<p> Kent Health Protection Team T 0344 225 3861Ext 1 Level 2, Civic Centre F 01233 639747 Tannery Lane Ashford TN23 1PL</p><p>Surrey & Sussex Health Protection T 0344 225 3861Ext 1 Team F 01403 251006 Parkside Chart Way Horsham RH12 1XA</p><p> www.gov.uk/phe</p><p>8 January 2016</p><p>To Care Home managers in Kent, Surrey and Sussex</p><p>Dear Colleague,</p><p>Re: Seasonal influenza outbreaks – awareness and notification</p><p>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. </p><p>The definition of a flu outbreak is: </p><p>• 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</p><p>Symptoms and signs of flu-like illness include:</p><p> 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</p><p>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. </p><p>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.</p><p>Yours sincerely</p><p>Dr Sarah Lock Consultant in Communicable Disease Control Kent, Surrey and Sussex Health Protection Team</p>