title: Surveillance for outbreaks of influenza-like illness in the institutionalized elderly.
abstract: Respiratory outbreaks are common in aged-care facilities (ACFs), are both underreported and frequently identified late, and are often associated with considerable burden of illness and death. There is emerging evidence that active surveillance coupled with early and systematic intervention can reduce this burden. Active surveillance for influenza-like illness and rapid diagnosis of influenza were established in 16 ACFs in Sydney, Australia, prior to the winter of 2006. A point-of-care influenza test and laboratory direct immunofluorescence tests for common respiratory viruses were used for diagnosis. We achieved early identification of seven respiratory disease outbreaks, two of which were caused by influenza. For the influenza outbreaks, antiviral treatment and prophylaxis were initiated 4-6 days from symptom onset in the primary case. A simple active surveillance system for influenza was successfully implemented and resulted in early detection of influenza and other respiratory disease outbreaks. This enabled earlier implementation of prevention and control measures and increased the potential effectiveness of anti-influenza chemoprophylaxis.
authors.affiliation: National Centre for Immunisation Research and Surveillance for Vaccine Preventable Diseases, The Children's Hospital at Westmead, University of Sydney, NSW 2052, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Rosewell
authors.forename: C
authors.initials: C
authors.lastname: Chiu
authors.forename: R
authors.initials: R
authors.lastname: Lindley
authors.forename: D E
authors.initials: DE
authors.lastname: Dwyer
authors.forename: C R M
authors.initials: CR
authors.lastname: Moffatt
authors.forename: C
authors.initials: C
authors.lastname: Shineberg
authors.forename: E
authors.initials: E
authors.lastname: Clarke
authors.forename: R
authors.initials: R
authors.lastname: Booy
authors.forename: C R
authors.initials: CR
authors.lastname: MacIntyre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D004196:Disease Outbreaks; D019085:Fluorescent Antibody Technique, Direct; D006268:Health Facilities / Q000706:statistics & numerical data; D006801:Humans; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology*; D008503:Medical Staff / Q000706:statistics & numerical data; D019095:Point-of-Care Systems; D011159:Population Surveillance