Viral infections reduced 40% by monthly 100,000 IU Vitamin D – RCT review
The effectiveness of interventions to reduce the transmission of acute respiratory infections in care homes: a systematic review
Journal of Public Health, fdae178, https://doi.org/10.1093/pubmed/fdae178
Merlin L Willcox, Deepthi Lavu, Usaid Yousaf, Sam Dalton, Nia Roberts, Annette Plüddemann
Background
Care home residents are at high risk from outbreaks of respiratory infections, such as influenza and COVID-19. We conducted a systematic review of randomized controlled trials, to determine which interventions (apart from vaccines) are effective at reducing transmission of acute respiratory illnesses (ARIs) in care homes.
Methods
We searched CINAHL, Medline, Embase and Cochrane for randomized controlled trials (RCTs) of interventions to prevent transmission of ARIs in care homes (excluding vaccines), to April 2023.
Results
A total of 21 articles met inclusion criteria. Two infection control interventions significantly reduced respiratory infections.
Oseltamivir significantly reduced risk of symptomatic laboratory-confirmed influenza (OR 0.39, 95%CI 0.16–0.94, three trials), and influenza-like illness (OR 0.50, 95%CI 0.36–0.69), even in a vaccinated population.
High dose vitamin D supplementation reduced incidence of ARIs (incidence rate ratio 0.60; 95%CI 0.38–0.94, one trial).
Nine other RCTs of vitamin, mineral, probiotic and herbal supplements showed no significant effect.
Conclusion
Transmission of respiratory infections in care homes can be reduced by educational interventions to improve infection control procedures and compliance by staff, by antiviral prophylaxis soon after a case of influenza has been detected, and by supplementation with high-dose Vitamin D3. Further research is needed to confirm the effect of high-dose Vitamin D3.
How this fits in
NICE guidelines recommending antiviral prophylaxis for care home residents, during influenza outbreaks, are often not implemented. This research shows that antiviral prophylaxis can halve the risk of influenza even in vaccinated care home residents, if given within 7 days of the first case in the care home.
Current NICE guidelines recommend supplementation with Vitamin D at 400 IU daily. This research shows that high-dose supplementation (100 000 IU per month) can reduce risk of respiratory infections by 40%.
Refers to: High-dose monthly vitamin D for prevention of acute respiratory infection in older longterm care residents - RCT 2017
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