Dr. Fiona Ryan, Department of Public Health,

HSE South7th September 2017

Cork Kerry Community Healthcare Influenza Preparedness 2017-2018

� Influenza - facts

� Influenza Outbreaks

oNational and Local Data

� Prevention of Outbreaks in Vulnerable Populations

� Influenza vaccine uptake

� Pneumococcal vaccination

When some people get the flu it may be mild, but for many others it could be fatal.

� Most of these excess deaths are in the elderly/those with underlying illness

� Death 0.5-1/1000 cases (1/10,000 pop per year).

� Approximately, 200-500 Irish people will die each year because of flu. In a bad year this can be up to 1000 people (2008-2009)

� Recent European study reported weeks of excess mortality coincided with medium or high influenza activity weeks

� 2015/16 season >150 people admitted to ICU with confirmed influenza

• Diseases• Those with chronic medical conditions e.g. Chronic respiratory, cardiac etc., Diabetes Mellitus, neurological disorders, immunosuppressed either through disease or treatment including those with asplenia or splenic dysfunction, morbid obesity-BMI ≥ 40

• Vulnerable age• Young children < 5 years

• hospitalisation rates comparable to those aged 50-64

• those under 6 months have highest hospitalisation rate of any age

• > 65 years

• Account for 90% deaths from seasonal flu

• Pregnancy• SAGE WHO background paper on Influenza vaccines and Immunization

Cork Kerry Community HealthcareInfluenza Preparedness 2017-

2016

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Cork Kerry Community Healthcare Influenza Preparedness 2017-

2016Source HPSC

Cork Kerry Community Healthcare Influenza Preparedness 2017-2016Source HPSC

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� Several strains of influenza – constantly changing

� New vaccine every year -3 or 4 virus strains (A+B)

� WHO monitors strains circulating globally – Northern and Southern hemisphere

� Jan/Feb each year WHO advises on strains for vaccine

� Vaccines take months to produce – ready for September in Northern Hemisphere

� Sometimes change in circulating virus and the vaccine is not fully effective

� 2015/16 season Influenza A (H1N1) circulating good match but Influenza B not in the vaccine

� 2016/17 season Influenza A (H3) circulating good match but poor response to AH3 in elderly

� Vulnerable setting- nursing homes, long stay residential - including disability mental health

� Vaccination of residents (not 100% effective)

� Vaccination of staff

� Preparations and staff education

� HCWs at higher risk of getting flu

� HCWs look after the most vulnerable

� HCWs frequently implicated as the source of influenza transmission in health care settings

• Employees continue to work while sick with influenza

• Unvaccinated workers who are not sick can still spread the virus

� Benefits of influenza vaccination of HCWs:

• Reduce risk of outbreaks in health care facilities

� Recommended for HCWs annually since 1999, both for their own protection and for the protection of patients

� HCWs: all staff (including ancillary staff, such as cleaners, porters, kitchen staff) working in health care setting or health related activities in acute and non acute health care settings, including those working in health related activities in the community settings

YES! YES! YES! YES!

� When you get the flu it may be mild, but for those at high risk it could be fatal.

◦ Patients.

◦ Family Members and Friends.

� Getting the flu vaccine helps to protect the people you work so hard to keep healthy.

� Many studies have shown that increasing the vaccination rates of HCWs decreases patient illness and death.

� One study showed a 40% reduction of influenza related deaths in hospitals with higher rates of HCW influenza vaccination.

YES!

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National Target 40% uptakeCorkCorkCorkCork

� Cobh Community Hospital 61%(9th highest uptake nationally)� Kanturk Community Hospital 47%

� Kinsale Community Hospital 33%KerryKerryKerryKerry� CNU Tralee 21%

1 Unit reported uptake of 0%

� StStStSt. . . . Lazerian'sLazerian'sLazerian'sLazerian's House, House, House, House, CoCoCoCo. Carlow . Carlow . Carlow . Carlow (89%) (89%) (89%) (89%) €€€€5K5K5K5K

� O'Gorman O'Gorman O'Gorman O'Gorman Home, Home, Home, Home, CoCoCoCo. Kilkenny. Kilkenny. Kilkenny. Kilkenny (87%) (87%) (87%) (87%) €€€€3K3K3K3K

� Lusk Lusk Lusk Lusk Community Unit, Community Unit, Community Unit, Community Unit, Co. Co. Co. Co. DublinDublinDublinDublin (75%) (75%) (75%) (75%) €€€€1K1K1K1K

Cork Kerry Community Healthcare Influenza Preparedness 2017-

2016

National Target 40% uptake

CorkCorkCorkCork

� Mallow General Hospital 46%

� Bantry General Hospital 31%

� CUH/CUMH 22%

KerryKerryKerryKerry

� University Hospital Kerry 16%

� Residents: Change in returns this year – will be easier.

� Staff: Returns are required� Will be follow up this year

� Financial reward for the areas with highest uptake

� If you’re not in you cant win!

Cork Kerry Community Healthcare Influenza Preparedness 2017-

2016

� National and local promotional material

� Important that Peer Vaccinators get this material to assist them

� Need to know the peer vaccinators

Contact

� Orla O’Sullivan (PA to Priscilla Lynch)

� Phone: 028 40469 Ext: 55469

� Email: orla.osullivan2@hse.ie

Cork Kerry Community Healthcare Influenza Preparedness 2017-

2016

� Bacterial respiratory infections common complication of influenza especially in at risk – pneumococcal

� Pneumococcal vaccine (Pneumovax) recommended for all aged 65+ and risk groups

� Most patients once only vaccine

� On admission record pneumococcal vaccination history

� If never given and indicated should be given

� Influenza circulates every season

� Vaccine is the best protection

� Vaccine is less effective in the elderly but still the best protection we can offer

� HCWs are both at higher risk of infection and a significant source of infection to patients

� Vaccination of HCWs is vital to protect vulnerable patients

� Long-term care facilities need to plan every year for the prevention, detection and management of influenza cases and outbreaks

Cork Kerry Community Healthcare Influenza Preparedness 2017-2016