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. Antiviral chemoprophylaxis is meant for residents who are not exhibiting influenza-like illness but who may be exposed or who may have been exposed to an ill person with influenza, to prevent transmission. It should be noted that some long-term care residents may have difficulty using the inhaler device for zanamivir. Member Research and Reports January 14, 2021 Brown: Adjuvanted Vaccine Cuts Nursing Home Flu Outbreaks by 17 Percent, Researcher Reports Long-term use of oseltamivir for the prophylaxis of influenza in a vaccinated frail older population. Evaluation of the use of oseltamivir prophylaxis in the control of influenza outbreaks in long-term care facilities in Alberta, Canada: a retrospective provincial database analysis. A statement from Boulevard Health Center in Rochester Hills says it … More information about testing is included below. Limit visitation and exclude ill persons from visiting the facility via posted notices. To receive weekly email updates about Seasonal Flu, enter your email address: Co-circulation of Influenza Viruses and SARS-CoV-2, Centers for Disease Control and Prevention. The outbreak at the Hecheltown Road nursing facility is the first so far during the pandemic among the 195 patients, but not for employees. Approximately 20 residents and 20 staff have presented with flu symptoms, manager Robert O'Shea told AAP on Wednesday. Shijubo N, Yamada G, Takahashi M, Tokunoh T, Suzuki T, Abe S. Experience with oseltamivir in the control of nursing home influenza A outbreak. changed the mood': Charlottetown nursing home restricts visits Information about influenza testing is available at: https://www.cdc.gov/flu/professionals/diagnosis/index.htm. You will be subject to the destination website's privacy policy when you follow the link. Infection 2015; 43:73–81. 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. ll 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/ciy866/5251935external icon). Containing influenza outbreaks with antiviral use in long-term care facilities in Taiwan, 2008–2014. The number of flu-related deaths climbed to eight last week, according to the Arkansas Department of Health (ADH). A nursing home in southern New South Wales is in lockdown following a flu outbreak which has left four people dead. For persons aged ≥65 years, any age-appropriate IIV formulation (standard-dose or high-dose, trivalent or quadrivalent, unadjuvanted or adjuvanted) or quadrivalent recombinant influenza vaccine are acceptable options. While the data is still emerging about how these pandemic-related changes to operations are going to impact nursing home residents long term, one study of the COVID-19 outbreak … Neither routine infection control measures nor vaccination prevented illness, complications, or death in a nursing home outbreak of influenza A. Spread of influenza can occur between and among residents, healthcare personnel and visitors. MMWR 2011:60(RR07);1-45, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2020–21 Influenza Seasonpdf icon, 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 Influenzaexternal icon, 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. mirror.co.uk - Care homes have yet again become the epicentre of Covid outbreaks, heartbreaking new data shows. Wearing a gown if soiling of clothes with a resident’s respiratory secretions is anticipated. 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. 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. 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. If resident movement or transport is necessary, have the resident wear a facemask (e.g., surgical or procedure mask), if possible. 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. National Advisory Committee on Immunization (NACI). Isolating and containing people with the flu is a highly effective measure for curbing an outbreak of the flu, but symptoms typically don’t appear for 2-3 days. 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. If influenza molecular assays are not available and antigen detection tests are used such as rapid influenza diagnostic tests (RIDTs) or immunofluorescence assays, false negative results can occur because RIDTs and immunofluorescence assays have lower sensitivity than molecular assays for detection of influenza viruses. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial. It was reported that staff worked on more than one floor in the home. In the majority of seasons, influenza vaccines will become available to long-term care facilities beginning in September, and influenza vaccination should be offered by the end of October. A Guide to the Control of Respiratory Infection Outbreaks in Long Term Care Homes 2004. 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. Saving Lives, Protecting People, Nursing Home COVID-19 Infection Control Assessment and Response (ICAR) Tool, Applying COVID-19 Infection Control Strategies in Nursing Homes, Nursing Home Infection Preventionist Training Course (CDC TRAIN), Use Personal Protective Equipment Correctly for COVID-19, Sparkling Surfaces: Stop COVID-19’s Spread, CMS Emergency Preparedness & Response Operations, Supporting Your Loved One in a Long-Term Care Facility, Applying COVID-19 Infection Prevention and Control Strategies in Nursing Homes (Recorded Webinar), National Center for Immunization and Respiratory Diseases (NCIRD), Duration of Isolation & Precautions for Adults, Nursing Homes & Long-Term Care Facilities, SARS-CoV-2 Antigen Testing in Nursing Homes, Post Vaccine Considerations for Healthcare Personnel, Decontamination & Reuse of N95 Respirators, Purchasing N95 Respirators from Another Country, Powered Air Purifying Respirators (PAPRs), Operational Considerations for Non-US Settings, Responding to SARS-CoV-2 Infections in Acute Care Facilities, U.S. Department of Health & Human Services, Sample Notification Letter to Residents and Families: COVID-19 Transmission Identified​. *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. Integrated care pathway (Checklist) for outbreak management of diarrhoea and vomiting in care homes. CDC’s influenza antiviral medication page for health professionals. Merritt T, Hope K, Butler M, et al. