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Primary Care

Implications of the incidence of influenza-like illness in nursing homes for influenza chemoprophylaxis: descriptive study

BMJ 2004; 329 doi: (Published 16 September 2004) Cite this as: BMJ 2004;329:663
  1. Richard Harling (, specialist registrar in public health1,
  2. Andrew Hayward, senior lecturer1,
  3. John M Watson, consultant epidemiologist2
  1. 1 University College London Centre for Infectious Disease Epidemiology, Department of Primary Care and Population Sciences, Royal Free Hospital, London NW3 2PF
  2. 2 Respiratory Diseases Department, Communicable Disease Surveillance Centre, Health Protection Agency, London NW9 5EQ
  1. Correspondence to: R Harling
  • Accepted 16 June 2004


Influenza causes substantial morbidity and mortality among nursing home residents. In September 2003, the National Institute for Clinical Excellence (NICE) issued guidelines for the use of neuraminidase inhibitors for flu prophylaxis.1 These state that oseltamivir should be given to all residents in nursing and residential homes each time a single case of influenza-like illness (ILI) is recognised in a resident or staff member and when flu is known to be circulating in the community. Oseltamivir is effective for flu prophylaxis in young healthy people, but there is little evidence of its effectiveness in elderly nursing home residents.2 Estimates of its cost effectiveness vary widely. Last winter, from 3 November 2003 to 25 January 2004, we conducted surveillance for ILI in a chain of nursing homes across England. The data allow an analysis of the implications of implementing the NICE guidelines.

Participants, methods, and results

Nurses in 48 nursing homes recorded data daily about ILI in residents on …

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