Baloxavir is approved for early treatment of uncomplicated influenza in people 12 years and older who are otherwise healthy or at high-risk for influenza complications and have been ill for no more than 2 days. Murti M, Fung CK, Chan K, Bigham M. Duration of influenza outbreaks in long-term care facilities after antiviral prophylaxis initiation: Fraser Health, British Columbia, 2014-2017. Abstract. O’Neil CA, Kim L, Prill MM et al. Integrated care pathway (Checklist) for outbreak management of diarrhoea and vomiting in care homes. Infect Control Hosp Epidemiol. Long-term care facilities may be defined as institutions, such as nursing homes and skilled nursing facilities that provide healthcare to people (including children) who are unable to manage independently in the community. A nursing home in southern New South Wales is in lockdown after being struck with the “killer” flu outbreak that’s sweeping the country. CDC and the Advisory Committee on Immunization Practices (ACIP), recommend that all U.S. healthcare personnel get vaccinated annually against influenza. Respiratory illness outbreak at retirement home kills 2 and ... assisted living and skilled nursing ... a year in the winter and flu season. Specific recommendations are highlighted below. Make sure there is an adequate supply of masks on hand. Please see Antiviral Drugs: Information for Healthcare Professionals for the current summary of recommendations for clinical practice regarding the use of influenza antiviral medications. Neither routine infection control measures nor vaccination prevented illness, complications, or death in a nursing home outbreak of influenza A. As well, five staff cases were employed in other acute and long-term care homes. Oseltamivir is the recommended antiviral drug for chemoprophylaxis of influenza in long-term care settings. Preventing transmission of influenza viruses and other infectious agents within healthcare settings, including in long-term care facilities, requires a multi-faceted approach that includes the following: If possible, all residents should receive inactivated influenza vaccine (IIV) annually before influenza season. A single oral dose of baloxavir is equivalent to 5 days of twice daily oral oseltamivir. Consider restricting visitation by children during community outbreaks of influenza. Antiviral prophylaxis in the management of an influenza outbreak in an aged care facility. Immunization of Health-Care Personnel. AUBURN, N.Y. (WSYR-TV) — COVID-19 continues to attack the most vulnerable population of people: Those in nursing homes. The journal Clinical Infectious Diseases published a study on January 5, 2021 that focused on influenza outbreaks in nursing homes. Australia is gripped by its worst ever flu season with more than 71,000 people sick and up to 3,000 expected to die, including three nursing home residents who were caught in an outbreak. More information about testing is included below. A team from the Public Health Unit at Sydney Local Health District has developed an application to help staff at Use of antiviral drugs for chemoprophylaxis of influenza is a key component of influenza outbreak control in institutions that house residents at higher risk of influenza complications. Arch Intern Med 1998; 158:2155–9. Ye M, Jacobs A, Khan MN, et al. BMC Geriatr. Restrict healthcare personnel movement from areas of the facility having illness to areas not affected by the outbreak. Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities pdf icon[153 KB, 7 pages]. 11 October 2018. If possible, all residents should receive inactivated influenza vaccine (IIV) annually before influenza season. Member Research and Reports January 14, 2021 Brown: Adjuvanted Vaccine Cuts Nursing Home Flu Outbreaks by 17 Percent, Researcher Reports Outbreaks of infectious diseases can decimate resident populations in nursing home facilities. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Saving Lives, Protecting People, When there is a confirmed or suspected influenza outbreak, Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating, Recommendations of the Advisory Committee on Immunization Practices – United States, 2020-2021 Season, Antiviral Drugs: Information for Healthcare Professionals. CDC’s influenza antiviral medication page for health professionals. changed the mood': Charlottetown nursing home restricts visits Figure 2 summarizes staff and resident symptoms.. That's up from 101 and 119, respectively, a week ago, which itself was more than the 86 and 101 outbreaks announced on Dec. 2. (For more information see Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medications and (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935external icon). 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. Commun Dis Intell Q Rep 2004; 28:396–400. 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. COVID-19 Ongoing Outbreaks in Congregate Living Settings Report will be updated every Tuesday and Friday by 4 p.m. . 