Pandemic Influenza Plan - Questar III

Section 4: Infection Control
systems may shed the virus in the respiratory tract for a prolonged period (i.e., weeks to
months).
Clinically, influenza-like illness (ILI) is described as acute onset of constitutional and
respiratory signs and symptoms (e.g., fever of > 100° F, myalgia, headache, malaise,
cough, sore throat, and rhinitis). Among children, otitis media, nausea, and vomiting
may also be present. The classic symptoms of ILI (e.g., fever) may not always be present
in the elderly, children, and persons with altered immune status. The duration of illness
typically is a few days, although cough and malaise may persist for weeks.
Complications and hospitalizations from seasonal influenza are increased for children
aged 0-23 months, adults > 65 years, and persons with pre-existing medical conditions
(e.g., cardiac or pulmonary disease) and include secondary bacterial pneumonia, or
primary influenza viral pneumonia. See Section 5: Clinical Guidelines for additional
information on the clinical presentation of influenza.
Because vaccine for influenza is developed using strain characterization from the
previous influenza season, it can be assumed that vaccine will provide little if any
protection from developing infection during a pandemic influenza outbreak. Given this,
adherence to infection control principles to prevent transmission of influenza and
initiation of antiviral medication for treatment and prophylaxis will be paramount to
control the spread and reduce morbidity and mortality during an influenza pandemic.
The level of surveillance and infection control will depend on the global, regional, and
local epidemiology of the influenza season. Implementing aggressive infection control
strategies for containment (e.g., screening healthcare workers and visitors for illness,
initiating cohorts of patients and staff, and establishing separate triage areas) may be
indicated during a pandemic, specifically if a pandemic reaches the local area.
The specific characteristics of a new pandemic influenza virus, including virulence,
transmissibility, incubation period, period of communicability, and drug susceptibility,
will remain unknown until the pandemic gets under way. The NYSDOH will continue to
work with their national and world public health partners (i.e., the Centers for Disease
Control and Prevention and the World Health Organization) to assess differences in any
of these aspects and to revise infection control guidance as appropriate.
III.
Recommendations for Infection Control in Healthcare Settings
The following recommendations for infection control are applicable throughout the
pandemic periods that have been defined by the World Health Organization (See
Introduction), and have been used successfully by facilities for the control of seasonal
epidemic influenza. The key to successfully controlling transmission of influenza (and
other communicable respiratory infections) is the early identification of potentially
infectious patients, and the immediate implementation of control measures for
containment.
February 7, 2006 4-4