Oral Presentation Australian Society for Microbiology Annual Scientific Meeting 2019

Microbes that have changed the world: Influenza in the vulnerable elderly (#4)

Richard I Lindley 1
  1. University of Sydney, The University Of Sydney, NSW, Australia

The continued importance of influenza in modern day society will be illustrated by discussion of the epidemiology of ageing and frailty, our personal lifetime risk of being in an Aged Care Facility, and the importance of ACFs as incubators for viral disease. This will be illustrated by data from the cluster randomized controlled trial of influenza control (Booy et al PLoS ONE 2012; 7(10) e46509). Key lessons included:

  1. The complexities of research in a vulnerable population in ACFs (very topical given the current Royal Commission).
  2. The importance of laboratory investigations, with only 9/23 influenza like illness outbreaks proven to be influenza, 5/23 with other viral aetiology, 9/23 no viral agent identified.
  3. A policy of treatment and prophylaxis (T&P) with the antiviral agent oseltamivir (compared to only treating symptomatic residents –“T”) was found to have modest benefits in reducing influenza outbreak duration (T&P 10.8 days versus T only 24 days, p = 0.04), attack rate (T&P 22.9% versus T only of 36.5%, p = 0.002), hospitalisation (T&P 3.5% versus T only 4.7%, p = 0.7) and deaths (T&P 2.5% versus T only 3.5%, p = 0.7).
  4. ACFs acted as local reservoirs of influenza infection, with staff and visitors vectors to the local community.

    Public health policy for ACFs can influence overall community health emphasising the importance of “difficult” research involving vulnerable people in our community.