The current non-systematic methods of controlling influenza and notifiying authorities of flu outbreaks in Melbourne's aged care facilities are inadequate, according to an article in the current issue of The Medical Journal of Australia.

The researchers, from the Victorian Department of Human Services (DHS), the Victorian Infectious Diseases Reference Laboratory, the University of Melbourne and the WHO Collaborating Centre for Reference and Research on Influenza, recommend that healthcare workers in aged-care facilities be routinely vaccinated against the flu and that outbreak control measures be implemented urgently.

In Australia, flu vaccination is recommended and funded for people aged 65 and over, but not publicly funded for healthcare workers in aged care facilities. Outbreaks occur in aged-care facilities despite high rates of vaccination amongst residents.

"In view of this, the priority for preventing influenza outbreaks in aged-care facilities should be to prevent individuals introducing the virus into the facility", said Dr Stephen Lambert, Senior Research Fellow, Vaccine and Immunisation Group, Murdoch Children's Research Institute and the School of Population Health at the University of Melbourne.

"The key way to do this is to ensure that healthcare workers (including attending GPs) are vaccinated."

In outbreaks studied at two Victorian aged care facilities in January and March 2002, there was low staff vaccination coverage and, in one case, staff appeared to contribute to ongoing transmission.

Dr Lambert said aged care facilities should be encouraged to establish a sentinel surveillance system to recognise, notify and diagnose early cases of respiratory illness in staff and residents. This would allow outbreak control measures to be implemented quickly.

Furthermore, the response to flu outbreaks should be a collaborative effort between the facility, the attending GPs and the DHS. The DHS will be piloting a system of respiratory diseases surveillance for the 2004 respiratory virus season.

Guidelines from the DHS would also help staff make decisions on appropriate antiviral treatments in outbreak situations - including considerations such as cost and the health status of residents.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT                 Dr Stephen LAMBERT            (0408) 887 241  / (03) 8344 9330
                              Judith TOKLEY, AMA            (0408) 824 306 / (02) 6270 5471