In the Netherlands, the top of this growth will be reached in 2050 with at that time an estimated 25% of the population over the age of 65 and 40% of them being 80 years or older. Immunosenescence, the state of dysregulated immune function with aging, is felt to be a significant contributor to the increased risk and severity of infections in the elderly. Especially frail elderly in long-term care facilities have unique risks for infectious diseases.
In the U.S.A. prolonged attention is drawn into the increased risk of infection of elderly people and infection control programs for long term care facilities have been developed. In the SHEA/APIC guideline published in 2008 the importance of infectious disease surveillance in the long term care facilities is stated as an essential part of infectious disease prevention and control.
In the last years also in Europe joint initiatives have been established to survey antimicrobial consumption (European Surveillance of Antimicrobial Consumption (ESAC)) and healthcare-associated infections in long term care facilities (Healthcare-Associated infections and related practices in European Long-Term care facilities (HALT)). In the Netherlands the PREZIES project surveys since 1996 the occurrence of infections in acute care hospitals and in 2009 a prevalence module was developed for the long term care setting. Prevalence is a measure to study the total number of cases of disease in a population. Incidence rates give insight in the rate of new cases per time interval and make it possible to study seasonal fluctuations in infections and are usually more useful than prevalence in understanding the disease etiology. In Europe several other prevalence studies have been performed with different results, but until now no results from ongoing sentinel incidence surveillance in nursing homes are reported.
In 2007 the Dutch Centre for Infectious Disease Control (CIDC) took the initiative to set up a national sentinel surveillance network for infectious diseases in nursing homes (SNIV). In the Netherlands, since 1970 routine surveillance of influenza-like illness in the community is conducted by general practitioners. A similar network structure for nursing homes was preferred to provide weekly incidence rates for the infectious diseases under surveillance. The aim of the SNIV network is to provide systematic year-round surveillance data for local interventions and national policy making and for the development of infection control guidelines for the nursing home setting.