# 6292
Earlier this week a number of news stories emerged regarding two dozen elderly residents of a Rocky Hills, CT veterans home who were hospitalized for influenza (see More Influenza Cases At Rocky Hill Veterans’ Home).
As all of these patients reportedly had received the seasonal flu vaccine early in the fall, there were some concerns expressed in the media that a variant strain of flu, not covered by the current vaccine, might be the cause.
Today, The Hartford Courant is reporting that the culprit – based on laboratory tests conducted by the state health department – has been determined to be regular seasonal H3N2.
The same strain contained in the flu shot.
First the report, then I’ll return with more on why this isn’t a particularly surprising event.
State Officials ID Strain Of Flu That Caused Outbreak At Rocky Hill Vets Home
H3N2, A Strain Targeted By This Season's Vaccine, Is The Culprit
BY WILLIAM WEIR, bweir@courant.com The Hartford Courant
4:00 p.m. EDT, April 19, 2012
The strain of flu that sent 24 veterans living at a Rocky Hill residential home to the hospital has been identified as one that was targeted by this year's influenza vaccine.
This veteran’s residence is home to 478 vets, nearly all male, and their average age is said to be 80-85. The 2 dozen residents hospitalized make up only about 5% of the facility’s population.
While influenza can strike people of any age, it is the elderly who experience the greatest health burden from the illness. Those over 65 are more likely to be hospitalized, or die, as a result of the flu.
(Credit NFID )
The immune system of those over 65 is often less robust than their younger counterparts, and they are often dealing with underlying chronic conditions such as heart disease, COPD, and diabetes that further increase their risks.
Complicating matters, the influenza vaccine is generally less effective in the elderly as well (see Study: Flu Vaccines And The Elderly, Flu Shots For The Elderly May Have Limited Benefits).
Last year NFID (National Foundation for Infectious Diseases) convened a panel of experts to address the issues of influenza and the elderly that included such familiar names in public health as Arnold Monto, MD; Kristin Nichol, MD, MPH; H. Keipp Talbot, MD, MPH; and William Schaffner, MD.
From that panel a 5-page brief has emerged, called: Understanding the Challenges and Opportunities in Protecting Older Adults from Influenza.
Although the elderly generally see less protection from the flu vaccine, older individuals may still mount a robust immune response. In populations 65 and older, the brief points out that:
- Hospitalization rates for influenza and pneumonia are lower in community-dwelling adults who received the seasonal influenza vaccine.
- Immunization is associated with reduced hospitalization of older patients for cardiac, respiratory, and cerebrovascular diseases.
While the goal of vaccinating the younger population is to prevent infection, the authors point out that:
. . . the goal in older adults is to prevent severe illness, including exacerbation of underlying conditions, hospitalization, and mortality.
In other words, even if the vaccine doesn’t always prevent infection in the elderly, studies suggest that the vaccine may blunt the seriousness of the illness in those over 65.
And since (so far) none of these veterans has died, and that only about 5% of the residents have been seriously sickened by the virus, this vaccine would appear to have afforded these residents at least some degree of protection.
It is no secret that the flu vaccine could stand improvement, particularly for those with weakened immune responses.
In 2010 a new high-dose flu vaccine containing 4 times the normal amount of antigen; 60 µg of each of the three recommended strains, instead of the normal 15 µg, was approved (see MMWR On High Dose Flu Vaccine For Seniors).
But this shot is too new to know how much better it works in the elderly. We should get answers to that question in the next year or so.
In the meantime, better (and faster) vaccine technologies are needed. To improve not only the efficiency of the vaccine, but the availability in the event of a pandemic, as well.
For more on all of this, NFID has a resource rich website with information fact sheets on a variety of infectious diseases, continuing medical education (CME) links, information on conferences and courses, and publications.
