Residents of long-term care facilities can experience severe and fatal illness during influenza outbreaks. 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. 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). CDC guidelines for fully vaccinated people: Your questions, answered COVID-19 Vaccine Access in Long-Term Care Settings Examples include: intravenous injections, wound care and catheter care.. Older adults (especially those ages 50 years and older, with risk increasing with older age) are more likely than younger people to get very sick if they get COVID-19. *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., behavior change), and may not have fever (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935). Thank you for taking the time to confirm your preferences. Beginning May 19th, 2021, mask-wearing rules . After skilled nursing facilities, consider broadening to other facilities, including: Intermediate care facilities for individuals with developmental disabilities. Arch Intern Med 1998; 158:21559. 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. Spread of influenza can occur between and among residents, healthcare personnel and visitors. Family and friends. Indoor Visits With Nursing Home Residents OK, New CDC Guidance Says You can review and change the way we collect information below. Centers for Disease Control and Prevention. Fact sheets, guidelines, reports, and resources, Fact sheet, patient safety and other information, Checklists, fact sheet, toolkits, and additional links, Specialized training and resources for nursing home staff, How facilities are keeping residents safe from infections, State-developed resources and information, The Core Elements of Antibiotic Stewardship for Nursing Homes, The Department of Health and Human Services has developed a strategy to address infections in Long-term Care Facilities in Phase 3 of the National Action Plan to Prevent Health Care-Associated Infections: Road Map to Eliminationexternal icon. Additional Information for Community Congregate Living Settings (e.g., Group Homes, Assisted Living), Management of COVID-19 in Homeless Service Sites and Correctional and Detention Facilities, Centers for Disease Control and Prevention. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Infection prevention and-control measures are especially important for patients who are immunocompromised to reduce the risk for transmission of oseltamivir-resistant viruses. 2019 Nov;40(11):1309-1312. CMS now posts this information on the CMS COVID-19 Nursing Home Data website along with other COVID-19 data, such as the weekly number of COVID-19 cases and deaths. Co-circulation of Influenza Viruses and SARS-CoV-2, Centers for Disease Control and Prevention. Based on available data, COVID-19 vaccination is expected to elicit systemic post-vaccination symptoms, such as fever, headache, and myalgias. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Deaths, which bottomed at about 60 in June . CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. Commun Dis Intell Q Rep 2004; 28:396400. The Commonwealth has prioritized protecting the most vulnerable populations, including long-term care (nursing home, rest home, and assisted living) residents and staff. 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. The Road Back: COVID-19 Resources for Congregate Settings Order of the State Public Health Officer Requirements for Visitors in Requirements for residential care facilities - Michigan They are more likely to need hospitalization, intensive care, or a ventilator to help them breathe, or they could die. 03, 2023: The CDC has listed three Connecticut CountiesLitchfield, Middlesex and New Haven Countiesin the Medium/Yellow category as part of its weekly COVID-19 Community Levels update. 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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Most COVID-19 deaths occur in people older than 65. Consult with the health department about testing strategies, including whether to implement routine. hereby ORDER all Residential Care Facilities as defined in R.C. Merritt T, Hope K, Butler M, et al. 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. Sub-prioritization of LTCF residents for COVID-19 vaccination ACIP recommends that LTCF residents be prioritized in the earliest phase of COVID-19 vaccination. 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 perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Visitors should call ahead to arrange or schedule a visit. Influenza Other Respir Viruses 2014; 8:7482. CDC guidelines for fully vaccinated could set stage for easing of some These cookies may also be used for advertising purposes by these third parties. their vaccination status or to show proof of vaccination. Antiviral treatment works best when started within the first 2 days of symptoms. Respiratory viral surveillance of healthcare personnel and patients at an adult long-term care facility. *Patients with illness associated with influenza virus infection often have fever or feverishness with cough, chills, headache, myalgias, sore throat, or runny nose. assisted living facilities CDC is committed to keeping long term care patients safe from infections. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Assisted living facilities: facility providing help with activities of daily living. 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. CMS is committed to continuing to take critical steps to ensure America's healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). March 10, 2020. 