• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Australian nursing home flu remains untyped

S

scottmcpherson

Resident
http://www.abc.net.au/news/newsitems/200611/s1798747.htm

Interesting that Australian authorities cannot yet positively identify the strain of flu that killed eight and infected 69 in a nursing home in Canberra. Now it appears that a second hursing home may be affected.

All the Australian press can report is that an influenza A virus ran through the facility.

This also leads me to believe the virus was outside the targets the WHO recommended for the trivalent vaccine for the Southern Hemisphere.

Your comments eagerly solicited.
Scott McPherson
 
Re: Australian nursing home flu remains untyped

It happens. I worked in one nursing home a few years ago where my patients were mostly vaccinated. They still got the flu. How do I know it was flu? Curiously, it was the first time we were EVER requested to test for influenza by the CDC.
Yep, they had the flu, and we gave them....you guessed it, Tamiflu! First time I ever gave that drug. This was about 3 years ago.
 
Re: Australian nursing home flu remains untyped

scottmcpherson said:
http://www.abc.net.au/news/newsitems/200611/s1798747.htm

Interesting that Australian authorities cannot yet positively identify the strain of flu that killed eight and infected 69 in a nursing home in Canberra. Now it appears that a second hursing home may be affected.

All the Australian press can report is that an influenza A virus ran through the facility.

This also leads me to believe the virus was outside the targets the WHO recommended for the trivalent vaccine for the Southern Hemisphere.

Your comments eagerly solicited.
Scott McPherson
Click to expand...

Some reports had mentioned H1N1 in some patients, but human H1N1 is picking up swine sequences, so the typing results may look "funny", leading to "untyped" statements to the media.
 
Re: Australian nursing home flu remains untyped

Thank you, Dr. Niman. Greatly appreciated. I guess this all gets us back to the pressing issue of typing influenzas quickly and reliably. Your posts and commentary regarding false negatives on avian flu tests are disconcerting, when one realizes that quick identification of A/H5N1 in humans will be absolutely essential in humankind's "delaying action" to prevent a pandemic.

If it is taking this long to nail down H1N1 as the culprit in Australia, then would it be appropriate to say the virus (in this case) has drifted enough to make standard typing very difficult?
 
Re: Australian nursing home flu remains untyped

This article doesn't reveal the virus type either - only says it is same as others circulating in Australia.


See this additional thread:
http://www.flutrackers.com/forum/showthread.php?t=13335&highlight=nursing+home

Health authority plays down fears of flu strain spread

ACT Health says the fact that a flu strain at the Jindalee Nursing Home in Canberra may match a virus at another nearby home does not mean the virus has spread.


The Health Department has confirmed a resident has tested positive to a flu virus at Morling Lodge, an aged care facility in Red Hill.


But the department will not say if the strain is linked to the outbreak at Jindalee, in Narrabundah, which has claimed the lives of eight people.


Acting chief health officer Charles Guest says authorities are looking closely at the Morling sample to see if there is a match.


"This is a circulating virus type. The circulating virus sub-type predicted correctly by the authorities that formulated this year's southern hemisphere vaccine," he said.

"This is a common influenza sub-type circulating in Australia before and during and after the Jindalee outbreak."


Mr Guest says the Health Department is still keeping a close eye on the second home, but says there is no cause for alarm.


"It's because of the cluster of cases at Jindalee that we're now looking harder at cases elsewhere and finding a few," he said.


"So I don't believe there's anything particularly strange going on anywhere except at Jindalee where we have this outbreak, I believe, contained at present."
Click to expand...


http://www.abc.net.au/news/newsitems/200611/s1797863.htm
 
A curious choice of words by Dr. Guest.....

A curious choice of words by Dr. Guest.....

I had emailed him last week and asked if this influenza matched the target for the Southern Hemisphere vaccine. So I guess the answer is "Yes." And/or else he reads Flutrackers!
 
Re: Australian nursing home flu remains untyped

Scott
An earlier article with a set of questions I posed may be found at
http://www.flutrackers.com/forum/showthread.php?p=50425#post50425
I think we are on the same track. This is an opportunity to demonstrate the effectiveness of the plans. It also poses an opportunity to test our strategy of supportive but persistent questioning in order to improve public health performance.
JT
 
Re: Australian nursing home flu remains untyped

From Scott 11/29/2006
I received an email from Dr. Guest. It is H3N2. He said a Promed update was coming.
Click to expand...
I am still looking on ProMed for the follow-up.
JT
 
Re: Australian nursing home flu remains untyped

Thank you jt.

