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Bureau of Communicable Diseases Information Update |
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Spread of Multiple Respiratory Viruses in Wisconsin Long-Term Care Facilities
Background
Data from the Wisconsin Department of Health Services (DHS) show respiratory viruses are spreading rapidly in Wisconsin. In recent weeks, the number of new respiratory syncytial virus (RSV), influenza (flu), and COVID-19 cases have all increased. People at the greatest risk of severe disease caused by these viruses include:
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People with weakened immune systems.
This is the first year these three viruses are circulating simultaneously. RSV and influenza activity is uncharacteristically high for this time of year and hospitalizations due to respiratory viruses are increasing in some parts of Wisconsin. Given the current situation, timely testing, reporting, and infection control is crucial in the event an acute respiratory illness (ARI) outbreak is suspected or confirmed, especially in long-term care facilities (LTCF).
Preventing and Controlling ARI Outbreaks in LTCFs
An ARI is an illness characterized by two or more of the following signs and symptoms:
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Runny nose or nasal congestion
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Sore throat
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Cough
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Muscle aches (greater than a resident’s baseline)
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Shortness of breath or difficulty breathing
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Low oxygen saturation in the blood (normal levels are between 95 and 100 percent but may vary for people with certain medical conditions)
An ARI outbreak is determined when three or more residents and/or staff from the same unit experience onset of ARI within 72 hours of each other. Confirmed or suspected outbreaks of ARIs must be reported immediately by telephone to the local health officer.
Testing
When an ARI outbreak is suspected, testing to determine the etiology of the disease is essential to determine the appropriate precautions needed to control the outbreak. Continue to prioritize testing all patients with respiratory illness for COVID-19. Additional testing for other respiratory viruses with a multiplex respiratory virus panel using RT-PCR, is indicated for residents who test negative for COVID-19. Wisconsin LTCFs can contact the Division of Public Health (DPH) for approval to send specimens to the Wisconsin State Laboratory of Hygiene (WSLH) for testing free of charge.
Infection Control
Transmission-based precautions, including contact and/or droplet precautions, are recommended when caring for, or in the presence of, a resident with suspected or confirmed respiratory illness in order to prevent further transmission. Recommended precautions vary depending on the type of suspected or confirmed respiratory virus. However, facilities should use the most protective level of precautions (including gown, gloves, fit-tested N95, and eye protection) until the cause(s) of the outbreak is determined. LTCFs are encouraged to follow guidance from the Centers for Disease Control and Prevention (CDC) for recommendations on precaution types and duration.
Everyday Infection Prevention and Control Practices
Implementing other infection prevention best practices can help prevent the spread of respiratory viruses and other infectious agents:
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Perform hand hygiene. Frequently wash your hands with soap and water or use alcohol-based hand rub.
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Wear necessary PPE. This may include gown, gloves, eye protection, and well-fitting face mask.
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Practice respiratory hygiene. Cover coughs and sneezes.
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Ensure adequate cleaning and disinfection. Use Environmental Protection Agency (EPA) registered products and follow the labeling instructions, including dwell time.
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Stay home if you are ill. Review employee health policies.
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Stay up to date on all recommended vaccines and booster doses. COVID-19 and flu vaccines may be received at the same time.
Resources
Questions?
For questions or assistance on preventing and controlling ARI outbreaks contact your Regional Infection Preventionist.
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