1, New SARS-CoV-2 infection identified in HCP or nursing home-onset infection in a resident should prompt additional testing in the facility.1. 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. They help us to know which pages are the most and least popular and see how visitors move around the site. Initiation of antiviral treatment should not wait for laboratory confirmation of influenza. Residents often live in their own room or apartment within a building or group of buildings. 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. Placing ill residents in a private room. Influenza can be introduced into a long-term care facility by newly admitted residents, healthcare personnel and by visitors. 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. This guidance applies at all large facilities - nursing, assisted living and residential 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. You will be subject to the destination website's privacy policy when you follow the link. J Hosp Infect 2008; 68:837. The patient must be able to perform Activities of Daily Living (ADLs) independently. Putting on or removing PPE inappropriately can negate its protective properties. COVID-19 Long-Term Care Facility Guidance . CDC twenty four seven. This will also reduce transmission of viruses that may have become resistant to antiviral drugs during therapy. lf exposed residents on units or wards with influenza cases in the long-term care facility (currently impacted wards) should receive antiviral chemoprophylaxis as soon as an influenza outbreak is determined (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935). 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; 158:21559. 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. Assisted living facilities: facility providing help with activities of daily living. B) Residents confirmed with influenza only should be placed in a single room, if available, or housed with other residents with only influenza. You will be subject to the destination website's privacy policy when you follow the link. When asked what the CDC announcement meant for the tens of thousands of people who live in nursing homes and assisted living facilities in New Jersey, Persichilli noted the federal government's . The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 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. These cookies may also be used for advertising purposes by these third parties. 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. The updated guidance, which applies regardless of a nursing home's level of vaccination status, includes the following recommendations: Source control - Everyone in a health care facility. There are no data on use of baloxavir to control influenza outbreaks in long-term care facilities. If influenza is suspected and RIDTs or immunofluorescence results are negative, perform confirmatory testing using molecular influenza assays. Residents (or their medical proxies) get a. As of October 7, 2021, all adult care facility staff must have received at least one dose of vaccine. Additionally, all staff should wear a face covering at all times. If one laboratory-confirmed influenza positive case is identified along with other cases of acute respiratory illness in a unit of a long-term care facility, an influenza outbreak might be occurring. Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction [1 MB, 4 Pages]is also available. The CDC has provided guidance on communal activities and dining based on resident vaccination status. For persons aged 65 years, the following quadrivalent influenza vaccines are recommended: high-dose IIV, adjuvanted IIV, or recombinant influenza vaccine. 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. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. But many assisted living facilities and other senior care communities have implemented policies that mirror much of the federal COVID-19 guidance for nursing homes, including infection-prevention practices and vaccination requirements. Residents in the facility who develop symptoms of acute illness consistent with influenza or COVID-19 should be moved to a single room, if available, or remain in current room, pending results of viral testing. Saving Lives, Protecting People, Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the, The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. Gloves do not replace the need for performing hand hygiene. See the CDC guidance Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on communal dining and activities. Code chs. Cookies used to make website functionality more relevant to you. 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. risks and benefits of the vaccines, offer to administer the vaccine, and report residentand staff vaccination data to CDC's National Healthcare Safety Network. B. Pursuant to the CDPH Guidance for Vaccine Records Guidelines & Standards, only the following modes may be used as proof of vaccination: 1. Antiviral treatment works best when started within the first 2 days of symptoms. Test any resident with symptoms of COVID-19 or influenza for both viruses. 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. Facilities ma y need to limit indoor visitation in some cases, which include, but are not limited to: An Executive Order restricting visitation is in effect because of a known case or suspected case of COVID-19 among staff and residents. Updated (bivalent) boosters are the best protection from current COVID-19 variants. 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). 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. CDC recommends everyone stay up to date with COVID-19 vaccines for their age group: People who are moderately or severely immunocompromised have. The Centers for Disease Control and Prevention on May 13 loosened indoor mask-wearing guidance for fully vaccinated people after previously easing restrictions in outdoor settings. Ask a family member or friend to help you schedule a vaccination appointment if you cant get vaccinated on site. Published: September 23, 2022. covid19@ahca.org. All information these cookies collect is aggregated and therefore anonymous. You can review and change the way we collect information below. 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 Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Cookies used to make website functionality more relevant to you. