Reducing the impact of pandemic influenza in residential care homes for the elderly using pre-pandemic vaccination

2011 ◽  
Author(s):  
Shui-wah, Doreen Ko
Keyword(s):  
Residential Care ◽  
Pandemic Influenza ◽  
The Elderly ◽  
Care Homes ◽  
Homes For The Elderly ◽  
The Impact

scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018

2019 ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P Harris ◽  
Sarah J O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01-1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60-0.91), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

scholarly journals What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016-2018

2019 ◽  
Author(s):  
Thomas Inns ◽  
Deb Wilson ◽  
Petra Manley ◽  
John P Harris ◽  
Sarah J O’Brien ◽  
...  
Keyword(s):  
Care Home ◽  
Implementation Strategies ◽  
The Elderly ◽  
Care Homes ◽  
Viral Pathogens ◽  
North East ◽  
Infectious Gastroenteritis ◽  
Homes For The Elderly ◽  
Stool Samples ◽  
The Impact

Abstract Background Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings. Methods We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression. Results From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with submitted stool samples. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 5.92, 95% CI 2.30-16.50) and larger care homes (aOR 2.35, 95% CI 1.05-5.38), compared to outbreaks caused by other viral pathogens. Conclusions These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.

The Effects and Costs of a Hearing Screening and Rehabilitation Program in Residential Care Homes for the Elderly in the Netherlands1

2013 ◽  
Vol 22 (1) ◽  
pp. 186-189 ◽  
Author(s):  
A. M. Linssen ◽  
M. A. Joore ◽  
E. J. J. M. Theunissen ◽  
L. J. C. Anteunis
Keyword(s):  
Hearing Loss ◽  
Residential Care ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
The Elderly ◽  
Rehabilitation Program ◽  
Hearing Screening ◽  
Care Homes ◽  
Homes For The Elderly

Purpose This study describes the effects and costs of hearing screening and rehabilitation in residential care homes for the elderly. It was hypothesized that offering an in-house hearing screening and rehabilitation program would be an effective strategy to increase hearing aid ownership among the residents. Method All 705 residents of 8 residential care homes in the Netherlands were invited to participate in a hearing screening (pure-tone audiometry) and rehabilitation (hearing aids) program. Resident participation was analyzed, and the costs were calculated. Results A total of 243 residents (34%) participated in the screening, 222 (91%) of whom had hearing loss. Ninety-one (41%) of the screening participants with hearing loss started rehabilitation, which was successful for 50 (55%) of them. Hearing aid ownership among the residents with hearing loss increased from 28% at the start of the program to 33% at the end. The costs were €1,896 (US $2,480) per successfully rehabilitated resident. Hearing aid trials and hearing aids together accounted for 83% of the total costs. Conclusion The effectiveness of the program was limited, as hearing aid ownership increased only slightly. Cost reduction measures should focus on decreasing the number of unsuccessful hearing aid trials.

scholarly journals Role of Hand Hygiene Ambassador and Implementation of Directly Observed Hand Hygiene Among Residents in Residential Care Homes for the Elderly in Hong Kong

2018 ◽  
Vol 39 (5) ◽  
pp. 571-577 ◽  
Author(s):  
Vincent C. C. Cheng ◽  
Hong Chen ◽  
Shuk-Ching Wong ◽  
Jonathan H. K. Chen ◽  
Wing-Chun Ng ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Residential Care ◽  
Environmental Contamination ◽  
The Elderly ◽  
Multidrug Resistant ◽  
Care Homes ◽  
Controlled Study ◽  
Acinetobacter Species ◽  
Homes For The Elderly ◽  
Communal Areas

OBJECTIVEMultidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs.METHODSFrom July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE. Environmental contamination by MRDOs, such as methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum β-lactamse (ESBL)–producing Enterobacteriaceae, was evaluated using specimens collected from communal areas at baseline, then twice weekly. The volume of alcohol-based hand rub (ABHR) consumed per resident per week was measured.RESULTSThe overall environmental contamination of communal areas was culture-positive for MRSA in 33 of 100 specimens (33%), CRA in 26 of 100 specimens (26%), and ESBL-producing Enterobacteriaceae in 3 of 100 specimens (3%) in intervention and nonintervention RCHEs at baseline. Serial monitoring of environmental specimens revealed a significant reduction in MRSA (79 of 600 [13.2%] vs 197 of 600 [32.8%]; P<.001) and CRA (56 of 600 [9.3%] vs 94 of 600 [15.7%]; P=.001) contamination in the intervention arm compared with the nonintervention arm during the study period. The volume of ABHR consumed per resident per week was 3 times higher in the intervention arm compared with the baseline (59.3±12.9 mL vs 19.7±12.6 mL; P<.001) and was significantly higher than the nonintervention arm (59.3±12.9 mL vs 23.3±17.2 mL; P=.006).CONCLUSIONSThe direct observation of hand hygiene of residents could reduce environmental contamination by MDROs in RCHEs.Infect Control Hosp Epidemiol 2018;39:571–577

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