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. New Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating, The following guidance is current for the 2020-2021 influenza season. 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 resident’s room. Public Health Agency of Canada. Five residents were hospitalised and three died. Flu outbreak kills two at Qld nursing home MORE than a dozen residents at a Queensland nursing home where two people died from the flu have tested positive to Influenza A. AAP March 28, 2013 11:22am Even if it’s not influenza season, influenza testing should occur when any resident has signs and symptoms of acute respiratory illness or influenza-like illness. To limit the potential transmission of antiviral drug-resistant influenza virus, whether in chronic or acute-care settings or other closed settings, measures should be taken to reduce contact between ill persons taking antiviral drugs for treatment and other persons, including those receiving antiviral chemoprophylaxis. Monitor healthcare personnel absenteeism due to respiratory symptoms and exclude those with influenza-like symptoms from work until at least 24 hours after they no longer have a fever. David Levine Oct. 16, 2020 Containing influenza outbreaks with antiviral use in long-term care facilities in Taiwan, 2008–2014. What is an outbreak? Bowles SK, Lee W, Simor AE, et al. 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. These researchers conducted a pragmatic cluster-randomized trial comparing adjuvanted trivalent influenza vaccine (aTIV) versus trivalent influenza vaccine (TIV). Visitors entering may be at risk of getting sick or taking the illness home to others. Influenza transmission may have been mediated by staff via either contaminated hands or fomites. Facility Outbreak Bulletin This bulletin lists ongoing and recently ended outbreaks in licensed long-term and acute care facilities throughout Vancouver Coastal Health, as of 03:08 PM, 10-Jan-2021 DISEASE LOCATION RESTRICTIONS IMPOSED RESTRICTIONS FACILITY LIFTED COVID-19 Vancouver General Hospital, LB8A 899 W 12th Ave, Vancouver 06-Jan-21 "Getting any flu outbreak under control quickly is really important as it quickly spreads into the local community from bad outbreaks in nursing homes and schools," Professor Dwyer said. This will also reduce transmission of viruses that may have become resistant to antiviral drugs during therapy. Infection 2015; 43:73–81. 2019 Aug 5;19(1):210. doi: 10.1186/s12877-019-1236-6. No transmission to these homes was reported. Clin Infect Dis 2004; 39:459–64. Sudbury's health unit says it may take a while to clear two active Western Pac Surveill Response J 2016; 7:14–20. Added information on patient group direction (PGD) templates. The local public health and state health departments should be notified of every suspected or confirmed influenza outbreak in a long-term care facility, especially if a resident develops influenza while on or after receiving antiviral chemoprophylaxis. To receive email updates about COVID-19, enter your email address: Nursing Homes and Long-Term Care Facilities, Videos for Training Front Line Long-Term Care Staff, Centers for Disease Control and Prevention. CDC. Iowa reported 143 nursing homes with coronavirus outbreaks, and thousands of residents have tested positive for the virus. There are no data on baloxavir in these populations. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Persons whose need for antiviral chemoprophylaxis is attributed to potential exposure to a person with laboratory-confirmed influenza should receive oral oseltamivir or inhaled zanamivir. Older adults and other long-term care residents, including those who are medically fragile and those with neurological or neurocognitive conditions, may manifest atypical signs and symptoms of influenza virus infection (e.g. Detection and control of influenza outbreaks in well-vaccinated nursing home populations. Residents of long-term care facilities can experience severe and fatal illness during influenza outbreaks. Influenza can be introduced into a long-term care facility by newly admitted residents, healthcare personnel and by visitors. Influenza-like illness (ILI): managing outbreaks in care homes ... templates have been published for post-exposure prophylaxis and treatment of flu for adult residents and staff of care homes. For persons aged ≥65 years, any age-appropriate IIV formulation (standard-dose or high-dose, trivalent or quadrivalent, unadjuvanted or adjuvanted) or quadrivalent recombinant influenza vaccine are acceptable options. 