Underreporting of influenza outbreaks in aged care facilities in South Western Sydney, Australia, 2014

In 2014, influenza activity was high in New South Wales (NSW), Australia, and 21 443 people were hospitalized with a diagnosis of influenza-associated pneumonia. This translates to a rate of 252.4 cases per 100 000 population. More than 18 000 cases of laboratory-confirmed influenza were reported in NSW. The majority were influenza A, dominated by A/H3N2 subtype. There were also 111 influenza outbreaks in aged care facilities (ACFs) reported in NSW in 2014, the highest number on record.\ud\udElderly residents in ACFs experience high rates of morbidity and mortality during influenza outbreaks. They are at increased risk of developing complications due to underlying diseases. These residents also have an increased risk of infection because of the institutional environment they share with many other residents and staff. Furthermore, impaired oral intake, limited dexterity and altered consciousness may limit treatment options when they are infected.\ud\udThe Australian Government’s Department of Health and Ageing (DHA) has issued specific guidelines for prevention and control of influenza outbreaks in residential care facilities. While ACFs have primary responsibility for managing outbreaks, Public Health Units (PHUs) are required to promote ACF compliance with these guidelines and facilitate delivery and administration of antivirals. However, effective influenza prophylaxis and other timely interventions can only occur if PHUs are notified in a timely manner.\ud\udDHA guidelines indicate influenza outbreaks in ACFs are to be reported to PHUs. However, under NSW public health legislation, reporting of outbreaks in ACFs is not mandatory. In this report we investigated whether there were outbreaks that were not reported to the South Western Sydney Local Health Districts PHU during the 2014 influenza season