For Healthcare Professionals
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Influenza ("the flu") is an acute, highly contagious respiratory disease characterized
by abrupt onset of fever, myalgia, sore throat, headache, and cough, and in children,
can also cause diarrhea and vomiting.
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Guidelines
The guidelines below are being provided to assist in minimizing transmission and
the impact of outbreaks.
- Employees of healthcare facilities, including EMS and others who have regular patient
contact, should be vaccinated against influenza. FluMist, the live attenuated vaccine,
can be given to healthy health-care workers younger than 50, except those who provide
direct care to severely
immunocompromised patients.
- Influenza vaccine may not be fully protective in the frail, elderly, and immunocompromised
patients. If an outbreak of influenza should occur, the facility may wish to consider
giving some patients and staff preventive antiviral medications.
- For those who have the flu (both staff and patients), antiviral treatment may reduce
viral shedding. For this treatment to be effective, it must be started as soon as
possible. (Antivirals are most effective if started within 48 hours of onset of
symptoms.)
- The specific antiviral drug used may depend on the strain of influenza circulating
in the facility. Testing a sample of patients should be considered in an outbreak
situation. Contact the Maricopa County Department of Public Health at 602-747-7111
for assistance with clinical testing.
How to Prevent Spread
- Transmission commonly occurs from unprotected coughs or sneezes. Tissues should
be available at all times in all common areas, vehicles, and patient rooms. Patients
and staff should cover their mouths when coughing and use a tissue when sneezing
or blowing their noses. Tissues should be disposed of immediately, followed by proper
hand washing with soap and water. (Alcohol hand sanitizers also may be used.)
- Provide an easily accessible container for proper disposal of tissues.
- Any ill staff member should stay home.
- Staff should use standard and droplet precautions when caring for patients with
respiratory symptoms.
- Staff must practice good hand hygiene at all times. This means using warm water
and soap for at least 15 to 20 seconds each time. Alcohol hand sanitizers may be
used for this purpose if hands are not visibly soiled.
- Patients should wash hands or have hands washed before leaving rooms, after sneezing
or coughing, and at other appropriate times. Alcohol hand sanitizers may be used
for this purpose if hands are not visibly soiled.
- Common-use surfaces, such as door handles, handrails, table surfaces, etc., should
be cleaned twice daily with disinfectant. (Bleach solutions or commercial disinfectants
are appropriate.)
- Patients in isolation for known or suspected influenza should stay in their rooms.
If many patients are ill, cohorting to a specific area or ward may be considered.
- If cohorting is practiced, staff also should be cohorted (i.e., those caring for
patients with influenza should not be allowed to care for other patients).
- Family members and other visitors with respiratory illness should be asked not to
visit or should wait to visit when their symptoms resolve. If they must visit, family
members should be educated on infection control before the visit.
Universal Respiratory Etiquette Strategy for Health-Care Facilities (Including Clinics
and EMS)
- Hand hygiene is the most important means of preventing spread of the flu. This means
washing hands for 15 to 20 seconds with warm water, friction and soap, and drying
with paper towels or air dyers. If hand washing ins not available or convenient,
antimicrobial hand sanitizers can be used if hands are not visibly soiled.
- Provide surgical masks to all patients with symptoms of a respiratory illness, prior
to entry to facility or ambulance, if possible. Provide instructions on the proper
use and disposal of masks. For patients who cannot wear a surgical mask, provide
tissues and instructions about when to use them (i.e., when coughing, sneezing,
or controlling nasal secretions), how and where to dispose of them, and the importance
of hand hygiene after handling this material.
- Provide hand
hygiene materials in waiting room areas, and encourage patients with respiratory
symptoms to perform hand hygiene.
- Designate an area in waiting rooms where patients with respiratory symptoms can
be segregated (ideally by at least three feet) from other patients who do not have
respiratory symptoms.
- Place patients with respiratory symptoms in a private room or cubicle as soon as
possible for further evaluation.
- Have health-care providers (and others such as intake personnel) use surgical masks
during the processing and evaluation of patients with respiratory symptoms.
- Instruct intake personnel to wear a surgical mask or remain at least three feet
from unmasked patients.
- Use droplet precautions to manage patients with respiratory symptoms until it is
determined that the cause of symptoms is not an infectious agent that requires more
than standard precautions.
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