THE LOWDOWN
Winter 2023

An Educational Resource for Long-Term Care

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​​​​​​​​​​Welcome to the winter edition of The Lowdown, an educational resource focused on bringing you information to promote health and safety for residents and healthcare workers. This winter has brought the triple threat of respiratory viruses: influenza, COVID-19, and respiratory syncytial virus (RSV). This edition of The Lowdown provides information about these viruses, ways to prevent their spread, and resources to conduct staff education. Happy reading!

Respiratory Viruses

Respiratory viruses such as influenza, COVID-19, and RSV are very prevalent this winter, causing illness and hospitalizations. These illnesses spread person to person through droplets that are released when an infected person coughs, sneezes, or talks. These droplets travel about 6–10 feet through the air and can cause infection when they enter through someone’s eyes, nose, or mouth. The viruses can also spread by fomites: surfaces or objects contaminated by the droplets from the infected person. When the surface is touched, our hands are contaminated and can carry the virus to our eyes, nose, or mouth, or to another person. Research estimates people touch their face about 23 times an hour.1–3

The following actions will help prevent the spread of respiratory illness:
Hand hygiene
  • Hand hygiene is the most important way to prevent the
  • spread of infection!
  • Be a good role model by always practicing excellent hand hygiene.
  • Educate residents, staff, and visitors about proper hand hygiene and
  • monitor compliance.
  • Make sure sinks have soap and towels available and alcohol-based
  • hand sanitizer dispensers are filled.
  • Post information on hand hygiene throughout the facility.
Don’t touch the T-Zone!
  • Avoid touching your eyes, nose, and mouth. Remind everyone not to touch their faces.
  • Practice respiratory etiquette
  • Germs spread easily through mucous membrane: the tissue that lines the eyes, nose, and mouth.
  • Cough or sneeze into a tissue or elbow. Discard the tissue and perform hand hygiene immediately.
  • Post information on respiratory etiquette throughout your facility.
Stay home if you feel ill
  • Limit resident contact with sick individuals as much as possible.
  • Wear personal protective equipment (PPE) when caring for infected people. Droplet precautions require masks and eye protection.
  • Wear a mask if you may be around people who are coughing or sneezing and in crowded, indoor places.
  • Educate visitors to stay home if ill. Post signage as a reminder.
Practice respiratory etiquette
  • Germs spread easily through mucous membrane: the tissue that lines the eyes, nose, and mouth.
  • Cough or sneeze into a tissue or elbow. Discard the tissue and perform hand hygiene immediately.
  • Post information on respiratory etiquette throughout your facility.
​Stay home if you feel ill
  • Limit resident contact with sick individuals as much as possible.
  • Wear personal protective equipment (PPE) when caring for infected people. Droplet precautions require masks and eye protection.
  • Wear a mask if you may be around people who are coughing or sneezing and in crowded, indoor places.
  • Educate visitors to stay home if ill. Post signage as a reminder.
Keep the environment clean
  • RSV, influenza, and COVID-19 can survive on surfaces for several hours.
  • Regularly clean and disinfect frequently-touched surfaces, such as doorknobs, faucets, light switches, bed rails, wheelchair arms,
  • remote controls.
  • Make sure durable medical equipment is cleaned and disinfected after each use and between residents.
Vaccination
  • While hand hygiene is the best way to prevent the spread of infections in general, vaccination is the best tool to prevent inoculable diseases (that have vaccines) such as influenza and severe COVID-19 and protect others around you.
  • ​Annual flu shots are recommended for everyone age 6 months or older. 
  • Make sure you and your residents are up to date on COVID-19 vaccination

​Respiratory Syncytial Virus (RSV)

Symptoms of RVS include coughing, wheezing, sneezing, fever, and rhinitis and may be more severe in adults. Infected people are contagious and spread virus for 3–8 days. Immunosuppressed people may spread virus for 3–4 weeks.3

People at high risk for severe illness from RSV:3,7
  • Infants and very young children
  • Adults 65 or older
  • Adults with chronic lung or heart disease
  • Immunocompromised individuals​

The “Dirt” About Scarves and Gloves

Cold weather has arrived, along with sore throats, runny noses, coughs, and respiratory infections. The gloves and scarves we wear to protect from the cold can become heavily contaminated if they are used to cover a cough or sneeze or to wipe a runny nose! These germs are easily transmitted to other people or their belongings. Gloves and scarves should be cleaned regularly. The Association of Professionals in Infection Control and Epidemiology (APIC) recommends cleaning them once a week and when soiled.8​

More tips to help prevent illness this winter:
  • Do not pull gloves off with your teeth! This makes it easier for germs to enter ​your body and make you sick.
  • Take your gloves off when touching objects other people have touched. It is easier to clean your hands than your gloves.
  • Wash your gloves and scarves often—preferably once a week or when soiled.
  • Do not put dirty gloves or scarves into your pocket. Dry them thoroughly to kill the germs.​

Is It Pink Eye?

Conjunctivitis (i.e., pink eye) is an irritation of the inner eye lid and the white part of the eye. It can be caused by bacteria or viruses or result from allergies. It is often spread by rubbing or touching the eye with contaminated hands or objects, such as improperly cleaned contact lenses. Symptoms of conjunctivitis include redness, grittiness, tearing, and purulent drainage (i.e., a thick discharge that may be yellow, green, or brown with a strong odor). As most cases of conjunctivitis areviral, treatment focuses on symptom relief. Bacterial conjunctivitis is treated with antibiotic eyedrops.9 

Conjunctivitis is a reportable infection into the Pennsylvania Patient Safety Reporting System (PA-PSRS) under Skin and Soft Tissue Infection (SSTI) Conjunctivitis. 

References
  1. Association of Professional in Infection Control and Epidemiology. APIC Text. 4th Edition.
  2. APIC Consumer Alert: Don’t Touch Your Face. [online]. Accessed 12/2/2022. https://apic.org/monthly_alerts/dont-touch-your-face/
  3. Centers for Disease Control and Protection. Respiratory Syncytial Virus. [online]. Accessed 12/1/2022. https://www.cdc.gov/rsv/index.html
  4. Centers for Disease Control and Prevention. Respiratory Hygiene/Cough Etiquette in Healthcare
  5. Settings. [online]. Accessed 12/1/2023. https://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm
  6. Centers for Disease Control and Prevention. Handwashing. [online]. Accessed 12/2/2022. https://
  7. www.cdc.gov/handwashing/when-how-handwashing.html?CDC_AA_refVal=https%3A%2F%2Fwww.
  8. cdc.gov%2Ffeatures%2Fhandwashing%2Findex.html
  9. Kwok, YLA., Gralton, J., and McLaws, ML. Face touching: A frequent habit that has implications for
  10. hand hygiene. Am J Infect Control. 2015;43(2):112-114. Accessed 12/2/2022. https://www.ajicjournal.org/article/S0196-6553(14)01281-4/fulltext​
  11. Red Book 2021. 32nd ed. American Academy of Pediatrics. Pp 628-636.
  12. APIC Consumer Alert: Germy Gloves and Scarves. [online]. Accessed 12/2/2022. https://apic.org/​monthly_alerts/germy-gloves-and-scarves-oh-my/
  13. Centers for Disease Control and Prevention. Conjunctivitis. [online]. Accessed 12/2/2022. https://www.cdc.gov/conjunctivitis/about/symptoms.html​