Does influenza require quarantine?

Influenza Quarantine Guidelines

Quarantine is not generally recommended for influenza patients due to practical implications and because infections transmitted by pre-symptomatic people are rare. 1

Current Recommendations for Influenza Control

Home Isolation vs. Quarantine

• Early isolation at home of people feeling unwell and feverish is recommended when influenza is circulating 1
• Quarantine (restriction of movement of well people exposed to influenza) is not generally recommended for routine influenza cases 1
• The European Centre for Disease Prevention and Control (ECDC) specifically states that quarantine is not generally recommended for influenza patients due to practical challenges and the rarity of pre-symptomatic transmission 1

Special Circumstances Where Isolation/Quarantine Measures May Apply

• Institutional outbreaks (nursing homes, hospitals) require more stringent control measures including isolation of confirmed or suspected cases 1
• During severe pandemics, voluntary household quarantine following diagnosis of influenza in a family member might be considered 1
• Quarantine may be supported in specific situations based on local risk assessments:
  • When trying to prevent spread in healthcare settings 1
  • When a person known to be exposed to influenza is nearing the end of incubation period and plans to travel where self-isolation would be impossible 1

Recommended Control Measures for Influenza

Personal Protective Measures

• Regular handwashing (strongly supported) 1
• Good respiratory hygiene (covering mouth and nose when coughing or sneezing) 1
• Mask wearing in healthcare settings for those with symptoms of acute respiratory infections 1
• Early self-isolation at home for symptomatic individuals 1

Institutional Outbreak Control

• Droplet precautions and establishing cohorts of patients with confirmed or suspected influenza 1
• Re-offering influenza vaccinations to unvaccinated staff and patients 1
• Restricting staff movement between wards or buildings 1
• Restricting contact between ill staff or visitors and patients 1
• Using antiviral drugs for treatment and prophylaxis as a key component of outbreak control 1

Healthcare Settings

• Patients with influenza requiring hospitalization should be placed in isolation using Standard and Droplet Precautions 1
• Private rooms with doors kept closed are preferred; if unavailable, confirmed cases may be cohorted 1
• Isolation precautions should continue until hospital discharge or until symptoms resolve and the patient has been afebrile for at least 24 hours 1
• Healthcare workers should wear appropriate PPE (surgical mask, gloves, gowns) when caring for influenza patients 1

Important Considerations

Duration of Contagiousness

• Patients with influenza are contagious to others 1 day before symptoms develop 1
• Adults typically remain infectious for approximately 5 days after symptom onset 1
• Immunosuppressed individuals and children may be contagious for 10 or more days 1

High-Risk Settings

• Nursing homes and healthcare facilities require more aggressive control measures due to vulnerable populations 1
• In these settings, chemoprophylaxis should be administered to all residents regardless of vaccination status when outbreaks occur 1
• Antiviral prophylaxis should continue for at least 2 weeks or until approximately 1 week after the end of the outbreak 1

Pitfalls to Avoid

• Relying solely on quarantine measures without implementing other infection control strategies 1
• Failing to recognize that influenza transmission primarily occurs through respiratory droplets and contact with contaminated surfaces 1
• Underestimating the importance of early isolation of symptomatic individuals as the primary control strategy 1
• Neglecting to implement appropriate infection control measures in institutional settings where outbreaks can spread rapidly 1

While quarantine is not generally recommended for routine influenza cases, early self-isolation of symptomatic individuals and appropriate infection control measures in healthcare and institutional settings remain critical components of influenza control strategies.