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Concurrent Summer Influenza and Pertussis Outbreaks in a Nursing Home in Sydney, Australia

Published online by Cambridge University Press:  02 January 2015

Mark J. Ferson ,
Keira Morgan ,
Peter W. Robertson ,
Alan W. Hampson ,
Ian Carter  and
William D. Rawlinson
Mark J. Ferson*
Affiliation:
South Eastern Sydney Public Health Unit, Randwick, New South Wales, Australia School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Keira Morgan
Affiliation:
South Eastern Sydney Public Health Unit, Randwick, New South Wales, Australia
Peter W. Robertson
Affiliation:
Serology Laboratory, SEALS Microbiology, Randwick, New South Wales, Australia
Alan W. Hampson
Affiliation:
WHO Collaborating Centre for Reference and Research on Influenza, Melbourne, Victoria, Australia
Ian Carter
Affiliation:
Virology Division, SEALS Microbiology, Randwick, New South Wales, Australia
William D. Rawlinson
Affiliation:
Virology Division, SEALS Microbiology, Randwick, New South Wales, Australia School of Medical Sciences and the School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
*
Public Health Unit, Locked Bag 88, Randwick, NSW 2031, Australia
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Abstract

Objective:

To report on the investigation of a summer outbreak of acute respiratory illness among residents of a Sydney nursing home.

Design:

An epidemiologic and microbiological investigation of the resident cohort at the time of the outbreak and medical record review 5 months later.

Setting:

A nursing home located in Sydney, Australia, during February to July 1999.

Patients:

The cohort of residents present in the nursing home at the time of the outbreak.

Interventions:

Public health interventions included recommendations regarding hygiene, cohorting of residents and staff, closure to further admissions, and prompt reporting of illness; and virologic and serologic studies of residents.

Results:

Of the 69 residents (mean age, 85.1 years), 35 fulfilled the case definition of acute respiratory illness. Influenza A infection was confirmed in 19 residents, and phylogenetic analysis of the resulting isolate, designated H3N2 A/Sydney/203/99, showed that it differed from strains isolated in eastern Australia during the same period. Serologic evidence of Bordetella infection was also found in 10 residents; however, stratified epidemiologic analysis pointed to influenza A as the cause of illness.

Conclusions:

The investigation revealed an unusual summer outbreak of influenza A concurrent with subclinical pertussis infection. Surveillance of acute respiratory illness in nursing homes throughout the year, rather than solely during epidemic periods, in combination with appropriate public health laboratory support, would allow initiation of a timely public health response to outbreaks of acute respiratory illness in this setting.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 11 , November 2004 , pp. 962 - 966
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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