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Monthly Board Report - March 2001
FLU Campaign Summary
Submitted by Jane Futcher, Director Clinical Services
As the flu immunization campaign for 2000-2001 comes to an end, it is time to look at the successes we have had in promoting and delivering influenza immunization in Leeds, Grenville and Lanark.
The 1999-2000 flu campaign focused on the long-term care facilities and the immunization of their clients and staff. The Ministry of Health had set goals for immunization rates at 100 % for residents and at 70 % for staff. At the February 2000 Board of Health meeting, we celebrated the successful vaccination campaigns in the long-term care facilities, nursing and retirement homes. Twenty-six of 30 (87%) facilities in the health unit, including all 15 of our long-term care facilities, achieved staff immunization rates of 70% or higher. The average rate per facility was 91%.
At that time, we were unable to predict the success of the campaign in terms of illness and death as the flu season was still underway. However, in September an article, describing the Leeds, Grenville and Lanark Health Unit experience about the relationship between staff immunization and rates of illness and death was published in PHERO ( Public Health and Epidemiology Report, Ontario).
Tables 1 and 2 illustrate that, as the rates of staff immunization in the Leeds, Grenville and Lanark counties increased, the number of institutional outbreaks remained fairly constant but attack rates and rates of pneumonia, hospitalization, and death declined significantly.
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Table 1. Comparison of LTCF staff immunization rates,
outbreaks and duration, 1997-2000, LGLD Health Unit. |
Year |
Overall Staff Immunization Rate |
Number of InfluenzaOutbreaks |
Facilities having an outbreakn, (%) |
AverageDuration of Outbreak(days) |
97-98 |
15% |
8 |
8/33 (24) |
19.6 |
98-99 |
33% |
8 |
8/33 (24) |
21.5 |
99-00 |
91% |
7 |
7/34 (21) |
15.4 |
| Table 2. Number and rates of influenza and influenza complications in LTCF residents, 1997-2000, LGLD Health Unit. |
Number of LTCF residents |
Influenza Casesn, (rate per 1000) |
Cases of Pneumonian, (rate per 1000) |
Number Hospitalizedn, (rate per 1000) |
Deathsn, (rate per 1000) |
3010 |
255 (84.7) |
40 (13.2) |
20 (6.6) |
29 (9.6) |
2961 |
204 (68.9) |
21 (7.1) |
9 (3.0) |
3 (1.0) |
2938 |
61 (20.1) |
6 (2.0) |
2 (0.7) |
2 (0.7) |
In July 2000, the Ministry of Health announced its intention to provide influenza immunization to all residents in Ontario, as part of its strategy to relieve the pressures on the hospital emergency departments across the province.
This addition to our original mandate to immunize the "at risk" population, at first seemed daunting. We didn't want to lose the momentum that had been generated in the long term care facilities (LTCFs) by turning our focus solely to the immunization of the general population.
The "out break" team, staffed by PHIs and PHNs continued to work with the LTCFs, providing "in services" for staff and support to the infection control officers of the facilities. They presented a work shop Influenza: Prevention and Control in September, which included a panel discussion about motivating staff to be immunized. Its members were Kay Olmstead & Sally MacInnis: Brockville Psychiatric Hospital, Faye Barkley: Maple View Lodge, Carey Duncan: Stone Ridge Manor, Aileen Conboy: Lanark Lodge and Carol Martin: Rideau Regional Centre.
The 2000-2001 campaign began with immunization clinics in these facilities and the Health Unit began with clinics for other "at risk" individuals in the community. At the March 2001 Board of Health Meeting, we will be recognizing the 26 agencies, who met the Ministry's goal for staff immunization for the 2000- 2001 campaign. Of those meeting this goal the average staff immunization rate was 89 %.
The goal of the Ministry of Health was an over all influenza immunization rate of 70 % for the general population. According to the survey of "possibilities" done in August we estimated that upwards of 85,000 people in Leeds, Grenville and Lanark would choose to be immunized against influenza. (At a population of approximately 158,000, this represents 55 % of the total population). A full report of the population coverage by municipality will be given at the March meeting of the Board of Health. Data is being collected from all the physicians in the tri-county who administer vaccine, the long-term care facilities, acute and chronic care hospitals, community health centres, private nursing agencies, local businesses who ran their own "work - place" flu clinics. The scope of the campaign and its success is due to the cooperative effort of all health care partners in the tri-county. In particular, we would like to recognize the Health Unit Immunization Team who worked long hours and travelled under difficult conditions to ensure that all communities in the tri-county had easy access to influenza immunization.
One of the most important elements of a successful partnership is the will to evaluate the process and to make the improvements suggested or indicated by the assessment. We choose to look at the campaign from its inception, surveying partners about their involvement, from the planning process to the delivery stage of immunization in the community clinics. The results of this evaluation will be shared at the March Board meeting and will be used in next year's planning.
Results of the evaluation and a full report of the tri-county immunization coverage will be found in the April Board of Health Report. |
