Abkhazia Institute for Social and Economic Research

Infection Control: Influenza viruses are spread from person-to-person, primarily through inhalation of small particle aerosols and large droplet infection. Influenza can be highly contagious, particularly among persons without pre-existing antibodies against influenza, such as young children during normal influenza seasons and anyone during a pandemic. The typical incubation period of influenza is two days (range one to four days). Viral shedding, and the period during which a person may be infectious to others, generally peaks on the second day of symptoms, but may begin the day before symptoms start, and typically lasts five to seven days in adults. Young children and immunocompromised persons may shed virus and be infectious for three weeks or longer. The amount of virus shed and the length of time of viral shedding may be prolonged during initial infection with a new influenza subtype.

Infection control practices for pandemic influenza are the same as for other human influenza viruses and primarily involve the application of standard and droplet precautions.

Special guidelines for infection control may need to be in place during pandemic influenza, taking into account the likelihood that a high proportion of the population will be affected and that secondary infections are a major source of morbidity and mortality. Healthcare facilities, in addition to standard, droplet, and contact precautions, should consider the following:

1. Conduct annual staff education about the prevention and control of influenza.
2. Strongly encourage annual vaccination of staff.
3. Healthcare workers and visitors should wear a surgical mask when they are within three feet of the patient.
4. Consider separate waiting rooms for patients potentially infected with influenza
5. Patients should be educated about what they can do to decrease transmission of influenza to other patients, health care workers, and visitors. Information on Respiratory Hygiene/Cough Etiquette should be posted and communicated individually to patients hospitalized with respiratory disease.
6. Visitors should be limited as much as possible to reduce the likelihood of transmission of influenza among visitors, patients, and health care workers. The use of family members and volunteers to assist in patient care may be considered with documented policies and education in place.
7. Ideally, patients with suspected or diagnosed influenza should be in a private room. During a pandemic, private rooms are unlikely to be available and containment of infection is likely to be difficult. Consideration should be given to cohorting patients with active confirmed or suspected influenza infection. If for some reason cohorting is not achievable, at least 3 feet spatial separation should be maintained between the infected patient and other patients and visitors. Special air handling and ventilation are generally not necessary. It is recommended that all influenza specific bed management measures should be maintained for at least 7 days after onset of illness or longer if symptoms persist.
8. Limit the movement of patients with suspected or diagnosed influenza to essential purposes only. If a patient must be transported, the patient should wear a surgical mask to decrease the risk of virus transmission to other patients and health care workers.