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France - Flu outbreak in the residential facility for dependent elderly (EHPAD) Korian Berthelot in Lyon - 72 cases including 13 deaths

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  • France - Flu outbreak in the residential facility for dependent elderly (EHPAD) Korian Berthelot in Lyon - 72 cases including 13 deaths

    Translation Google

    Ministry of Social Affairs and Health

    Epidemic of influenza in the residential facility for dependent elderly (EHPAD) Korian Berthelot in Lyon

    Published on 07.01.17

    Press releases and press kits

    The Ministry of Social Affairs and Health was informed on Friday 6 January by the Regional Health Agency (ARS) of Auvergne Rh?ne-Alpes of the exceptional importance of the influenza epidemic within the accommodation establishment For dependent elderly people (EHPAD) Korian Berthelot in Lyon. This property has 110 rooms.

    The Ministry of Social Affairs and Health was informed on Friday 6 January by the Regional Health Agency (ARS) of Auvergne Rh?ne-Alpes of the exceptional importance of the influenza epidemic within the accommodation establishment For dependent elderly people (EHPAD) Korian Berthelot in Lyon. This property has 110 rooms.

    According to the institution, as of January 7, 72 people had contracted the flu and 13 of them died between December 23, 2016 and January 7, 2017. The average age of the deceased is 91.5 years. 6 people are still hospitalized.

    At the request of Marisol TOURAINE, Minister of Social Affairs and Health, the ARS Auvergne Rh?ne-Alpes immediately launched an inspection mission on 6 January to monitor the institution's implementation since the beginning of the project. The epidemic, recommendations from health authorities to fight the flu.
    The Minister also requested the Director-General of Health to visit the country on the same day (6 January) in order to assess precisely the situation and to take urgent measures to contain the epidemic and to take In charge of the residents in need. The Director-General of Health noted that by that date the preventive measures had been put in place. In order to strengthen the care of residents, the Director General of Health, in conjunction with the Director General of the ARS, asked a medical team of the Hospices civils de Lyon to visit the site on Saturday 7 January. All people with flu-like symptoms received a medical examination this morning. As a precautionary measure, an additional person was hospitalized.

    Marisol TOURAINE asked the Inspectorate General of Social Affairs (Igas) on 7 January to carry out an inspection mission to identify and analyze the causes behind this exceptional event. A first progress report is expected within 10 days.

    Given the particular sensitivity of people over the age of 65 to the influenza virus currently in circulation, Marisol TOURAINE reminds principals of institutions hosting elderly people to take all necessary measures to contain the epidemic and ensure close follow-up The health status of all residents. It also calls on families to be particularly attentive to the situation of their relatives.

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

  • #2
    Translation Google

    Deadly flu in Lyon: Korian answers on vaccination

    By Benjamin Roure

    Published on 08/01/2017 at 14:55

    After the death of 13 residents in two weeks in a nursing home in Lyon, Paul-Emile Ha?, medical director of Ehpad of the group Korian, manager of the establishment, explains why the vaccination campaign did not save the lives of these the elderly.

    What was the rate of influenza vaccination among residents of Korian Berthelot?

    More than rate, I prefer to start talking about numbers. 41 people were vaccinated, out of the 102 present in the establishment which has a total of 110 places. 13 people or their families refused the vaccine. Others have not been vaccinated because they have immune deficiencies or pathologies or a fragility preventing vaccination. So if a rate is needed, 46% of residents who are not opposed to the vaccine have received an injection. Of the deceased, six had been vaccinated.

    "The vaccination campaign was halted on 21 December"

    Is it normal, on January 8, to have fewer than one resident in two vaccinated?

    On 3 October, we launched a campaign on hygiene measures and vaccination in our network of institutions for dependent elderly people. Each Ehpad is then responsible for implementing this campaign. When we realized that the epidemic threshold was approaching, we asked for an acceleration of vaccination. But once the epidemic was proved to Korian Berthelot, the vaccination campaign was stopped because it is no longer efficient under these conditions: it takes 15 days for the vaccine to be active. Usually, we reach the rate of 80% vaccinated at the end of the campaign, that is to say at the end of January.

    When did the epidemic occur?

    We reported the epidemic to the Regional Health Agency on December 21, when five clustered cases were recorded in Ehpad. The diagnosis was not always simple. Because initially, these symptoms of respiratory infection are triggered. And the elderly have flu profiles sometimes atypical: fever or not long, cough little pronounced, no feeling of great fatigue ... And they are fragile people, who sometimes suffer from other pathologies.

    "39% of staff were vaccinated"

    What about vaccination of staff?

    We are very proactive towards our people, supporting the message of altruism: "Do it for others." We offer them free vaccination in our establishments. But, as in the general population, we often come up against refusals, fears. At Korian Berthelot, 39% of the staff were vaccinated, which is slightly above average in health care facilities.

