INFLUENZA CONTROL IN ACUTE-CARE HOSPITALS

Background: Influenza causes increased morbidity and mortality among p atients in longterm care facilities, but little information is availab le on the impact of influenza in acute care settings. We wished to hav e such information when revising our hospital influenza control policy Methods: We reviewed recent reports of influenza among patients in ac ute care hospitals and surveyed large (approximately 500-bed) acute ca re teaching hospitals by telephone to determine the nature of their in fluenza control policies.Results: Seventeen reports of influenza outbr eaks in acute care hospitals were published from 1959 to 1994. Influen za A caused 13 of these outbreaks. Five involved children and 12 invol ved adults. The mean number of patients in each outbreak was 14 (range 1 to 49), with a mortality rate of 0% to 50% (median 0%, mean 6.5%). Health care workers were implicated in transmission in five reports. V accine was used infrequently during the outbreaks, and use of chemopro phylaxis was not reported. Our survey of current practices in 15 unive rsity-affiliated hospitals from 12 states revealed that all offered va ccine in the fall but none required either immunoprophylaxis or chemop rophylaxis at any time. Only three had formal policies detailing manag ement of influenza in the hospital.Conclusions: Nosocomial influenza i n acute care hospitals is infrequently reported and associated with a low mortality rate. Health care workers rarely comply with preventive measures, and few institutions have formal influenza control policies.