Controlling influenza outbreaks in aged care facilities
Symptoms of influenza include sudden onset of fever, headache, muscle and joint pain, feeling tired, sore throat, cough, runny or stuffy nose, and fatigue. During influenza outbreaks, prompt action can help control spread.
Last updated: 15 September 2004
Normally, standard precautions for infection control should be used when caring for residents. During a suspected influenza outbreak, droplet precautions should also be used.
If an outbreak is suspected, follow these steps.
1. Confirm the cause
Make sure that appropriate respiratory tract specimens are collected for rapid laboratory testing for influenza and other viruses (PCR, immunofluorescence, point-of-care test kits, or virus isolation) to quickly determine if the outbreak is due to influenza or another respiratory infection.
Contact your local laboratory or reference laboratory for advice.
2. Set up an outbreak control team
In the event of an outbreak of influenza-like illness, it is strongly recommended that facilities set up an outbreak control team that includes clinical, infection control and management staff.
Seek input from your local Public Health Unit, as well as from a microbiologist and respiratory physician, if they are available.
3. Isolate ill residents and restrict staff and visitors
Isolate residents with influenza from other residents, and confine ill residents to their rooms for five days after the onset of illness or until symptoms have completely resolved, whichever is the shorter.
Exclude staff with influenza-like illness from work for five days from the onset of symptoms or until symptoms have resolved. Encourage ill staff to seek medical care for treatment and/or confirmation of their illness.
Place affected residents in a single room, preferably with ensuite facilities. If a single room is not available, place ill residents with other residents suspected of having influenza. Place all confirmed influenza cases together. Ill residents should use separate toilet and bathroom facilities from unaffected residents.
Avoid moving residents and staff between different units or wings of the facility.
Cancel group activities.
Discourage visitors during the outbreak, especially visitors with respiratory symptoms.
Postpone transfers, new admissions and the re-admissions of residents who were hospitalised before the outbreak commenced.
Before sending residents to hospital, inform the hospital and transport staff of the outbreak.
4. Wash your hands regularly
Alert staff, residents and visitors to the outbreak and reinforce the need for frequent hand washing.
Post hand washing signs.
Make sure that hand washing facilities are available to staff, residents and visitors.
Wash hands vigorously for a minimum of 15 seconds with a antimicrobial soap:
Alternatively, if your hands are not visibly soiled and hand washing facilities are not immediately available, use a non water-based cleaner or antiseptic (eg. alcohol handrub).
5. Wear a mask
When caring for a resident with influenza, wear a fluid-repellent surgical mask when you enter the resident's room or when you are working within one metre of the resident. Remove the mask when you leave the resident's room, dispose of it in a waste container, then wash your hands.
Consider your mask contaminated if it gets wet, and dispose of it. Do not re-use masks.
If you are moving or transporting a resident with influenza, get them to wear a mask, if possible.
Always wear a fluid-repellent surgical mask and protective eyewear if there is a likelihood that blood or other body substances will be splashed.
6. Wear gloves and gown
Wear gloves if you expect that your hands will come in contact with blood or body substances (including respiratory secretions), or on potentially contaminated surfaces.
Wash your hands after removing and disposing of gloves.
Wear an impervious gown if you expect your clothes to be soiled with a resident's respiratory or other body substances.
Be careful to avoid contamination of clothing and skin when removing personal protective equipment.
Change gloves, gowns and mask after each encounter and wash your hands thoroughly.
7. Keep your environment clean
Use a neutral detergent to clean commonly-touched surfaces such as handrails, chair arms, doorknobs, hand basins, taps, toilet handles.
Clean isolation areas with cleaning equipment designated for the affected area.
Wear personal protective equipment, including a mask, when cleaning isolation areas.
Provide residents with tissues and appropriate disposal containers.
8. Consider anti-influenza medication
Anti-viral medications can be used to treat those who are ill with influenza. These medications can shorten the duration of illness if they are administered within 48 hours of onset of influenza symptoms (fever, headache, muscle and joint pain, fatigue, sore throat, cough, runny or stuffy nose).
If an influenza outbreak is confirmed, consider anti-viral medication for residents--irrespective of vaccination status--and unvaccinated staff (or all staff if the outbreak involves a strain not covered by the vaccine). Seek the advice of clinical or public health specialists.
9. Immunise staff and residents every year
To prevent outbreaks, arrange vaccination for all residents and staff before winter each year.
If an outbreak occurs, encourage vaccination of all unvaccinated residents and staff (including volunteers) and suggest that visitors also be vaccinated. It takes up to two weeks for the vaccine to become fully effective.
|Further information - Public Health Units in NSW|
|For more information please contact your doctor, local public health unit or community health centre - look under NSW Government at the front of the White Pages|
|Metropolitan Areas||Location||Number||Rural Areas||Location||Number|
|Northern Sydney||Hornsby||02 9477 9400||Greater Southern||Goulburn||02 4824 1837|
|Central Coast||Gosford||02 4349 4845||Albury||02 6080 8900|
|South Eastern Sydney||Randwick||02 9382 8333||Greater Western||Broken Hill||08 8080 1499|
|Illawarra Shoalhaven||Wollongong||02 4221 6700||Dubbo||02 6841 5569|
|Sydney South West||Camperdown||02 9515 9420||Bathurst||02 6339 5601|
|Sydney West||Penrith||02 4734 2022||Hunter/New England||Newcastle||02 4924 6477|
|Parramatta||02 9840 3603||Tamworth||02 6764 8000|
|Justice Health Service||Matraville||02 9311 2707||North Coast||Port Macquarie||02 6588 2750|
|Lismore||02 6620 7585|