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New AMMI Antiviral Guidance for Influenza Outbreaks

In December 2015, the Association of Medical Microbiology and Infectious Disease Canada (AMMI) published an updated guidance document for the use of antivirals in the management of care facility influenza outbreaks for the 2015-16 season.

Given the potential for low vaccine effectiveness of this season’s influenza vaccine, the AMMI guidance document states that, at the discretion of the local health authority or Medical Health Officer, antiviral prophylaxis may be extended beyond unvaccinated health care providers to also include vaccinated health care providers, in the context of care facility influenza outbreaks. Notably this applies to outbreaks caused by H3N2 viruses.

Excerpt from the document:

“[Current] measures for facility influenza outbreak control that are considered the ongoing standard of care include: seasonal influenza vaccination of staff and residents (preferably pre-season); antiviral prophylaxis of all non-ill residents; early antiviral treatment of symptomatic individuals (workers or residents both vaccinated and unvaccinated); reinforced infection control measures including respiratory etiquette and use of personal protective equipment; and exclusion of ill staff or visitors and new admission deferral. Outbreak control measures also include antiviral chemoprophylaxis for unvaccinated staff; this may be extended to vaccinated staff as an option or at the discretion of the local health authority/Medical Officer of Health during outbreaks, notably those due to H3N2 viruses that may otherwise be poorly controlled by standard measures.” 

What does this mean for you?

Currently the provincial guidance on the prophylactic use of antivirals for healthcare providers pertains only to unvaccinated healthcare providers. Therefore, if you have questions about how the new AMMI recommendations may affect your facility, for long-term care sites you can contact your local Medical Health Officer or designate, and for acute care sites you can contact your local Infection Control Practitioner.

You can read the AMMI guidance document here; supplementary documents can be found on the AMMI website Guidelines page.

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