Preparing your facility for the flu season

Influenza (“the flu”) is a serious respiratory disease caused by influenza viruses that can cause mild to severe illness. Seasonal flu activity can begin as early as October and linger as late as May. During the 2017–2018 flu season, the Centers for Disease Control and Prevention (CDC) estimates that the flu was associated with nearly 49 million illnesses, more than 22 million medical visits, nearly one million hospitalizations, and nearly 80,000 deaths in the U.S.

The severity of disease during the flu season can create a tremendous burden on the healthcare system. As a result, it is important to plan for the upcoming flu season, which can be a daunting task. In order to prevent the spread of flu, most healthcare facilities have policies in place that limit visitors during the flu season. These policies often prohibit children ages 12 and under from entering the facility or visiting patient care areas because children often carry viruses without exhibiting any signs or symptoms.

Everyone 6 months of age and older should get a flu vaccine—including pregnant women and people with chronic health conditions. Below are some guiding principles to help infection preventionists prepare for the flu season. Vaccine-preventable diseases, such as the flu, are everybody’s business!

Annual seasonal flu vaccine

  • Annual seasonal flu vaccine is the best way to help protect against the flu. Are all healthcare personnel and staff at your facility required to get a flu vaccine? If not, what strategies are in place to prevent transmission of the flu from healthcare personnel to their colleagues, patients, and visitors?
  • What type of vaccine was ordered for your facility?
  • When and how will the vaccine be delivered to staff (e.g., on flu vaccine day, while rounding on units, during extended clinic hours, etc.)?
  • According to the CDC, for the 2019–2020 flu season, trivalent (three-component) flu vaccines shall contain: A/Brisbane/02/2018 (H1N1) pdm09-like virus (updated); A/Kansas/14/2017 (H3N2)-like virus (updated); and B/Colorado/06/2017-like (Victoria lineage) virus. Quadrivalent (four-component) flu vaccines, which protect against a second lineage of B viruses, shall contain the three recommended viruses in the trivalent, as well as B/Phuket/3073/2013-like (Yamagata lineage) virus.


  • Have policies been reviewed and updated to plan for the upcoming flu season?
  • Will your facility implement visitor restrictions? What will trigger these restrictions (e.g., level of flu in the community, number of tests your lab is performing, etc.)? What type of visitor restrictions will your facility implement and where, if applicable (e.g., children 12 and under, facility wide, intensive care units, transplant units, oncology units, etc.)?
  • Are full season signs and education materials available for staff, patients, and visitors? These tools can be especially helpful when visitor restrictions have been implemented.
  • Are alcohol-based hand rub, tissues, and masks readily available for all staff, visitors and patients?
  • Have staff been educated about the upcoming flu season policy and visitor restrictions, if applicable?
  • Are healthcare workers discouraged from coming to work sick?

Who is most vulnerable to the flu?

  • Adults over the age of 65
  • People who are immunocompromised such as those with HIV, hepatitis, and cancer
  • People who live with or care for the immunocompromised or elderly
  • Pregnant women
  • People with chronic medical conditions such as asthma, diabetes, heart disease, and lung disease
  • People who have any of the following signs/symptoms are more vulnerable to acquiring the flu and may already be carrying it: fever, cough, sore throat, runny or congested nose, body aches, chills, fatigue, nausea and/or vomiting, and/or diarrhea

How do you prevent the spread of flu?

Keep these points in mind when educating staff, patients, and visitors:

  • Always cover your mouth and nose when you cough or sneeze (try to cough into your sleeve).
  • Clean your hands often—especially before entering, and after exiting, patient care areas/rooms.
  • Use soap and water to wash your hands or an alcohol-based hand run to disinfect your hands.
  • Avoid touching your eyes, nose, or mouth.
  • Get your flu shot. The best way to prevent the spread of the flu is by getting vaccinated each year.

Additional resources

  • APIC—Materials for healthcare facilities
  • APIC—Vaccination saves lives
  • CDC—Influenza (Flu)
  • CDC—Prevent seasonal flu
  • Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: Recommendations of the advisory committee on immunization practices—United States, 2018–19 influenza season. MMWR Recommendations and Reports. 2018; 67(3):1–20. DOI: 10.15585/mmwr.rr6703a1
  • Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and control of seasonal influenza with vaccines: Recommendations of the advisory committee on immunization practices—United States, 2019–20 influenza season. MMWR Recommendations and Reports. 2019; 68(3):1–21. DOI: 10.15585/mmwr.rr6803a1