Respiratory Outbreak Guidance

All outbreaks (2 or more cases of a similar illness) must be reported to NKY Health within 24 hours. Please visit our reporting page to learn more.

Facility Wide Recommendations

• Ensure all residents and staff receive the influenza, COVID, and RSV vaccine, unless there is a medical contraindication

• Conduct daily surveillance of staff and residents for signs and symptoms of flu/COVID like* symptoms or any respiratory illness for at least 1 week after onset of illness in either staff or residents. 

• Consider chemoprophylaxis (such as influenza antiviral medications) as recommended if exposed to residents/staff/ family sick with influenza.

• Ensure any isolation rooms are adequately stocked with supplies to avoid staff having to leave rooms while providing care. Prior to visiting a patient's room walk through a checklist of needed supplies and upon leaving make note of any low supplies in the room to ensure rooms are well stocked.

• Ensure sufficient supplies of masks, eye protection, gowns, gloves, hand hygiene products, tissue, and garbage cans that they are readily available throughout the facility. 

• Communicate with all ancillary departments and staff i.e. physical therapy, etc. and educate on influenza/COVID guidelines.

• Monitor environmental services for disinfection activities; consider a schedule of enhanced disinfection in common areas throughout the day in addition to the daily disinfection of resident’s rooms.

• Post visual alerts at entrances and in strategic places encouraging proper respiratory hygiene and cough etiquette. Download free/pictures/posters from the CDC.

• Set up a triage station at the front door to assess and screen any visitors for ILI.

• Consider restricting all visiting, especially children under 18 years of age during an outbreak.

• If ill residents have to travel outside of the facility, notify the destination of current status and have residents wear face masks in transit. 

• Send out notification to families regarding influenza/COVID prevention and control and have it readily available at entrances to families/visitors.

• Ensure front line staff have adequate respiratory hygiene supplies and are educated about influenza/COVID prevention and control (such as administrative assistants that will have close contact with incoming visitors, etc.)

• Stop communal activities for units with sick residents. If the outbreak is not restricted establish a facility-wide stop on communal activities. 

Staff Specific Recommendations:

• Stay home if sick (if staff member becomes ill with flu like * symptoms while at work, put on a mask if unable to leave.)

Follow strict hand hygiene:

• Before and after touching residents, their environment, or any respiratory secretions (suctioning)

• Before and after glove use

• Before and after putting on appropriate PPE

• Use Standard precautions (wearing PPE) if coming into contact with any blood or body fluids, e.g., if residents are sneezing/ coughing wear a gown and eye protection. Gloves are recommended as droplets may be on surfaces but they do not take the place of hand hygiene.

• Put on PPE before entering and take off before exiting a room for residents in droplet precautions including when bringing meals.

• Always cover cough and sneeze, dispose of tissue immediately and perform hand hygiene,every time. Teach residents and visitors to cover their cough/sneezes and to perform hand hygiene.

• Wash work clothes in hot water and dry in a hot dryer. Do not re-wear scrub jackets or lab jackets without laundering daily during outbreaks.

• Ensure EVS staff adheres to recommended contact time of the disinfectant that is being used and that is being used properly. In order to disinfect, surfaces have to be cleaned of debris such as dried food, blood or other substances.

• Conduct a site visit with an environmentalist so an inspection can be done. 

• Establish a schedule for enhanced (more frequent) facility disinfection during outbreaks 

• Disinfect resident rooms daily paying close attention to high touch areas

  • Door knobs, around light switches

  • Any beside ot tray table used for meals

  • Resident restrooms including all handrails, knobs, countertop surfaces

• Disinfect common areas such as hallway railings, community restroom doors/knobs/ railings, recreation rooms, cafeteria, sitting areas, and any ancillary departments that residents may visit.

• Launder resident room curtains as soon as possible when outbreak is controlled.

Medical Providers:

• Use CDC guidelines for testing, prophylaxis, and treatment of residents. Consider chemoprophylaxis as recommended if exposed to residents/staff/family with influenza.

• If working in more than one facility during the same day, consider wearing clean lab coats guarantee no horizontal transmission between facilities.

• When testing residents and staff, consider contacting the Kentucky division of laboratory services (DLS) for subtyping. They may accent 1-2 viral cultures for testing and subtyping. Please contact DLS at 899-REPORT to assess and coordinate testing in the event of an outbreak.

*People  with illness associated with influenza virus infection or COVID often have fever or feverishness with cough, chills, headache, myalgias, sore throat or runny nose. Some people such as elderly, children with neuromuscular disorders and young infants may have atypical clinical presentations.

Click below for a downloadable copy of these guidelines