Delay in notifying lethal flu outbreak

GUIDELINES GIVEN to nursing homes for handling flu outbreaks suggest public health officials should have been notified at least a day earlier of a lethal flu outbreak in Donegal.

The interim guidelines on preventing and managing flu outbreaks at residential care facilities in Ireland for 2011-2012, issued by the national Health Protection Surveillance Centre, stipulate public health officials must be notified if three or more cases of influenza-like illness occur in a nursing home within 72 hours.

Six residents of Nazareth House nursing home at Fahan, near Buncrana, died over a 10-day period between March 22nd and April 2nd.

Three of the deaths occurred within 72 hours, between March 29th and 31st. But officials in the Health Service Executive were not notified until the evening of April 1st.

The guidelines state residential care facility staff should “suspect an outbreak of influenza” if an increase in respiratory or influenza-like illness is noted during routine surveillance.

“The local medical team for the institution and the local director of public health must be informed and an outbreak control team convened,” they state.

A Health Information and Quality Authority inspection being carried out at the home – which was triggered by the outbreak – was continuing there last night.

A spokesman for the authority said they would report on the inspection in due course. The remit of the authority was to try to ensure the quality of care was up to standard at the home, he said.

He could not say whether the report would detail the circumstances that led up to the outbreak and to the calling in of public health officials.

“We have never carried out an inspection like this before,” he added.

To date eight flu outbreaks have been reported in Ireland, including three in community hospitals/ long-stay units and two in residential units.

Last night, 11 residents at Nazareth House were still suffering with the flu and concerns remained for a small number of these people.

A spokesman for the HSE said there was no change in their health status and no additional residents had exhibited symptoms of the condition.

The HSE also moved to reassure the public of the value of the seasonal flu vaccine after it emerged that four of the people who died in the Buncrana out-break had been vaccinated.

A spokesman for the HSE said the European Centre for Disease Control and Prevention had found that the A (H3) virus had “changed slightly” since it was put into the seasonal flu vaccine issued last October, but the vaccine would still provide protection.