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. A nursing home in southern New South Wales is in lockdown after being struck with the “killer” flu outbreak that’s sweeping the country. October 2004. Influenza-like illness (ILI): managing outbreaks in care homes ... templates have been published for post-exposure prophylaxis and treatment of flu for adult residents and staff of care homes. Effect of antiviral prophylaxis on influenza outbreaks in aged care facilities in three local health districts in New South Wales, Australia, 2014. A nursing home on the NSW South Coast has been placed in lockdown over a flu outbreak. Two die in Qld nursing home flu outbreak By Melissa Maddison Posted 27 Mar March 2013 Wed Wednesday 27 Mar March 2013 at 9:05pm , updated 28 Mar … Examples of standard precautions include: Droplet Precautions are intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions. Western Pac Surveill Response J 2016; 7:14–20. 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. van der Sande MA, Meijer A, Sen-Kerpiclik F, et al. Clin Infect Dis 2004; 39:459–64. According to public health officials, 151 people tested positive during a recent 03 April, 2012. 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. 2019 Aug 5;19(1):210. doi: 10.1186/s12877-019-1236-6. Zapata County Influenza Outbreak •A nursing home, first identified through influenza rapid testing on March 18, 2017, four (4) patients and one (1) staff member (CNA) as positive for Influenza A. Flu and gastro can then spread very quickly to other residents, staff and visitors. Sixth death in flu outbreak nursing home. In the event that a new patient or resident is admitted after the influenza vaccination program has concluded in the facility, the benefits of vaccination should be discussed, educational materials should be provided, and an opportunity for vaccination should be offered to the new resident as soon as possible after admission to the facility. Case-based scenarios are used to discuss how to apply infection prevention and control guidance for nursing homes and other long-term care facilities preparing for and responding to COVID-19. Informed consent is required to implement a standing order for vaccination, but this does not necessarily mean a signed consent must be present. What is an outbreak? "Getting any flu outbreak under control quickly is really important as it quickly spreads into the local community from bad outbreaks in nursing homes and schools," Professor Dwyer said. Four elderly residents have died and a nursing home is in lockdown on the South Coast of New South Wales after an influenza outbreak. Placing ill residents in a private room. 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. Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medications, CDC’s influenza antiviral drugs page for health professionals, CDC’s seasonal influenza vaccination resources for health professionals page, Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2020–21 Influenza Season, Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza, Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2019-2020 Preliminary In-Season Burden Estimate, Who is at High Risk for Flu Complications, 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, 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. 11 October 2018. Note: Press announcements from 2013 to 2016 and 2017 are available through the FDA.gov Archive.Some links in press announcements may no … (For more information see Recommended Dosage and Duration of Treatment or Chemoprophylaxis for Influenza Antiviral Medications and (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935external icon). Notify the health department if a resident develops influenza while on or after receiving antiviral chemoprophylaxis. 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 high risk for complications of influenza. Determining influenza virus type or subtype of influenza A virus can help inform antiviral therapy decisions. 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. Eastside Center for Health and Rehabilitation, which provides both long-term and short-term care, is the latest congregate living setting to face an outbreak. Influenza Other Respir Viruses 2014; 8:74–82. Respiratory illness outbreak at retirement home kills 2 and ... assisted living and skilled nursing ... a year in the winter and flu season. 2018 Sep;46(9):1077-1079. For the latest information on influenza vaccination, see. However, no nursing homes have reported influenza outbreaks this flu … Oseltamivir is the recommended antiviral drug for chemoprophylaxis of influenza in long-term care settings. Flu outbreak kills two at Qld nursing home MORE than a dozen residents at a Queensland nursing home where two people died from the flu have tested positive to Influenza A. AAP March 28, 2013 11:22am Effectiveness of post-exposition prophylaxis with oseltamivir in nursing homes: a randomised controlled trial over four seasons. 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. Even if it’s not influenza season, influenza testing should occur when any resident has signs and symptoms of acute respiratory illness or influenza-like illness. Setting: The Jewish Home and Hospital for Aged, a skilled-care nursing facility. 