Definition of an influenza outbreak in long-term care (LTC) facilities:
An outbreak in a LTC facility is defined as a sudden increase of acute febrile respiratory illness (AFRI) cases over the normal background rate or one laboratory-confirmed* influenza positive case along with other cases of respiratory infection in a unit of a long-term care facility.
A cluster of influenza in a LTC facility is defined as three or more cases of AFRI occurring within 48 to 72 hours, in residents who are in close proximity to each other (e.g., in the same are of the facility)
* Rapid influenza tests that are tested positive are not considered lab-confirmed. We recommend you send rapid positives to the State Hygienic Lab (SHL) for RT-PCR confirmation.
1. If you suspect an outbreak of influenza-like illness is occurring, please contact local public health , your field epidemiologist, or the Center for Acute Disease Epidemiology (CADE) at 800-362-2736. The regional epidemiologist or the CADE staff will help facilitate outbreak investigation and control and enter cases into the outbreak database maintained by CADE staff.
2. Collect specimens for patients with influenza-like illness, without other apparent cause and submit specimens to the State Hygienic Laboratory at the University of Iowa (SHL)
3. Administer antiviral prophylaxis to residents and health care personnel in accordance with current CDC recommendations during influenza outbreaks.
4. Vaccinate all unvaccinated residents and staff with the current season influenza vaccine unless medically contraindicated.
5. Reinforce respiratory hygiene/cough etiquette in long-term care facilities.
6. Implement droplet precautions during the care of a resident with suspected or confirmed influenza.
7. Cohort and/or isolate ill residents as appropriate.
8. Restrict ill personnel from patient care. Restrict personnel movement from areas of the facility having outbreaks to areas without patients with influenza.
9. Limit visitation, exclude ill visitors. Consider restricting visitation of all visitors via posted notices.
10. Limit new admissions.