Healthcare-associated Exposure to Influenza Viruses

Influenza viruses are transmitted from person-to-person primarily by inhalation of airborne droplets generated by coughing or sneezing; less frequently by contact with freshly contaminated articles and environmental surfaces.  It is strongly recommended that HCP be vaccinated annually.  Antiviral drugs for PEP can be administered to unvaccinated HCP (1) during outbreaks of influenza, (2) following exposure to a person with influenza, or (3) after exposure to a strain against which vaccination is not protective.12

PEP with either oseltamivir or zanamivir, 1 dose daily for 10 days, is effective if initiated before the onset of illness.12  However, following healthcare-associated exposures, watchful waiting and early treatment (when signs and symptoms of infection appear) is preferred to PEP.  Treatment consists of 1 dose twice daily for 5 days with either oseltamivir or zanamivir.  These antiviral agents appear to be effective against both influenza A and B viruses.