Commun Dis Intell Q Rep 2004; 28:396400. Restrict healthcare personnel movement from areas of the facility having illness to areas not affected by the outbreak. Some states may have regulations in place . Test for influenza with a molecular assay in the following: Ill persons who are in the affected unit(s) as well as previously unaffected units in the facility, Persons who develop acute respiratory illness symptoms after beginning antiviral chemoprophylaxis. CDC and the Advisory Committee on Immunization Practices (ACIP), recommend that all U.S. healthcare personnel get vaccinated annually against influenza. DHS 132, DHS 134, and DHS 145. Residents who receive a COVID-19 vaccine (or their medical proxy) also receive a fact sheet before vaccination. Visitation Guidance: CMS is issuing new guidance for visitation in nursing homes during the COVID-19 PHE. Some patients, such as older adults, children with neuromuscular disorders, and young infants, may have atypical clinical presentations. C) Residents with symptoms of acute respiratory illness who are determined to have neither SARS-CoV-2 infection nor influenza should be cared for using Standard Precautions and any additional Transmission-Based Precautions based on their suspected or confirmed diagnosis.8, A) Prescribe antiviral treatment as soon as possible if influenza testing is positive OR prescribe empiric antiviral treatment based upon a clinical suspicion of influenza while test results are pending for symptomatic residents.9-12. More information is available, Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available, Recommendations for Fully Vaccinated People, CDCs Infection Prevention and Control Recommendations, more likely to get very sick from COVID-19, characteristics that might accelerate spread, National Center for Immunization and Respiratory Diseases (NCIRD), CDC COVID-19 Response Health Equity Strategy, Upper-Room Ultraviolet Germicidal Irradiation (UVGI), Guidance for Schools & Child Care Programs, Ventilation in Schools and Child Care Programs, Homeless Service Sites & Correctional Facilities, COVID-19 Childrens Eagle Book Coloring Storybook, U.S. Department of Health & Human Services, Facilities that serve unrelated people who live in close proximity and share at least one common room (e.g., group or personal care homes and assisted living facilities) should apply prevention strategies based on, Healthcare services delivered in these settings should be informed by. The Centers for Disease Control and Prevention (CDC) reports that weekly Covid-19 cases in nursing homes increased four-fold from June 20 to July 25. If a private room is not available, place (cohort) residents suspected of having influenza residents with one another; Wear a facemask (e.g., surgical or procedure mask) upon entering the residents room. Please see Recommendations of the Advisory Committee on Immunization Practices United States, 2022-2023 Season [523 KB, 32 pages] for the latest information regarding recommended influenza vaccines. Detection and control of influenza outbreaks in well-vaccinated nursing home populations. Given the predominance of women of child-bearing potential among the healthcare workforce, a substantial number of HCP are estimated to be pregnant or breastfeeding at any given time. , "facilities should ensure that physical distancing can still be maintained during peak times of visitation," and "facilities should avoid large gatherings (e.g., parties, events)." This means that facilities, residents, and visitors should refrain from having large gatherings where physical distancing cannot be maintained in the facility. These residents should continue to be cared for using all recommended PPE for the care of a resident with SARS-CoV-2 infection.1. Use of oseltamivir during an outbreak of influenza A in a long-term care facility in Taiwan. For newly vaccinated healthcare personnel, antiviral chemoprophylaxis can be considered for up to 2 weeks following inactivated influenza vaccination until vaccine-induced immunity is acquired. Essential Caregiver Guidance This interim guidance provides guidelines for nursing homes and other long-term care (LTC) facilities on the appropriate use of essential caregivers (ECs) to provide companionship and assist residents with activities of daily living. The agency defers to states that may have local guidance restricting the size of gatherings. For persons aged 65 years, the following quadrivalent influenza vaccines are recommended: high-dose IIV, adjuvanted IIV, or recombinant influenza vaccine. If unable to move a resident, he or she could remain in the current room with measures in place to reduce transmission to roommates (e.g., optimizing ventilation, antiviral chemoprophylaxis). Putting on or removing PPE inappropriately can negate its protective properties. There are no FDA-cleared influenza diagnostic assays that utilize saliva specimens. Post-Vaccination Considerations for Residents. These Precautions are part of the overall infection control strategy to protect against influenza in healthcare settings and should be used along with other infection control measures, such as isolation or cohorting of ill residents, screening employees and visitors for illness, furloughing ill healthcare personnel, and discouraging ill visitors from entering the facility. It is estimated that 1 to 3 million serious infections occur every year in: CDC is committed to keeping long term care patients safe from infections. If infection with an antiviral-resistant influenza virus is suspected, the local or state public health department should be notified promptly. Infection prevention and-control measures are especially important for patients who are immunocompromised to reduce the risk for transmission of oseltamivir-resistant viruses. Baloxavir is approved for post-exposure antiviral chemoprophylaxis of influenza in persons aged 5 years and older but no data are available from clinical trials of baloxavir chemoprophylaxis of influenza in long term care facility residents. Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis. Limit the number of large group activities in the facility and consider serving all meals in resident rooms if possible when the outbreak is widespread (involving multiple units of the facility). Interim Guidance for Influenza Outbreak Management in Long-Term Care and Post-Acute Care Facilities. Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014. Western Pac Surveill Response J 2016; 7:1420. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. To report a case of COVID-19 in a long-term care facility: Call the Infectious Disease Epidemiology team at 802-863-7240 (option 7 after business hours or on weekends; option 8 during business hours), or. Skilled nursing facilities should be prioritized among LTCFs as they provide care to the most medically vulnerable residents. Arch Intern Med 1998; 158:21559. While unusual, an influenza outbreak can occur outside of the normal influenza season; therefore, testing for influenza viruses and other respiratory pathogens should also be performed during non-influenza season periods. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. The new. D) Test for other respiratory pathogens; if residents with acute respiratory illness test negative for both influenza and SARS-CoV-2 consider additional viral or bacterial testing based on respiratory pathogens known or suspected of circulating in the community. Use of oseltamivir during influenza outbreaks in Ontario nursing homes, 19992000. Emerg Themes Epidemiol 2014; 11:13. This will also reduce transmission of viruses that may have become resistant to antiviral drugs during therapy. Viral culture should be performed at a public health laboratory if additional information on influenza viruses, such as influenza A virus subtype, antigenic characterization to compare with influenza vaccine strains, or antiviral resistance data, are needed. How to Acquire PPE All long-term care facilities are instructed to purchase necessary personal protective equipment. 1. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Informed consent is required to implement a standing order for vaccination, but this does not necessarily mean a signed consent must be present. Antiviral prophylaxis in the management of an influenza outbreak in an aged care facility. BMJ Open 2016; 6:e011686. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Baloxavir is approved for early treatment of uncomplicated influenza in people 5 years and older who are otherwise healthy or in people aged 12 years and older who are at higher risk for influenza complications and have been ill for no more than 2 days. Influenza Surveillance Report (FluView), Previous Forecasts for the 2021-2022 Season, Tools to Prepare Your Practice for Flu Season, Information for Clinicians on Influenza Virus Testing, Multiplex Assays Authorized for Simultaneous Detection of Influenza Viruses and SARS-CoV-2, Information on Collection of Respiratory Specimens for Influenza Virus Testing, Information for Clinicians on Rapid Diagnostic Testing for Influenza, Information on Rapid Molecular Assays, RT-PCR, and other Molecular Assays for Diagnosis of Influenza Virus Infection, Algorithm: Interpreting Influenza Testing Results When Influenza is Circulating, Algorithm: Interpreting Influenza Testing Results When Influenza is NOT Circulating, Guide: Influenza Diagnostic Testing in Closed Setting Outbreaks, Guidance: Standard-Based Electronic Laboratory Reporting, Guidance: Antiviral and Obstetric Health Care, Guidance: Outbreak Management in Long-Term Care Facilities, Guidance: Use of Mask to Control Influenza Transmission, Guidance: Prevention & Control in Peri- and Postpartum Settings, U.S. Department of Health & Human Services. COVID-19 vaccines may be administered along with and on the same day as other vaccines, such as the flu vaccine. These cookies may also be used for advertising purposes by these third parties. These include: ACIP recommends that LTCF residents be prioritized in the earliest phase of COVID-19 vaccination. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Administer the current seasons influenza vaccine to unvaccinated residents and healthcare personnel as per current vaccination recommendations. When should a facility choose to implement quarantine? The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The patient must be able to perform Activities of Daily Living (ADLs) independently. To receive weekly email updates about Seasonal Flu, enter your email address: We take your privacy seriously. Bush KA, McAnulty J, McPhie K, et al; Southern New South Wales Public Health Unit. CMS and CDC continue to provide guidance for nursing homes and other long-term care . Centers for Disease Control and Prevention. Ensure that the laboratory performing influenza testing notifies the facility of tests results promptly. The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance today for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). G) Encourage residents and HCP to remain up to date with recommended COVID-19 vaccine doses. Infection 2015; 43:7381. The latest CDC antiviral recommendations are available on CDCs influenza antiviral drugs page for health professionals. See the CDC guidance Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on communal dining and activities. All information these cookies collect is aggregated and therefore anonymous. All Residential Care Facilities, Assisted Living Facilities, Intermediate Care Facilities, Skilled Nursing Facilities should follow current Centers for Disease Control and Prevention (CDC) Guidelines related to managing healthcare personnel who have tested positive or an exposure to COVID-19. Thank you for taking the time to confirm your preferences. Persons receiving chemoprophylaxis who become sick should be switched to treatment dosing. Examples include: intravenous injections, wound care and catheter care.. While the incidence and timing of post-vaccination symptoms will be further informed by phase III clinical trial data, strategies are needed to mitigate possible HCP absenteeism and resulting personnel shortages due to the occurrence of these symptoms. CDC has developed many resources specific to help support long-term facilities during the COVID-19 pandemic. Regardless, visitors should physically distance from other residents and staff in the facility. As part of Standard Precautions, eye protection should be worn if splashes or sprays are anticipated (e.g., the resident is coughing or sneezing). Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. You can review and change the way we collect information below. Long-term use of oseltamivir for the prophylaxis of influenza in a vaccinated frail older population. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. You can review and change the way we collect information below. The facilities identified in this Order must either: (1) verify visitors are fully vaccinated, or (2) for unvaccinated or incompletely vaccinated visitors, verify documentation of a negative SARS-CoV-2 test. Antiviral treatment works best when started within the first 2 days of symptoms. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. The Quarantine and Isolation Intake Call Center is open 7 days a week from 8am-8pm: 833-596-1009. You will be subject to the destination website's privacy policy when you follow the link. These cookies may also be used for advertising purposes by these third parties. Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities [153 KB, 7 pages]. When at least 2 patients are ill within 72 hours of each other and at least one resident has laboratory-confirmed influenza, the facility should promptly initiate antiviral chemoprophylaxis with oral oseltamivir to all non-ill residents living on the same unit as the resident with laboratory-confirmed influenza (outbreak affected units), regardless of whether they received influenza vaccination during the current season. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. In response to increasing cases of COVID-19 in Virginia's long-term care facilities, Governor Northam established the Virginia COVID-19 Long-Term Care Task Force on April 10 to: Ensure long-term care facilities have the resources they need to combat the virus; Strengthen staffing, testing and infection control measures at long-term care . Long-Term Care Facilities & Assisted Living Guidance for long-term care facilities including visitation guidance, infection prevention and control measures, and outbreak management. All information these cookies collect is aggregated and therefore anonymous. Changing gloves and gowns after each resident encounter and performing hand hygiene. Having preapproved orders from physicians or plans to obtain orders for antiviral medications on short notice can substantially expedite administration of antiviral medications. Thank you for taking the time to confirm your preferences. J Am Geriatr Soc 2001; 49:102531. The facility should promptly initiate antiviral chemoprophylaxis with oral oseltamivir to all exposed individuals (e.g., roommates) of residents with confirmed influenza. C. Indoor Visitation Ill residents should be placed on droplet precautions with room restriction and exclusion from participating in group activities as described below. Some COVID-19 vaccination providers may require written, email, or verbal consent from recipients before getting vaccinated. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Drinka PJ, Gravenstein S, Schilling M, Krause P, Miller BA, Shult P. Duration of antiviral prophylaxis during nursing home outbreaks of influenza A: a comparison of 2 protocols. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. It is designed to assist facilities to improve their infection prevention and control practices, to prevent the transmission of COVID-19, and keep residents and the health care personnel (HCP) who care for them safe from infection. A) Residents confirmed to have SARS-CoV-2 infection should be placed in a single room, if available, or housed with other residents with only SARS-CoV-2 infection. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Thank you for taking the time to confirm your preferences. Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction [1 MB, 4 Pages]is also available. If single room isolation or cohorting of residents with SARS-CoV-2 and influenza virus co-infection is not possible, consult with public health authorities for guidance on other management options (e.g., transferring the resident; placing physical barriers between beds in shared rooms and initiating antiviral chemoprophylaxis for roommates to reduce their risk of acquiring influenza). If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Communicate information about patients with suspected, probable, or confirmed influenza to appropriate healthcare personnel before transferring them to other departments. In the setting of an influenza outbreak, empiric antiviral treatment should be given as soon as possible to residents with suspected influenza without waiting for influenza testing results, especially if results will not be available on the day of specimen collection. Flyers to Promote Vaccination (CDC): [All Our Tools] . Considerations might include: Further considerations on the management of post-COVID-19 vaccination symptoms among healthcare personnel is under development. 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Cookies used to make website functionality more relevant to you. Residential Care Facilities must allow outdoor visits for all residents, regardless of vaccination status, under written policies and implementation plans that include all of the following restrictions and minimum requirements. Deaths, which bottomed at about 60 in June . We take your privacy seriously. Cheng HY, Chen WC, Chou YJ, Huang AS, Huang WT. Rainwater-Lovett K, Chun K, Lessler J. Information for Long-term Care Administrators and Managers, Information for Jurisdictions (State and Local Immunization Programs).