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. The outbreak at the Hecheltown Road nursing facility is the first so far during the pandemic among the 195 patients, but not for employees. When there is influenza activity in the local community, active daily surveillance (defined below) for influenza illness should be conducted among all new and current residents, healthcare personnel, and visitors of long-term care facilities, and continued until the end of influenza season. In an aged care home, a flu or gastro outbreak can start with just 2 or 3 residents getting sick. behavior change), and may not have fever (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935external icon). Changing gloves and gowns after each resident encounter and performing hand hygiene. Peters PH Jr, Gravenstein S, Norwood P, et al. *Note that older adults and other long-term care residents, including those who are medically fragile and those with neurological or neurocognitive conditions, may manifest atypical signs and symptoms of influenza virus infection (e.g. Throat swabs from two of 10 acutely ill residents yielded influenza A virus similar to the A/Taiwan/1/79 strain. Implementation of outbreak control measures can also be considered as soon as possible when one or more residents have acute respiratory illness with suspected influenza and the results of influenza molecular tests are not available the same day of specimen collection. Four influenza antiviral drugs approved by the U.S. Food and Drug Administration are recommended for treatment of uncomplicated influenza in the United States: neuraminidase inhibitors: oral oseltamivir (available as a generic version or under the trade name Tamiflu®), as a pill or suspension; zanamivir (trade name Relenza®), available as an inhaled powder using a disk inhaler device; and intravenous peramivir (trade name Rapivab®); and a cap-dependent endonuclease inhibitor: baloxavir marboxil (trade name Xofluza®). COVID-19 Clusters in North Carolina Report will be updated every Monday by 4 p.m. A sixth person has died in an outbreak of a flu virus at a nursing home, NHS Tayside said has said. Please also refer to the Infectious Diseases Society of America (IDSA) 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.external icon. Although vaccination by the end of October is recommended, influenza vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons because the duration of the season is variable, and influenza activity might not occur in certain communities until February or March. Determine if influenza virus is the causative agent by performing influenza testing on upper respiratory tract specimens (i.e. Limit visitation and exclude ill persons from visiting the facility via posted notices. Longer antiviral treatment courses for hospitalized patients who remain severely ill after 5 days of treatment can be considered. Older adults and other long-term care residents, including those who are medically fragile and those with neurological or neurocognitive conditions, may manifest atypical signs and symptoms of influenza virus infection (e.g. The latest CDC antiviral recommendations are available on CDC’s influenza antiviral drugs page for health professionals. That is supplemented by separate “strike teams” that can bolster infection control if an If infection with an antiviral-resistant influenza virus is suspected, the local or state public health department should be notified promptly. When a higher-than-average number of people who live and work in a health care facility are sick with similar symptoms. Conduct daily active surveillance until at least 1 week after the last laboratory-confirmed influenza case was identified. The warning comes after a nursing home at Unanderra, near Wollongong, was placed in lockdown following an outbreak which began on the June long weekend.. According to public health officials, 151 people tested positive during a recent Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medications, CDC’s influenza antiviral drugs page for health professionals, CDC’s seasonal influenza vaccination resources for health professionals page, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2020–21 Influenza Season, Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza, Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2019-2020 Preliminary In-Season Burden Estimate, Who is at High Risk for Flu Complications, Who Should & Who Should NOT Get Vaccinated, Live Attenuated Influenza Vaccine (LAIV)/Nasal Spray Vaccine, Selecting Viruses for the Seasonal Influenza Vaccine, Flu Vaccine and People with Egg Allergies, Frequently Asked Questions on Vaccine Supply, Historical Reference of Vaccine Doses Distributed, Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN), How Vaccine Effectiveness and Efficacy are Measured, What People with a Staph Infection Should Know about Flu, Resources for Hosting a Vaccination Clinic, Overview of Influenza Surveillance in the United States, Influenza Hospitalization Surveillance Network (FluSurv-NET), Weekly U.S. When 2 cases of laboratory-confirmed influenza are identified within 72 hours of each other in residents on the same unit, outbreak control measures should be implemented as soon as possible. For the latest information on influenza vaccination, see. However, no nursing homes have reported influenza outbreaks this flu … Cheng HY, Chen WC, Chou YJ, Huang AS, Huang WT. The number of flu-related deaths climbed to eight last week, according to the Arkansas Department of Health (ADH). A nursing home on the NSW South Coast has been placed in lockdown over a flu outbreak. Zapata County Influenza Outbreak •A nursing home, first identified through influenza rapid testing on March 18, 2017, four (4) patients and one (1) staff member (CNA) as positive for Influenza A. Health Care Personnel . Two die in Qld nursing home flu outbreak By Melissa Maddison Posted 27 Mar March 2013 Wed Wednesday 27 Mar March 2013 at 9:05pm , updated 28 Mar … Flu and gastro can then spread very quickly to other residents, staff and visitors. 