In the event of a respiratory outbreak in a nursing home, the primary care provider (attending physician, nurse practitioner or the nursing home’s medical advisor) will consult with the regional Medical Officer of Health (MOH) to determine if the cause of the respiratory outbreak is or believed to be due to influenza.
If the cause of the outbreak is determined to be, or likely to be, influenza, the MOH will make general recommendations regarding antiviral use in the nursing home. The responsibility for individual resident treatment or prophylaxis decisions during the outbreak remains with the primary care provider.
It is important to begin antiviral treatment within 24-48 hours of symptom onset. Antiviral medication is unlikely to benefit residents who have been ill for more than 48 hours.
Antiviral treatment should be continued for a maximum of five days as a longer duration is unlikely to benefit most individuals.
During an influenza outbreak, residents who do not have an influenza-like illness should be considered for antiviral prophylaxis regardless of influenza vaccination status. Prophylaxis should be continued until the outbreak is declared over (7 days after symptom onset in the last case at the nursing home).
For more guidance on the use of antiviral drugs for influenza, please refer to the following link: Association of Medical Microbiology and Infectious Disease Canada.
If antiviral use is recommended by the MOH then the process for coverage of antivirals should be followed.
