Common viruses pose a serious threat in nursing homes, often sabotaging standard infection control measures, a new case study suggests.
"Long-term care facilities have unique challenges. Infection-control policies from acute care hospitals cannot simply be mirrored in this setting and expected to work," said study lead author Dr Schaefer Spires.
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His report details a 16-day outbreak of two viruses – respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) – that swept through a long-term dementia ward in Tennessee. Nearly three-quarters of the patients became sick and five died.
"RSV and HMPV are viruses that need to be taken as seriously as we take the flu, especially in older adults," said Spires, an assistant professor of infectious diseases at Vanderbilt University School of Medicine in Nashville.
Why so dangerous?
RSV causes infections of the lungs and respiratory tract. HMPV is a cold virus.
According to the report, 30 of 41 patients contracted at least one of the viruses and 15 were hospitalised.
The outbreak led the facility to implement new protocols for protecting these vulnerable patients. These included active screening; more efficient separation of ill and healthy residents during cold and flu season; improved hand hygiene; use of personal protective equipment by staff; and faster respiratory viral testing.
But many of the health care providers also became sick, hindering efforts to separate the sick from the healthy, the report said.
Also, dementia prevented many patients from reporting their symptoms, which delayed identification of new cases, Spires said.
"Early detection of a contagious pathogen and identification of infected patients is important when trying to prevent an outbreak. However, once a certain number of residents were infected, we had almost no chance at preventing further cases from developing," Spires said in a journal news release.
Thanks to better technology, viruses other than influenza can be detected on a more routine basis. As a result, "we are recognising the importance of RSV, HMPV, and other viruses in causing [illness] in the older adult population," he added.
"There is a clear need for vaccines and new antivirals to aid our efforts in prevention of these viral infections," Spires said.
The study was in the journal Infection Control & Hospital Epidemiology.