+ All Categories
Home > Documents > Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 –...

Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 –...

Date post: 01-Jan-2016
Category:
Upload: nickolas-smith
View: 212 times
Download: 0 times
Share this document with a friend
15
Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire Sud, Marseilles, France ESCAIDE 24 th October 2012
Transcript
Page 1: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Increase in notified acute respiratory infection clusters in nursing homes:Surveillance 2011 – 2012 in Paca, France

Teija Korhonen EPIET fellow, Cire Sud, Marseilles, FranceESCAIDE 24th October 2012

Page 2: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• About 750 nursing homes in Provence-Alpes-Côte d’Azur (Paca)

• Elderly people vulnerable

• Close living conditions

Background

Page 3: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• Recommendations by the High Council of Public Health in 2005

• Surveillance system in Paca since 2005 in order to

– promote prevention efforts and influenza vaccinations– facilitate early cluster detection and guide control efforts– conduct epidemiological investigations when severe outbreaks

• Circular by the Ministry of Health in 2006

Surveillance history

Page 4: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• Describe notified acute respiratory infection (ARI) clusters in nursing homes in Paca in 2011 – 2012

• Compare characteristics to the four previous influenza seasons– explore trends

Objectives of this presentation

Page 5: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Person with a cough AND

at least one symptom from both lists: • dyspnea, chest pain, whistles, recent auscultatory findings

• fever, sweating, headache, joint pain, sore throat, nasal discharge

Case definition of ARI

Page 6: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• If three or more cases of ARI within eight days– residents and personnel

• Nursing home personnel reports to the Regional Health Office

• Information transferred to the national ARI surveillance database– weekly national and regional reports

ARI cluster surveillance

Page 7: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Number of notified ARI clusters in nursing homes by week of illness onset of the first case

in Paca October 2011 – April 2012

Page 8: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• 84 clusters: 1745 residents and 325 personnel ill

• 28% average AR for residents • 9% average AR for personnel

• 10% (137) of ill residents hospitalised• 5% (86) of ill residents died • At least one confirmed case of influenza in 60% of clusters• Influenza A(H3N2) identified in seven outbreaks

Results – surveillance 2011 - 2012

Page 9: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• Dominant type A(H3N2)– 1648 typed: 82% A(H3N2)

• 31% of A(H3N2) differed from the vaccine strain

* Bull Epidémiol Hebd. 2012;38:424-427

Results – virus types in France 2011 – 2012 *

Page 10: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Number of notified ARI clusters in nursing homes by influenza season

in Paca since 2007 - 2008

0

10

20

30

40

50

60

70

80

90

2007-2008 2008-2009 2009-2010 2010-2011 2011-2012

INFLUENZA SEASONS

NU

MB

ER

OF

CLU

ST

ER

S

Page 11: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Results – comparison with previous seasonsInfluenza virus types in France since 2007

Season Predominant strains %

2007 - 2008 A(H1N1) – influenza B 60 – 40

2008 - 2009 A(H3N2) 80

2009 - 2010 A(H1N1)pdm09

2010 - 2011 A(H1N1)pdm09 – influenza B 50 – 40

2011 - 2012 A(H3N2) 80

Page 12: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Significant p-values (< 0.05)

Results – comparison with previous seasons

2011 - 2012 Mean of 2007 - 2011

Number of clusters 84 34

Case-fatality (%) 5 2.8

Clusters with at leastone confirmedinfluenza case (%)

60 12

Page 13: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

Largest amount of notified ARI clusters since the implementation ofthe surveillance system

• Circulation of A(H3N2)– first time predominant virus since season 2008 – 2009– one third variant from the vaccine strain

• Increased cluster-ascertainment – better familiarisation with the system

– potential underreporting

Discussion

Page 14: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• Explore reasons for non-participation to increase reporting

• Investigate possible differences in ARI outbreak management between participating and non-participating nursing homes

• Evaluate ARI surveillance at the regional and national level

Recommendations

Page 15: Increase in notified acute respiratory infection clusters in nursing homes: Surveillance 2011 – 2012 in Paca, France Teija Korhonen EPIET fellow, Cire.

• Personnel of the participated nursing homes

• Caroline Six, Francis Charlet, Philippe Malfait and other colleagues in the InVS and the Regional Health Office in Paca

• Kostas Danis and Ioannis Karagiannis

Acknowledgements


Recommended