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Iowa Department of Health and Human Services

Respiratory Outbreaks in Long-Term Care Facilities

Long-term care facilities are defined as institutions that provide healthcare to people who are unable to manage independently in the community. This includes nursing homes, inpatient units and other residential facilities that provide chronic care management or shorter-term rehabilitative services.

Respiratory illnesses can be introduced and spread in a long-term care facility by residents, health care workers, and visitors.

Preventing transmission of influenza within long-term care facilities requires multiple strategies including vaccination, testing, infection control, and use of antiviral medications for prevention and treatment.
Many other respiratory viruses have similar symptoms, methods of transmission and control measures. See the links below for information about influenza and other respiratory viruses in health care facilities.

Reporting Respiratory Illness Outbreaks

OUTBREAKS are REQUIRED TO BE REPORTED even if single cases are not.

Some respiratory virus infections are found more frequently October through April, but many are also detected year-round.

Most individual respiratory virus cases are not reportable in Iowa. However, all disease outbreaks are required to be immediately reported to Iowa HHS by Iowa Administrative Code [641] Chapter 1.

The following outbreak definitions should be used to determine if your facility is experiencing a reportable respiratory virus outbreak:

  • Influenza:
    • One laboratory-confirmed influenza positive resident along with other residents having respiratory illness symptoms in a unit within a 72 hour period.
  • COVID-19:
    • Three or more COVID-19 positive residents occurring within a 14 day period.
  • Other respiratory viruses:
    • One laboratory-confirmed positive resident along with other residents having respiratory illness symptoms in a unit within a 72 hours period.

Immediately report respiratory outbreaks in Iowa long-term care facilities using the Iowa HHS Respiratory Outbreak Reporting Survey.

If your facility is experiencing a situation resulting in any severe illness and/or deaths call the 24/7 hotline (1-800-362-2736) to report immediately instead of using the online report. 

Additional Resources