Do you manage or work in a long-term care or rehabilitation facility, military base, dorm, a camp, prison or jail? Germs can spread more easily in residential settings. During South Carolina's flu season, we ask that you make a special effort to do all you can to slow the spread of flu and protect your residents and staff.

Each year, flu is a serious threat for people living in residential facilities. Seasonal flu typically kills about 36,000 Americans and hospitalizes 200,000 each year. Flu can cause mild to severe respiratory illness and other symptoms.

We urge you to follow the guidelines below and work closely with us to slow the spread and severity of South Carolina's flu season. Make sure your employees are familiar with the symptoms of flu and urgent warning signs.

Preventing and Limiting Outbreaks

Make plans to protect your residents and employees from flu using this information from the Centers for Disease Control and Prevention (CDC):

• Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities
• Severe Influenza Among Children and Young Adults with Neurologic and Neurodevelopmental Conditions - Ohio, 2011 (pdf) This CDC Morbidity and Mortality Weekly Report describes the challenges involved in a flu outbreak that ended up killing 7 young residents of a residential facility for young people in Ohio in 2011.
• Plan for the Impact of Influenza Pandemic on Your Business

Take These Steps to Protect Residents, Staff and Visitors

• Encourage staff to learn the facts about vaccination and get vaccinated against flu.
• Tell your employees about websites that can help them find flu vaccination providers in the local community.
• Require employees to stay home if they have a fever of 100ºF or higher with a cough or sore throat.
• Require staff members who have the flu to remain at home until their fever has been gone for 24 hours without the use of fever reducing medications. In most cases employees with the flu will miss 3 to 5 days.
• Expect and plan for higher than normal staff absences during flu season. Establish a list of on-call workers to cover for employees who are ill.
• Change your policies to encourage and support rather than penalize staff who must miss work because they are ill with the flu or caring for a family member who has the flu. When symptoms are mild, the employee may not need to see a health care provider, so it's best not to require a doctor's excuse. Also, some employees may be forced to stay home in an outbreak due to school and child care closings. Employees who stay home when sick are helping to protect other employees, customers and the public. Allow them to do this without fear of losing their jobs.
• Separate ill residents from the general residential population.
• Recommend that residents and staff who have flu symptoms see their health care provider right away if they are at high risk for complications from the flu. Early treatment with antiviral medications may help lessen the symptoms. Those at high risk include:
  • Adults and children who have chronic conditions such as asthma and diabetes or other lung, heart, liver, blood, neurologic, neuromuscular, or metabolic disorders
  • Pregnant women
  • People aged 50 years or older
  • Adults and children with weak immune systems
  • Children younger than 5 years old
  • Children younger than 18 years who are on long-term aspirin treatment
• Encourage residents and staff to wash their hands often with soap and water. Ask them to get into the habit of washing their hands for about as long as it takes to sing the Happy Birthday song twice.
• Ask residents and staff to cover their nose and mouth with a tissue when they cough or sneeze and throw the tissue in the trash.
• Encourage residents to eat a healthy diet, exercise and get plenty of rest.
• Frequently wipe down commonly touched surfaces like stairway railings, telephones, and door handles. Otherwise, follow your normal housekeeping routine.
• Order copies of or download free DHEC flu materials for staff and residents.
• Educate everyone in your facility about the dangers of giving aspirin (acetylsalicylic acid) to people, especially children or teenagers, who have the flu. This can cause a rare but serious illness called Reye's syndrome.
• Dorms and camps and other group residential settings that have the option to do so may want to consider selective closings if there is a flu outbreak in your facility. This is especially true if your residents include people with chronic health conditions or pregnant women.

Long Term Care Facility Flu Outbreak Guidance

The following materials provide guidance and information related to flu outbreaks in long term care facilities. Use the guidance document to know when to report a flu outbreak in your facility, how to report it, and ways to stop the spread of flu, particularly during an outbreak.

• Influenza Long Term Care Facility Outbreak Guidance, 2023-2024
• Quick Reference Guide for Long Term Care Facility Outbreaks, 2023-2024