A comprehensive isolation plan was developed and widely distributed for outpatient and inpatient facilities (SCCA adult cancer patients receive inpatient care at the University of Washington Medical Center and SCCA pediatric inpatients are cared for at Seattle Children's). Adherence to hand hygiene and compliance with isolation guidelines are monitored regularly. An electronic surveillance system allows for real-time quantification of the numbers of patients and staff who are infected with influenza, which is reviewed daily by the infection control team.

The infection control program is rounded out with the requirement that staff receive annual influenza vaccinations (or sign a written declination waiver), a sick leave policy that is tolerant of absences for respiratory illnesses, redundant work plans for staff at all levels should absences be required, helping families and caregivers identify resources for furloughing caregivers and a plan for giving antiviral drugs to exposed patients and staff.

The authors urge that healthcare institutions caring for immunocompromised patients require that all of their staff receive influenza vaccination as key goal to control influenza.

While vaccination is a primary prevention tool, healthcare staff who have significant exposure to confirmed cases of influenza who have not been vaccinated or who received a vaccination less than three weeks prior to the time of exposure should be considered for preventive antiviral therapy, the authors said.