Screening triage for fever and respiratory symptoms
All patients who present to a health care setting should be screened for fever and respiratory symptoms. This should include:

• Passive screening: visual alerts posted at the entrances to all health care settings asking patients to report whether they have fever and any new or worsening respiratory symptoms, and
• Active screening: At first contact, staff asks about fever and respiratory symptoms.

Respiratory symptoms include cough, sore throat, coryza (runny nose), and myalgias (general body aches).

Infection prevention and control precautions for patients
Patients who report fever and respiratory symptoms should be instructed to:

• clean their hands with 60-90% alcohol-based hand gel (or soap and water if immediately available),
• don a surgical mask (should be made available to patients on request or when identified by staff to have ILI), and
• be seated at least 1 meter (3 feet) away from others. If this is not possible in the waiting room setting, he/she should be placed immediately in an examining room.

The clinic staff should also provide the following whenever possible;

• Facilitate the practice of cough etiquette (re-enforced with visuals aids / posters) with availability of tissues placed at strategic areas in clinic
• Provision of foot operated disposal bins for tissue and mask disposal in the patient waiting area

Routine practices and contact precautions for clinicians
The following infection control practices are indicated when assessing patients with fever and respiratory symptoms:
Before a clinical assessment:

• Ensure patient is still wearing a surgical mask
• Perform hand hygiene (alcohol based hand rub or soap and water) before and after patient assessment
• Put on gloves
• A gown is needed only when there is a risk of clothing or skin contamination (such as when examining young children who may have difficulty controlling their secretions)

Respiratory protection
Healthcare workers should wear respiratory protection when within 1 meter of a suspect influenza-like illness (ILI) case. The choice between a surgical mask and N95 respirator should be based on the following:
a)  Wear a surgical mask:

• If the patient is compliant with respiratory hygiene practices (e.g. wearing a surgical mask) or
• If the patient has a weak or no cough.

b)  Wear an N95 mask

• If conducting an aerosol-generating medical procedure on a suspect ILI case. All individuals in the room should wear an N95 respirator, or
• When the patient is coughing forcefully and is unable or unwilling to comply with respiratory hygiene (e.g., coughing patient who is unable or unwilling to wear a surgical mask);

Whenever a surgical mask or respirator is required, the HCW should also wear eye or
face protection.
After a clinical assessment:

• Eye or face protection should be removed after leaving the case’s room and disposed of in either a hands-free waste receptacle (if disposable) or in a separate receptacle to go for reprocessing (if reusable).
• The surgical mask or N95 respirator should be removed by the straps, being careful not to touch the mask or respirator itself, after leaving the case’s room and disposed of in a hands-free waste receptacle.
• HCWs should perform hand hygiene after removing the respiratory protection and after leaving the case’s room
• Affected surfaces that may have been contaminated with droplets need to be cleaned. Routine office cleaning products are effective for respiratory viruses including influenza; no special cleaning products are needed.
• There is no indication for use of personal air-purifying respirators (PAPRs) in the care of a suspect ILI case.