）。
本研究发现两组在关键暴发参数上无显著差异。然而，需要进一步的高质量证据来指导在应对老年护理机构流感暴发时使用抗病毒药物。
