Influenza Precautions and Control Measures

Patient Isolation and Room Placement

Patients with confirmed influenza should be placed in a private room or cohort with other confirmed influenza patients, unless medical contraindications exist, as recommended by the Centers for Disease Control and Prevention (CDC) 1, 2, 3, 4, 5
For suspected influenza cases, patients should be placed in a private room and rapid diagnostic testing should be performed promptly to facilitate appropriate downgrading of precautions, according to the CDC guidelines 1, 2, 3
Patient movement and transport from the room should be limited to essential purposes only, as stated by the CDC 1, 2, 3, 4, 5
When transport is necessary, patients should wear a surgical mask to minimize droplet dispersal, as recommended by the CDC 1, 2, 3, 4, 5

Patients must cover their nose and mouth when coughing or sneezing, preferably using tissues that are immediately disposed of, as advised by the American Academy of Pediatrics 6, 7
Alternatively, patients should cough or sneeze into their elbow rather than their hands, according to the American Academy of Pediatrics 6, 7
If tolerated and feasible, patients should wear a size-appropriate surgical mask to prevent respiratory droplet dispersal, especially in common areas, as recommended by the American Academy of Pediatrics 6, 7
Patients should maintain at least 3 feet of separation from others when in common waiting areas, as advised by the American Academy of Pediatrics 6, 7

Patients must perform hand hygiene after having contact with respiratory secretions and contaminated objects or materials, as recommended by the American Academy of Pediatrics 6, 7
Hand hygiene options include alcohol-based hand rub, handwashing with soap and water, or use of antiseptic handwash, according to the American Academy of Pediatrics 6, 7

Healthcare personnel must wear a surgical mask upon entering the patient's room or when working within 3 feet of the patient, as recommended by the CDC 1, 2, 3, 4, 5
Healthcare personnel should decontaminate hands before and after giving care to or touching a patient, or after touching respiratory secretions, whether or not gloves are worn, according to the CDC guidelines 1, 2, 3, 4, 5
If hands are visibly soiled with blood, body fluids, or proteinaceous material, healthcare personnel should wash with soap and water; otherwise, alcohol-based hand rub is acceptable, as stated by the CDC 1, 2, 3, 4, 5
Healthcare personnel should wear gloves if hand contact with the patient's respiratory secretions is expected, as recommended by the CDC 1, 2, 3, 4, 5
Healthcare personnel should wear a gown if soiling of clothes with the patient's respiratory secretions is expected, according to the CDC guidelines 1, 2, 3, 4, 5

Healthcare personnel with influenza-like illness must be evaluated by employee health services and removed from direct patient contact duties, as recommended by the CDC 1, 2, 3, 4, 5
More stringent criteria should be applied for personnel working in high-risk areas, including intensive care units, nurseries, and organ transplant units, according to the CDC guidelines 1, 2, 3, 4, 5

Patients should stay home and avoid contact with others, especially high-risk individuals, until fever-free for 24 hours without antipyretics, as advised by the American Academy of Pediatrics 6, 7
Patients should remain off work while symptomatic to prevent transmission to colleagues, according to the American Academy of Pediatrics 6, 7
Visual alerts and educational materials should be provided at facility entrances instructing patients to inform staff of respiratory symptoms when registering for care, as recommended by the American Academy of Pediatrics 6, 7
Tissues and no-touch receptacles for disposal should be readily available in reception areas, according to the American Academy of Pediatrics 6, 7

Rapid influenza virus testing should be performed on nasopharyngeal swab or nasal-wash specimens from patients with recent symptom onset, as recommended by the CDC 1, 2, 3, 4, 5
Viral cultures should be obtained from a subset of patients to determine the infecting virus type and subtype, according to the CDC guidelines 1, 2, 3, 4, 5
Current inactivated influenza vaccine should be administered to unvaccinated patients and healthcare personnel, as recommended by the CDC 1, 2, 3, 4, 5
Antiviral prophylaxis should be considered for all patients without influenza illness in the involved unit for a minimum of 2 weeks or until approximately 1 week after outbreak end, according to the CDC guidelines 1, 2, 3

Droplet precautions should not be delayed while awaiting laboratory confirmation - initiate precautions based on clinical suspicion and downgrade once testing is complete, as recommended by the CDC 1, 2, 3
Alcohol-based hand sanitizers should not be relied upon solely - handwashing with soap and water is superior when hands are visibly soiled, according to the CDC guidelines 1, 2, 3