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. The facility should promptly initiate antiviral chemoprophylaxis with oral oseltamivir to all exposed individuals (e.g., roommates) of residents with confirmed influenza. Long Term Care and Group Living Settings - Vermont Department of Health 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. CDC Updates COVID-19 Guidance for Nursing Homes - APIC Below you will find a summary of these . Are residents of assisted living communities required to wear masks Consent/assent for vaccination should be obtained from the resident or their medical proxy and documented in the residents chart per standard practice. Testing 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. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. van der Sande MA, Meijer A, Sen-Kerpiclik F, et al. For persons aged 65 years, the following quadrivalent influenza vaccines are recommended: high-dose IIV, adjuvanted IIV, or recombinant influenza vaccine. You will be subject to the destination website's privacy policy when you follow the link. Assisted living facilities: facility providing help with activities of daily living. As part of Standard Precautions, eye protection should be worn if splashes or sprays are anticipated (e.g., the resident is coughing or sneezing). New Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating. However, in settings where the initial vaccine supply is insufficient to vaccinate residents of all LTCFs, sub-prioritization of vaccine doses may be necessary. While CDC recommends judicious use of antiviral medications for chemoprophylaxis to reduce the possibility of development and spread of antiviral resistant influenza viruses, chemoprophylaxis may be considered for healthcare personnel, regardless of their influenza vaccination status, if the outbreak is caused by a strain of influenza virus that is not well matched by the vaccine, or based upon other factors (e.g., 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). (For more information seeRecommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medicationsand (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935). CDC twenty four seven. Facilities can also assess the unique risks of their setting and the populations they serve and use enhanced COVID-19 prevention strategies, described below, to help reduce the impact of COVID-19. (https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm). You can review and change the way we collect information below. These cookies may also be used for advertising purposes by these third parties. Long-Term Care Facility Administrators and Managers For the latest information on influenza vaccination, see. Standard Precautions are intended to be applied to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of an infectious agent. For newly vaccinated individuals with exposure, antiviral chemoprophylaxis can be considered for up to 2 weeks following inactivated influenza vaccination until vaccine-induced immunity is acquired. A)Obtain respiratory specimens for influenza and SARS-CoV-2 testing2. 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. Residents found to have SARS-CoV-2 and influenza virus co-infection should be placed in a single room or housed with other co-infected residents. Specific recommendations are highlighted below. Since October 2005, the Centers for Medicare and Medicaid Services (CMS) has required nursing homes participating in Medicare and Medicaid programs to offer all residents influenza and pneumococcal vaccines and to document the results. These cookies may also be used for advertising purposes by these third parties. It should be noted that some long-term care residents may have difficulty using the inhaler device for zanamivir. The new. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. As of October 7, 2021, all adult care facility staff must have received at least one dose of vaccine. Notify the health department if a resident develops influenza while on or after receiving antiviral chemoprophylaxis. While these considerations are specific to care of residents residing in nursing homes, some practices could be adapted for use in other long-term care settings (e.g. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. 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. The CDC today released updates to three guidance documents now available on its website. 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 higher risk for complications of influenza. Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 was released on Dec. 23. Facilities should refer to the CDC's Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination, PA-HAN 626, and CMS QSO-20-39-NH for guidance in supporting close contact (including touch) with visitors. Containing influenza outbreaks with antiviral use in long-term care facilities in Taiwan, 20082014. If a fully vaccinated person decides to attend an event or large gathering, the CDC says, they should. Persons receiving chemoprophylaxis who become sick should be switched to treatment dosing. Updated (bivalent) boosters are the best protection from current COVID-19 variants. C) Test for influenza by rapid influenza nucleic acid detection assay6; if a rapid influenza nucleic acid detection assay is not available, perform rapid influenza antigen detection assay.9Because of lower sensitivities to detect influenza viruses, confirm negative rapid influenza antigen detection test results in a symptomatic person by influenza nucleic acid detection assay. An emphasis on close monitoring and early initiation of antiviral treatment is an alternative to chemoprophylaxis in managing certain persons who have had a suspected exposure to influenza virus. As of September 27, 2021, all nursing home staff must be vaccinated with at least one dose of vaccine. