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Prompt treatment of respiratory symptoms required for children with neurologic conditions

CDC. MMWR. 2012;60(51,52):1729-1733.

Residents of long-term care facilities should receive prompt testing for influenza, followed by treatment with antivirals when indicated, to avoid excess morbidity and mortality, according to a recent CDC report.

Earlier treatment may have curtailed an influenza outbreak in a residential care facility for children and young adults, where 13 patients became severely ill with suspected or confirmed influenza; 10 patients were hospitalized and seven patients died. Although eight residents received antiviral treatment, oseltamivir (Tamiflu, Genentech) was initiated within 48 hours of illness onset in only four cases.

In April 2011, the Ohio Department of Health and the CDC investigated an influenza outbreak that began 2 months earlier in a residential facility for 130 children and young adults with neurologic and neurodevelopmental conditions.

During the outbreak, 76 residents were diagnosed with acute onset of respiratory illness; 13 were severely ill, including seven with confirmed influenza and six with suspected influenza. The age range of severely ill residents was 14 to 33 years. All 13 residents with severe influenza had severe to profound neurologic and neurodevelopmental disabilities, and all of them had received 2010-2011 seasonal influenza vaccine during October and November 2010.

Because diagnosis is challenging in this population, the CDC advised that clinicians test for influenza in patients with neurologic and neurodevelopmental conditions who have respiratory illness or a decline in baseline medical status when influenza is circulating in the community. In addition, antiviral chemoprophylaxis also should be provided to all eligible residents of long-term care facilities during influenza outbreaks, and health care workers should be vaccinated, according to the Morbidity and Mortality Weekly Report.

Disclosure: The researchers report no relevant financial disclosures.

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