5-point plan for managing influenza in long-term care - Primary Health

5-point plan for managing influenza in long-term care

  • November 8, 2023

  • Adi Chandrasekhar, MD, MPH, FACP

  • 3 minutes

influenza and long-term care

Influenza can spread quickly in LTC facilities. Some foresight and planning will help keep your vulnerable population and staff safe and healthy.

November marks National Long-Term Care (LTC) Awareness Month, an optimal time to explore the management of influenza in LTC settings. The Centers for Disease Control and Prevention (CDC) has issued interim guidance on how to manage influenza outbreak in LTC facilities. Its multi-pronged approach encompasses five key recommendations. 

1. Vaccinations

The first focuses on improving rates of Influenza vaccination for LTC residents and staff. Ideally, both groups should be vaccinated before flu season kicks in by November. Individuals over the age of 65 should get a high dose vaccine if one is available. Staff vaccination helps to both reduce transmission risk for residents and also to maintain adequate staffing throughout the season. 

2. Testing

The CDC recommends LTC facilities test for influenza whenever it is suspected. Rapid testing is widely used in clinical settings with results available in minutes. Any time a case of influenza is confirmed by testing, the LTC should introduce measures to test other potential cases in the LTC facility. If more than two cases are confirmed in under 72 hours, the facility must implement outbreak measures. As a reminder, influenza can present outside of the traditional flu season, too. Consequently, testing for it is particularly important in LTC settings.

3. Preventive Measures

The third recommendation is instituting preventive measures during an outbreak. These include actions that likely sound familiar to many in the wake of the COVID-19 pandemic. Measures like good hand hygiene, masking, droplet precautions, and gowns can all help avoid further spread of infection. An outbreak is also a good time to reassess vaccination levels. 

4. Prompt Treatment

Prevention also ties in well with the fourth recommendation of prompt treatment. Influenza is usually treated with an oral medication called Oseltamivir for most patients. During an outbreak, treatment can be started even if lab results are not immediately available. There are other medications like Zanamivir, Baloxavir, and Peramivir but they are all used with much lower frequency than the widely prescribed Oseltamivir. 

5. Preventive Medications

The final recommendation concerns chemoprophylaxis. This refers to the use of medications to prevent influenza in someone who is not currently displaying any signs of being sick with influenza. This is important in LTC settings where influenza can spread quickly to other vulnerable populations. If there are two or more confirmed cases in a unit, then every resident of that unit should be offered Oseltamivir as a preventative measure if feasible. This has to continue for a minimum of two weeks or seven days after the last lab-confirmed case of influenza in the unit, whichever comes later.

Chemoprophylaxis is not uniformly effective and is recommended even if someone is vaccinated.


As demonstrated, these measures need active planning and integration of testing and medication dispensation to keep influenza under control in LTC facilities. With proper planning, your LTC can greatly reduce the impact of influenza on the highly vulnerable populations in your care.

Make Primary.Health your partner in preventing the spread of influenza with easy, affordable testing and vaccinations, supported by a robust software platform that streamlines program administration.

Disclaimer: This blog content and linked materials are not intended as individual medical advice, diagnosis or treatment, and should not be considered as such. Any readers with medical concerns should contact a licensed healthcare provider. This blog is provided for informational purposes only.

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