    What steps were taken after the epidemic was declared?

    First, more information about prevention: avoid visiting when you are sick yourself, wear a mask if necessary, do not go from one room to another ... About 2000 masks have been used In less than two weeks, and more than 100 liters of hydroalcoholic solution. On-site teams received reinforcements when the need arises.

    "No new cases since 3 days"

    How do you explain this high mortality in the institution?

    It is an event quite exceptional in its magnitude and is the result of cumulative factors. First, the epidemic was very early, interrupting the vaccination campaign. Then, at Korian Berthelot, people are older than in other institutions: 91.5 years for the deceased, while the average age in our Ehpad is closer to 84 years. They are sometimes present for a long time, know each other, circulate a lot in the establishment ... The flu kills every year several thousand people, alas. And every week, in the Ehpad of France, there are victims. Sometimes the epidemic is more virulent, as in 2015, when there were 16,000 deaths in our facilities.

    This is not the case this year.

    How are the six people hospitalized?

    Four of them are better off and have to return soon. Two are in stable condition and not disturbing, and kept a few days for surveillance. But the good news is that Korian Berthelot has not noticed any new cases of influenza for 3 days. Given the time of incubation, from 7 days without new case, one can say that the epidemic is finished.


    Après le décès de 13 résidents en deux semaines dans une maison de retraite lyonnaise, Paul-Emile Haÿ, directeur médical des Ehpad du groupe Korian, gestionnaire de l'établissement, explique pourquoi la campagne de vaccination n'a pas sauvé la vie de ces personnes âgées.
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

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    • #3


      Translation Google

      Influenza: series of deaths in a retirement home in Lyon

      > Society | Elsa Mari and Joffrey Vovos | January 08, 2017, 7:00 AM | MAJ: 08 January 2017, 8h24 | 9

      Thirteen residents of a facility for the elderly in Lyon died in fifteen days. The Ministry of Health announced last night an investigation.

      It is an "exceptional event" on which the General Inspectorate of Social Affairs (Igas) will have to shed full light. Thirteen residents of the retirement home Korian-Berthelot, home for dependent elderly (Ehpad) in Lyon, died in two weeks of the flu. Seven more were hospitalized. Victims averaged 91 years. It must be said that in this retirement home which has 110 places, 72 residents had contracted the flu.

      The vaccination rate would be only 38%

      Faced with the urgency of the situation, Marisol Touraine, Minister of Health, announced yesterday evening, around 8:30 pm, to have seized the Igas. The organization will investigate this series of deaths between December 23 and January 7. The regional health agency Auvergne-Rh?ne-Alpes, which alerted the Ministry to the exceptional importance of the epidemic, also launched "an inspection mission to monitor the implementation by the institution, Beginning of the epidemic, of the recommendations of the health authorities for the fight against influenza ".

      However, according to the director general of health, who visited Friday in this private establishment of the VII arrondissement of Lyon, the measures of prevention were well taken. However, the vaccination rate would be only 38% against 80% in other establishments of the Korian group, according to AFP. Solicited last night, management did not respond to our requests for interviews.

      Since the beginning of the epidemic in November, 22 deaths have been recorded throughout France. Of type A, the flu is particularly virulent and precocious this year. It particularly contaminates the elderly, as in 2014-2015.

      Since the end of December, the epidemic affects all regions of metropolitan France, except Corsica, and intensified strongly last week. Between 26 December and 1 January, 5,745 people went to the emergency room for flu-like symptoms, compared with 4,220 the previous week. 80 year old and over account for 63% of inpatients.

      The Auvergne - Rh?ne-Alpes region is the most affected, with 783 cases per 100 000 inhabitants. One of his retirement homes, the Pacaudiere in the Loire, had even to put his boarders in quarantine. Among the measures taken: limited visits with compulsory masks, canceled animations, meals in the rooms ...


      "We are rigorous in terms of hygiene"

      -
      President of the Association of Directors for Seniors (AD-PA), Pascal Champvert leads several establishments in the Val-de-Marne for the elderly. He reacts with great emotion to the deaths of the thirteen residents of the Ehpad Korian-Berthelot of Lyon.

      What are the recommendations to put in place during an epidemic of influenza in an Ehpad?

      PASCAL CHAMPVERT. The vaccination of the elderly, such as that of the staff, is facilitated. We put in place a confinement in the event of a crisis. We are very strict in terms of hygiene. We wash our hands regularly, staff who have flu-like symptoms do not come to work ... These tips are sent to us by the state. Here he does his job well. This is one of the lessons of the heat wave, besides ...

      What's your feeling tonight? (Editor's note: last night)

      The flu has killed more than 16,000 people in 2015, more than the heatwave of 2003. Yet these deaths have virtually gone unnoticed, especially those who died at home. I note, once again, that seniors are remembered only during serious events. French politicians, whoever they are, are always behind in this accompaniment. The underlying problem is that we are working in a tense sector, perpetually. We are short of employees.

