For detailed recommendations, see:
Vaccination
: All LTCF healthcare personnel (HCP) and residents should be vaccinated annually against influenza, or upon admission between August and April, if not already vaccinated.
Respiratory hygiene and cough etiquette
: Post visual alerts, provide tissues or masks to those symptomatic, ensure hand hygiene supplies are available, and exclude ill visitors and HCP.
Definitions
:
- A cluster of influenza-like illness (ILI) is two or more cases of ILI occurring within 72 hours.
- An influenza outbreak is one case of laboratory-confirmed influenza (or more) in the setting of a cluster of ILI within a 72 hour period.
Surveillance
: Implement active daily surveillance for ILI among all residents and staff throughout influenza season. Instruct HCP to self-report any influenza-like symptoms to their supervisor. Exclude ill HCP from work until at least 24 hours after fever resolves, without the use of fever-reducing medications.
Testing
: For cases of acute respiratory illness suggestive of influenza, the following influenza tests are recommended, in order of priority, if readily available: 1) real-time reverse-transcriptase (RT-PCR), 2) immunofluorescence, or 3) rapid influenza antigen tests. If immunofluorescence or antigen results are negative and influenza is suspected, specimens should be sent for confirmation by RT-PCR or viral culture. Real-time RT-PCR is the best way to confirm the diagnosis of influenza quickly.
Antiviral Prophylaxis
: Start antiviral chemoprophylaxis on
all
non-ill residents, regardless of influenza vaccination status, as soon as an influenza outbreak (as defined above) is determined. Antiviral chemoprophylaxis should continue for a minimum of two weeks and for at least 7-10 days after the last known case is identified, whichever is longer. Priority should be given to residents living in the same unit or floor as an ill resident, but all non-ill residents are recommended to receive the prophylaxis.
Infection Control Precautions
: Implement Standard and Droplet Precautions for all residents with suspected or confirmed influenza for 7 days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer.