Outbreaks of influenza and other winter respiratory viruses
Influenza, COVID-19, RSV and other viruses can all cause severe outbreaks in ARC facilities due to the age and pre-existing health of the residents, and person-to-person transmission.
Vaccination to prevent outbreaks
Vaccinations against COVID-19 and influenza significantly reduce hospitalisation and severe disease. Influenza vaccination (residents and staff) before the start of the season, which is typically May to October, is the best protection against influenza ('flu').
How to recognise an outbreak
It can be difficult to identify an outbreak compared with the usual background rate of coughs and colds.
An outbreak is the occurrence of: 3 staff or residents unwell with influenza like illness (ILI) within 48 hours, or 4 staff or residents within 7 days in the same wing or area should be treated as an outbreak until proven otherwise.
Outbreaks are notifiable to Public Health at www.rph.org.nz/health-professionals/notifications/arc-reporting-for-respiratory-illnesses/ . If you are concerned the outbreak is getting out of control or you have questions and want public health advice please phone 04 570 9002 and ask to speak to the on-call Health Protection Officer.
Stopping the spread of winter respiratory illness in an ARC facility
Usual infection control policies and procedures will help to control the spread of winter respiratory illnesses in ARC facilities. For example:
- Allocate the ill person a single room - if a single room is not available, cohort with other people who have an ILI
- Keep ill residents away from communal areas and have their meals in their room while unwell
- PPE - staff caring for ill residents should wear a face mask if the resident is coughing; use gloves and an apron if in contact with the resident’s body fluids and wash their hands regularly; use a N95 mask when caring for residents with COVID-19 or influenza
- Encourage everyone to cover their mouth and nose with tissues when coughing and sneezing, and put used tissues in a covered bin or a plastic bag. (If there are no tissues available, cough or sneeze into your elbow or upper sleeve – not your hands). Remember to wash hands afterwards or use sanitiser
- Encourage frequent hand washing for all staff and residents (see posters below). Alcohol hand gel can be used to supplement hand washing
- Regularly clean surfaces that are frequently touched (e.g. door handles, bench tops, taps)
- Reduce staff cross-over between ill and well residents
- Stagger staff breaks to minimise the number of staff who are eating and drinking in the same room - ideally only one person should have their mask off at a time
- Alert a hospital or other facilities to which any resident is transferred or referred of ILI
- Have a plan to defer/manage new admissions while you have an outbreak
- An outbreak is over when there have been no NEW cases for twice the viruses incubation period (time for virus to spread from person to person). Each virus is different e.g. an influenza outbreak is usually over when there have been 6 days with no NEW cases.
Staff returning to work after ILI or COVID-19 illness
Testing and treatment
- If COVID-19 RAT tests are negative in the context of an outbreak in your facility, discuss testing for respiratory viruses with the medical officer of health/local laboratory/ infectious diseases physician.
- A throat swab in UTM (universal transport media) can be tested for influenza and other viruses by PCR
- Include other tests considered as appropriate by the person's GP e.g. sputum, serology
- Discuss treatment with residents GP including treating bacterial infections promptly
Visitor policy
We encourage facilities to:
- restrict visitors who may have influenza-like symptoms from visiting
- encourage visitors to wear a face mask
You may wish to use the following poster at your ARC facility:
Communication
- Keep residents and their families updated about what is happening and the rationale for the infection control measures
- Encourage family and friends to telephone or send messages via email while visiting is restricted
- Keep GPs who provide care for residents and RPH informed about the situation
- Advise visitors about the outbreak
Documents
