Pandemic influenza: Tasmania's response

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Information for Residential Group Homes

There is no evidence to suggest people with disabilities are at increased risk of catching influenza or having a severe illness from influenza, unless they have other risk factors (see below).

However, Residential Group Homes are considered a “high-risk setting” for pandemic influenza.

This is because:

there may be a higher proportion of people in Group Homes who are at high risk of severe illness from pandemic influenza
residents in Group Homes may spend extended time together, in relatively close proximity
some people living in Group Homes may find it harder to comply with infection control
strategies including covering coughs and sneezes, frequent and effective handwashing, and keeping a distance from others.

How do I know if my client has influenza?

Key signs of pandemic H1N1/09 influenza are FEVER (temperature greater than 38°C) with a COUGH and/or SORE THROAT.

Other common signs are fatigue, body aches, headache, runny nose, diarrhoea and vomiting.

Special precautions

Because Residential Group Homes are considered high risk settings, special precautions are being taken during the Protect phase of pandemic influenza.

1. Laboratory testing of residents in Group Homes.

While testing of people with influenza-like illness in the general community is no longer being routinely done, testing continues for residents of Group Homes. This means if you have a resident with an influenza-like illness, it is important to seek medical advice early and to make sure the assessing doctor knows the client is a resident of a Group Home and that laboratory testing is indicated according to national protocols.

2. Notification to Public Health

So that appropriate action can be taken, please notify Public Health promptly of any confirmed case of pandemic H1N1/09 infection in your Group Home. Phone 1800 671 738.

3. Infection control

Restrict visitors to residents with pandemic H1N1/09 influenza to those who are necessary for the patient’s emotional well-being and care.
Use standard infection control droplet precautions for any resident with a flu-like illness. This includes frequent hand hygiene (with soap and/or alcohol-based hand rub) and good cough/sneeze etiquette for all ill residents and staff providing care.
Isolate residents who are ill with flu-like illness for seven days after the onset of their symptoms and until their fever has settled OR if the resident is treated with antiviral medications, isolate them for 72 hours after the start of antiviral treatment and until their fever has settled.

Isolation means:

using single rooms for ill residents or accommodating ill people together in multibed rooms, units or wings where multiple residents are infected
having dedicated staff and dedicated equipment to care for ill residents if possible
visitors maintaining a distance of at least 1 metre (a very large step) from ill people, keeping the duration of visits to a minimum (never greater than 4 hours) and wearing a surgical mask while visiting the infected resident.

4. Identification and management of contacts

Public Health will work with facility managers to identify those who spent significant time with the ill resident while they were infectious (from 1 day before the start of illness until 7 days after symptom onset – or 72 hours after onset if antivirals are taken).
Decisions about the use of prophylactic antivirals for residents and staff will be made by Public Health in consultation with facility managers and specialist medical advisors.

5. General protective measures

Place signage at entry points to the facility and within the facility urging anyone with flu symptoms not to enter (door signs are available to download below).
Exclude all staff, volunteers and visitors who have a fever with a cough and/or sore throat, for 7 days from the onset of their illness (or 72 hours after starting antiviral treatment) and until their fever has settled.
Enhance cleaning practices, with particular focus on frequently touched items.
Minimise unnecessary outings to crowded places, to minimise the likelihood of infection.
Send a letter to guardians, next of kin and frequent visitors advising of the outbreak, reinforcing the importance of the simple steps to slow the spread of flu and urging any contacts at high risk of complications to see their doctor early for treatment if they get sick. Standard letters are available for download below.

Who is at increased risk of severe illness from flu in 2009?

Pregnant women (particularly in the middle and later months of pregnancy)
People with chronic respiratory conditions like chronic obstructive pulmonary disease and people who require preventative medications for asthma
People who are very (morbidly) obese
Indigenous people of any age (because of high prevalence of other risk factors)
People with other chronic conditions including heart disease, weakened immune system (e.g. due to cancer treatment, HIV/AIDS or medication), diabetes, metabolic diseases, chronic kidney or liver disease, haemoglobinopathies, or chronic neurological conditions.

Seek medical care early for any resident who has any of these risk factors and develops flu symptoms. Antivirals must be started within 48 hours of symptom onset for them to work effectively.

People who may be at increased risk of severe illness from flu in 2009:

Smokers
People who have sleep apnoea
Women in the first three months of pregnancy
Children under five.

Closely monitor any clients with flu-like illness who have these risk factors, and seek medical advice if you are worried about how sick they are.

Seek urgent medical care if a resident has:

difficulty breathing or shortness of breath
chest pain
severe or persistent vomiting
a high fever that lasts for more than three days, particularly when accompanied by a general worsening of symptoms
becomes less alert, confused or has difficulty waking up.

Caring for someone with influenza:

Encourage rest
Encourage fluids, especially water
Encourage a healthy diet with fruit and vegetables. Offer frequent small meals if the ill person don’t feel hungry
Provide paracetamol as directed to help ease symptoms and control fever
Discourage smoking.