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.^10,13 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.¹⁰

Oseltamivir is the preferred PEP agent. If oseltamivir is unavailable, oral baloxavir, inhaled zanamivir, or intravenous peramivir can be used for PEP.¹³ To better preserve medication availability, some authorities recommend against PEP and endorse watchful waiting and prompt treatment (within 2 days) only when signs and symptoms of infection appear.¹⁰