179 / 290
Results:
Of the 44 patients analyzed the average age was 78.8 years
and the average hospital stay was 9 days. 16% of patients had
non-specific symptoms such as agitation or disorientation as reason
for consultation, the rest of them had dyspnea as main clinic. 38% of
patients developed pneumonia associated with respiratory infection
symptoms by influenza A. There was a 4% re-admission rate in the
30 days. 27% of patients were admitted to the intensive care unit
requiring invasive ventilation due to mainly respiratory complications.
33% of the patients admitted to intensive care unit died during
hospitalization. 15% of the reported mortality was by respiratory
complications mainly.
Conclusions:
The analysis shows: atypical symptoms for influenza
infection in the elderly. High rate of respiratory infectious complica-
tions during hospitalization. High rate of survival after stay in intensive
care unit.
P-545
Syphilis infection as a cause of neutropenia in the elderly?
–
a case
report
M. Galo
1
, J. Mata
2
, S. Pessoa
1
, I. Calvinho
1
.
1
USF Oriente,
2
UCSP Marvila,
Portugal
Introduction:
Neutropenia is a relatively frequent finding in the
elderly population that can be associated with multiple causes
including drugs, autoimmune, bone marrow and infectious diseases.
Methods:
Description of a case report.
Results:
We report a case of a 73-year-old asymptomatic woman with
persistent neutropenia in the past 3 years. Her medical history
included localized breast cancer for which she received a 5 year course
of tamoxifen and allergic rhinitis medicated with ebastine. Complete
blood count revealed a low leukocyte count (2.6 × 10^9/L) and a low
neutrophil count (1.2 × 10^9/L). Posterior investigations showed past
cytomegalovirus and parvovirus infection and positive VDRL and
TPHA tests. There was no history of syphilis treatment and onset of
infection was not known. Investigation was otherwise unremarkable.
Bone marrow biopsy showed no alterations. After receiving treatment
with benzathine benzylpenicillin cell counts improved.
Conclusions:
In the elderly patient with acquired neutropenia an
infectious disease is a common cause. Recovery of cell counts after
syphilis treatment raises the hypothesis of neutropenia caused by this
infection. Although not commonly associated with neutropenia, in a
patient with no known cause for it, syphilis diagnostic tests may be
considered an option.
P-546
Outbreak of human metapneumovirus in a nursing home, a
retrospective study
D. Seynaeve
1,2
, B. Rivière
2
, M.R. Mallaret
1
, C. Landelle
1
, G. Gavazzi
2
.
1
Infection control Unit, University Hospital of Grenoble-Alpes,
2
University Clinic of Geriatric Medicine, University Hospital of
Grenoble-Alpes
Introduction:
Despite Human metapneumovirus (HMPV) seropreva-
lence is near 100% in elderly, outbreaks of LRTI in nursing home (NH)
mainly related to Influenza, Respiratory Syncytial Virus or unknown,
few outbreak of HMPV have been reported; however the extent of this
“
benign
”
infection is not well known. We report a clinical and outcome
analysis of an HMPV outbreak in a French NH.
Methods:
retrospective, case-control study, including all residents
(78) from 27th December 2014 to 20th January 2015, considering that
the incubation period for hMPV is 5
–
9 days. Identification of HMPV
was realized on nose swab by RT-PCR.
Results:
Seventy-eight residents were present at time of outbreak; 3
out of 4 were positive by RT PCR and negative for 13 other viruses or
bacteria. Clinical presentation: cough, was present in all cases and
other symptoms were variable. Biological results were non-specific
(inflammatory response -mean Protein C reactive 50 mg/mL). The
median length of disease was 7 days. Attack rate of the outbreak
among resident was high (51%) leading to 5 hospitalizations (12,5%)
and 1 death (2,5%) and 10 Health careworkers were affected,; Duration
of the outbreak was 1 month. Basic hygiene precaution were
reinforced but droplet precaution is difficult to apply. We will
present further analysis of the impact on functional status.
Key conclusions:
The attack rate was high. Clinical and biological
presentations were non-specific; the disease may be severe possibly
because of co-infection. It needs awareness to enhance rapidly basic
hygiene precaution in case of outbreak.
P-547
Seniors vaccination in Europe: the state of play of
recommendations and coverage rates compared with childhood
vaccination
G. Gavazzi
1
, S. Esposito
2
, E. Franco
3
, A. Gil de Miguel, R. Hardt,
G. Kassianos, I. Bertrand, J.A. López Trigo.
1
Grenoble-Alpes University
GREPI EA 7308, University Clinic of Geriatric Medicine, Univeristy
Hospital of Grenoble-Alpes, Grenoble, France;
2
Pediatric Highly
Intensive Care Unit, Department of Pathophysiology & Transplantation,
Università degli Studi di Milano, Milan,
3
Dipartimento di Biomedicina e
Prevenzione
–
Università Degli Studi di Roma Tor Vergata, Roma, Italy
Introduction:
Vaccination is critical component of preventive strat-
egies at all ages of life. In seniors, vaccination aims to prevent diseases
and their severe complications to avoid adverse impact on age-related
functional decline and loss of autonomy. Childhood routine vaccin-
ation demonstrated dramatic declines of morbidity and mortality due
to vaccine-preventable diseases (VPD). With an ageing European
population, it is interesting to know the state of play of vaccine
recommendations in seniors and to compare vaccine coverage rates
(VCR) in seniors and in children.
Method:
Review of national age-based vaccination recommendations
for seniors on ECDC and country official websites for 32 European
countries. When available, comparison of VCR of influenza vaccination
for seniors with those of diphteria-tetanus-pertussis and measles for.
Results:
National age-based vaccination recommendations for seniors
are against influenza (n = 32), pneumococcal diseases (n = 18) and
herpes zoster (n = 5 Despite Influenza VCR target of 75% recommended
by WHO and EU council, only 2 countries reach it or nearly (NL & UK).
Influenza VCR in seniors ranges between around 1% and 76%, and is
globally declining throughout Europe in recent years. Concerning
childhood vaccination, more than 90% of 1-year-old children received
the recommended DTP and measles vaccinations in accordance with
national immunisation schedules: VCR in seniors are far lower than for
children in the same European countries.
Conclusions:
In spite of a sound medical rationale, and strong
evidence of individual and public health benefits, not all European
countries recommend or promote vaccination against VPD in seniors,
and no country achieves comparable VCRs to childhood rates.
P-548
Review of burden of vaccine-preventable diseases in seniors in
Europe
G. Gavazzi
1
, S. Esposito
2
, E. Franco
3
, A. Gil de Miguel, R. Hardt,
G. Kassianos, I. Bertrand, J.A. López Trigo.
1
Grenoble-Alpes University
GREPI EA 7308, University Clinic of Geriatric Medicine, Univeristy
Hospital of Grenoble-Alpes, Grenoble, France;
2
Pediatric Highly Intensive
Care Unit, Department of Pathophysiology & Transplantation, Università
degli Studi di Milano, Milan,
3
Dipartimento di Biomedicina e
Prevenzione
–
Università Degli Studi di Roma Tor Vergata, Roma, Italy
Introduction:
In addition to boosters, several vaccinations are
recommended in Europe for seniors considering their higher
vulnerability to vaccine-preventable diseases (VPD) due to immuno-
senescence. It is interesting to assess the remaining burden of these
VPD in Europe.
Method:
Literature and WHO and ECDC websites review of European
epidemiological and morbidity-mortality data.
Poster presentations / European Geriatric Medicine 7S1 (2016) S29
–
S259
S173