Public Health England (PHE), North West Health Protection Team (Cheshire &Merseyside), UK.
International Union Against Tuberculosis and Lung Disease, Paris, France; London School of Hygiene and Tropical Medicine, London, UK.
Public Health. 2019 Dec;177:48-56. doi: 10.1016/j.puhe.2019.07.018. Epub 2019 Sep 15.
To assess the association of antiviral prophylaxis and care home characteristics with the spread and severity of influenza-like illness in care homes with influenza outbreaks in North West England in the 2017/2018 influenza season.
This is a retrospective observational study.
Routinely collected outbreak surveillance data reported to Public Health England were extracted from health protection electronic records. Data included use of antiviral prophylaxis, influenza-like illness or confirmed influenza, hospital admissions and deaths. Care home characteristics were obtained from the Care Quality Commission website. Single variable analysis and multivariable logistic regression were used to examine associations between care home characteristics, antiviral prophylaxis and influenza-related outcomes.
In the 109 homes, there were 3498 residents; of whom, 855 (24%) developed an influenza-like illness. Antiviral prophylaxis was given to residents of 67 of the 109 care homes with outbreaks (61%). A significantly higher attack rate was observed among residents of homes given antiviral prophylaxis (27%) than among residents of homes not given antivirals (20%) (P < 0.001). Significantly more deaths occurred in homes for people with learning disabilities and homes that received antiviral prophylaxis (P < 0.001).
In homes given antiviral prophylaxis, there were a higher number of residents with influenza-like illness and deaths. To improve our understanding of the impact of antiviral prophylaxis use in real life, enhanced and timely data collection is needed for identification of temporal associations between exposure and administration of antiviral prophylaxis. Consideration needs also to be given to ensure people with learning disabilities are protected through the seasonal influenza vaccine and timely antiviral prophylaxis when appropriate.
评估抗病毒预防措施和养老院特征与英格兰西北部流感暴发期间养老院中流感样疾病的传播和严重程度的关系。
这是一项回顾性观察研究。
从公共卫生电子记录中提取向英格兰公共卫生署报告的常规暴发监测数据。数据包括抗病毒预防措施、流感样疾病或确诊流感、住院和死亡的使用情况。养老院特征从护理质量委员会网站获得。单变量分析和多变量逻辑回归用于检查养老院特征、抗病毒预防措施和流感相关结果之间的关系。
在 109 个养老院中，有 3498 名居民；其中 855 人（24%）患有流感样疾病。暴发养老院中 109 家的 67 家（61%）为居民提供了抗病毒预防措施。接受抗病毒预防措施的居民的发病率明显高于未接受抗病毒药物的居民（27%比 20%）（P<0.001）。在智障人士养老院和接受抗病毒预防措施的养老院中，死亡人数明显更多（P<0.001）。
在接受抗病毒预防措施的养老院中，流感样疾病和死亡的居民人数更多。为了更好地了解现实生活中使用抗病毒预防措施的影响，需要加强和及时收集数据，以确定暴露与抗病毒预防措施之间的时间关联。还需要考虑确保智障人士通过季节性流感疫苗和适时的抗病毒预防措施得到保护。
