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Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities for Public Health Units in Australia

4.1 Assess the Suspected Outbreak

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PHUs may receive notifications of suspected respiratory disease outbreaks from medical practitioners, hospitals, RCFs or others. As influenza-specific control measures such as vaccination and antiviral treatment are more effective if instituted early, it is important to establish early if the reported outbreak is due to influenza virus. The PHU should contact the facility concerned to gather further information. The initial assessment may be done by communicable disease control officers, depending on resources available.

Initial information gathered should include onset date of first case, total number of cases to date (staff and residents), spectrum of symptoms, and results of any pathology tests that may have been done.

The following steps can be used as a guide to assess whether the outbreak is due to influenza.

  • Follow up and review any available pathology testing that may have been done.
  • If the symptoms are not consistent with influenza but are more like the common cold (i.e. sore throat, runny nose) consider whether specimens need to be taken.
  • If symptoms are consistent with influenza and appropriate pathology tests have not already been ordered, this should be done as soon as possible (see section 4.4).
  • Develop a working case definition for the cases in the outbreak. Check against outbreak definitions (refer to chapter 3).
  • Review information available. Request a line listing of cases.

    If initial information and laboratory testing does not show influenza to be the cause of the outbreak the PHU may choose to:

  • Discuss whether the facility can handle the management of the outbreak independently or requires support from the PHU.
  • Recommend general respiratory infection control measures and leave further management to the RCF.

    If the outbreak is proven to be due to influenza, an Outbreak Investigation and Management team (OIMT) can be established.

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    • Table of Contents
    Guidelines for the Prevention and Control of Influenza Outbreaks in Residential Care Facilities for Public Health Units in Australia
      Disclaimer
      Acknowledgements
      Preface
      How to use this document
      Summary Flow Chart
      Chapter 1: Introduction
       1.1 Influenza
       1.2 Linkages with other documents and the internet
      Chapter 2: Preventing Outbreaks
       2.1 Vaccination
       2.2 Infection Control Precautions
      Chapter 3: Outbreak and Case Definitions
       3.1 Introduction
       3.2 Respiratory Disease Outbreak Definition
       3.3 Case definition
       3.4 Outcome definitions
      Chapter 4: Investigation and Management of Outbreaks
       4.1 Assess the Suspected Outbreak
       4.2 Outbreak Investigation and Management Team
       4.3 The Investigation
       4.4 Diagnostic tests
       4.5 Documents for communication with the facility
       4.6 Outbreak control measures
       4.7 Monitoring the outbreak
       4.8 Declare that the outbreak is over
       4.9 Debriefing
      Chapter 5: References
      Appendices
       Appendix 1: Environmental Cleaning
       Appendix 2: Respiratory Outbreak Control Measures
       Appendix 3: Checklist for Public Health Unit for Investigation and Management of Outbreaks
       Appendix 4: Respiratory Outbreak Line Listing - Residents ONLY
       Appendix 5: Part A Respiratory Outbreak Line Listing Form - Staff ONLY
       Appendix 6: Influenza & Pneumococcal Immunisation Survey
       Appendix 7: Sample Collection Guide*
       Appendix 8: Guidelines for Taking Nasal and Throat Swabs
       Appendix 9: Respiratory outbreak transfer notification
       Appendix 10: Visitor Restriction Sign - Facility
       Appendix 11: Visitor Restriction Sign - Room
       Appendix 12: Antiviral medications for treatment and prophylaxis of influenza
       Appendix 13: Respiratory illness/Influenza outbreak alert letter to RCF Manager
       Appendix 14: Respiratory illness/Influenza outbreak alert letter to medical practitioner
       Appendix 15: Glossary and List of Abbreviations