Unusual outbreak of influenza A in a Wyoming nursing home

An explosive outbreak of Influenza A (H3N2) occurred during early February 1985 among the 55 residents of a nursing home in Douglas, Wyoming. Thirty of the 55 (55%) had febrile respiratory illnesses. Thirty-six (65%) had received influenza vaccine. The attack rate was 84% in unvaccinated and 39% in vaccinated persons. Vaccine efficacy was estimated to be 54%. There were eight cases of pneumonia in unvaccinated and four in vaccinated persons, three deaths in unvaccinated and one death in vaccinated persons. Complement fixation and hemagglutination inhibition tests on sera from 47 residents confirmed the diagnosis of Influenza A in the great majority of individuals, and furthermore showed very low levels of antibody for the Influenza A H1N1 and Influenza B components of the vaccine.