Do You Suspect an Outbreak?
Much of the guidance and information you find here can be used during any respiratory outbreak, not just flu.
In any outbreak:
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Get vaccinated
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Cover mouth and nose when coughing and sneezing
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Wash hands often with soap and water
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Routinely clean and disinfect commonly-touched surfaces
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Avoid touching eyes, nose, and mouth
Find Outbreak Management Resources For Your Facility
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You can use an online reporting form to report flu or ILI outbreaks. Review the K-12 school scenario job aid or the LTCF scenario job aid to walk through the online format.
Outbreak at a Long-Term Care Facility
You can use an online reporting form to report flu or ILI outbreaks. Review the job aid to walk through the online format.
What is an Outbreak?
A single resident with a positive flu test and two or more additional residents with respiratory illness symptoms.
OR
Two or more residents with at least two of the following symptoms:
- Fever of 100 degrees Fahrenheit or more
- Nonproductive cough
- Myalgia (muscle pain)
- Pharyngitis (sore throat)
If an Outbreak is Suspected
- Report influenza-like illness outbreaks to the Health Department 24/7 by calling 802-863-7240 and filling out a viral respiratory illness outbreak report form. It is important to report so that the Health Department can help coordinate testing. Health Department staff will ask about symptoms, onset, case totals, exposure, treatments, outcomes, and actions taken.
- Collect specimens from 3-5 residents within 72 hours of symptom onset for surveillance testing at the Vermont Department of Health Laboratory using the testing instructions and forms.
- Treat symptomatic residents with antivirals. Do not wait for laboratory confirmation of the flu.
- Sick staff should stay home until 24 hours after fever has resolved without the use of fever-reducing medication.
- Start a list of sick residents and staff and track symptom onset using the Influenza-like illness line list.
- When at least 2 residents/patients are ill within 72 hours of each other and at least one resident has lab-confirmed influenza, promptly initiate antiviral prophylaxis to all non-ill residents. CDC recommends antiviral prophylaxis for a minimum of 2 weeks and continuing for at least 7-10 days after the last known case was identified.
Actions to Control the Outbreak
- Stop taking new admissions or transfers when possible.
- Discourage symptomatic people from visiting.
- Follow droplet precautions for symptomatic residents.
- Encourage symptomatic residents to practice respiratory hygiene.
- Ensure ill employees do not work.
- Do not float staff between units.
- Provide training in infection control and hand hygiene for staff.
- Perform routine and thorough cleaning of commonly touched surfaces.
- Restrict symptomatic residents to their rooms, or cohort on the infected unit.
- Limit group activities and serve meals in rooms.
- If a resident is transferred to another facility during the outbreak, notify the receiving facility of the outbreak whether or not the individual has symptoms.
- Offer flu vaccine to unvaccinated staff, residents, and new admissions throughout the flu season.
Vermont Department of Health Resources
- Flu Activity and Surveillance
- Influenza Prevention and Control Measures for LTCFs
- Influenza-like Illness (ILI) Linelist
- Specimen collection and shipping guide (Vermont Department of Health Laboratory)
- Test Request Form (Vermont Department of Health Laboratory)
CDC Resources for Long-Term Care Facilities
Outbreak at a K-12 School
You can use an online reporting form to report flu or ILI outbreaks. Review the job aid to walk through the online format.
What is an Outbreak?
Increased absenteeism* throughout the school in association with influenza-like illness. This includes:
- Students who are sent home with fever and cough or sore throat.
- Absent students with parental reports of flu.
- Absent students with parental reports of fever and cough or sore throat.
*Increased absenteeism is defined as absentee rates exceeds 10% for entire school; OR absentee rate exceeds 20% of one grade or class.
If an Outbreak is Suspected
- Report influenza-like illness outbreaks to the Health Department 24/7 by filling out a viral respiratory illness outbreak report form.
- Sick students and staff should stay home until 24 hours after fever has resolved without the use of fever-reducing medication.
- It can be helpful to keep track of students and staff who are part of the outbreak using a line list to fill out the Outbreak Report Form. Here is a template that may be helpful: Influenza-like illness line list.
Actions to Control the Outbreak
- Encourage washing hands with soap and water.
- Provide tissues and no-touch trash cans around the school and classrooms.
- Routinely clean and disinfect commonly touched surfaces.
- Send a letter home to parents with flu prevention information.
- Avoid touching mouth, eyes or nose.
- Encourage staff to stay home if they are sick.
- Encourage students not to share food or drinks.
- Encourage any unvaccinated staff to get vaccinated.
- Recommend that students and their families get vaccinated.
Vermont Department of Health Resources
CDC Resources for Schools
Outbreak at a Child Care Facility
What is an Outbreak?
Increased absenteeism throughout the facility in association with influenza-like illness. This includes:
- Children who go home early with fever and cough or sore throat,
- Absent children with parental reports of flu,
- Absent children with parental reports of fever and cough or sore throat.
If an Outbreak is Suspected
- Report influenza-like illness outbreaks to the Health Department 24/7 by filling out an viral respiratory illness outbreak report form.
- Sick children and staff should stay home until 24 hours after fever has resolved without the use of fever-reducing medication.
- It can be helpful to keep track of students and staff who are part of the outbreak using a line list to fill out the Outbreak Report Form. Here is a template that may be helpful: Influenza-like illness line list.
Actions to Control the Outbreak
- Encourage washing hands with soap and water.
- Provide tissues and no-touch trash cans around the facility.
- Routinely clean and disinfect commonly touched surfaces.
- Send a letter home to parents with flu prevention information.
- Avoid touching mouth, eyes, or nose.
- Discourage sharing of food or drinks between children.
- Encourage any unvaccinated staff to get vaccinated.
- Recommend that children and their families get vaccinated.
Vermont Department of Health Resources
CDC Resources for Child Care Facilities
Outbreak at a Shelter
What is an outbreak?
An outbreak is when you are seeing multiple people at your facility with flu-like symptoms, like:
- Fever
- Cough
- Headache
- Body aches
- Fatigue
- Sore throat
- Chills
If an outbreak is suspected:
If you are seeing multiple people at your facility with flu-like symptoms, please fill out the viral respiratory illness outbreak report form and call 802-863-7240.
Actions to Control the outbreak
- Encourage staff to get a flu shot.
- Be aware when individuals have flu-like symptoms.
- Staff and volunteers should stay home until their fever has been gone for at least 24 hours.
- Put up posters around the facility that show hygiene practices, such as covering coughs and sneezes and proper handwashing.
- Place alcohol-based hand sanitizer in areas where handwashing is not available.
- Perform routine surface cleaning of commonly-touched surfaces like door knobs.
- Place tissues and trash cans around the facility.
- When possible, locate ill individuals away from those that are well.
- Place cots head-to-toe and keep cots six feet apart.
- Encourage individuals to report to a staff member if they are feeling ill.