      You are angry ?
      I am an active optimist. We must never stop reminding ourselves that we must take care of those people who built the France of today. We have a duty of solidarity.

      Interview by Christine Mateus

      Treize pensionnaires d'un établissement pour personnes âgées de Lyon sont morts en quinze jours. Le ministère de la Santé a annoncé hier soi
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

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      • #4
        Translation Google

        Health News

        How influenza enters retirement homes

        By Damien Mascret Published on 09/01/2017 at 18:54 Published on 09/01/2017 at 18:54

        Only 39% of Ehpad staff where 13 people died were vaccinated.

        Between December 23 and January 7, 13 residents of the retirement home Korian Berthelot of Lyon died in an epidemic of influenza that struck 72 people.

        The Minister of Health, Marisol Touraine, asked the General Inspectorate of Social Affairs (IGAS) to "carry out an inspection mission to identify and analyze the causes behind this exceptional event". A first progress report is expected within 10 days.

        The Director General of Health, Beno?t Vallet, has already considered that the emergency measures to contain the epidemic and to take care of the residents requiring it, were well established. Igas will now have to determine whether prevention has been properly conducted in Lyon.

        "The vaccination campaign started on 7 October," said the Korian group, interviewed by Le Figaro. "It was due to end no later than the end of January, but we interrupted it to take further action, in accordance with the general recommendations on 20 December. There were six new cases on that day. "Of the 102 residents in the Lyon facility, 13 had refused vaccination (3 were among the 13 deaths) and of the remaining 89, 41 had been vaccinated at the time of the stop of the campaign.

        What about the staff of the institution? According to figures provided by the Korian group, 39% of the staff were vaccinated against influenza. This figure may seem insufficient - it is - but, in the discharge of the Lyons institution, it is almost the same rate that was found in a national survey conducted by INVS (now Public Health France ) in nearly one hundred homes for the elderly during the 2007-2008 epidemic.

        Obviously, it is not always easy to convince staff to get vaccinated. Yet caregivers are not naturally immunized against the seasonal influenza virus. The same INVS survey found staff affected by influenza in half of the facilities (55%) tested.

        At present, flu vaccination is not compulsory for health personnel, as are pertussis, chicken pox and measles. "The High Council of Public Health (HCSP) has established criteria for a vaccine to be made compulsory for health professionals," Prof Daniel Floret, former chairman of the technical committee on vaccinations, told Le Figaro. In particular, it must be a serious illness, caregivers must be highly exposed, there must be a risk of transmission carer-patient, the vaccine must have a favorable risk-benefit balance and be very effective. It is this last point that stuck. "Influenza vaccine is far from 100% effective.

        But this is not an excuse for Dr. Liliane Keros, a virologist and immunologist (Paul-Brousse Hospital, Villejuif): "For me, it's a professional mistake not to be vaccinated against the flu, we cannot put forward our personal freedom to the detriment of the patient. The staff must have this altruistic sensitivity. If not, it must be imposed. "

        "Influenza is a frequent disease that kills enormously," insists Professor Ga?tan Gavazzi, a professor of geriatrics at the University Hospital of Grenoble, which is why vaccination as a collective is very important. "At the Ehpad Korian Berthelot in Lyon, "Six employees have become ill, but it is not known if they were vaccinated or not," it is said. Others may have been sick without knowing it. Because in a third of the cases, according to a French-English publication of 2008, people infected with the flu have no symptoms. They may contaminate others without realizing it.

        Influenza vaccine is less effective with age

        Six of the thirteen residents who died during the flu epidemic at the Ehpad Korian Berthelot in Lyon were vaccinated. An information that struck the spirits. Yet this is not as surprising on a scientific level. "The vaccine is not 100% effective, especially in the elderly," says Prof. Daniel Floret, former chair of the Vaccination Technical Committee.

        "This is called immunosenesis," says Dr. Liliane Keros, immunologist and virologist (Paul-Brousse Hospital, Villejuif). With age, cells in the immune system function less well. "A meta-analysis by the Cochrane Institute in 2010 did not find interest in influenza vaccination after 65 years.

        But the same group, by re-analyzing the same studies with a finer methodology, found a little later, in 2013, more encouraging results. "A vaccine efficacy of 30% for the prevention of lethal and non-lethal complications of influenza, of 40% for the prevention of clinical influenza (symptomatic, Editor's note)," detailed the High Council of Public Health in its March 2016 report on vaccination of the elderly. The efficacy was even greater when integrating the patient's unnoticed influenza, but revealed by the blood tests. Prevention with the vaccine was then 60%.

        Seulement 39 % du personnel de l’Ehpad de Lyon, où 13 personnes sont mortes entre le 23 décembre et le 7 janvier, étaient vaccinés.



        "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
        -Nelson Mandela

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