Abstract
Long‐term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. As the population ages over the coming decades, increased provision of such facilities seems likely. The need for robust infection prevention and control practices will therefore remain of paramount importance if the impact of outbreaks is to be minimised. In this review, we discuss the nature of the problem of influenza in long‐term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence.
Highlights
The term “long-term care facility” (LTCF) encompasses a diverse range of healthcare settings including nursing homes, rehabilitation centres, long-term care hospitals, psychiatric care facilities and facilities for people with intellectual disabilities.[1]
Antiviral treatment of symptomatic residents is recommended to be started immediately given their high risk of complications
For asymptomatic residents, the decision to give antiviral prophylaxis should be made on an individual basis using clinical judgement and risk of exposure, but as influenza vaccine is considered less effective in the elderly, the threshold for offering antiviral prophylaxis to all residents should be low
Summary
Long-term care facility environments and the vulnerability of their residents provide a setting conducive to the rapid spread of influenza virus and other respiratory pathogens. Infections may be introduced by staff, visitors or new or transferred residents, and outbreaks of influenza in such settings can have devastating consequences for individuals, as well as placing extra strain on health services. The need for robust infection prevention and control practices will remain of paramount importance if the impact of outbreaks is to be minimised. We discuss the nature of the problem of influenza in long-term care facilities, and approaches to preventive and control measures, including vaccination of residents and staff, and the use of antiviral drugs for treatment and prophylaxis, based on currently available evidence
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