Influenza Vaccination Among Adults 65 Years or Older: A 2009–2010 Community Health Survey in the Honam Region of Korea

The present study examined the rates and related factors for influenza vaccination among the elderly Korean population during the 2008/09 influenza seasons. We obtained data for 6,391 adults aged 65 years or older from Community Health Surveys conducted in 2009 and 2010 in 13 communities in the Honam region of Korea. A multiple logistic regression analysis was used to identify the factors associated with self-reported influenza vaccinations. In this elderly population, 81.7% reported to having received an influenza vaccination in the past year. The main contributing factors were older age, lower economic status, lower educational level, married, non-smoking, regular alcohol consumption, regular walking exercise, receiving a health check-up during the past two years, not stressed, and having comorbid conditions. The influenza vaccination coverage rate among elderly Koreans was relatively high, but improvements in vaccination rates are required

Absence of influenza vaccination among high-risk older adults in Taiwan

<p>Abstract</p> <p>Background</p> <p>Older adults, who often have more than one chronic disease, are at greater risk of influenza and its complications. However, because they often see physicians for other more pressing complaints, their physicians, focusing on one condition, may forget to suggest preventive measures for other diseases such as influenza. This study investigates what major factors affect an older adult with more than one chronic condition missing a vaccination opportunity.</p> <p>Methods</p> <p>Retrospectively reviewing a nationally representative random sample of medical claims from Taiwan's National Health Insurance Research Database during the period 2004 - 2006, we first identified patients sixty-five years or older who had visited physicians. Each patient was assigned a proxy for health status, the Charlson Comorbidity Index (CCI) score. An older claimant was defined has having "absence of a vaccination" when he or she had visited a physician during an influenza season but did not receive an influenza vaccination. Multivariate logistic regression was performed to estimate how likely it would be for older adults with various CCI scores to miss a vaccination.</p> <p>Results</p> <p>Out of 200,000 randomly selected claims, 20,923 older adults were included in our final analysis. We found older adults with higher CCIs to be more likely to have an absence of vaccination (<it>p </it>< 0.01). Our multivariate logistic regression results revealed CCI to be the greatest predictor of absence of vaccination, after controlling for individual factors and medical setting. Older adults with CCI scores three or higher were nearly five times more likely to miss a vaccination than those with a CCI of zero [OR: 4.93 (95%CI, 4.47-5.42)]. Those with CCIs of one and two were 2.53 and 3.92 times more likely to miss vaccination than those with a CCI of zero [OR 2.53 (95%CI, 2.26-2.84) and OR 3.92 (95%CI, 3.51-4.38), respectively].</p> <p>Conclusions</p> <p>The greater the number of certain comorbid conditions, the greater the likelihood a flu vaccination will be missed. Physicians would be well advised to not let the presenting problems of older patients distract from other possible health problems that might also need attention, in this case influenza vaccinations.</p

Methicillin-Susceptible Staphylococcus aureus in Skin and Soft Tissue Infections, Northern Italy

Summary statement: A community outbreak with intrafamilial skin infections was associated with an MSSA clone

Therapy-refractory Panton Valentine Leukocidin-positive community-acquired methicillin-sensitive Staphylococcus aureus sepsis with progressive metastatic soft tissue infection: a case report

We report a case of fulminant multiple organ failure including the Acute Respiratory Distress Syndrome (ARDS), haemodynamic, and renal failure due to community-acquired methicillin-sensitive Panton Valentine Leukocidin (PVL) positive spa-type 284 (ST121) Staphylococcus aureus septic shock. The patient's first clinical symptom was necrotizing pneumonia. Despite organism-sensitive triple antibiotic therapy with linezolid, imipenem and clindamycin from the first day of treatment, progressive abscess formation in multiple skeletal muscles was observed. As a result, repeated surgical interventions became necessary. Due to progressive soft tissue infection, the anti-microbial therapy was changed to a combination of clindamycin and daptomycin. Continued surgical and antimicrobial therapy finally led to a stabilisation of the patients' condition. The clinical course of our patient underlines the existence of a "PVL-syndrome" which is independent of in vitro Staphylococcus aureus susceptibility. The PVL-syndrome should not only be considered in patients with soft tissue or bone infection, but also in patients with pneumonia. Such a condition, which may easily be mistaken for uncomplicated pneumonia, should be treated early, aggressively and over a long period of time in order to avoid relapsing infection

