特別養護老人ホームで流行した高齢者インフルエンザA(H3N2)の検討  [in Japanese] An Outbreak of Influenza A(H3N2) in a Nursing Home  [in Japanese]

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Abstract

名古屋市厚生院の特別養護老人ホームで, 1995年1月にインフルエンザの流行がみられた.今回ホーム内感染状況および高齢者インフルエンザの実態を明らかにする目的で検討を行った.対象はウイルス抗体価およびウイルス培養によりインフルエンザA (H3N2) と診断した入所者23名で, 年齢は67~95歳 (平均83.1歳), 性別は男性8名, 女性15名で, 23名中21名 (91.3%) が長期臥床状態であった.全例に基礎疾患がみられ, 脳血管障害後遺症が16名で最も多く, 次いで心疾患7名, 大腿骨骨折後遺症6名の順であった.臨床症状は, 発熱が最も多く (100%), ついで咳嗽 (95.7%), 喀痰 (60.9%) の順で, 咽頭痛などの上気道症状の出現率は低かった.18名にウイルス培養を施行し, 6名にA (H3N2) 型ウイルスが分離された.インフルエンザに罹患した入所者23名のうち2名に肺炎を合併し, 14名が入院したが, 死亡例はみられなかった.インフルエンザ感染群と非感染群の比較では感染群においてCRP, 好中球の値が有意に高く, これは二次的細菌感染による気管支炎, 肺炎を合併したためと考えられた.今回の流行はインフルエンザに罹患した医療従事者との接触が流行のきっかけとなっており, 医療従事者の健康管理および老人ホームでの感染予防対策の重要性が示された.

In the nursing home belonging to our hospital, an outbreak of influenza A (H3N2) occurred in January 1995, and we studied 23 elderly residents with influenza A infection. Twenty three residents with influenza A (8 males and 15 females) ranged in age from 67 to 95 years (average 83.1 years), 91.3% of them were bedridden. And all had underlying medical conditions with neurologic, cardiac, orthopedic, being the most frequent. The most common complaints were fever (100%), followed by cough (95.7%), sputum (60.9%), but sore throat was significantly less frequent.<BR>Influenza A virus was isolated from throat swab specimens from 6 of 18 ill patients. Fourteen persons were hospitalized and 2 of them had pneumonia, but nobody died. The levels of CRP, WBC were significantly high in the influenza group, as compared to the non influenza group. So this result suggested that influenza A infection among elderly subjects was apt to cause bacterial infection such as bronchitis and pneumonia. This outbreak was caused by contact from the staff to residents, so we think the health care of the staffs and prevention of influenza should be a high priority in nursing homes.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 70(5), 449-455, 1996-05-20

    The Japanese Association for Infectious Diseases

References:  18

Codes

  • NII Article ID (NAID)
    10008723035
  • NII NACSIS-CAT ID (NCID)
    AN00047715
  • Text Lang
    JPN
  • Article Type
    ART
  • ISSN
    03875911
  • NDL Article ID
    3968183
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-193
  • Data Source
    CJP  NDL  J-STAGE 
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