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Influ-Info - Influenza Kit for Community Aged Care

Early control measures are critical in minimising the impact and spread of Influenza. The Influ- Info Kit is a set of resources developed to assist community care providers to recognise a possible outbreak of Influenza and to respond rapidly and appropriately when an outbreak occurs.

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Influ-Info - Influenza Kit for Community Aged Care

Disclaimer

This publication and all its component parts are provided to assist community aged care services and carers in making decisions about the prevention and control of influenza. Any policies and practices dealing with the prevention and control of influenza in a community aged care service should be developed in the context of relevant legislation, codes of practice and other professional standards, policies and guidelines relevant to the practice setting, together with appropriate advice on legal care issues.

The Australian Government and the authors expressly disclaim all and any liability to any person, whether a purchaser of this publication or not, in respect of anything and of the consequences of anything done or omitted to be done by any person in reliance, whether in whole or in part, upon the whole or any part of the contents of this publication.

What is Influenza?

Influenza, or ‘the flu’, is caused by infection with influenza viruses A, B and rarely C. It mainly affects the throat and lungs, but can also cause problems with the heart and rest of the body, especially in people with other health problems.

What are the symptoms?

The initial symptoms of influenza may be similar to those of other respiratory infections. Symptoms usually develop rapidly, 1-3 days after infection, and may include sudden onset of fever, headache, sore throat, cough, muscle and joint pain, runny or stuffy nose and severe tiredness.

How is it spread?

• Influenza is mainly spread from person to person through droplets after an infected person coughs or sneezes, or through touching.
• Most people are usually infectious for 3-4 days after infection and may be infectious 1-2 days before symptoms appear.

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Who is at risk?

Anyone can get influenza. People who are at higher risk include:

• those aged 65 years of age and over
• those with chronic debilitating disease/s
• Aboriginal and Torres Strait Islander people 50 years of age and over, and
• residents of long-term care establishments e.g. residential aged care homes.

How is it prevented?

Vaccination against influenza viruses A and B are available annually (mid-February). Unless medical or conscientious exemption is provided, influenza vaccination is especially recommended for people who are at higher risk.

As care staff in the community, it is recommended you see your doctor and have an influenza vaccination annually.

You may also wish to suggest to your clients that they see their doctor and discuss the influenza and pneumococcus vaccination.

NB: The vaccine takes approximately two weeks after vaccination to become effective and usually protects recipients against the annually specified types of influenza.

Recognising and managing influenza in community clients

Activity	What to do
Influenza suspected	Signs & Symptoms: Fever/chills, cough, muscle & joint pain, runny nose, tiredness/exhaustion, headache, sore throat, loss of appetite, onset or increase of confusion, shortness of breath, increasing COAD symptoms
Implement infection control practice	Increase hygiene measures Use Personal Protective Equipment (ie. mask & gloves) Notify your employer of any clients with influenza-like symptoms
Protection of care workers’ health	Personal hygiene – wear gloves, mask, ensure good hand washing Care workers are advised to seek medical advice regarding immunisation if not vaccinated, and the use of anti-viral medication
Notify	Notify your employer of clients with influenza With client’s permission, notify their relatives or representatives of their condition if they haven’t. Suggest they inform other community visitors Encourage client to notify their GP, or, notify their GP at your client’s request
Environment	Enhance cleaning measures, especially of frequently touched surfaces, with a neutral detergent such as dishwashing detergent Regularly clean your work case or bag and other items carried in it Correctly dispose of all tissues, clinical waste, and sharps
Document	Details of each of your clients exhibiting influenza symptoms Onset date of influenza-like illness Symptoms – any three of: fever, cough, muscle and joint pain, tiredness/exhaustion Contacts – identify possible ‘at risk’ groups (eg. other community helpers, visitors)
Manage clients who are ill	Encourage your client to rest and adhere to treatment Recommend client limits their group activities and stay at home until they are better Encourage client to seek medical advice if they continue to be unwell
Restrict contact	If a care worker exhibits symptoms they should be encouraged to stay away from work and not to return until free from symptoms or advised by a doctor If a care worker has recently been exposed to a client with influenza, their employer may limit their contact with other clients

