CDC Posts Influenza Guidance: Interim Guidance for Influenza Outbreak Management in LTC Facilities and Influenza Antiviral Medications

Karen Morris in Clinical & Quality

CDC has posted a guidance document for LTC facilities “Interim Guidance for Influenza Outbreak Management in LTC Facilities” located at http://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm.  This resource will be helpful to you in reviewing your current infection control policies related to respiratory diseases. Per this guidance, once a single laboratory-confirmed case of influenza has been identified, it is likely there are other cases among exposed persons and outbreak protocols should be instituted immediately (see page 5 of guidance document.) When at least 2 persons are ill within 72 hours of each other, and at least one has a laboratory confirmed case, it is recommended facility wide antiviral prophylaxsis should also be initiated.   Per a DOH Health Advisory dated October 9, 2014, “Influenza Surveillance and Reporting Requirements 2014-2015” (see attached or MM dated Oct 9, 2014), “nursing homes must report all confirmed or suspected healthcare associated influenza outbreaks via the NORA system located on the HCS. A single confirmed case is considered an outbreak. Suspected or confirmed cases of Novel influenza A virus must also be reported via phone to the local health department.”
 
Additionally, CDC has posted an Influenza Antiviral Medication Summary for Clinicians which outlines the effectiveness and dosing parameters for various influenza antivirals and guidelines for use of chemoprophylaxis to control outbreaks in long term care facilities.   Per the summary, “two FDA-approved influenza antiviral medications are recommended for use in the United States during the 2014-2015 influenza season: oral oseltamivir (Tamiflu®) and inhaled zanamivir (Relenza®). Oseltamivir and zanamivir are chemically related antiviral medications known as neuraminidase inhibitors that have activity against both influenza A and B viruses. As in recent past seasons, there continues to be high levels of resistance (>99%) to adamantanes among influenza A (H3N2) and influenza A (H1N1) pdm09 ("2009 H1N1") viruses. Therefore, amantadine and rimantadine are not recommended for antiviral treatment or chemoprophylaxis of currently circulating influenza A viruses.

The summary can be accessed at http://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm

NYSHFA CONTACT
Karen Morris

Director, Clinical & Quality Services
518-462-4800, ext. 15