Grant: Operating Grant

Influenza is a major threat to the health of residents of nursing homes. Almost half of all deaths from influenza occur in residents of nursing homes despite high rates of influenza vaccination. It is hypothesized that the increased risk of infection stems from an aging immune system. It is known that immune system parameters change with age and these altered parameters (also referred to as immune biomarkers) can predict death. It is unknown whether immune biomarkers can predict risk of influenza infection and its complications. The goals of this study are to: 1) identify immune biomarkers predictive of influenza infection in nursing home residents; and 2) test whether an immune biomarker that rises during influenza infection will predict worsening mobility. To accomplish these goals, we will enroll 1600 nursing home residents over two influenza seasons. Residents will be eligible to participate if they are over 65 years, if they receive the seasonal influenza vaccine and if they are not taking medications that affect the immune system. Blood for immune cell analysis will be obtained prior to the influenza season. Residents will be closely monitored throughout the influenza season. In the event of respiratory symptoms, a nose swab will be obtained, and tested in the laboratory for influenza. The immune biomarkers of residents who acquire influenza will be compared to residents who do not acquire influenza. Changes in mobility during influenza infection will be recorded. The ability of the influenza specific biomarker to predict a decrease in mobility will be tested. This study aims to establish an effective way to identify nursing home residents at highest risk for influenza infection and its complications. These residents may benefit from heightened surveillance for influenza and alternative prevention strategies such as preventative anti-influenza medications. Residents who are at risk of a decline in mobility following influenza may benefit from rehabilitation.