On a unit with an influenza A outbreak, what transmission-based precautions should be instituted?

• A. A private room with airborne isolation
• B. Standard precautions only
• C. Cohort confirmed influenza patients together in semiprivate rooms on droplet precautions
• D. Private rooms with contact precautions

Answer: (C)

Influenza spreads mainly through respiratory droplets expelled when an infected person coughs, sneezes, or talks. Because of this, the protective approach focuses on droplet precautions rather than airborne ones. Place infected patients in a private room when possible, but if multiple confirmed influenza patients are present and private rooms are limited, they can be cohorted together in semiprivate rooms as long as droplet precautions are strictly followed. This means healthcare workers should wear masks when within about 3 to 6 feet of the patient, patients should wear masks when they leave the room, and gloves and gowns should be used as needed for contact with secretions, with rigorous hand hygiene.

Airborne isolation is unnecessary for influenza because it is not typically transmitted via small aerosol particles over long distances. Standard precautions alone don’t address the droplet route, and relying on contact precautions alone would miss the primary droplet transmission pathway, so combining droplet precautions with the practical option of cohorting influenza patients in semiprivate rooms best balances safety and resource use.