Maine’s winter flu season is moving into high gear, jumping last week to the top-level “widespread” status and taking hold among nursing home residents, according to the weekly influenza report from the Maine Center for Disease Control and Prevention.
That means flu has been positively identified in at least half the areas of the state, according to U.S. Centers for Disease Control and Prevention reporting guidelines. As of the end of 2017, flu had been found in each of Maine’s 16 counties.
Most affected to date may be residents of Maine nursing homes, with 10 facilities reporting new outbreaks last week for a total of 24 outbreaks so far in long-term care facilities. The Maine disease control center does not identify specific facilities, but eight are located in Penobscot County, according to the report.
“We know it hits the elderly the hardest,” State Epidemiologist Siiri Bennett said.
Especially in group settings such as nursing homes, she said, flu finds an easy path of transmission.
“Our immune systems weaken as we age, so when [people are] grouped together in close contact with other people, it’s really easy to spread around,” she said. “It’s really a set-up for an outbreak.”
Influenza is a potentially deadly respiratory virus that kills tens of thousands of Americans each year and sends many more to the hospital.
The CDC’s definition of an outbreak varies from one setting to another, but for nursing homes it is constituted by two or more residents with acute respiratory illness when at least one of them has an influenza-positive lab test. At that point, the facility must report the outbreak to the state. Beyond confirming the outbreak and offering support, Bennett said the state’s role is minimal.
That’s because the real push comes in the fall, before flu season begins. Every long-term care facility receives a packet each year from the Maine disease control center full of information about preventing influenza and controlling its spread, Bennett said.
First and most important, she said, “We really push hard for vaccines.” That applies to both residents and staff, as it’s easy for direct caregivers and other workers to bring the flu virus into a facility, she said.
Flu vaccine is formulated each year to reflect experts’ best guess about strains most likely to emerge in the coming season. National reports show this year’s vaccine provides only limited coverage in what may turn out to be a particularly severe season. But experts say the vaccine still provides some protection against the flu and will lessen the severity of the illness for those who do get infected.
The CDC recommends that just about everyone over the age of 6 months should get vaccinated, with pregnant women and the elderly among the most vulnerable. It takes a couple of weeks to develop immunity, but as the flu season typically runs through March or April, there’s still plenty of benefit to be gained, health officials say.
Other preventive guidance for nursing facilities includes extra vigilance about handwashing, protecting coughs and sneezes and limiting visitors during the flu season.
It’s also important for nursing homes to have adequate sick-leave policies, so staff members can stay home if they become ill. Staff, visitors or residents who may be feeling the onset of illness, or recovering from a bout with flu, should wear face masks to protect others, according to health officials.
“Facilities have different policies about all of this,” Bennett said, “but you can have very mild symptoms yourself and still make residents sick.”
For nursing homes where flu has taken hold, additional measures may be instituted, including administering antiviral medicines prophylactically to all residents as well as isolating residents in their rooms and limiting group activities until the illness passes. These steps may prove upsetting to residents and their loved ones, Bennett said, but may help limit transmission.
Preventing a flu outbreak is the best approach, Bennett said.
“Vaccinate yourself and your family so you don’t carry flu into a nursing facility,” she said. “If you’re sick, stay home. Call your family member, but don’t go visit.”
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