Outbreak of Human Metapneumovirus in a Nursing Home: A Clinical Perspective.
Damien Seynaeve, Brigitte Augusseau-Rivière, Pascal Couturier and 5 others
PMID 31101588WHAT IT FOUND
A nursing home outbreak infected 40 of 78 residents, causing 5 hospitalizations and 1 death.
All infected residents coughed, but only 8 had fever. Influenza vaccination was associated with more infections in the analysis, but the authors called this surprising.
Key findings
0140 of 78 residents were infected; 5 were hospitalized and 1 died.
02All infected residents had cough; 10 had rhinorrhea, 9 had dyspnea, 8 had asthenia, and 8 had elevated temperature.
03When the researchers adjusted for other conditions, influenza vaccination was the only factor independently associated with infection (odds ratio 7.58, P=.028), but the authors called this surprising and possible bias.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
RT-PCR was not conducted on all suspected cases, leading to a severe classification bias. Only 4 cases had RT-PCR testing, and 3 were confirmed, so many probable cases were classified by symptoms alone. The authors said the influenza vaccination association was surprising and could be coincidental or due to methodologic bias. Clinical and biologic presentations were not very specific, and residents without blood tests may have been misdiagnosed. No specific reasons were reported to explain antibiotic use, and some antibiotic-treated residents may have had bacterial pneumonia. Infection control measures seemed difficult to apply because of cognitive impairment and possible behavioral disorders.
The easy way to misread this
Do not conclude that influenza vaccination caused hMPV infection. The association came from an adjusted analysis of one outbreak, the authors called it surprising, and they said it could be coincidental or due to bias.