Wash and Dry Hands Before & After Contact With Affected Clients
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Identification of potential episode

1. Signs and Symptoms of influenza

Rapid onset of:

• Fever/chills
• Tiredness or exhaustion
• Cough
• Headache
• Muscle and joint pain
• Sore throat
• Stuffy or runny nose

Symptoms in the elderly may also include:

• Loss of appetite
• Onset or increase of confusion
• Shortness of breath
• Increasing Chronic Obstructive Airways Disease symptoms

2. Precautions should commence as soon as the first client shows influenza-like symptoms

If your client shows influenza-like symptoms, recommend that they seek medical advice as soon as possible. Other precautions you can take include:
• Notifying your employer of any clients with influenza-like symptoms in the community.
• Increase hygiene measures.
• Increase use of Personal Protective Equipment.
• Recommend clients inform their visitors of their condition.
• Recommend clients limit their group activities and stay at home until they are better.

3. Manage clients who are ill

• Encourage your client to notify their general practitioner or notify the doctor at your client’s request. Based on symptoms and examination, a doctor can diagnose an influenza-like illness and if necessary, take a sample of your client’s fluids or blood to be tested.
• Use dedicated staffing and equipment where possible/practicable.
• Recommend clients inform their visitors of their condition.
• Recommend clients limit their group activities and stay at home until they are better.
• Discuss with your client alternative forms of care, such as a hospital if the condition warrants.

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4. Document

• Details of your clients exhibiting symptoms in the community.
• Onset date of influenza-like illness for each client.
• Symptoms — any three of: fever, cough, muscle and joint pain, tiredness/exhaustion.
• Contacts — identify where possible, (e.g. other community helpers, visitors) to identify ‘at risk’ groups.

5. Confirmed influenza

• Notify your employer of your clients with influenza in the community.
• With the permission of your client, notify their relatives or representatives of their condition if they haven’t. Suggest they inform other community visitors and limit their contact with the client where possible.
• Encourage your client to rest and adhere to treatment as recommended by their doctor.
• Discuss with your client and/or their relatives/representatives alternative forms of care, such as a hospital if the condition warrants.

Wash and Dry Hands Before And After Contact With Affected Clients

Prevent Spread

1. Continue hand washing

• Handwashing is the most important hygiene measure in preventing the spread of influenza.
• Gloves are not a substitute for handwashing.
• Wash your hands with soap and water before and after contact with each client. If hand washing facilities are not readily available use an alcohol-based hand wash according to the instructions.
• Care must be taken to wash your hands before removing items from or returning clean items to your work case or bag.

2. Increase Personal Protective Equipment

Your employer has a responsibility to provide you with personal protective clothing and equipment required to protect you from hazards that you may encounter.

Gloves

• Wear gloves if contact with respiratory secretions or potentially contaminated surfaces is likely. Change gloves and wash hands after contact with each client. Dispose of gloves correctly.

Masks

• Wear masks appropriate for respiratory infection on entering your client’s home or when working within one metre of the client. Remove the mask when leaving your client’s home and dispose of it correctly. Do not reuse the mask between your clients. Wash your hands after you have removed the mask.

Gowns

• Wear gowns if soiling of clothes with respiratory secretions is likely. Remove the gown and dispose of it correctly. Do not reuse the gown between your clients. Wash your hands after you have removed the gown.

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3. Restrict contact

• If you have any symptoms of influenza inform your employer and do not return to work until you are free from symptoms or as determined by your doctor.
• If you are currently working with a client with influenza your employer may wish you limit your contact with other clients in the community.
• Recommend clients inform their visitors of their condition.
• Recommend clients limit their group activities and stay at home until they are better.

