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Epidemiology of Acute Respiratory Illness During an Influenza Outbreak in a Nursing HomeA Prospective Study
Peter A. Gross, MD;
Manuel Rodstein, MD;
John R. LaMontagne, PhD;
Richard A. Kaslow, MD, MPH;
Alfred J. Saah, MD, MPH;
Sylvan Wallenstein, PhD;
Richard Neufeld, MD;
Carolyn Denning, MD;
Pureza Gaerlan, MD;
Gerald V. Quinnan, MD
Arch Intern Med. 1988;148(3):559-561.
Abstract
• We observed an influenza epidemic caused by influenza A/Arizona/82 (H3N2) in a nursing home during 1982 to 1983. A survey indicated that 59% of the residents were immunized before the outbreak. The outbreak was observed to begin in November, peak in February, and disappear in April. A significant level of herd immunity may have accounted for the slow progression through the nursing home. In addition, serologic evidence of concurrent infection with respiratory syncytial virus, parainfluenza virus, and Mycoplasma pneumoniae was present in many residents. Epidemics of influenza in a closed, partially immunized population in a nursing home may proceed at a slower rate than in an open, largely unimmunized community. By monitoring for infection with other respiratory agents, the complex nature of the outbreak in this nursing home became evident.
(Arch Intern Med 1988;148:559-561)
Author Affiliations
From Hackensack (NJ) Medical Center and New Jersey Medical School, Newark (Dr Gross); Division of Virology, Office of Biologics Research and Review, National Center for Drugs and Biologics, Food and Drug administration, Bethesda, Md (Dr Quinnan); Jewish Home and Hospital for the Aged, New York (Drs Rodstein and Neufeld); Microbiology and Infectious Diseases Program, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (Drs LaMontagne, Kaslow, and Saah); Department of Geriatrics, Mount Sinai School of Medicine, New York (Drs Rodstein and Neufeld); School of Public Health (Biostatistics), College of Physicians and Surgeons, Columbia University, New York (Dr Wallenstein); and St Vincent's Hospital Cystic Fibrosis Clinic, New York Medical College (Drs Denning and Gaerlan).
Footnotes
Accepted for publication Oct 10, 1987.
Reprint requests to Department of Internal Medicine, Hackensack Medical Center, 30 Prospect St, Hackensack, NJ 07601 (Dr Gross).
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