Kent Health Protection Team
Level 2, Civic Centre
Tannery Lane
Ashford TN23 1PL
T 0344 225 3861Ext 1
F 01233 639747
Surrey & Sussex Health Protection
Team
Parkside
Chart Way
Horsham RH12 1XA
T 0344 225 3861Ext 1
F 01403 251006
www.gov.uk/phe
8 January 2016
To Care Home managers in Kent, Surrey and Sussex
Dear Colleague,
Re: Seasonal influenza outbreaks – awareness and notification
As we are now heading into the flu season, we are writing to remind you to be alert for any
potential flu outbreaks in your care home setting, as well as the need to report to your local
health protection team as soon as you suspect an outbreak.
The definition of a flu outbreak is:
• Two or more cases of flu-like illness within 48 hours OR three or more case within 72 hours
• Which occur in residents and/or staff who are in close proximity to each other
Symptoms and signs of flu-like illness include:

Fever of 37.8˚C or above PLUS new onset or acute worsening of one or more of the
following symptoms:
- Cough (with or without sputum)
- Runny nose or congestion
- Sore throat
- Sneezing
- Hoarseness
- Shortness of breath
- Wheezing
- Chest pain
OR
 Sudden decline in physical or mental ability without other known cause
It is important to be aware that flu in the elderly may sometimes also initially present as
gastrointestinal symptoms (e.g. diarrhoea) or be diagnosed as simple chest infections, with
antibiotics possibly being prescribed. It is clear from the definition above that if there are only
two such cases, you may have an outbreak. You or your staff may be the first people to
identify this and prompt action is required to minimise the spread and impact on the
residents, staff and care home functioning.
If you suspect your care home may have a flu outbreak, then please telephone your local
Health Protection team (details at the top of this letter) who will provide you with further
advice and support.
Yours sincerely
Dr Sarah Lock
Consultant in Communicable Disease Control
Kent, Surrey and Sussex Health Protection Team