THE TRAGIC deaths of six Donegal nursing home patients, as a result of influenza infection, are a reminder of the destructive power of infectious illness.
The residents of Nazareth House nursing home in Buncrana are a frail group of people with conditions such as chronic obstructive airways disease, heart failure and chronic kidney disease. These illnesses make them especially vulnerable to infectious diseases such as influenza, which often tips their chronic illness into an acute and life-threatening form.
It has been a comparatively late influenza season this year and, although past its peak, the virus is still in active circulation. Influenza A (H3) has been the dominant influenza virus detected during this flu season and this strain has been identified as the cause of the Buncrana outbreak. It is a different strain from the avian flu and is mainly a threat to older people. Influenza A had been included in immunisations administered to at-risk groups since last September; when the wild virus began to circulate in the northern hemisphere there was an expectation the vaccine would offer good protection.
However, it recently emerged that the make-up of the H3 virus has altered slightly over the winter; this means the seasonal influenza vaccine may not be as effective as had been hoped. Combined with the fact that most of the nursing home residents are over 85 and therefore have poorly functioning immune systems which are less receptive to the influenza vaccine, this late change in the H3 strain completed a jigsaw which saw their vulnerability significantly increased.
An investigation into the cluster of deaths is continuing. It will address issues such as whether appropriate isolation measures were put in place as soon as the respiratory illness was first identified; and whether procedures to prevent cross-infection were fully operational.
But residents, their families and those recently bereaved can rest assured this tragedy was not the result of systematic neglect. The home was formally inspected in both 2010 and 2011 by the Health Information and Quality Authority.
Reading the regulator’s detailed reports is a welcome reminder of how far we have travelled since the days of Leas Cross and other nursing home scandals. That is not to say lessons cannot be learned from this influenza outbreak about how vulnerable older people in residential care could be better protected from the vagaries of infectious disease.