4. Environment

• Enhance cleaning measures, especially of frequently touched surfaces, with neutral detergent.
• Regularly clean your work case or bag and other items carried in it (e.g. stethoscopes), especially if they become soiled.
• Correctly dispose of all sharps and other clinical wastes.
• You may wish to suggest to your clients that they:
  • Sleep in a separate room where applicable
  • Stay in certain areas of their home if it is a shared house
  • Dispose of generated waste correctly, e.g. tissue papers
  • Use an independent air conditioner/filter system where applicable

5. Medical Management

• Encourage your client to rest and adhere to treatment (antiviral medication) as prescribed by their doctor.
• Recommend clients’ family, representatives and visitors who are in regular contact immunise against influenza if they haven’t.
• Use dedicated staffing and equipment where possible/practicable.
• Discuss with your client alternative forms of care, such as a hospital, if the condition warrants.

Wash and Dry Hands Before And After Contact With Affected Clients
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5. Contacts

Who to contact for assistance with and notification of a suspected outbreak of influenza

Disclaimer: Updated contact details supersedes contact details contained within both the downloadable and the hard copy kit.

Queensland

Southern Population Health Unit Network

Contact	Phone	Fax.
Brisbane Southside	Ph: 07 3000 9148	Fax: 07 3000 9121
Gold Coast	Ph: 07 5668 3700	Fax: 07 5562 1649
Darling Downs	Ph: 07 4631 9888	Fax: 07 4639 4722
South West	Ph: 07 4656 8100	Fax: 07 4654 2615
West Moreton	Ph: 07 3413 1200	Fax: 07 3413 1201

Central Population Health Unit Network

Contact	Phone	Fax.
Brisbane Northside	Ph: 07 3 624 1111	Fax: 07 3624 1159
Moreton Bay	Ph: 07 3142 1800	Fax: 07 3142 1824
Sunshine Coast	Ph: 07 5409 6600	Fax: 07 5443 5488
Wide Bay	Ph: 07 4184 1800	Fax: 07 4120 6009
Rockhampton	Ph: 07 4920 6989	Fax: 07 4920 6865
Bundaberg	Ph: 07 4150 2780	Fax: 07 4150 2729
Longreach	Ph: 07 4652 6000	Fax: 07 4652 6099

Tropical Population Health Unit Network

Contact	Phone	Fax.
Mackay	Ph: 07 4911 0400	Fax: 07 4885 6610
Townsville	Ph: 07 4753 9000	Fax: 07 4753 9001
Mt Isa and Gulf	Ph: 07 4744 9100	Fax: 07 4745 4573
Cairns	Ph: 07 4226 5555	Fax: 07 4031 1440

New South Wales

Greater Southern AHS Centre for Population Health

Contact	Phone	Fax.
Goulburn Office	Ph: 02 4824 1840 Fax: 02 4824 1831/4822 5038	A/Hrs: 02 6080 8900 (diverts to Albury Base Hospital) - Ask for Public Health Officer on call)
Albury Office	Ph: 02 6080 8900 Fax: 02 6080 8999	A/Hrs: 02 6080 8900 (diverts to Albury Base Hospital) - Ask for Public Health Officer on call

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Greater Western AHS Centre for Population Health

Contact	Phone	Fax.
Broken Hill Office	Ph: 08 8080 1499 Fax: 08 8080 1683 / 1196	A/Hrs: 08 8080 1333 (Broken Hill Base Hospital) - Ask for Public Health Officer on call.
Dubbo Office	Ph: 02 6841 5569 Fax: 02 6841 5571	A/Hrs: 02 6885 8666 (Dubbo Base Hospital) - Ask for Public Health Officer on call.
Bathurst Office	Ph: 02 6339 5601 Fax: 02 6339 5173	A/Hrs: mob. 0428 400 526 - Ask for Public Health Officer on call