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Persons receiving antiviral chemoprophylaxis should not receive live attenuated influenza virus vaccine (LAIV), and persons receiving LAIV should not receive antiviral treatment or chemoprophylaxis until 14 days after LAIV administration. Considerations might include: Further considerations on the management of post-COVID-19 vaccination symptoms among healthcare personnel is under development. To find COVID-19 vaccine locations near you:Searchvaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233. LAC | DPH | COVID-19 Healthcare Facilities Information In some cases, facilities may choose to apply Standard Precautions and Droplet Precautions for longer periods based on clinical judgment, such as in the case of young children or severely immunocompromised residents, who may shed influenza virus for longer periods of time. Limit visitation and exclude ill persons from visiting the facility via posted notices. Healthcare personnel who have occupational exposures can be counseled about the early signs and symptoms of influenza and advised to contact their health-care provider immediately for evaluation and possible early initiation of antiviral treatment if clinical signs or symptoms develop. When Can Visitors Return to Nursing Homes After COVID-19? - AARP Use the response checklist (updated 4/29/2022) to get started: All information these cookies collect is aggregated and therefore anonymous. Home health agencies. CDC recommends everyone stay up to date with COVID-19 vaccines for their age group: Children and teens ages 6 months-17 years Adults ages 18 years and older People who are moderately or severely immunocompromised have different recommendations for COVID-19 vaccines. 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. Mar 10, 2021. Thank you for taking the time to confirm your preferences. 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. 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. 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. COVID-19 vaccines, including boosters, are effective at protecting people from getting seriously ill, being hospitalized, and dying. Visitors. Gloves do not replace the need for performing hand hygiene. Bush KA, McAnulty J, McPhie K, et al; Southern New South Wales Public Health Unit. Because SARS-CoV-2 and influenza virus co-infection can occur, a positive influenza test result without SARS-CoV-2 testing does not exclude SARS-CoV-2 infection, and a positive SARS-CoV-2 test result without influenza testing does not exclude influenza virus infection. C. Indoor Visitation Because residents with influenza may continue to shed influenza viruses while on antiviral treatment, infection control measures to reduce transmission, including following Standard and Droplet Precautions, should continue while the resident is taking antiviral therapy. Planning for personnel to have time away from work if they develop systemic symptoms following COVID-19 vaccination. You will be subject to the destination website's privacy policy when you follow the link. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Staggering delivery of vaccine to HCP in the facility so that personnel from a single department or unit are not all vaccinated at the same time. Talk with the LTC staff about getting vaccinated on site. 3 should be adhered to. Therefore, they can add combinations of these enhanced prevention strategies as feasible for a layered approach to increase the level of protection. IDPH COVID-19 Guidance - Illinois Zanamivir should be used when persons require chemoprophylaxis as a result of exposure to influenza virus strains that are suspected or known to be oseltamivir-resistant. Clinicians should consult the manufacturers package insert for approved ages, recommended drug dosing adjustments and contraindications. Guidance: Long Term Care Facilities (LTCFs) and Residential Care Further considerations around use of COVID-19 vaccines in pregnant or breastfeeding HCP will be provided once data from phase III clinical trials and conditions of FDA Emergency Use Authorization are reviewed. Immunization of Health-Care Personnel. COVID-19 Vaccines for Long-term Care Residents, Safe, Easy, Free, and Nearby COVID-19 Vaccination, Centers for Disease Control and Prevention. CDC twenty four seven. Recommendations of the Advisory Committee on Immunization Practices (ACIP). B) Residents confirmed with influenza only should be placed in a single room, if available, or housed with other residents with only influenza. CDC guidance for nursing homes generally also applies to other long-term care facilities. All workers in long-term care settings like nursing homes, assisted living facilities, group homes, and others; D) SARS-CoV-2 post-exposure prophylaxis considerations, For recommendations on post-exposure prophylaxis following close exposure to a person with SARS-CoV-2 infection, visit the latest recommendations from the NIH COVID-19 Treatment Guidelines Panel. 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. Cookies used to make website functionality more relevant to you. Cheng HY, Chen WC, Chou YJ, Huang AS, Huang WT. Ensure that the laboratory performing influenza testing notifies the facility of tests results promptly. How to Acquire PPE All long-term care facilities are instructed to purchase necessary personal protective equipment. Centers for Disease Control and Prevention. Ask a family member or friend to help you schedule a vaccination appointment if you cant get vaccinated on site. 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.