Influenza in residential care facilities
Influenza is a serious issue in residential care facilities both because of the vulnerability of residents and the environment of communal living which facilitates the spread of respiratory viruses.
Facilities should regularly review their influenza policies and outbreak plans. Influenza season is generally during the winter months, however outbreaks can and do occur outside the season, particularly in tropical Queensland.
Contact your local public health unit for advice if an influenza outbreak is suspected.
Vaccinate staff and residents
The 2018 government-funded influenza vaccine will be available in April, and includes a new strain which differs from the 2017 vaccine. The vaccine is funded for people aged over 65 and other at-risk groups.
Annual vaccination is recommended for all residents and staff as it reduces the impact of illness on aged care facilities. It takes up to 2 weeks to develop a protective immune response.
Facilities should aim for at least 95% vaccination coverage in both residents and staff, and encourage regular visitors and volunteers to be vaccinated. Facilities can promote high rates of vaccination by offering staff vaccination clinics in the workplace and educating staff about the benefits of vaccination.
Record vaccination evidence of staff and residents in a register that is current and easily accessible. Public health units will need this information if an outbreak occurs.
Vaccinating staff, while protecting them against influenza, also reduces the likelihood of its introduction and spread within a facility.
Vaccinating residents is effective in reducing mortality and hospitalisation in the aged care setting.
Promote good hygiene
Influenza virus is primarily transmitted by respiratory droplets and also by hands. At the beginning of the season educate staff, residents, volunteers and visiting family members about preventing the spread of influenza:
- regular hand hygiene with alcohol based hand rub, or soap and water
- if using soap and water, dry hands thoroughly with a single-use towel
- encourage residents to cover their cough or sneeze with a tissue
- dispose of used tissues immediately.
Recognise the signs of influenza
Influenza is not always easily recognised in the elderly. Signs and symptoms may include:
- sudden onset of fever higher than 38°C
- sore throat, shortness of breath, or a new or worsening cough
- headache, muscle pain or weakness, tiredness
- chronic condition worsens.
Three or more people (residents or staff) with influenza-like illness in a three day period is a potential outbreak and the public health unit must be notified.
Identify and manage illness early
To detect influenza in residents:
- ensure systems for regular monitoring
- arrange early review by their primary care provider
- test early for suspected influenza
- collect nose and throat swabs for respiratory virus pathogens (including influenza)
- the recommended test is a nucleic acid test (NAT) also known as Polymerase Chain Reaction (PCR)
- collection by the GP or a local pathology provider is preferred.
Control the spread of influenza
If an outbreak occurs or is suspected:
- keep ill residents in single rooms or see the guidelines for other options
- use dedicated staff for these residents
- ensure the appropriate use of personal protective equipment by staff
- ensure adequate stocks of equipment are readily available
- exclude staff with influenza like illness while they are infectious (at least 5 days after illness onset or until symptom free, whichever is longer)
- increase cleaning frequency, especially for frequently touched surfaces
- restrict resident movement into and within the facility
- keep visitors to a minimum.
Plan for antiviral medication
Consult early with visiting GPs to forward plan and organise processes for timely prescription of antivirals including afterhours, on weekends and public holidays. Should they be needed, it is essential to avoid delays.