Six residents of a Salt Lake-area nursing home have died in the last two weeks, possibly the result of an influenza outbreak that has sickened almost 25 percent of residents and nearly two dozen staffers and prompted quarantine measures, according to Salt Lake Valley Health Department officials.
Neither SLVHD or the Utah Department of Health would name the nursing facility, citing an ongoing communicable disease investigation and concerns over a federal patient privacy regulation. A GRAMA open-records request to each from the Deseret Morning News was denied.
Some 35 of 150 facility residents have gotten the flu since the outbreak began in the facility Feb. 11.
No death certificate or lab results have yet confirmed that the six residents died from influenza, said Dr. Dagmar Vitek, deputy director of SLVHD. "I'm not sure how to report it to you. It's not yet clear if all or none actually died because of flu."
Flu might also have provided a complication to an existing serious medical condition. Many of the residents in the nursing home are very frail, including a number who receive hospice services. That also impacts how many of them had flu shots, since residents and their families do not always choose to take steps like vaccines in the face of terminal illness, health experts said.
Nursing-home staff members immediately implemented quarantine-type measures prescribed by the Centers for Disease Control and Prevention to control spread of the virus, according to SLVHD spokeswoman Pam Davenport. Among those, she said, were "lockdown limitations on visitors and flu shots again being offered for those who hadn't gotten one before."
Staff who were ill — 22 out of 160, although perhaps not all had the flu — were excluded from work, said Vitek. And Tamiflu, an antiviral that reduces duration, symptom severity and complications of influenza, was prescribed for those with the flu.
"The facility was very proactive," Vitek said. "They closed their doors to new residents and visitors. They're doing handwashing, respiratory hygiene and everyone wears a mask. They canceled all gatherings and group activities, and all the residents eat in their rooms."
The communicable disease investigation will continue until Thursday. If no new flu cases are reported, life will return to normal for the residents and staff, Vitek said. That seven days covers the incubation period for influenza.
Vitek said that only recently did the department start tracking flu outbreaks specifically in nursing home facilities, so when confronted with the severe outbreak, they consulted Colorado health officials, who have done so for many years. "Their take is this is very normal because they are dealing with a very vulnerable population in a crowded environment, and a lot of these people are in hospice," she said.
About 40 percent of the residents sickened in the outbreak had been vaccinated this year against flu. It's not known how many of the staffers who became ill had received a vaccination.
Each year, influenza experts predict what kind of flu will circulate the next year, so that a vaccine can be made up. It typically features two A strains and one B. This year, it was not a great match, CDC officials said last week. It's a good match to just under half the flu currently circulating. Still, they said, it's important for people who have not had their flu vaccine to get one, since it provides some protection with even a suboptimal match.
The flu vaccine is particularly important for people who are elderly, since they are more prone to complications of the disease. But it's not as effective for them, according to Dr. John Kriesel, infectious disease expert at the University of Utah School of Medicine. "They just don't make as good an immune response," he said. That's true of other vaccines, as well. Most are "somewhat effective in the elderly, but probably less effective than in younger populations."
The vaccine this year is a good match for influenza A sub-strain H1N1, the old Spanish flu. But the B strain circulating and the A sub-strain H3N2 are "not optimally matched," Kriesel said.
Most of the flu isolates this year have been H3N2.
Kriesel also strongly encourages anyone who has sudden onset of fever, headache and muscle aches, followed by a cough, to seek treatment immediately. The antivirals only help if given within two days of onset. "It clearly reduces the number of days of symptoms and it can be dramatic," he said.
E-mail: lois@desnews.com