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. Influenza season is generally during the winter months. However, outbreaks occur outside the season, particularly in tropical Queensland.
Facilities should review their influenza policies and outbreak management plans yearly. Guidelines providing national best practice in preparing for, preventing, identifying and managing outbreaks of influenza in residential care are provided to assist residential care services. The Winter Plan – A guide for residential aged care providers provides overarching guidance a resources for aged care providers to support their readiness, response and recovery from cases and outbreaks of COVID-19 and/or influenza during winter.
Ensure influenza treatment options and pathways are clearly considered and documented prior to the winter season. Refer to this national fact sheet for more advice.
Vaccination program requirements
Annual influenza vaccination is the most effective way to reduce the impact of the flu in the community, especially in residential care facilities. Residents of residential care facilities are at much higher risk of complications of severe influenza therefore the promotion of vaccination for all residents and staff is important to prevent and stop the spread of influenza. Records of vaccination status of all residents should be maintained and easily accessible. It is important to provide residents (or their substitute decision makers) with information about the benefits and risks of the influenza vaccine to ensure they are making an informed decision. Residents have the right to refuse vaccination.
Compliance with Aged Care Quality Standards requires a mandatory influenza vaccination program that can demonstrate action taken to promote the benefits of vaccination, access to free vaccination and vaccine administration record keeping. Further information regarding the responsibilities of residential care providers is available on the Australian Government Department of Health website.
It is highly recommended that visitors and volunteers entering a residential care facility be vaccinated against influenza. Influenza vaccination protects staff and provides an additional layer of protection for high-risk residents.
Promote good hygiene
The influenza virus is primarily transmitted by respiratory droplets and contact with contaminated surfaces or objects. At the beginning of the season educate staff, residents, volunteers and visiting family members about preventing the spread of influenza:
- perform regular hand hygiene using 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 in the bin and wash hands immediately after use.
Watch a short video (hand washing for hygiene) which shows you the correct way to wash your hands.
Recognise the signs of influenza
Early recognition of new or worsening acute respiratory symptoms or observation of atypical non-respiratory symptoms should prompt testing and infection prevention control strategies.
Influenza is not always easily recognised in the elderly. The elderly do not always have typical flu-like symptoms such as fever and may present with symptoms like increased levels of confusion or worsening of medical conditions such as heart failure or chronic obstructive pulmonary disease. More information is available about the common signs and symptoms of influenza in the elderly.
The Guidelines for the Prevention, Control and Public Health Management of Influenza Outbreaks in Residential Care Facilities in Australia and Winter Plan – A guide for residential aged care providers are provided to assist residential care services by providing best practice information for the prevention and management of influenza outbreaks in residential care facilities. Ensure treatment options and pathways are implemented for timely access to influenza treatment (Tamiflu). For further guidance review Aged Care Treatment for Influenza.
Three or more people (residents or staff) with influenza-like illness in a three-day period indicates a potential outbreak and the public health unit must be notified. Public health units can assist with advice on investigation and management of potential outbreaks.
Contact your local public health unit for advice if an influenza outbreak is suspected.
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 frequency of cleaning with particular attention to frequently touched surfaces
- restrict resident movement into and within the facility
- keep visitors to a minimum
Influenza and COVID-19
Influenza is not the same illness as COVID-19. There are separate vaccines available to protect individuals against influenza and COVID-19 and both are recommended for residents, staff and visitors entering residential facilities. Influenza and COVID-19 vaccines can be safely co-administered on the same day or separately. For further advice please visit Australian Technical Advisory Group on Immunisation (ATAGI).
Further information on COVID-19 and residential care can be found at Coronavirus (COVID-19) advice for people in residential aged care facilities and visitors
Communiques from Queensland Health
- Guidelines for the Prevention, Control and Public Health Management of Influenza Outbreaks in Residential Care Facilities in Australia
- Winter Plan – A guide for residential aged care providers
- Australian Immunisation Handbook – Influenza (flu)
- Influenza prevention resources
- Influenza fact sheet
- Influenza surveillance reports
- Public health unit contacts
- Queensland Health COVID-19 update
- Guidelines for prescribing oseltamivir for seasonal influenza in 2022 (PDF 177 kB)– This guideline applies to patients managed by Queensland Health hospital and health service