Infection prevention and control (IPC) considerations
7. Infection prevention and control (IPC) considerations Human-to-human transmission of influenza viruses occurs either directly or indirectly through close, unprotected contact with large respiratory droplets. The role of smaller droplet nuclei at close-range exposure in transmission of influenza is not known, but may be more important in certain settings (e.g. aerosol-generating procedures
7. Infection prevention and control (IPC) considerations
Human-to-human transmission of influenza viruses occurs either directly or indirectly through close, unprotected contact with large respiratory droplets. The role of smaller droplet nuclei at close-range exposure in transmission of influenza is not known, but may be more important in certain settings (e.g. aerosol-generating procedures associated with increased risk of virus transmission). Collection of nasopharyngeal swabs and aspirates is considered as aerosol generating. Any patient with suspected influenza could also have COVID-19, hence appropriate precautions must be taken. Therefore, IPC precautions need to be focused on controlling respiratory droplet spread. Recommended IPC precautions when caring for patients with suspected or confirmed influenza include:
When working in direct contact with patients, Standard and Droplet Precautions should be applied:
- Standard Precautions:
- Hand hygiene: washing hands with soap and water or the use of an alcohol-based hand rub
- Use of personal protective equipment (PPE): this includes facial protection (by means of a medical mask and eye-visor/goggles or a face shield) as well as use of a gown and clean gloves
- Droplet Precautions:
- Wear a medical mask if working within approximately 1 metre of the patient or upon entering the room/cubicle of a patient on Droplet Precautions
- Perform hand hygiene before and after patient contact and immediately on removal of a medical mask
- IPC precautions when performing aerosol-generating procedures associated with an increased risk of infection transmission (e.g. aspiration/open suctioning of the respiratory tract, including for the collection of respiratory tract specimens, intubation, resuscitation, bronchoscopy, autopsy):
- Wear a particulate respirator (e.g. fit-tested N95 respirator), a clean non-sterile long-sleeved gown, and gloves
- Perform hand hygiene before and after patient contact and after PPE removal
- IPC precautions for patients who are mechanically ventilated or undergoing respiratory therapy:
- Mechanically ventilated patients: Standard and Droplet Precautions (but when aerosol-generating procedures are performed, particulate respirators need to be worn)
- Chest physiotherapy: Standard and Droplet Precautions. A medical mask should be worn by the patient if possible
- Nebulisation: Standard and Droplet Precautions.
Influenza: NICD recommendations for the diagnosis, management, prevention and public health response, National institute of communicable diseases, 2021