Hunter / New England AHS, Hunter Population Health

Contact	Phone	Fax.
Newcastle Office	Ph: 02 4924 6477 Fax: 02 4924 6490/4922 3164	A/Hrs: 02 4924 6477 (diverts to John Hunter Hospital) - Ask for Public Health Officer on call
Tamworth Office	Ph: 02 6764 8000 Fax: 02 6766 3890	A/Hrs: 02 6764 8000 (diverts to Tamworth Base Hospital) – Ask for Public Health Officer on call

North Coast AHS Public Health Unit

Contact	Phone	Fax.
Port Macquarie Office	Ph: 02 6588 2750 Fax: 02 6588 2837	A/Hrs: mob. 04017 244 966 or 0407 904 208 - Ask for Public Health Officer on call.
Lismore office	Ph: 02 6620 7585 Fax: 02 6622 2151 or 02 6620 2252	A/Hrs: 132222 Pager no: 397635. If no answer :- Mobile: 0417 244 966 or 0407 904 208

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Northern Sydney / Central Coast AHS Public Health Unit

Contact	Phone	Fax.
Hornsby Office	Ph: 02 9477 9400 Fax: 02 9482 1650 / 1358	A/Hrs: 02 9477 9123 (Hornsby Hospital) – Ask for Public Health Officer on call
Gosford Office	Ph: 02 4349 4845 Fax: 02 4349 4850	A/Hrs: 02 4320 2111 (Gosford Hospital) – ask for Public Health Officer on call

South Eastern Sydney / Illawarra AHS Public Health Unit

Contact	Phone	Fax.
Randwick Office	Ph: 02 9382 8333 Fax: 02 9382 8334 / 8314	A/Hrs: 02 9382 2222 (Prince of Wales Hospital) – Ask for Public Health Nurse on call
Matraville Office	Ph: 02 9311 2707 Fax: 02 9700 3747 (s)	Ph: 02 9311 2707
Wollongong Office	Ph: 02 4221 6700 Fax: 02 4221 6722 / 6759	A/Hrs: 02 4222 5000 (Wollongong Hospital) – Ask for Public Health Officer on call

Sydney South West AHS Public Health Unit

Contact	Phone	Fax.
Eastern Zone (Camperdown Office) For Liverpool Area, call the Camperdown Office	Ph: 02 9515 9420 Fax: 02 9515 9440 / 9467	A/Hrs: 02 9515 6111 (Royal Prince Alfred Hospital) - Ask for Public Health Officer on call

Sydney West AHS Centre for Population Health

Contact	Phone	Fax.
Penrith Office	Ph: 02 4734 2022 Fax: 02 4734 3300 / 3444	A/Hrs: 02 9845 5555 (Westmead Hospital) – Ask for Public Health Officer on call
Parramatta Office	Ph: 02 9840 3603 Fax: 02 9840 3608 / 3591	A/Hrs: 02 9845 5555 (Westmead Hospital) – Ask for Public Health Officer on call

Victoria

Contact	Phone	Fax.
Communicable Disease Prevention and Control Unit	Ph: 1300 651 160	-

Tasmania

Contact	Phone	Fax.
Public and Environmental Health Service	Ph: 1800 671 738 – Free call	-

South Australia

Contact	Phone	Fax.
Communicable Diseases Control Branch	Ph: 1300 232 272	Fax: 08 8226 7187

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For more information

For more information, refer to the Infection Control Guidelines for the prevention of transmission of infection diseases in the health care setting. The Infection Control Guidelines can be accessed on the Department of Health and Ageing website www.health.gov.au.

• Infection Control in home and community health care settings - 37-1
• Responsibilities of health care workers - 5-3
• Overview of influenza - 28-17
  • Symptoms of influenza - 28-18
  • Transmission - 28-18
  • High risk groups - 28-18
  • Management – Patients and health care workers Immunisation/vaccination - 28-18, 2-5
• Basic infection control measures - 2-3
  • Handwashing and personal hygiene - 12-1 – 12-3
  • Personal protective equipment - 13-1 – 13.6
• Managing the environment - 18-1
• Collection and disposal of clinical wastes - 15-3
• Ethical and legal issues - 10-1
  • Patient decision making and consent - 10-4
• National Notifiable Diseases Surveillance System - A2-2

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Attention All Staff

There are currently a number of cases of respiratory illness including influenza in the community. We are trying to prevent influenza from spreading.