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. The Commonwealth has prioritized protecting the most vulnerable populations, including long-term care (nursing home, rest home, and assisted living) residents and staff. CDC. You can review and change the way we collect information below. Guidance for Infection Control and Prevention for Nursing Facilities: Revised Guidance- March 9, 2020. Quality Improvement Organizationsexternal icon. If available, multiplex nucleic acid detection assay for SARS-CoV-2, influenza A and B viruses can be performed onsite, or at an offsite clinical laboratory.3, Two different specimens may need to be collected if a multiplex nucleic acid detection assay including both influenza viruses and SARS-CoV-2 is unavailable.2,3, B) Test for SARS-CoV-2 by nucleic acid detection4OR by SARS-CoV-2 antigen detection assay.5,6, Because antigen detection assays have lower sensitivity than nucleic acid detection assaysfor detecting SARS-CoV-2 in upper respiratory tract specimens, a negative SARS-CoV-2 antigen detection assay resultin a symptomatic persondoes not exclude SARS-CoV-2 infection and should be confirmed by either a negative result from a SARS-CoV-2 nucleic acid detection assay or a second negative antigen test result on an upper respiratory tract specimen collected 48 hours after the first negative testresult. Ensure that the laboratory performing influenza testing notifies the facility of tests results promptly. 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. Examples include: intravenous injections, wound care and catheter care.. 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. The following influenza tests are recommended: molecular assays, including rapid molecular assays, other molecular tests, or reverse transcription polymerase chain reaction (RT-PCR). On April 27, 2021, CDC released updated healthcare infection prevention and control recommendations in response to COVID-19 vaccination, and CMS issued a revised QSO 20-39-NH (PDF) with updated guidance for visitation, group activities and communal dining in nursing homes accounting for the impact of COVID-19 vaccination. CDCs influenza antiviral medication page for health professionals. Ill residents should be placed on droplet precautions with room restriction and exclusion from participating in group activities as described below. Check the manufacturers package insert for approved respiratory specimens. You will be subject to the destination website's privacy policy when you follow the link. assisted living communities). We take your privacy seriously. Information on. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. What can be done to help keep people in a facility safe from COVID-19? These cookies may also be used for advertising purposes by these third parties. Centers for Disease Control and Prevention. These considerations will be updated as additional information becomes available. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Saving Lives, Protecting People, symptoms of influenza and COVID-19 are similar, healthcare-associated infection program in your state health department, National Institutes of Health COVID-19 Treatment Guidelines Panel, latest recommendations on treatment of nonhospitalized persons with mild-to-moderate COVID-19, Therapeutic Management of Nonhospitalized Adults With COVID-19, Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction, https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html, https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html, https://www.cdc.gov/flu/professionals/diagnosis/table-flu-covid19-detection.html, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular, https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigenhttps://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-antigen, https://www.cdc.gov/flu/professionals/diagnosis/table-nucleic-acid-detection.html, https://www.cdc.gov/flu/professionals/diagnosis/table-ridt.html, https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html, https://academic.oup.com/cid/article/68/6/895/5369363, https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm, https://www.cdc.gov/flu/highrisk/index.htm, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html, https://www.covid19treatmentguidelines.nih.gov/special-populations/influenza/, https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST, https://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2022-2023 Preliminary In-Season Burden Estimate, Who is at Higher Risk of Flu Complications, Flu and COVID-19 Vaccine Coadministration, 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, Investigating Respiratory Viruses in the Acutely Ill (IVY), Respiratory Virus Transmission Network (RVTN), Randomized Assessment of Influenza Vaccine Efficacy Network (RAIVEN), 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. Use of oseltamivir during influenza outbreaks in Ontario nursing homes, 19992000. As part of Standard Precautions, eye protection should be worn if splashes or sprays are anticipated (e.g., the resident is coughing or sneezing). Shijubo N, Yamada G, Takahashi M, Tokunoh T, Suzuki T, Abe S. Experience with oseltamivir in the control of nursing home influenza A outbreak. All information these cookies collect is aggregated and therefore anonymous. COVID-19 vaccines are safe and effective especially against becoming seriously ill, being hospitalized and dyingand very important for older adults. There are no FDA-cleared influenza diagnostic assays that utilize saliva specimens. Rainwater-Lovett K, Chun K, Lessler J. Last updated: December 29, 2022 Changes to visitor guidance Social visits have resumed at long-term care facilities. 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. 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. Droplet Precautions should be implemented for residents with suspected or confirmed influenza for 7 days after illness onset or until 24 hours after the resolution of fever and respiratory symptoms, whichever is longer, while a resident is in a healthcare facility. 1. Oseltamivir is the recommended antiviral drug for chemoprophylaxis of influenza in long-term care settings. More information about testing is included below. 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. 