Influenza, COVID-19, RSV and other viruses can all cause severe outbreaks in aged-residential care facilities due to the age and pre-existing health of the residents, and person-to-person transmission.

Vaccination to prevent outbreaks

Vaccinations against COVID-19 and influenza significantly reduce hospitalisation and severe disease. Influenza vaccination for residents and staff before the start of the season, which is typically May to October, is the best protection against influenza (the flu).

How to recognise an outbreak

It can be difficult to identify an outbreak compared with the usual background rate of coughs and colds.

An outbreak is the occurrence of either:

3 staff or residents unwell with influenza like illness within 48 hours
4 staff or residents unwell with influenza like illness within 7 days in the same wing or area should be treated as an outbreak until proven otherwise.

Outbreaks are notifiable to public health. If you are concerned the outbreak is getting out of control or you have questions and want public health advice, call 04 570 9002 and ask to speak to the on-call Health protection officer.

Aged-residential care facility outbreak notification

Stopping the spread of winter respiratory illness in an aged-residential care facility

Usual infection control policies and procedures will help to control the spread of winter respiratory illnesses in aged-residential care facilities.

Allocate the ill person a single room - if a single room is not available, put them with other people who have a similar illness.
Keep ill residents away from communal areas and have their meals in their room while unwell.
PPE - staff caring for ill residents should wear a face mask if the resident is coughing. Use gloves and an apron if in contact with the resident's body fluids and wash their hands regularly, use an N95 mask when caring for residents with COVID-19 or the flu.
Encourage everyone to cover their mouth and nose with tissues when coughing and sneezing, and put used tissues in a covered bin or a plastic bag. If there are no tissues available, cough or sneeze into your elbow or upper sleeve - not your hands. Remember to wash hands afterwards or use sanitiser.
Encourage frequent hand washing for all staff and residents. Alcohol hand gel can be used to supplement hand washing.
Regularly clean surfaces that are frequently touched. For example, door handles, bench tops and taps.
Reduce staff cross-over between ill and well residents.
Stagger staff breaks to minimise the number of staff who are eating and drinking in the same room - ideally only 1 person should have their mask off at a time.
Alert a hospital or other facilities to which any resident is transferred or referred of flu like illnesses.
Have a plan to defer and manage new admissions while you have an outbreak.

An outbreak is over when there have been no new cases for twice the viruses incubation period - time for virus to spread from person to person. Each virus is different. For example, a flu outbreak is usually over when there have been 6 days with no new cases.

Staff returning to work after flu like illnesses or COVID-19

Staff with flu-like symptoms should not be at work while they are ill. We recommend they stay off work until 24 hours after the major symptoms have resolved.

Follow guidance for health care staff returning to work after a COVID-19 infection.

COVID-19: Return to work guidance for healthcare workers

Testing and treatment

If COVID-19 RAT tests are negative in the context of an outbreak in your facility, discuss testing for respiratory viruses with the medical officer of health, local laboratory or infectious diseases physician.

A throat swab in UTM (universal transport media) can be tested for influenza and other viruses by PCR.
Include other tests considered as appropriate by the person's healthcare provider. For example, sputum, serology.

Discuss treatment with residents GP including treating bacterial infections promptly.

Visitor policy

We encourage facilities to:

restrict visitors who may have flu-like symptoms from visiting
encourage visitors to wear a face mask

You may want to use the door poster at your facility.

Communication

Keep residents and their whānau updated about what is happening and the rationale for the infection control measures.

Encourage whānau and friends to telephone or send messages by email while visiting is restricted.

Keep healthcare providers who provide care for residents and public health informed about the situation.

Advise visitors about the outbreak.

Notify public health of a gastro or respiratory illness outbreak

You should notify public health if there is a suspected gastro or respiratory illness, outbreak in your facility.

Notifiable diseases

Aged-residential care resources

On this page

Templates and guidelines

Illness register

Cleaning advice for staff

Influenza-like illness and RSV guidance

Isolation guidance

Long-term care facility outbreak procedures

RSV door poster

Outbreak management

Topics

Outbreaks of influenza and other winter respiratory viruses