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. Influenza transmission may have been mediated by staff via either contaminated hands or fomites. For persons aged ≥65 years, any age-appropriate IIV formulation (standard-dose or high-dose, trivalent or quadrivalent, unadjuvanted or adjuvanted) or quadrivalent recombinant influenza vaccine are acceptable options. Childs A, Zullo AR, Joyce NR et al. Healthcare personnel, and visitors who are identified with any illness symptoms should be excluded from the facility until their illness has resolved. Respiratory viral surveillance of healthcare personnel and patients at an adult long-term care facility. Published 23 October 2017 Some patients, such as older adults, children with neuromuscular disorders, and young infants, may have atypical clinical presentations. •The City of Laredo Health Department investigated the initial report via laboratory reports received by fax and Baloxavir is not approved for chemoprophylaxis of influenza and is not recommended for chemoprophylaxis of influenza in long term care facility residents. The burden of respiratory infections among older adults in long-term care: a systematic review. CDC twenty four seven. Figure 2 summarizes staff and resident symptoms.. 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. Please see Antiviral Drugs: Information for Healthcare Professionals  for the current summary of recommendations for clinical practice regarding the use of influenza antiviral medications. Please also refer to the Infectious Diseases Society of America (IDSA) 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenza.external icon. The warning comes after a nursing home at Unanderra, near Wollongong, was placed in lockdown following an outbreak which began on the June long weekend.. CDC: Flu outbreak in two Maine prisons showed need for preparedness An influenza outbreak at a pair of neighboring state prisons in Maine last year sickened 46 inmates and staff members and killed one inmate, pointing up the need to offer flu vaccine to prison populations and take other precautions, according to the US Centers for Disease Prevention and Control (CDC) today. behavior change), and may not have fever (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935external icon). No transmission to these homes was reported. Baloxavir is not recommended for pregnant women, severely immunosuppressed persons, those with severe disease, or hospitalized influenza patients. Am J Infect Control. Perform hand hygiene before and after touching the resident, after touching the resident’s environment, or after touching the resident’s respiratory secretions, whether or not gloves are worn. Specific recommendations are highlighted below. Long-term care facilities may be defined as institutions, such as nursing homes and skilled nursing facilities that provide health care to people (including children) ... which tracks nursing home health parameters. 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. Commun Dis Intell Q Rep 2004; 28:396–400. Oseltamivir is recommended for treatment of influenza in people of all ages. When an influenza outbreak occurs in a nursing home, several measures can be implemented by the treating physician. An outbreak of influenza A occurred in an elderly population in a Maryland nursing home between December 8, 1980 and January 13, 1981 and involved 76 of the 170 residents. If you are visiting a facility during an outbreak, consider taking certain precautions. The journal Clinical Infectious Diseases published a study on January 5, 2021 that focused on influenza outbreaks in nursing homes. 19 ACTION CARD: Respiratory Illness 29 Integrated care pathway (Checklist) for Acute Respiratory Infections in care homes (including flu-like illnesses) 29 Appendix 1: Transmission, incubation and communicability of respiratory pathogens 40 Administer the current season’s influenza vaccine to unvaccinated residents and healthcare personnel as per current vaccination recommendations. Antiviral treatment works best when started within the first 2 days of symptoms. 7, 2020 at 7:49 a.m. | Posted - Mar. O’Neil CA, Kim L, Prill MM et al. CDC twenty four seven. In the setting of an influenza outbreak, empiric antiviral treatment should be given as soon as possible to residents with suspected influenza without waiting for influenza testing results, especially if results will not be available on the day of specimen collection. 2. Post-acute and LTCFs provide rehabilitative, restorative, and/or ongoing skilled nursing care to patients or residents in need of assistance with activities of daily living. Flu outbreaks in several long-term care facilities in Nebraska and Iowa have health care officials on high alert. COVID-19 Ongoing Outbreaks in Congregate Living Settings Report will be updated every Tuesday and Friday by 4 p.m. . Outbreak ID Institution Setting Outbreak Type Causative Agent Date Reported Date Ended ; 2268-2021-31 : Chartwell Royal Marquis Retirement Residence - Facility 590 Grand Marais Rd E Windsor, ON N8X 3H4 : Retirement Home : Respiratory : COVID-19: January 7, 2021 Restrict healthcare personnel movement from areas of the facility having illness to areas not affected by the outbreak. These highly contagious respiratory viruses tend to peak in North America during the winter months, but can circulate from fall to spring. Wearing gloves if hand contact with respiratory secretions or potentially contaminated surfaces is anticipated. Australia is gripped by its worst ever flu season with more than 71,000 people sick and up to 3,000 expected to die, including three nursing home residents who were caught in an outbreak. Changing gloves and gowns after each resident encounter and performing hand hygiene. Information about influenza testing is available at: