Rosie Lyles

While many long-term care residents may be welcoming in the fall season by enjoying the cooler weather, changing leaves and apple cider, fall is also the time for long-term care facility managers and professionals to develop or dust off infection outbreak prevention plans. The colder months often bring increased cases of influenza and norovirus and for vulnerable populations in long-term care and assisted living facilities, these bugs are the un-welcome signs of the change in seasons. 

According to the Centers for Disease Control and Prevention (CDC), 80% of norovirus outbreaks occur November to April[1] and records show that 47% of the time, influenza activity peaks in February.[2] 

Furthermore, infection-related complications are more common in adults 65 years and older.[3] When you take a closer look at the infection risk statistics for elderly populations, it also paints a dark picture:  

  • 90% of norovirus-associated deaths in the U.S. occur in people 65 and older.[4]
  • 90% of influenza-related deaths and more than 60% of influenza-related hospitalizations in the U.S. occur in people 65 and older.[5]

Part of the problem is that many long-term care residents are at a greater risk of infection due to factors such as weakened immune systems and pre-existing conditions. Residents are often transferred between long-term care and acute-care facilities, increasing the opportunity for the transmission and acquisition of infections.[6] Long-term care environments are also conducive to the spread of infection since residents share communal spaces like dining rooms and recreational areas, allowing germs to spread through person-to-person contact or by coming into contact with contaminated surfaces. 

So how can long-term care facility professionals effectively stop influenza and norovirus outbreaks before they happen?

The answer lies in proper infection prevention, which requires a bundle of interventions to help stop infections before they start. Following are infection control tips long-term care facilities should keep in mind as they work to help protect their residents’ health and quality of life:

  • Get the Flu Vaccine – Vaccination is the first and most important step in influenza prevention. Encourage healthcare workers to get vaccinated each year to help protect not only themselves, but also residents, visitors and other staff.
  • Hand Hygiene – Healthcare professionals should always wash their hands when performing the following activities:
  1. Before and after all resident contact
  2. After contact with potentially infectious materials (e.g., blood, bodily fluids,
  3. contaminated surfaces)
  4. Before donning, and after removing, sterile gloves, gowns or face shields
  5. Before touching the eyes, nose or mouth and after blowing your nose, coughing or sneezing
  6. Before preparing food or eating
  7. After going to the bathroom
  • Isolation Precautions For residents with confirmed or suspected cases of influenza or norovirus, minimize their movement within the facility and limit visitors. Infected staff should also stay home for 48 hours after the resolution of symptoms.
  • Clean & Disinfect Frequently Touched Hard Surfaces – Keeping surfaces clean and disinfected will help ensure that residents and their families remain infection-free. Wipe down frequently touched hard surfaces such as doorknobs, remotes, light switches, railings and tables daily with bleach or another U.S. Environmental Protection Agency (EPA) registered disinfectant approved to kill influenza and norovirus. Always ensure the surface remains wet for the duration of the manufacturer-recommended contact time.
  • Choose the Right Products – When concerned about influenza or norovirus, using bleach or another EPA-registered product with a label claim to kill these pathogens is the best option. Ready-to-use, EPA-registered disinfecting wipes, such as Clorox Healthcare® Bleach Germicidal Wipes, which kill influenza and norovirus in one minute, are an easy option for staff as they do not need to be diluted before use. Ready-to-use products with no dilution or premixing required helps reduce the risk of staff error.

Rosie D. Lyles, M.D., is the Head of Clinical Affairs at Clorox Professional Products Company. Lyles is a physician-scientist with more than a decade of experience studying the epidemiology and prevention of multidrug-resistant organisms (MDROs) and infections such as C. difficile, MRSA and CRE. For more influenza and norovirus prevention tips, visit

[1] CDC – Seasonal Influenza (Flu) – The Flu Season. Centers for Disease Control and Prevention, 12 Oct. 2012. Date accessed: 3 Sept. 2013.

[2] CDC – Seasonal Influenza (Flu) – What You Should Know for the 2012-2013 Influenza Season. Centers for Disease Control and Prevention, 15 Mar. 2013. Date accessed: 3 Sept. 2013.

[3] CDC – Seasonal Influenza (Flu) – Key Facts About Influenza (Flu) & Flu Vaccine. Centers for Disease Control and Prevention, 13 Feb. 2013. Date accessed: 3 Sept. 2013.

[4] Trivedi, T.K., DeSalvo, T., Lee, L. “Hospitalizations and Mortality Associated With Norovirus Outbreaks in Nursing Homes, 2009-2010.” JAMA. 308.16 (2012): 1668-1675.

[5] Seasonal Influenza (Flu): CDC Influenza Update for Geriatricians and Other Clinicians Caring for People 65 and Older. Centers for Disease Control and Prevention, 25 Jan. 2013. Date accessed: 12 Aug. 2013.

[6] Smith, P.W., Bennett, G., Bradley, S., Drinka, P., Lautenbach, E., Marx, J., Mody, L., Nicolle, L., Stevenson, K. “SHEA/APIC Guideline: Infection Prevention and Control in the Long-Term Care Facility, July 2008.” Infection Control and Hospital Epidemiology. 29.9(2008): 785-814.