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Influenza in the Nursing Home

Quick Answer

Influenza is a highly contagious and harmful illness, particularly among the elderly, who have weaker immune systems. The close-quarter living of nursing homes heightens this threat. Aging bodies are more likely to experience long-term damage and even death from influenza.

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Influenza Virus in Nursing Homes

Influenza is a serious, even deadly, illness for all ages, but especially vulnerable populations like the elderly.

Aging bodies are not only more susceptible to the flu because of compromised immune systems, but experience more severe symptoms and longer recovery times.

“Between 70-90% of seasonal flu deaths occurred in people 65 years or older.” – Centers for Disease Control and Prevention (CDC)

Several factors make influenza in nursing homes more likely to breed and spread.

These factors include:

  • Close quarter living
  • Lower immune systems and overall poor health of residents
  • Frequent outside visitors and staff
  • Shared caregivers

The flu typically runs its course over two miserable weeks, but it can cause complications that have longer, more serious side effects.

Serious side effects include:

  • Bronchitis
  • Pneumonia
  • Sinus and ear infections
  • Worsening of existing medical conditions

Influenza is highly contagious. If proper precautions are not taken, it can result in an epidemic. Avoiding an outbreak of the flu in nursing homes is critically important because older residents are more vulnerable than the general population.

Nursing Homes and Influenza Risk Explained

Weak immune systems are just one factor that places the elderly at risk of contracting influenza.

Older patients don’t always show classic symptoms like a fever, and existing medical conditions like shortness of breath and cough can mask the appearance of flu.

“Between 50-60% of season flu-related hospitalizations in the U.S. can occur in people 65 years and older.” – County of Los Angeles Public Health

The close-quarter living of nursing homes makes them, by nature, sensitive to spreading a virus.

Residents share common living areas and eat side-by-side. Friendly interactions like sharing a book or passing a TV remote are all it takes to transmit a highly contagious virus, especially in a population with weaker immune systems.

While nursing homes are a permanent residence for some, there’s a steady stream of nurses, support staff, and visitors rotating in from outside the home. Traveling with them is influenza. It is imperative that nursing homes take necessary precautions. Neglect in nursing homes could lead to long-term and even deadly consequences for your loved ones.

Influenza Outbreaks in Nursing Homes

A proactive approach to any suspected case of the flu is crucial to preventing outbreaks of the flu in nursing homes. The CDC defines an outbreak as one confirmed case of the flu in a nursing home, along with other cases of acute respiratory illness.

Isolating and containing people with the flu is a highly effective measure for curbing an outbreak of the flu, but symptoms typically don’t appear for 2-3 days.

Additionally, because the flu can be mistaken for other illnesses, especially in the elderly, the 3-4 day window that the flu is most contagious can extend even further.

The threat of an influenza outbreak in a nursing home is so great that many major municipalities and federal agencies have drafted outlines to protect the elderly.

The procedures include:

  • Confirming influenza through lab testing
  • Reporting the outbreak to authorities
  • Treatment with medication
  • Infection control (quarantine)

Signs and Symptoms of Influenza

Doctors will suspect the flu if a fever greater than 100°F is presented along with:

  • Body aches
  • Chills
  • Headache or eye pain
  • Malaise or loss of appetite
  • New or increased dry cough
  • Sore throat

A lab test can confirm whether a resident is sick with the flu.

Influenza’s impact on the elderly is so much greater because they are often living with other chronic health conditions. Morbid obesity, kidney and heart disease, and chronic lung diseases like asthma and cystic fibrosis can all become much worse with the flu.

In some cases, like with lung issues, a persistent cough can linger for weeks and even develop into pneumonia.

Complications of Influenza

The flu is an awful illness, but the worst symptoms clear up for most adults after about two weeks. That’s not always the case for the elderly.

Some of the complications that linger after the flu has run its course include:

  • Pneumonia: Influenza limits your airflow and, consequently, your ability to clear your lungs. A build-up of phlegm and bacteria will eventually cause an infection in the lungs.
  • Ear and Sinus Infections: That same mucus build-up caused by the flu can inflame the eustachian tubes that connect the throat and ears.
  • Worsening of Chronic Medical Conditions: The flu dramatically weakens the body, making it harder to fight symptoms from other conditions like:
    • Asthma
    • Congestive heart failure
    • Diabetes

The flu can lead to death, typically as a result of the virus making other conditions worse. If the contraction of this virus was a result of nursing home neglect, failure of the nursing home to properly prevent outbreaks, you may be eligible for legal compensation.

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Diagnosing Influenza in Nursing Home Residents

The elderly do not always display the common symptoms of influenza, increasing the likelihood of spreading the disease before it’s caught. This can be attributed to physical symptoms, like the lack of a fever or a lack of awareness due to Alzheimer’s or dementia.

The flu’s symptoms can also be confused or misdiagnosed with a different illness or overlooked because of pre-existing conditions like shortness of breath or cough.

Correctly identifying the flu virus can take as little as 15 minutes with the Rapid Influenza Diagnostic Test. However, this swab sample from the throat or nose is not always accurate or reliable. Other tests can take 3-10 days.

Preventing and Treating Influenza in Nursing Homes


The seasonal flu vaccine is one of the most effective ways to avoid influenza, but it’s not foolproof. Experts recommend the elderly in particular renew their shot or receive a booster every six months.

In cases of nursing home outbreaks, quarantine and minimizing contact with infected residents is a drastic but necessary step. This could include canceling daily events and curtailing visits with outside family and friends.

Good practices common to all disease prevention are:

  • Covering coughs and sneezes and then washing hands
  • Frequent and thorough hand-washing, along with alcohol-based sanitizers


Not much beyond bed rest and fluids can be done to treat the flu. Over-the-counter medications for pain can help with some of the symptoms.

In some instances, doctors will prescribe the drugs oseltamivir (Tamiflu) or zanamivir (Relenza). These can curb the worst of the symptoms if taken early and can shorten the duration of the flu by a day or two.

Steps for Family Members

Influenza is a potentially deadly disease, especially for the elderly. That risk goes up significantly in the close quarters of nursing homes.

Here’s what you should do if your loved one becomes sick with the flu in a nursing home:

  • Communicate with staff members and doctors on the steps they’re taking to control an influenza outbreak and protect their patients
  • Monitor your loved one’s health and advocate for their care and treatment

Legal Options for Influenza Infections in Nursing Home Residents

Influenza is a persistent and contagious virus, but it can be kept in check with good habits and sanitation.

If a nursing home fails to take the proper steps for prevention and treatment, it can have long-term and even deadly consequences for your loved one.

If your loved one was harmed by an outbreak of influenza in a nursing home or is still living with the long-term consequences of influenza, you could be entitled to legal compensation. This will help cover medical expenses and bring justice and closure to a painful situation.

To learn more about the risk of influenza in nursing homes and your legal options, call (855) 264-6310 or fill out our contact form today.

Nursing Home Abuse Support Team
Julie Rivers HeadshotReviewed by:Julie Rivers, MBA

Eldercare Advocate & Expert

  • Fact-Checked
  • Editor

Julie Rivers is an eldercare advocate with over 15 years of dedicated service to victims of nursing home abuse and neglect. Her journey in this field became deeply personal when she assumed the role of an unpaid caregiver during her mother’s battle with Alzheimer’s disease.

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

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