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This bulletin is being sent to local health officers, Tribal health directors, public health nurses, local public health department staff, infection preventionists, NHSN Users, and subscribers to the Assisted Living Forum, and DQA Notifications.
Background
In recent weeks, COVID-19 activity has increased, based on emergency department, laboratory testing, hospitalization, and wastewater data. As respiratory illness activity is expected to increase in the coming months, the Healthcare-Associated Infections (HAI) Prevention Program encourages health care facilities, including skilled nursing and assisted living facilities, to be proactive in planning for and preventing acute respiratory illness (ARI) outbreaks in their facilities.
An ARI outbreak in a health care setting is determined when three or more residents, patients, and/or staff from the same unit experience illness onset within 72 hours of each other and have pneumonia, acute respiratory illness, or laboratory-confirmed viral or bacterial infection (including influenza and COVID-19). For non-long-term care facility health care settings, only healthcare-associated cases should be counted.
Confirmed or suspected outbreaks of ARI must be reported immediately by telephone to the local health officer.
Recommendations
The Department of Health Services (DHS) strongly recommends health care facilities review the DHS Preventing and Controlling Respiratory Illness Outbreaks in Long-Term Care Facilities and Other Health Care Settings webpage for guidance, in addition to the information provided below.
Core infection prevention and control practices
Health care facilities should implement core infection prevention and control practices to help prevent the transmission 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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Follow proper precautions. Health care facilities should use standard and transmission-based precautions when caring for, or in the presence of, a patient or 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) when the cause of the outbreak is unknown. When the cause(s) of an outbreak is determined, precautions taken may be adjusted based on confirmed diagnosis.
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Practice respiratory hygiene. Encourage visitors, patients, residents, and health care personnel to cover coughs and sneezes. Consider posting visual reminders at the entrance of your facility and in strategic places (such as waiting areas, elevators, cafeterias).
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Ensure adequate cleaning and disinfection. Use Environmental Protection Agency (EPA) registered products and follow the manufacturer’s instructions for use, including contact time.
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Take steps to improve air quality and help lower risk of respiratory virus transmission.
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Stay home if you are sick. Review facility employee health policies.
- Stay up to date on all recommended immunizations for respiratory viruses.
Additional resources
DHS resources:
CDC (Centers for Disease Control and Prevention) resources:
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