Persons who are potentially infectious should: stay home if they are ill; cover their nose and mouth when coughing or sneezing, and use facial tissues to contain respiratory secretions and dispose of them in a waste container (respiratory hygiene/cough etiquette); and wash their hands (with soap and water, an alcohol-based hand rub, or antiseptic hand wash) after having contact with respiratory secretions and contaminated objects/materials (hand hygiene).

Persons who are around individuals with influenza-like symptoms should: maintain spatial separation of at least 6 feet from that individual; turn their head away from direct coughs or sneezes; and wash their hands (with soap and water, alcohol-based hand rub, or antiseptic hand wash) after having contact with respiratory secretions and contaminated objects/materials.

Antibacterial hand washing products do not appear to offer an advantage over soap and water in most settings for removing influenza virus from hands.

Minimizing workplace exposure to pandemic influenza can be facilitated by developing policies and strategies for isolating and excusing employees who become ill at work; allowing unscheduled and non-punitive leave for employees with ill household contacts; restricting business-related travel to affected geographic areas; and establishing guidelines for when employees who have become ill can return to work.

Within the workplace, social distancing measures could take the form of: guidelines modifying the frequency and type of face-to-face encounters that occur between employees (e.g., moratoriums on hand-shaking, substitution of teleconferences for face-to-face meetings, staggered breaks, posting of infection control guidelines in prominent locations); policies establishing flexible work hours or worksite, including telecommuting; and promotion of social distancing between employees and customers.

Some social distancing measures, such as the recommendation to maintain 6 feet of spatial separation between individuals or to otherwise limit face-to-face contact, may be adaptable to certain work environments and in appropriate settings should be sustainable indefinitely at comparatively minimal cost. Low-cost or sustainable social distancing measures should be introduced within the workplace immediately after a community outbreak begins, and units should prepare for the possibility of measures that have the potential to disrupt their business continuity.

The on-line assessment tool should be utilized to classify employee exposure risk to pandemic influenza in the workplace. Where risks indicate the advisability to wear surgical masks or respirators, sufficient stock of such items should be maintained. Personnel required to wear respirators must have medical clearance, be fit tested, receive training, and be covered by a written respiratory protection program. It is essential that these preparations be made early; waiting until a pandemic occurs will significantly decrease the ability to implement a respiratory protection program and purchase appropriate supplies. Contact Environmental Health and Safety for further information on respiratory protection.

During a pandemic, persons who are diagnosed with influenza or who have a respiratory illness should remain at home until the fever and the cough are resolved to avoid exposing others. If symptomatic persons appear in the workplace, they must be required to wear a surgical or procedure mask. Any mask must be disposed of if it becomes moist. Individuals must wash or otherwise sanitize their hands after touching or discarding a used mask.

Given the concern regarding the spread of influenza through contaminated objects and surfaces, additional measures may be required to minimize the transmission of the virus through environmental surfaces such as sinks, handles, railings, and counters. Transmission from contaminated hard surfaces is unlikely, but influenza viruses may live up to 2 days on such surfaces. Surfaces that are frequently touched with hands should be cleaned at least daily during community outbreaks. At a minimum, units should develop procedures for cleaning facilities during an outbreak and develop procedures for employees to follow to keep work areas clean (e.g., disinfecting phones, keyboards, personal items). There is no evidence to support the efficacy of widespread disinfection of the environment or air.

If a unit’s employees or students travel outside the United States for business or educational reasons, plans should include consideration of the management of these personnel in the event of an influenza pandemic. Once a pandemic emerges, international travel may be disrupted. It is also possible that containment measures may be instituted affecting airline passenger movement. Organizations should anticipate that such measures might further aggravate staffing shortages.