[Influenza prevention, surveillance, and control in long term care facilities]. / Prévention, surveillance et contrôle de l'influenza en milieu d'hébergement.

OBJECTIVE: Describe the implementation of various activities suggested in the guide entitled Prevention, surveillance et contrôle de l'influenza en milieu d'hébergement et de soins de longue durée (CHSLD) au Quebec, distributed in 2000 to Montréal-area CHSLD. METHOD: The study was conducted in 2001 among 57 CHSLDs (39 public institutions and 18 private institutions under agreement) in Montréal. A self-administered questionnaire collected data on the characteristics of the centres and main activities recommended in the guide. The principal activities recommended were grouped into three components: influenza prevention, surveillance and control. Data were entered and analyzed using SPSS 10.0. A descriptive analysis was performed. RESULTS: The overall rate of response was 81% (46/57). The proportion of centres that had carried out the various components was 35% (16/46) for prevention and 41% (19/46) for surveillance; only 2 centres had applied the influenza control component. CONCLUSION: Over half of CHSLDs in Montreal did not implement the influenza prevention, surveillance and control components. Gaps were noted, especially related to vaccine coverage of staff and rapid access to chemoprophylaxis. Several additional control measures recommended were also considered to be inapplicable. We must review our strategies to identify the barriers to optimal implementation of these measures.

Influenza immunization of chronically ill children in pediatric tertiary care hospitals.

Despite a publicly funded immunization program and continuous promotional efforts, vaccine uptake for seasonal influenza in Quebec (Canada) remains under its goal of 80%. Missed opportunities can explain the low influenza vaccine rates among chronically ill children. To address that, demonstration projects using the live attenuated influenza vaccine (LAIV) were implemented in 3 pediatric tertiary care hospitals to evaluate the feasibility and acceptability of implementing influenza immunization of chronically ill children in hospitals' outpatient clinics. A diary was used to document barriers and enabling factors regarding the implementation, and a questionnaire was distributed to healthcare professionals involved in the project in each hospital. Parent's knowledge, attitudes and behaviors (KAB) about influenza immunization and acceptability of immunization in outpatient clinics were also measured with a questionnaire. As part of the project, 2,478 children were immunized. Enabling factors included the financial support received from Quebec ministry of Health, the nasal mode of administration of the LAIV and the presence of a leader specifically dedicated to influenza immunization. Barriers to influenza immunization in outpatient clinics included difficulties of hiring extra staff to work in immunization clinics and additional tasks added to regular activities of the clinics. Results from both questionnaires illustrated a high level of acceptability of seasonal influenza immunization in hospitals' outpatient clinics by parents and healthcare professionals. Influenza immunization in pediatric tertiary care hospital is an effective way to reach chronically ill children and does not involve major feasibility or acceptability issues.