Influenza is a devastating infection that disproportionately affects residents of long-term care facilities (LTCFs), resulting in high attack rates, as well as high hospitalizations and related deaths.

Nasal swab specimens are collected from residents of long-term care facilities with acute respiratory infections and are tested for influenza.

A multidisciplinary team of researchers led by Jonathan Temte, MD, PhD, professor of family medicine and community health at the UW School of Medicine and Public Health, aims to develop an innovative infection control approach for this highly vulnerable population. The project, Rapid Assessment of and Prophylaxis for Influenza in Dwellers of Long-term Care Facilities, will test the effectiveness of very simple, inexpensive and adaptable technology for extremely early detection of influenza in LTCFs and the immediate transmission of test results to public health officials. The initiative is funded by a three-year $500,000 Collaborative Health Sciences Program award from the Wisconsin Partnership Program.

According to Temte, most long-term care facilities across Wisconsin and the nation have clear guidelines regarding what the facilities should be doing to detect and respond to influenza. “However,” he said, “most facilities don’t have the capacity to test for influenza when a case is suspected.”

He adds, “This project is very innovative in how we are taking inexpensive, efficient and adaptable technology and equipping long-term care facilities with the technology and ability to serve their patients.”

Usually by the time influenza is detected at a long-term care facility, cases are widespread. Through this project, we hope to show that by introducing a much earlier influenza detection and intervention, we can lessen the number of illnesses, hospitalizations and related deaths.

Twenty LTCFs in Wisconsin are participating in the randomized controlled clinical trial, which began in November. At the intervention sites, nurses collect nasal swab specimens from residents with acute respiratory infections and perform rapid influenza detection testing of the specimens. Anonymous results are then sent automatically to the study team and public health personnel for daily review.

If the results test positive for influenza, the study team will communicate directly with the LTCF staff, provide advice on antiviral treatment or prophylaxis; preventive measures, such as for roommates and other residents; and appropriate infection control measures, such as hand washing and/or isolation.

Temte says, “As we age, we respond less strongly to flu vaccines, so the protection we receive decreases.”

He adds, “Usually by the time influenza is detected at a long-term care facility, cases are widespread. Through this project, we hope to show that by introducing a much earlier influenza detection and intervention, we can lessen the number of illnesses, hospitalizations and related deaths.”

Currently there are 396 long-term care facilities in Wisconsin. Their residents contribute disproportionately to the estimated $160 million in annual costs of influenza for our state’s elderly.

Over the course of three flu seasons, the randomized, controlled clinical trial will assess the effect of on-site, rapid influenza detection at LTCFs on influenza-related hospitalizations, deaths and healthcare-associated costs. Ultimately the project would provide a translatable model for very early and proactive detection of, and response to, influenza in LTCFs, allowing for appropriate medical and public health interventions.

Additional members of the project team include:

  • Irene Hamrick, MD, and Marlon Mundt, PhD, UW School of Medicine and Public Health Department of Family Medicine and Community Health
  • Wisconsin State Laboratory of Hygiene diagnostic laboratory scientist and Acting Director Peter Shult, PhD
  • Wisconsin Division of Public Health influenza epidemiologist Tom Haupt, MS

The Wisconsin Partnership Program represents a far-reaching commitment by the UW School of Medicine and Public Health to improve health and well-being of Wisconsin residents through investments in research, education and community partnerships. Established in 2004, the Wisconsin Partnership Program has awarded more than 427 research, education and community partnership grants totaling more than $186 million, aimed at improving the health of the people of Wisconsin.