outbreak of influenza A [H1N1] among long-term-care facility patients in Taif - KSA: challenges faced and lessons learned

ABSTRACT

To describe and analyze an outbreak of novel 2009 influenza A [H1N1] among patients of a long term care facility [LTCF] in Prince Mansour Military Hospital [PMMH], Taif -Kingdom of Saudi Arabia. Those patients were admitted to the LTCF months or years before the outbreak due to several reasons [e.g. cerebral palsy, neurological deficits due to road traffic accidents with handicapping, chronic diseases associates with old age]. An observational study was done to demonstrate and analyze the epidemiological characteristics [demographic factors, risk factors, and outcomes] associated the outbreak, to elucidate prevention and control measures taken, and recommendations concluded. During the period from October 28-November 11, 2010, twenty-one LTCF residents suspected clinically to be involved [fever > 38°C with influenza like illness], their age ranged from 9-91 years [mean age = 46 +/- 24.13], 62% were males. Among them, 12 [57%] proved by RT-PCR to be influenza A [H1N1] positive. Mortality involved 2 [17%] of the A [H1N1] -lab- confirmed individuals. Implementation of the recommended infection control measures mitigated the transmission of infection to new individuals. The fulfillment of strict infection control measures could limit H1N1 infection among LTCF-PMMH patients. Routine influenza, including specific H1N1 immunization of all LTCF residents together with their healthcare staff should be mandatory in those settings serving immunocompromised patients