If you have symptoms of any respiratory illness now (fever, sore throat, cough, muscle and joint pain, tiredness/exhaustion) you should see your doctor immediately and not return to work until you are free of symptoms or until your doctor advises that you are fit to return to work.

There is a risk that you will acquire influenza. To minimise the risk you should:

• Arrange for an influenza vaccination if you have not already had one this year.
• Wash your hands with soap and water before and after contact with each client.
• If you are working with those clients who have influenza, avoid contact with other clients and staff.
• Wear gloves if contact with respiratory secretions or potentially contaminated surfaces is likely.
• Wear masks appropriate for respiratory infection on entering the client’s home or working within one metre of the client.
• Wear gowns if soiling of clothes with respiratory secretions is likely.
• Do not reuse any gloves, masks or gowns.
• Do remove and dispose of them correctly after each client. Wash your hands after removal.

Thank you for your co-operation.

Sincerely

Manager/DoN

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Attention All Visitors

There have been a number of cases of influenza recently. We are trying to prevent this illness from spreading.

Visitors are advised that there is a risk of acquiring this influenza by visiting this house at this time.

If you have recently been ill, have symptoms of any respiratory illness now (fever, sore throat, cough, muscle and joint pain, tiredness/exhaustion) or have been in contact with someone who is ill we strongly advise you not to enter this house.

If you choose to visit at this time, please wash your hands with soap and water before and after the visit and then leave as soon as possible.

Thank you for your co-operation.

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Influenza Information for family and visitors

Influenza, or ‘the flu’, is a highly infectious virus. It spreads through droplets caused by sneezing or coughing. Symptoms develop rapidly one to three days after contact with an infectious person. Individuals are infectious for three to four days after infection and may transmit the virus one to two days before the onset of symptoms.

Influenza is a particular risk of serious illness and death to:

• people 65 years of age and over;
• Aborigines and Torres Strait Islander people 50 years of age and over; and
• residents in long term health care facilities such as residential aged care homes.

Influenza can be prevented, or the severity of the illness reduced, by immunisation with the current vaccine each year. Vaccine is available free of charge to those 65 years of age or over, Aboriginal and Torres Strait Islander people 50 years of age or over, and 15–50-year-olds considered to be at high risk of complications and death, because they have heart disease, lung disease, kidney disease, severe asthma or diabetes, have an immune compromising condition or are heavy drinkers.

It is recommended that all older clients, household members of older people, and health care staff receive the annual influenza vaccination to minimise the risk of infection to themselves and others.

It is strongly recommended that you see your doctor immediately AND do not visit your family member or friend, if you have been in contact with people with influenza-like symptoms or if you have three or more of the following symptoms:

Rapid onset of:

• Fever/chills
• Cough
• Muscle and joint pain
• Stuffy/runny nose
• Tiredness/exhaustion
• Headache
• Sore throat

Symptoms in the elderly may also include:

• Loss of appetite
• Onset or increase of confusion
• Shortness of breath
• Increasing Chronic Obstructive Airways Disease symptoms

If there are suspected cases of influenza in a family member or friend that you visit, you can reduce the risk of infection to yourself and others by:

• Washing your hands thoroughly with soap and water before you enter the person’s room/home;
• Minimising physical contact with the person;
• Covering your mouth if you cough or sneeze;
• Keeping your visit short; and
• Washing your hands thoroughly with soap and water as soon as you leave the person’s room.

If the person you are visiting has influenza-like symptoms, you should wear a face mask appropriate for respiratory protection during your visit. Not all masks are suitable for this purpose. You should discuss this with a pharmacist if you are purchasing these. You should also check with staff that the person’s doctor has been notified.
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