Trends in influenza vaccination coverage rates in Germany over five seasons from 2001 to 2006

BACKGROUND: To assess influenza vaccination coverage from 2001 to 2006 in Germany, to understand drivers and barriers to vaccination and to identify vaccination intentions for season 2006/07. METHODS: 9,990 telephone-based household surveys from age 14 were conducted between 2001 and 2006. Essentially, the same questionnaire was used in all seasons. RESULTS: The influenza vaccination coverage rate reached 32.5% in 2005/06. In the elderly (> or years), the vaccination rate reached 58.9% in 2005/06. In those aged 65 years and older, it was 63.4%. Perceiving influenza as a serious illness was the most frequent reason for getting vaccinated. Thirteen percent of those vaccinated in 2005/06 indicated the threat of avian flu as a reason. The main reason for not getting vaccinated was thinking about it without putting it into practice. The major encouraging factor to vaccination was a recommendation by the family doctor. 49.6% of the respondents intend to get vaccinated against influenza in season 2006/07. CONCLUSION: Increasing vaccination rates were observed from 2001 to 2006 in Germany. The threat of avian influenza and the extended reimbursement programs may have contributed to the recent increase

Variations in influenza vaccination coverage among the high-risk population in Sweden in 2003/4 and 2004/5: a population survey

<p>Abstract</p> <p>Background</p> <p>In Sweden, the vaccination campaign is the individual responsibility of the counties, which results in different arrangements. The aim of this study was to find out whether influenza vaccination coverage rates (VCRs) had increased between 2003/4 and 2004/5 among population at high risk and to find out the influence of personal preferences, demographic characteristics and health care system characteristics on VCRs.</p> <p>Methods</p> <p>An average sample of 2500 persons was interviewed each season (2003/4 and 2004/5). The respondents were asked whether they had had an influenza vaccination, whether they suffered from chronic conditions and the reasons of non-vaccination. For every county the relevant health care system characteristics were collected via a questionnaire sent to the medical officers of communicable diseases.</p> <p>Results</p> <p>No difference in VCR was found between the two seasons. Personal invitations strongly increased the chance of having had a vaccination. For the elderly, the number of different health care professionals in a region involved in administering vaccines decreased this chance.</p> <p>Conclusion</p> <p>Sweden remained below the WHO-recommendations for population at high risk due to disease. To meet the 2010 WHO-recommendation further action may be necessary to increase vaccine uptake. Increasing the number of personal invitations and restricting the number of different administrators responsible for vaccination may be effective in increasing VCRs among the elderly.</p

Changes to the varicella and pertussis immunisation schedule in Germany 2009: Background, rationale and implementation

In July 2009, the German Standing Committee on Vaccination (STIKO) modified its recommendations for varicella and pertussis vaccination, based on newly available data on disease epidemiology, vaccine effectiveness (VE) and safety, and an evaluation of the feasibility of the recommended immunisation strategy. The recommendation for varicella vaccine now includes a routine two-dose schedule with the administration of the first dose at the age of 11 to 14 months and the second dose at the age of 15 to 23 months, with a minimum interval of four weeks between these doses. Furthermore, STIKO recommended adding a one-time pertussis booster to the adult vaccination schedule to expand the cocoon strategy in place since 2004. The recommendation of a booster vaccination with an acellular pertussis vaccine every 10 years for persons employed in the care of pre-school children and for healthcare personnel in paediatric, gynaecologic and obstetric health facilities was extended to persons employed in schools and in other institutions caring for older children, and to all healthcare personnel. These recommendations were based on available epidemiological data showing an increase in incidence from 7-10 cases per 100,000 inhabitants in 2002-2004 to over 30 by 2007. Moreover, the high burden of pertussis in infants at 94 hospitalised cases per 100,000 infants in 2007 suggested that the previous cocoon strategy was insufficient

