Publications
| Value Of Zanamivir Prophylaxis In A Nursing Home Outbreak Of Influenza A. |
Authors: W. Lee, A. McGeer, M. McArthur, P. Friedman, A. Kam, T. Mazzulli, M. Loeb, A.E. Simor.
Background:
Objective: To assess the impact of zanamivir prophylaxis in controlling influenza A outbreaks in long term care.
Design: Resident symptoms were assessed daily. Nasopharyngeal swabs were performed on all residents with any respiratory symptom.
Method: Outbreak-associated illness was defined as acute respiratory illness associated either fever or malaise and with a positive culture or antigen test for influenza A.
Intervention: Standard precautions for outbreak control, including vaccination, isolation of ill residents, exclusion of ill staff, restriction of visitors and cancellation of shared activities. Staff classified residents as capable of using a diskhaler or not, residents deemed capable were offered zanamivir. Residents not capable, and those refusing zanamivir were offered amantadine.
Results: Zanamivir was not given to 52/249 (21%) residents: 42 were judged unable to use the inhaler, 3 preferred AM, 2 refused all therapy, and 5 were out of the facility. An additional 41 (16.5%) residents were switched to amantadine after difficulty with two attempts at inhalations. A total of 39 cases were identified. After the start of antiviral prophylaxis, 4/82 (4.8%) residents prescribed amantadine, 7/146 (4.8%) prescribed zanamivir, and 1 of 2 refusing any prophylaxis developed illness meeting the case definition (P=.01). No side effects were identified due to zanamivir, and no resident required discontinuation of amantadine due to side effects.
Conclusions: Zanamivir was as effective as amantadine in the prevention of influenza A. Use of zanamivir was associated with termination of the outbreak. The majority (157/239, 66%) of residents in this nursing home were able to comply with inhalations of zanamivir.
Presented At:
Community and Hospital Infection Control Assocation - Canada Conference, Toronto, Ontario, 5/29/2000.
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1999 Microbiology Department, Mount Sinai Hospital, Toronto, ON, Canada.
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