Luke Skywalker
Super Moderator
{vb:raw ozzmodz_postquote}:
Priscilla Myers of Johnston, Iowa, kisses her mother, Rosemary Hall, on the cheek before leaving the Bishop Drumm Retirement Center in Johnston on Thursday. Hall, 96, recently recovered from the flu outbreak that infected many care center residents.(Photo: Bryon Houlgrave, The Des Moines Register)
DES MOINES, Iowa — Flu viruses have slammed into dozens of Iowa care centers this winter, showing that meticulous safeguards can't always prevent frail, elderly residents from becoming infected.
Staff members, residents and their families were stunned at how quickly the virus spread once it got into the Bishop Drumm Retirement Center in Johnston in mid-December.
"It was awful for them here. It seemed like they all got the flu at once," said Priscilla Myers of Johnston, whose mother, Rosemary Hall, was among the residents who became infected.
Every resident and employee at the 150-bed nursing home had been vaccinated, and the staff had been taking careful sanitation measures, administrators said. But 35 residents became ill, developing coughs, fevers, aches, and in some cases, pneumonia. Several residents had to be hospitalized. Everyone is thankful that none died.
At least 32 Iowa care centers have seen flu outbreaks this winter, and some of those have included deaths, said Dr. Patricia Quinlisk, the state's top infectious-disease expert. She doesn't yet know how many such deaths have occurred, and she's not permitted to say where they were. But such cases should be no surprise, given that flu contributes to hundreds of deaths of the elderly during a typical flu year.
And this is far more than a typical flu year.
USA TODAY
26 children have died from flu as outbreak widens
The disease has been striking harder and sooner than usual throughout the country. A strain known to stalk the elderly has been circulating widely, and vaccines have limited power to block it.
Quinlisk, who is medical director for the Iowa Department of Public Health, has been hearing several reports a day of flu outbreaks in nursing homes, assisted-living centers and other care facilities. "It's certainly much higher than it's been in the past," she said last week.
The flu is most likely to grab headlines when it kills children, but the elderly are much more likely to succumb. According to the state health department, 64 percent of Iowans hospitalized for flu complications this winter have been 65 or older, even though that age group makes up less than 16 percent of the population. Just 15 percent of those hospitalized have been younger than 25.
Care facilities are ideal spots for flu viruses to spread because they are filled with frail people living in close proximity. The residents' weak immune systems make them prime targets. Center administrators and staff members strive mightily to keep the viruses out, but no safeguards are foolproof.
operations director, brings Rosemary Hall into an activity area Thursday so she can meet with her daughter Priscilla Myers.(Photo: Bryon Houlgrave, The Des Moines Register)
Myers said Bishop Drumm's staff members gave her mother antiviral medications soon after she started coughing. Employees wore gowns and masks when working in flu patients' rooms, and they tried to isolate those who were ill. Hall's roommate had to go to the hospital for treatment of flu complications, but Hall managed to recover in her room with close oversight, her daughter said.
Hall, 96, has memory problems, so she doesn't recall much of what happened. By late last week, she was smiling and feeling perky enough to try to get up out of a wheelchair as an administrator started to wheel her back to her room.
Myers said the family feels fortunate that her mother's cough and fever didn't lead to pneumonia, which often is what kills elderly flu patients. "We call her the Energizer Bunny, because she always comes back. She's a survivor," she said.
By last week, only two residents at Bishop Drumm were still sick, and they seemed to be mending, said J. Bennett, a consultant for the center. "Hopefully we're getting into the tail end of it."
USA TODAY
Influenza walloping schools in South, Midwest
Care centers aren't required to report flu cases, but many do as they seek advice from public health officials. Quinlisk, the state expert, said she's been told of several recent flu-related deaths among Iowa care center residents. A solid number won't be available until death certificates are submitted and analyzed. Even then, she said, flu isn't always listed as a contributing cause to deaths of people who suffered from other health conditions.
Dr. Yogesh Shah, a geriatrician who teaches at Des Moines University, said national research has found that nursing-home death rates increase about 5 percent during a typical flu season. With this year's extra-virulent strain and problems with the vaccine, Shah said, "I would be very worried for multiple reasons."
Most nursing home residents have chronic health conditions, such as diabetes, high blood pressure, lung disease or heart ailments. All of those make it harder for a person to withstand a bout with the flu, Shah said.
Frail people often have relatively weak coughs, making it hard for them to clear their lungs, he added. Also, fluid can pool in the lungs of people who spend most of their time in bed. Both of those things can encourage the development of pneumonia. Pneumonia shots can help prevent the complication, but they're not foolproof.
Some common medications, such as steroids, also can interfere with the immune system, Shah said. And even when the flu vaccine is a good match to viruses, elderly people's immune systems generally don't build as many antibodies in response to the shots.
Mischelle Denison of Johnson visits with her mother-in-law, Darlene Denison, 87, on Thursday at the Bishop Drumm Retirement Center in Johnston. Darlene Denison came down with the flu a couple of weeks ago, but “took it all in stride,” Mischelle Denison said. The retirement home’s infection-control efforts have been extensive, Mischelle Denison said.(Photo: Bryon Houlgrave, The Des Moines Register)
Shah said care facilities should move quickly to clamp down on the flu if it appears among residents. If there are two or more cases in a facility, he said, staff should limit visitors and consider giving antiviral drugs to any resident who might have been exposed to the virus.
Quinlisk agreed that antiviral medications can be given to people who were exposed to the virus even if they aren't yet ill. However, she noted the drugs, such as Tamiflu, can have side-effects. For example, she said, the medicine can make elderly patients dizzy, which could cause them to fall and break bones. "So you can't just give them to everyone," she said.
Dot Donaldson, director of nursing for Trinity Center at Luther Park in Des Moines, said nursing home staff face unusual challenges in keeping residents safe. For example, she said, they can encourage ill residents to stay in their rooms, but they can't order them to do so.
"We have a lot of residents with dementia, so they're not going to remember, 'Oh, I'm supposed to stay in my room today,'" Donaldson said.
Donaldson said care centers also have to weigh the benefit to residents' morale of having visitors against the potential risk of having those visitors carry in germs, even if they're not sick. Like many other centers, Trinity has asked visitors to stay out if they're feeling ill, but it has not had curbed visits.
So far this winter, she said, her facility hasn't seen a flu outbreak. "Knock on wood," she said.
Powered By WizardRSS.com | Full Text RSS Feed