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. Effectiveness of post-exposition prophylaxis with oseltamivir in nursing homes: a randomised controlled trial over four seasons. CDC Resources for Nursing Homes CDC Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spre COVID-19 Community Transmission Level COVID-19 Vaccines for People who are Moderately or Severely Immunocompromised Stay Up to Date with Your COVID-19 Vaccines CMS Resources for Nursing Homes 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. CDC Releases Updates to COVID-19 Infection Prevention and Control Guidance Bringing Relief. Monto AS, Rotthoff J, Teich E, et al. 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. Deaths, which bottomed at about 60 in June . Stay connected with the healthcare-associated infection program in your state health department, as well as your local health department, and their notification requirements. 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). Centers for Disease Control and Prevention. The agency defers to states that may have local guidance restricting the size of gatherings. To find COVID-19 vaccine locations near you:Searchvaccines.gov, text your ZIP code to 438829, or call 1-800-232-0233. The following practices should be considered when SARS-CoV-2 and Influenza viruses are found to be co-circulating based upon local public health surveillance data and testing at local healthcare facilities. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 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. See thelatest recommendations on treatment of nonhospitalized persons with mild-to-moderate COVID-19, andTherapeutic Management of Nonhospitalized Adults With COVID-19. The latest CDC antiviral recommendations are available on CDCs influenza antiviral drugs page for health professionals. 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. Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014. Below are resources to support nursing homes, assisted living facilities, and adult day services with new requirements for visitation, testing, vaccination, and service delivery. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Considerations Strategies Visitation Facilities shall not restrict visitation without a reasonable clinical or safety cause. 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). All information these cookies collect is aggregated and therefore anonymous. Having preapproved orders from physicians or plans to obtain orders for antiviral medications on short notice can substantially expedite administration of antiviral medications. Place symptomatic residents in Transmission-Based Precautions using all recommended PPE for care of a resident with suspected SARS-CoV-2 infection1. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial. They should not be placed in a room with new roommates nor should they be moved to a COVID-19 care unit (if one exists) unless they are confirmed to have COVID-19 by SARS-CoV-2 testing. Conduct daily active surveillance until at least 1 week after the last laboratory-confirmed influenza case was identified. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Sub-prioritization of LTCF residents for COVID-19 vaccination ACIP recommends that LTCF residents be prioritized in the earliest phase of COVID-19 vaccination. People who are moderately or severely immunocompromised have different recommendations for COVID-19 vaccines. If you have additional questions about how to get a COVID-19 vaccine, talk with your healthcare provider. 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. The burden of respiratory infections among older adults in long-term care: a systematic review. Goriek Miksi N, Uri T, Simonovi Z, et al. Anthony S. Fauci, the government's leading infectious-disease expert, told Axios that the public is misinterpreting the Centers for Disease Control and Prevention's announcement last week that . Effective July 1, 2022, the Department of Public Health advises that individuals should wear a mask or face covering when indoors (and not in your own home) if you have a weakened immune system, or if you are at increased risk for severe disease because of your age or an underlying medical condition, or if someone in your household has a . Post-Vaccination Considerations for Residents. Flyers to Promote Vaccination (CDC): [All Our Tools] . The COVID-19 vaccine is finally rolling out, with people who live in long-term care facilities, such . 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) available as a tablet. 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. Guidance for Long-Term Care Providers and Facilities. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. 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. Facility operators should balance the need for COVID-19 prevention with the impact from reducing access to daily services and programming. If resident movement or transport is necessary, have the resident wear a facemask (e.g., surgical or procedure mask), if possible. Determine if influenza virus is the causative agent by performing influenza testing on upper respiratory tract specimens (i.e., nasopharyngeal swab, nasal swabs, nasopharyngeal or nasal aspirates, or combined nasal and throat swabs) of ill residents with recent onset of signs and symptoms suggestive of influenza or acute respiratory illness. 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. Respiratory viral surveillance of healthcare personnel and patients at an adult long-term care facility. In the latest guidance, however, the CMS recommends that indoor visit should be limited in cases where an unvaccinated resident is in a county where the coronavirus positivity rate exceeds 10% and. 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. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. F) Encourage influenza vaccination for unvaccinated residents and HCP. MMWR 2011:60(RR07);1-45, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization PracticesUnited States, 202223 Influenza Season [523 KB, 32 pages], Seasonal Influenza Vaccination Resources for Health Professionals, Interim Guidance for Routine and Influenza Immunization Services During the COVID-19 Pandemic, Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza, Influenza Antiviral Medications: Summary for Clinicians, Information for Clinicians on Influenza Virus Testing, Influenza virus testing in investigational outbreaks in institutional or other closed settings, Information on Rapid Molecular Assays, RT-PCR, and other Molecular Assays for Diagnosis of Influenza Virus Infection, Healthcare-associated infections and long-term care settings, Prevention Strategies for Seasonal Influenza in Healthcare Settings, CDC.