Respiratory Viral Diseases
COVID-19, influenza, and respiratory syncytial virus (RSV) are three common respiratory viral illnesses. The viruses spread from person to person and cause significant morbidity and mortality, with higher levels of disease activity typically occurring during the fall and winter. Older adults, young children, and people with certain health conditions are at greater risk of serious illness.
Actions Required and Control Measures
Reporting Requirements – Category 2
Hospitalizations and deaths associated with COVID-19, influenza and RSV are reportable within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). Healthcare providers should also report COVID-19 cases if diagnostic testing was performed on-site in a healthcare facility (e.g., provider’s office, urgent care clinic, long-term care facility, etc.). In addition, healthcare providers should report cases of multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. The director of any clinical laboratory must report laboratory evidence of infection with SARS-CoV-2, influenza, or RSV to both DPH and the LHD.
Additional laboratory requirements: Laboratories are asked to submit respiratory specimens on a weekly basis from a sample of influenza and COVID-19 patients to the State Public Health Laboratory (SPHL). The purpose of this surveillance is to monitor circulating strains, rapidly identify new strains, detect antiviral resistance, and determine the effectiveness of this season’s vaccines. Detailed instructions for specimen selection and submission are updated annually here.
To assure you have the most up-to-date information concerning reportable diseases, please visit the Reporting of Diseases, Emergency Illnesses, Health Conditions, and Laboratory Findings page.
National Surveillance Case Definitions
Influenza-associated hospitalizations
Influenza-associated pediatric mortality
Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection
Note: There is not a national case definition for COVID-19 hospitalizations, influenza cases, influenza-associated adult mortality, RSV cases or RSV-associated hospitalizations. Although a national case definition does not exist for COVID-19-associated deaths, guidance is available from the National Center for Health Statistics.
Case Investigation
There is no recommendation for routine case investigation of seasonal influenza, RSV, or COVID-19 cases. Case investigation may be a useful tool in congregate settings to mitigate outbreaks and minimize severe outcomes.
DPH Responsibility: For reported hospitalizations and deaths, DPH staff will identify the corresponding laboratory test result to confirm the diagnosis. In addition, Emerging Infections Program staff at Yale School of Public Health conduct enhanced surveillance on COVID-19, influenza, and RSV hospitalizations in three Connecticut planning regions (South Central, Lower Connecticut River Valley, and Naugatuck Valley).
Control Measures
Surveillance
DPH uses multiple surveillance systems to monitor influenza, RSV, and COVID-19 activity in the community. Surveillance data from laboratory, hospitalization, and death reports are stored in CTEDSS. It is recommended that local health departments use the Local Health Data Portal to access line-level data on respiratory viral diseases. Additional information is available from syndromic surveillance of emergency department visits, wastewater surveillance, vital records death certificates, and CDC’s National Healthcare Safety Network (NHSN). NHSN collects data about COVID-19 hospital admissions and COVID-19 cases and deaths in nursing home residents and staff. Surveillance data are summarized in the DPH Respiratory Viral Disease Surveillance dashboard, which is updated weekly. Surveillance data inform public messaging about respiratory viral disease activity and prevention.
Preventing Severe Illness and Reducing Spread
Key measures for prevention of severe COVID-19, influenza and RSV include vaccines and therapeutics (i.e., long-acting monoclonal antibody). See CDC immunization recommendations for more information. Other measures, such as masking, physical distancing, washing hands, and improving airflow can provide an additional layer of protection by reducing spread.
CDC recommends that people in the community with COVID-19, influenza or RSV should remain home until fever free for 24 hours without the use of fever reducing medications and symptoms are improving. CDC provides specific guidance for exclusion from work of healthcare personnel with COVID-19 and influenza. Antiviral treatments and prophylaxis are available for individuals at increased risk of severe outcomes for COVID-19 and influenza.
Outbreaks
DPH Responsibility: DPH staff recommend appropriate diagnostic testing and provide infection control and prevention guidance to facilities reporting respiratory disease outbreaks.
LHD Responsibility: In case of an outbreak, the LHD works with DPH and local partners to implement control measures.