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In October 2017, the National Poll on Healthy Aging surveyed a nationally representative sample of 2,007 adults aged 50–80 years to assess attitudes toward influenza (flu) vaccination policies in long-term care facilities. Support for requiring vaccinations was lowest for visitors. Policy makers can use these findings to develop sustainable vaccination strategies.

Objectives:Emergency preparedness becomes more important with increased age, as older adults are at heightened risk for harm from disasters. In this study, predictors of preparedness actions and confidence in preparedness among older adults in the United States were assessed.Methods:This nationally representative survey polled community-dwelling older adults ages 50-80 y (n = 2256) about emergency preparedness and confidence in addressing different types of emergencies. Logistic regression was used to identify predictors of reported emergency preparedness actions and confidence in addressing emergencies.Results:Participants’ mean age was 62.4 y (SD = 8); 52% were female, and 71% were non-Hispanic white. Living alone was associated with lower odds of having a 7-d supply of food and water (adjusted odds ratio [aOR] = 0.74; 95% confidence interval [CI]: 0.56-0.96), a stocked emergency kit (aOR = 0.64; 95% CI: 0.47-0.86), and having had conversations with family or friends about evacuation plans (aOR = 0.59; 95% CI: 0.44-0.78). Use of equipment requiring electricity was associated with less confidence in addressing a power outage lasting more than 24 h (aOR = 0.66; 95% CI: 0.47-0.94), as was use of mobility aids (OR = 0.65; 95% CI: 0.45-0.93).Conclusions:These results point to the need for tailored interventions to support emergency preparedness for older adults, particularly among those who live alone and use medical equipment requiring electricity.

Objective.To assess the response of long-term care facilities (LTCFs) to the 2004-2005 influenza vaccine shortage and the impact on resident and healthcare worker (HCW) immunization rates.Methods.A 12-item questionnaire was sent to 824 randomly selected LTCFs in December 2004. The following 2 open-ended questions were also asked: “How did you cope with the vaccine shortage?” and “Who helped you get your supply?” Immunization rates reported by LTCF administrators for 2003-2003 and 2003-2004 were compared with those for 2004-2005. Immunization rates were defined as the proportion of all eligible residents and HCWs who received influenza vaccine.Results.Responses were received from 380 LTCFs (46.3%), which had a total of 38,447 beds. Resident mean influenza immunization rates (±SD) decreased from 85% ± 15.3% in 2002-2003 and 85.1% ± 15.3% in 2003-2004 to 81.9% ± 19.4% in the 2004-2005 influenza season (P = .025). The immunization rates among HCWs also decreased from 51% in 2002-2003 and 2003-2004 to 38.4% in 2004-2005 (PConclusions.The influenza vaccine shortage in 2004-2005 impacted immunization practices of LTCFs across the United States, leading to decreases in both resident and HCW vaccination rates. The significant decrease in vaccination rates in LTCFs is of concern and has broad implications for policy makers working on emergency preparedness for a possible pandemic of influenza.

We reviewed the frequency and duration of vancomycin use during 93 left ventricular assist device placements. Vancomycin prophylaxis was administered for a mean duration (± standard deviation) of 10.5 ± 11 days. Empirical vancomycin use was frequent, with a mean duration (± standard deviation) of therapy of 9.8 ± 9 days (median, 8 days) given during 81 (87%) of the implantations. The most common indications for empirical vancomycin treatment were isolated leukocytosis or driveline drainage. Strategies to improve vancomycin use during left ventricular assist device support should be considered.

Dr. Malani is an Associate Editor of the journal. Infect Control Hosp Epidemiol 2007; 28:1321-1322 2007 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2007/2812-0001$15.00. DOI: 10.1086/523860 As specialists in infection control and infectious diseases, issues of poverty and disease prevention have always been fundamental to our work. Beginning with the early efforts of Edward Jenner and Ignaz Semmelweis, we learned that simple, well-executed interventions can have a profound impact on prevention and control of infectious disease. Today the importance of clean water, simple sanitation, and access to basic health care remains essential; lapses in these practices result in modern day infectious diseases catastrophes, including outbreaks of diarrheal diseases, hepatitis, human immunodeficiency virus infection, and resistant tuberculosis, among others. In many ways, the concept of global health is synonymous with infection control. Infection Control and Hospital Epidemiology (ICHE) has been committed to publishing work from developing nations, precisely because it is these studies that have the most real-life value in places where most modern tools to detect, treat, and prevent infection remain out of reach because of cost and the lack of educated personnel, as well as the lack of infrastructure to deliver that care. In celebration of the integral role infection control plays in improving living standards among the world’s poorest people, we are pleased to present the following special section as our contribution to the Global Theme Issue on Poverty and Human Development organized by the Council for Scientific Editors. ICHE is one of more than 230 scientific journals simultaneously publishing new original research, reviews, editorials, and other articles addressing poverty and human development. The solutions for many of the challenges facing humans (past, present, and future) invariably include some basic aspects of infection control. In recognition of the intimate connection between poverty and the essentials of infection control, we present the following 4 selections. In choosing these articles, we focused on works that offer insight into how to improve infection control in underdeveloped areas in a manner that is sustainable, scalable, and economically feasible. Our section begins with a commentary from Allegranzi and Pittet that offers an overview of the numerous barriers to adequate infection control efforts in much of the world. Besides simple economics, the authors cite inadequate knowledge, poor staff preparedness, and the problem of “counterfeit” drugs. The implementation of minimum standards for infection control is further hindered by the lack of basic equipment, overcrowding of patients, and limited availability of surveillance data. Allegranzi and Pittet offer background on an ongoing campaign to improve hand hygiene, calling for a “systematic switch to alcohol-based hand rub at the point of care as the ‘gold standard’ practice.” In sharing the rationale for selecting hand hygiene they also detail the numerous obstacles (some unexpected) that the program has faced. Through their description of how economically viable methods to manufacture alcohol-based hand rub can be brought to the poorest areas of the world, the authors offer concrete evidence for a sustainable, scalable project to accomplish this critical component of infection control. It is encouraging that the First Global Patient Safety Challenge has already been embraced by 43 countries, more than half of which are developing nations. The deficits in fundamental skills and knowledge described by Allegranzi and Pittet are addressed in a very practical manner in the article by Caniza and colleagues. In this article, the authors share the nuts and bolts of an existing program specifically developed to address the need for infection control education in Latin America. The program emerged as a collaborative venture between St. Jude Children’s Research Hospital and several Latin American hospitals because of the observation that potentially preventable infection caused a third of deaths among pediatric hematology-oncology patients. Caniza and colleagues offer a detailed description of a 4week course consisting of lectures and hands-on laboratory and hospital experience. Results from the program’s 2005 and 2006 experiences are provided, during which 44 health care professionals received basic training in all aspects of infection control and hospital epidemiology. The plan also includes formal methods to evaluate trainees’ knowledge acquisition, an important aspect for potential funding agencies. By sharing