Guidelines for preventing respiratory illness in older adults aged 60 years and above living in long-term care: A rapid review of clinical practice guidelines

Patricia Rios; Amruta Radhakrishnan; Sonia M. Thomas; Nazia Darvesh; Sharon E. Straus; Andrea C. Tricco

For suspected or confirmed cases of respiratory illness in residents caused by influenza it is preferable that only staff who have been vaccinated for influenza provide care for these residents. During a confirmed influenza outbreak unvaccinated staff are recommended to attend work only if they are asymptomatic and wear a single use face mask, or are asymptomatic and taking appropriate antiviral prophylaxis. All staff members (vaccinated and unvaccinated) should self-monitor for signs and symptoms of respiratory illness and self-exclude if unwell. Staff with respiratory illnesses should be excluded from work for the period during which they are infectious (generally five days after the onset of the acute illness or until symptoms have ceased). During an outbreak, wherever possible, HCWs should not move between wings or units of the facility to provide care for other residents. This is particularly important if not all wings/units are affected by the outbreak. It is preferable to cohort staff to areas (in isolation or not in isolation) for the duration of the outbreak. Unvaccinated staff who have been working in the outbreak affected area should not be moved as they may be incubating infection. They should be offered immediate influenza vaccination. Please note that vaccination may not prevent illness if already incubating. A protective immune response takes approximately two weeks to develop.