A long-term dementia care ward saw an outbreak of respiratory syncytial virus and human metapneumovirus that infected 73 percent of patients, showing the challenges inherent in preventing the spread of infectious diseases in long-term care settings, according to a study published in Infection Control & Hospital Epidemiology.
Researchers studied a 16-day outbreak at a Tennessee-based long-term dementia unit. Thirty patients contracted at least one of the viruses, 15 had to be hospitalized and five died.
The facility's staff attempted various infection control measures including grouping patients and staff, isolation precautions for patients with suspected illness and stopping group activities. Additionally, healthcare personnel experienced widespread illness in the unit, which made separation of the ill and healthy difficult.
The patients' underlying comorbid illness of dementia also created challenges. For example, patients were unable to report symptoms and found it hard to adhere to recommended restrictions. Also, the need for isolation carts exceeded the number available.
"Long-term care facilities have unique challenges. Infection control policies from acute care hospitals cannot simply be mirrored in this setting and expected to work," said S. Schaefer Spires, MD, lead author of the study and assistant professor of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tenn. "RSV and HMPV are viruses that need to be taken as seriously as we take the flu, especially in older adults."
The outbreak led to improvements in the unit, including greater awareness of these pathogens as well as the importance of hand hygiene and personal protective equipment
Additionally, the unit now has partnered with a private laboratory to provide respiratory viral testing within 24 hours to 48 hours.
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