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ARTICLE |

The Roles of Vaccination and Amantadine Prophylaxis in Controlling an Outbreak of Influenza A (H3N2) in a Nursing Home

Nancy H. Arden, MN; Peter A. Patriarca, MD; Mary Beth Fasano, MD; Kung-Jong Lui, PhD; Maurice W. Harmon, PhD; Alan P. Kendal, PhD; David Rimland, MD
Arch Intern Med. 1988;148(4):865-868. doi:10.1001/archinte.1988.00380040105016.
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• An outbreak caused by influenza A/Philippines/2/82 (H3N2)—like viruses occurred in a partially vaccinated nursing home population in January 1985. During the first six days of the outbreak, 14 (25%) of 55 residents developed influenzalike illness. The risk of illness was most strongly associated with undetectable levels of antibody against the epidemic strain, with unvaccinated case-patients having more severe illnesses and a higher rate of hospitalization than vaccinated case-patients (5/8 vs 0/6). During the period of amantadine hydrochloride prophylaxis (100 mg/d) from days 7 to 35, only two (5%) of the remaining 41 residents became ill, even though 11 (27%) had no detectable antibody. Serum amantadine levels obtained on day 35 ranged from 117 to 737 ng/mL (mean 309 ng/mL), similar to therapeutic levels documented in younger adults who have taken the standard regimen of 200 mg/d; there were few clinically significant side effects. These findings illustrate the benefits of influenza vaccination and support the use of amantadine hydrochloride at a dosage of 100 mg daily for outbreak control among elderly persons.

(Arch Intern Med 1988;148:865-868)

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