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This is the first in a 3-part series. Recognition and control of respiratory infection outbreaks will be discussed in part 2, and the use of amantadine in part 3.
Residents of long-term care facilities are exposed, through staff, visitors and outside visits, to respiratory infections circulating in the community. Once introduced, respiratory viruses spread easily in the institutional setting.
One of the best means of protecting this highly vulnerable population is yearly influenza vaccination for residents and staff. In frail elderly people, influenza vaccination reduces rates of pneumonia, hospital admission and death, although it does not prevent all illness.' Nursing homes with vaccination rates above 80% are less likely to have outbreaks than those with lower coverage,2 and outbreaks that do occur in well-vaccinated populations are usually mild. Unfortunately, the average coverage in Canadian facilities is below 80%.3,4
The physician's role
All patients and staff of long-term care facilities should be vaccinated against influenza every year. The physician advisor can play a pivotal role by providing direction and monitoring results. Keys to success include ensuring that the program is well timed, simplifying procedures and overcoming barriers to vaccination. The annual vaccination campaign should take...