https://www.cdc.gov/flu/professionals/diagnosis/index.htm, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy866/5251935, influenza diagnostic testing is available online, those who are at high risk for complications of influenza, https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm. There are no data on baloxavir in these populations. Fifteen residents of the Marco Polo Aged Care Services in Unanderra, south … Interim Guidance for Influenza Outbreak Management in Long-term Care Facilities pdf icon[153 KB, 7 pages]. A sixth person has died in an outbreak of a flu virus at a nursing home, NHS Tayside said has said. van der Sande MA, Ruijs WL, Meijer A, Cools HJ, van der Plas SM. When 2 cases of laboratory-confirmed influenza are identified within 72 hours of each other in residents on the same unit, outbreak control measures should be implemented as soon as possible. Monto AS, Rotthoff J, Teich E, et al. Antiviral chemoprophylaxis should also be considered in personnel for whom influenza vaccine is contraindicated. Use of oseltamivir during influenza outbreaks in Ontario nursing homes, 1999–2000. The outbreaks have sickened hundreds of staff members and patients and led to scores of deaths. For some other, rarer diseases, just 1 case can be considered an outbreak. Applying COVID-19 Infection Control Strategies in Nursing Homes Clinical Outreach and Communication Activity (COCA) Webinar, June 16, 2020. Cheng HY, Chen WC, Chou YJ, Huang AS, Huang WT. Emerg Themes Epidemiol 2014; 11:13. Remove the facemask when leaving the resident’s room and dispose of the facemask in a waste container. 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. J Am Geriatr Soc 2001; 49:1025–31. Define the outbreak… Conduct daily active surveillance until at least 1 week after the last laboratory-confirmed influenza case was identified. This information is to be reported as part of the CMS Minimum Data Set, which tracks nursing home health parameters. Visitors entering may be at risk of getting sick or taking the illness home to others. That is supplemented by separate “strike teams” that can bolster infection control if an 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. The following influenza tests are recommended: molecular assays, including rapid molecular assays, other molecular tests, or reverse transcription polymerase chain reaction (RT-PCR). For example, Morens and Rash [] reported an outbreak of influenza A infection in a 37-bed unit of a 5-ward nursing home in Honolulu, Hawaii, that affected 28% of exposed residents, even though 92% of residents had received influenza vaccine prior to the outbreak. Flu Prevention in Nursing Homes Elder care facilities have always worked hard to prevent and control flu outbreaks, and COVID-19 has only heightened their diligence. Infection prevention and-control mea­sures are especially important for patients who are immunocompromised to reduce the risk for transmission of oseltamivir-resistant viruses. Limit the number of large group activities in the facility and consider serving all meals in resident rooms if possible when the outbreak is widespread (involving multiple units of the facility). Chang YM, Li WC, Huang CT, et al. 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. To receive email updates about COVID-19, enter your email address: Nursing Homes and Long-Term Care Facilities, Videos for Training Front Line Long-Term Care Staff, Centers for Disease Control and Prevention. The CDC defines an outbreak as one confirmed case of the flu in a nursing home, along with other cases of acute respiratory illness. Flu Watch Report February 13 to February 19, 2005. Public Health Agency of Canada. Active surveillance for additional cases should be implemented as soon as possible once one case of laboratory-confirmed influenza is identified in a facility. A team from the Public Health Unit at Sydney Local Health District has developed an application to help staff at Influenza Other Respir Viruses 2018; 12:287–92. Ye M, Jacobs A, Khan MN, et al. A single oral dose of baloxavir is equivalent to 5 days of twice daily oral oseltamivir. Dosage adjustment may be required for children and persons with certain underlying conditions. Persons receiving chemoprophylaxis who become sick should be switched to treatment dosing. 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. The recommended dosing and duration of antiviral treatment is twice daily for 5 days for neuraminidase inhibitors (oseltamivir and zanamivir), and one dose for intravenous peramivir. 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. behavior change), and may not have fever. An Oakland County nursing home is barring visitors from entering and residents from leaving because of a flu outbreak. While highly effective, antiviral chemoprophylaxis is not 100% effective in preventing influenza illness. Adjuvanted trivalent vaccine (Fluad) is significantly more protective against nursing home flu outbreaks than standard vaccines, according to a large new study. Immunization of Health-Care Personnel. 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. Health Care Personnel . unavoidable mixing of residents or healthcare personnel from affected units and unaffected units). CCDR 2005;31(ACS-6):1-32. Long-Term Care Facility Toolkit: Preparing for COVID-19 Vaccination at Your Facility, Post Vaccine Considerations for Residents, Mini Webinar training series for front-line staff to help protect residents from COVID-19. Of 2009 Pandemic influenza a viruses oral oseltamivir or inhaled zanamivir for Section 508 (... Facilities in three local health districts in New South Wales public health department should be placed on droplet precautions room... Rotthoff J, McPhie K, Butler M, Jacobs a, Zullo AR, Joyce NR et.... 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