Date: Fri 8 Dec 2006
From: Charles Guest <Charles.Guest@act.gov.au>
Source: ACT Health Acute Response Team. Fri 8 Dec 2006 [edited]


Influenza outbreak in an Aged Care Facility, Australian Capital
Territory (ACT) - Update
----------------------------------------------------
Further to our ProMED-mail posting of 22 Nov 2006 archived as
"Influenza, nursing home - Australia (Canberra) (02) 20061122.3323,"
we provide the following update.

Between 11 Oct and 6 Dec 2006, 55 (42 percent) of 132 residents and
22 (12 percent) of 173 staff in a Canberra Aged Care Facility [the
Jindalee Nursing home] reported onset of symptoms including cough,
fever and runny nose. Of these, 18 (32.7 percent) of affected
residents and 1 (4.5 percent) affected staff member have had
laboratory-confirmed Influenza A infection. Laboratory confirmation
of Influenza A required either a PCR positive result, and/or a
positive immuno-fluorescence (IF) result on a nose or throat swab,
and/or a 4-fold rise in convalescent sera or a single titre of 64 or
more specific for Influenza A. In one instance, a rapid antigen test
was considered confirmatory despite a negative IF due to subsequent
specimen quality issues.

Thirty-five of 55 (65 percent) affected residents and 10 (45 percent)
of 22 affected staff were appropriately immunised with the 2006/2007
influenza vaccine prior to the outbreak. Six (17 percent) of 35
vaccinated residents and 2 (20 percent) of the 10 vaccinated staff
were subsequently laboratory confirmed with Influenza A.

Nine residents and no staff have died during the outbreak
period. The mean age at death is 88 years, median 91 (range 75 to
100 years). Two residents who died were fully vaccinated for
influenza with the 2006/2007 vaccine.

Vaccination clinics for staff and residents, enhanced infection
control including exclusion of unvaccinated staff and visitors,
isolation of cases, restricting resident transfers and admissions,
cancellation of group activities and restrictions for staff on
working in other nursing homes were key features of the outbreak
control strategy.

Oseltamivir prophylaxis was provided to asymptomatic staff and
recommended to residents' medical practitioners. Treatment doses
were prescribed for those who had respiratory symptoms. Oseltamivir
for staff was provided by the ACT Health Protection Service on a cost
recovery basis from the ACT Oseltamivir stockpile.

At time of the outbreak, at least 77 percent of the 31 164 adults
aged over 65 years in the ACT were appropriately immunised in the ACT.

HA PCR was performed on outbreak specimens by the Institute of
Clinical Pathology & Medical research in Sydney. The haemagglutinin
in region 1 (535 base pairs) was sequenced. Homology of 99 percent
with influenza A/New York/3/2006 (H3N2) and influenza A/Western
Australia/76/2005 was determined using the Basic Logical Alignment
Search Tool (BLAST).

Nucleoprotein PCR was performed and the PCR amplicon sequenced (250
base pairs). BLAST search revealed 99 percent homology with
influenza A/New York/3/2006 (H3N2) which is covered in the current vaccine.

--
Mary Deeble and Charles Guest
ACT Health Acute Response Team
<Charles.Guest@act.gov.au>

[ProMED-mail appreciates this comprehensive account of the
investigation of the outbreak of illness at the Jindalee Nursing
home, Canberra, by the ACT Acute Response Team; a model for others to
follow. The data illustrate the relatively greater vulnerability of
the very elderly to influenza A virus infection, even when
appropriately vaccinated. - Mod.CP]
 
Re: Australian nursing home flu remains untyped

niman said:
Some reports had mentioned H1N1 in some patients, but human H1N1 is picking up swine sequences, so the typing results may look "funny", leading to "untyped" statements to the media.
Click to expand...

We now know those early report were wrong. The typing may not have been done as fast as members of this board would want, but most people don't worrying about a pandemic or human/swine recobinations after a flu outbreak in senior centers. As we all know the elder respond poorly to vaccinations and in this case became infected by a strain that 90% of them had been vaccinated against. Of course it would be better if the results came quicker, but the important thing is to get it right- not speculate and hype a pet (undocumented) hypothesis.
 
You must log in or register to reply here.
Back
Top