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. While the data is still emerging about how these pandemic-related changes to operations are going to impact nursing home residents long term, one study of the COVID-19 outbreak … Gorišek Miksić N, Uršič T, Simonović Z, et al. to reduce the risk of short staffing in facilities and units where clinical staff are limited and to reduce staff reluctance to provide care to residents with suspected or laboratory-confirmed influenza). Editor's Note: For the latest updates on the 2020 coronavirus outbreak, see our news coverage. While highly effective, antiviral chemoprophylaxis is not 100% effective in preventing influenza illness. When an influenza outbreak occurs in a nursing home, several measures can be implemented by the treating physician. Information about influenza testing is available at: https://www.cdc.gov/flu/professionals/diagnosis/index.htm. The outbreaks have sickened hundreds of staff members and patients and led to scores of deaths. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial. Monto AS, Rotthoff J, Teich E, et al. A nursing home in southern New South Wales is in lockdown following a flu outbreak which has left four people dead. Ensure that the laboratory performing influenza testing notifies the facility of tests results promptly. However, these medications can still help when given after 48 hours to those that are very sick, such as those who are hospitalized, or those who have progressive illness, or those who are at high risk for complications of influenza. •The City of Laredo Health Department investigated the initial report via laboratory reports received by fax and Fifteen residents of the Marco Polo Aged Care Services in Unanderra, just outside Wollongong, were suffering with flu symptoms after the June long weekend. Two die in Qld nursing home flu outbreak By Melissa Maddison Posted 27 Mar March 2013 Wed Wednesday 27 Mar March 2013 at 9:05pm , updated 28 Mar … October 2004. Antiviral chemoprophylaxis is meant for residents who are not exhibiting influenza-like illness but who may be exposed or who may have been exposed to an ill person with influenza, to prevent transmission. 5 November 2020. Infection prevention and-control measures are especially important for patients who are immunocompromised to reduce the risk for transmission of oseltamivir-resistant viruses. 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. CDC’s guidance titled Prevention Strategies for Seasonal Influenza in Healthcare Settings contains details on the prevention strategies for all healthcare settings. Antiviral chemoprophylaxis should also be considered in personnel for whom influenza vaccine is contraindicated. Intern Med 2002; 41:366–70. Placing ill residents in a private room. 2018 Sep;46(9):1077-1079. Emerg Themes Epidemiol 2014; 11:13. If influenza is suspected and RIDTs or immunofluorescence results are negative, perform confirmatory testing using molecular influenza assays. Laboratory investigations. Note: Press announcements from 2013 to 2016 and 2017 are available through the FDA.gov Archive.Some links in press announcements may no … behavior change), and may not have fever. If you are visiting a facility during an outbreak, consider taking certain precautions. Fifteen residents of the Marco Polo Aged Care Services in Unanderra, south … Flu outbreaks in nursing homes can lead to pneumonia, stroke and heart attacks among elderly residents. Dosage adjustment may be required for children and persons with certain underlying conditions. Updated to include COVID-19 outbreak management and algorithm. J Am Geriatr Soc 2001; 49:1025–31. Chang YM, Li WC, Huang CT, et al. Four other residents have tested positive for COVID-19, along with three caregivers and three administrative employees of the nursing home. 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. Right now, The Commons on St. Anthony, which is … Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014. Guidance on outbreaks of influenza in care homes poster Information on recognising and notifying an outbreak of influenza in care homes. Apr 5, 2012. For some other, rarer diseases, just 1 case can be considered an outbreak. 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