“A flu outbreak is probably the number one thing that we fear in a nursing home.”
Robert E. Page
Health Center Director
Chemung County Nursing Facility
Elmira, New York
Click here for tools to help manage seasonal flu
A Special Risk for the Elderly
Influenza is a particularly serious concern for elderly residents of long-term care facilities because of the closeness residents have with one another, and also because many residents have comorbidities that increase their susceptibility to serious complications of the flu.
Signs and Symptoms of Influenza in the Elderly
When flu is present in the community, look for the combination of fever and cough, which tend to be the best indicators of influenza infection.17Classic signs of flu in the elderly are not always as clear cut as in younger healthy adults. Other signs of flu to be on the lookout for in the elderly are lassitude and confusion.18
It Starts with Vaccination
Vaccination against influenza is the number one recommended prevention strategy according to CDC guidelines; however, vaccine efficacy rates in the elderly range between 17%-53% when vaccine and virus are matched. This is considerably lower than that in healthy adults who are less than 65 years of age.11 Despite the diminished efficacy of influenza vaccine in the elderly, the vaccine can still reduce the impact of the viral infection in terms of hospitalizations for pneumonia and death.19
Treatment and Prophylaxis Guidelines for the Elderly
During the 2007-08 flu season, many communities reported a substantial increase in flu activity. This prompted the CDC to issue a
special health advisory emphasizing the importance of considering neuraminidase inhibitors (prescription antiviral medications) for use in the treatment and prophylaxis of influenza for persons at high risk for influenza complications or with severe influenza illness. To summarize the advisory, treatment with these agents should begin within 48 hours of symptom onset.
A number of excellent influenza management resources are available to help facilitate resident care before, during, and after a flu season. Several of these are included here.
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SPEED Preseason Implementation Checklist (Adobe PDF format)
Flu outbreaks in a long-term care facility can be controlled if the healthcare staff is ready with a plan that can go into action as soon as flu is detected. The SPEED Preseason Implementation checklist can help you be prepared. |
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OPT IN Plan (Adobe PDF format)
If flu reaches your community, you need to be extra vigilant. With visitors coming and going to your facility, the chances of having a flu outbreak increase dramatically. The OPT IN plan described below will help you manage an outbreak. |
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Vaccine Fiction vs. FACT(Adobe PDF format)
There are many misconceptions concerning influenza vaccination, and these are often given as reasons why staff members do not get annual vaccinations. Print this list to share with your staff to help them overcome any objections to an annual vaccination. |
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Signs and Symptoms Card (Adobe PDF format)
When you know that flu is in the community, you want everyone on your staff to be on high alert for its signs and symptoms. This handy card can be given to your nurse assistants to help them know what flu looks like in elderly residents. |
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CDC Health Advisory -Because of the vast extent of the 2007-08 influenza season, the CDC issued a special health advisory on February 29, 2008 recommending the use of antiviral medications for persons at high risk for complications or with severe influenza illness.
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CDC Flu Gallery -The CDC has developed numerous educational materials for healthcare professionals to help them better understand flu and how to manage it. Visit the CDC’s flu gallery to download any flu management tools that may be useful in your facility. Many tools are available in both English and Spanish. |
Flu Outbreak Management Case Studies
Video: Duncan, Oklahoma
Video: Elmira, New York