Elements and basics of infection prevention

Infektionsprävention ist ein wichtiger Aspekt der Gesunderhaltung der Menschen und der sie umgebenden Lebensräume. Für die Infektionsprävention werden in der vorliegenden Schrift verschiedene Bausteine von Maßnahmen sowie notwendige Grundlagen für die Entwicklung von geeigneten Präventionsbündeln beschrieben werden. Infektionspräventionsmaßnahmen finden Anwendung in verschiedenen Settings, wie im Krankenhaus oder in der Allgemeinbevölkerung. Zudem richten sich die Maßnahmen nach den vorliegenden Optionen, d.h. liegen für die jeweilige Infektionskrankheit Impfstoffe vor, ist eine Dekolonisation möglich oder kann durch eine rationale Antibiotikaanwendung die Entwicklung von antimikrobieller Resistenz (AMR) eingedämmt werden. Zudem ist stets die Umgebung in den Gesundheitsschutz einzubeziehen. Für die Entwicklung von Maßnahmen zur Verhinderung bzw. Reduktion von Transmissionen und Infektionen sowie zur Kontrolle von Infektionskrankheiten, AMR und multiresistenten Erregern sind ausreichend valide Daten aus der infektionsepidemiologischen Forschung notwendig. Diese geben ein Verständnis für die Häufigkeit und Schwere einer Infektionskrankheit (Krankheitslast), für die Infektionsdynamik, mögliche Transmissionswege, Risikofaktoren in der Bevölkerung sowie Behandlungs- und Präventionsmöglichkeiten. Daraus lassen sich geeignete Maßnahmen für die Infektionsprävention ableiten, die die Besonderheit von Infektionskrankheiten berücksichtigt, nämlich, dass sie über Erreger von einem Menschen zum anderen übertragen werden können. Je nach Erregerspezifikationen, der aktuellen epidemiologischen Situation, Risikogruppen und Therapieoptionen können aus nicht-pharmakologischen und pharmakologischen Maßnahmen Präventionsbündel komponiert werden. Die in dieser Schrift vorgestellten wissenschaftlichen Ergebnisse finden Anwendung in der Praxis und gingen in Empfehlungen oder als Daten für den Entscheidungsfindungsprozess bzw. die Entwicklung von Präventionsstrategien ein.Infection prevention is an important aspect of keeping people and their environment healthy. For infection prevention, this paper describes different elements of measures as well as the necessary basis for developing appropriate prevention bundles. Infection prevention measures are applied in different settings, e.g. in hospitals or in the general population. Furthermore, the measures depend on the available options, i.e. are vaccines available for the respective infectious disease, is decolonisation possible or can the development of antimicrobial resistance (AMR) be contained by appropriate antibiotic use. In addition, the environment must always be included in health protection. For the development of measures to prevent or reduce transmissions and infections and to control infectious diseases, AMR and multiresistant pathogens, sufficiently valid data from infectious disease epidemiological research are necessary. These provide information on the frequency and severity of an infectious disease (disease burden), the infection dynamics, possible transmission routes and risk factors in the population as well as on treatment and prevention options. From this, suitable infection prevention measures can be derived that take into account the special feature of infectious diseases that they can be transmitted from person to person via pathogens. Depending on the pathogen specification, current epidemiological situation, risk groups and therapy options, prevention bundles can be put together from non-pharmacological and pharmacological measures. The scientific results presented in this paper are applied in practice and have been incorporated into recommendations or as data for the decision-making process or the development of prevention strategies