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Zanamivir Use During Transmission of Amantadine‐Resistant Influenza A in a Nursing Home
Formats Available in JSTOR: PDF
Abstract(back to top)
OBJECTIVE. To describe the use of zanamivir during an influenza A outbreak.
POPULATION. Residents of a 176‐bed long‐term–care facility for the elderly in Newmarket, Ontario, Canada, 90% of whom received influenza vaccine in the fall of 1998.
OUTBREAK. When respiratory illness due to influenza A was confirmed, infection control measures and amantadine prophylaxis were initiated. Despite these measures, transmission of influenza A continued.
INTERVENTION. Zanamivir inhalations, 10 mg daily for prophylaxis and 10 mg twice daily for treatment of influenza.
RESULTS. There were 13 definite and 66 probable outbreakassociated cases of influenza A. Twelve (15%) cases developed pneumonia, 7 (9%) were hospitalized, and 2 (2.6%) died. All 12 culturepositive cases yielded influenza A/Sydney/H3N2/05/97‐like virus, a 1998/99 vaccine component. The three isolates obtained prior to the initiation of amantadine were amantadine‐susceptible; all nine obtained after prophylaxis was instituted were amantadine‐resistant. One hundred twenty‐nine (92%) of 140 residents who were offered zanamivir accepted it and were able to attempt inhalations. Of these 129, 78% (100) had no difficulty in complying with inhalations. Difficulty with inhalations was associated with decreased functional and mental status. Fifteen (58%) of 26 residents fully dependent in activities of daily living had difficulty compared to 14 (14%) of 100 others (P<.001). Twenty‐two (45%) of 49 residents not oriented to person, place, or time had difficulty compared to 7 (10%) of 77 others (P<.001). In the 2 weeks after zanamivir prophylaxis, only 2 new cases of respiratory illness occurred, neither confirmed as influenza. No side effects were identified in 128 zanamivir‐treated residents.
CONCLUSION. A minority of nursing home residents have difficulty following instructions for zanamivir inhalations. Zanamivir was well tolerated, and its use was temporally associated with termination of an outbreak that amantadine had failed to control (Infect Control Hosp Epidemiol 2000;21:700‐704).
Bibliographic Information(back to top)
- Zanamivir Use During Transmission of Amantadine‐Resistant Influenza A in a Nursing Home
- Christine Lee , MD, Mark Loeb , MD, Anne Phillips , MD, Judy Nesbitt , RN, Karen Smith , MD, Margaret Fearon , MD, Margaret A. McArthur , RN, Tony Mazzulli , MD, Yan Li , PhD and Allison McGeer , MD
- Infection Control and Hospital Epidemiology
- Vol. 21, No. 11 (November 2000) (pp. 700-704)
Notes and References(back to top)
This item contains 1 note(s).
Notes
From the Department of Microbiology (Drs. Lee, Mazzulli, McGeer; Ms. McArthur), Mount Sinai and Princess Margaret Hospitals, University of Toronto, Toronto, Ontario; Aurora Resthaven Nursing Home (Dr. Smith, Ms. Nesbitt), Aurora, Ontario; Ministry of Health and Long Term Care (Dr. Fearon), Laboratory Branch, Ottawa, Ontario; Department of Pathology and Molecular Medicine (Dr. Loeb), McMaster University, Hamilton, Ontario; Bureau of Microbiology (Dr. Li), Laboratory Centre for Disease Control, Health Canada, Ottawa, Ontario; and Glaxo‐Wellcome, Inc (Dr. Phillips), Toronto, Ontario, Canada. Address reprint requests to Allison McGeer, MD, Room 1460, Department of Microbiology, Mount Sinai Hospital, 600 University Ave, Toronto, Ontario M5G 1X5, Canada. This study was presented in part at the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco, California, September 26‐29, 1999. 00‐OA‐150. Lee C, Loeb M, Phillips A, Nesbitt J, Smith K, Fearon M, McArthur MA, Mazzulli T, Li Y, McGeer A. Zanamivir use during transmission of amantadine‐resistant influenza A in a nursing home. Infect Control Hosp Epidemiol 2000;21:700‐704.
Items Citing this Item (back to top)
2 item(s) in JSTOR cite this item
- Z. Hirji , BSc, BScN, RN; S. O’Grady , MLT, BAS, CIC; J. Bonham , BScN, RN; M. Mak , BScPhm; J. Takata‐Shewchuk , BScPhm; K. Hawkins , BScPm; M. Gardam , MSc, MD, FRCPC; L. Law , BSc, MLT, ART; T. Mazzulli , MD, FRCPC; J. Conly , MD, CCFP, FACP, FRCPCVol. 23, No. 10 (October 2002) pp. 604-608Stable URL: http://www.jstor.org/stable/10.1086/501979
- Andrew Simor , MD, FRCPC, FACPVol. 23, No. 10 (October 2002) pp. 564-567Stable URL: http://www.jstor.org/stable/10.1086/501971