It’s hard to believe that it has been five years since the COVID-19 pandemic. In retrospect, the COVID-19 pandemic prompted senior living communities to improve their internal infection control practices and reinforced the importance of resilience when facing the unknown nature of a pandemic.
While the pandemic profoundly affected senior living, prompting the need for new internal policies and instilling safety practices to protect all those living and working in a senior living community, the lessons learned were many. They can be applied to future infectious outbreaks and the readiness plans for pandemics. The COVID-19 pandemic highlighted the need for new infection-control standards and regulatory requirements in senior living settings.
While COVID-19 may not be fully normalized like other common infections such as the flu, the infection has evolved significantly since 2020, and healthcare providers have adapted to living with the virus. Today, the COVID-19 virus is being treated similarly to other respiratory viruses. In addition, senior living community infection control plans have evolved, and communities are held to higher infection prevention standards. Because of the need for public health response and proactive identification detection of emerging pathogens, U.S. media outlets have been reporting on recent pathogens to keep an eye on in 2025. Recent reports have been highlighting bird flu and measles outbreaks.
Measles
Measles is most dangerous for children up to age five and immunocompromised adults 65 and older. For individuals born before 1957, they have most often had measles and developed a natural immunity. Nearly everyone born before 1957 was infected with measles during their childhood and in that case won’t need a vaccine. While measles primarily effects children, older adults can suffer severe complications including pneumonia, encephalitis and other serious healthcare issues.
A recent announcement of the measles outbreak is noted to be the worst since 2019 and now more than 200 measles cases being confirmed, according to the CDC’s latest data reported on March 7. While the vast majority of those cases being reported are among people who haven’t been vaccinated, many questions arise about the measles vaccine’s longevity and effectiveness later in life and whether there’s a booster for adults.
The MMR vaccine includes protection against measles, mumps and rubella. The MMRV vaccine adds varicella, or chickenpox, to the same regimen, according to the CDC.
According to the CDC, If you have not ever been vaccinated, the MMR vaccine can be administered to someone in the first 72 hours after they were knowingly exposed to measles and that can offer some protection against the worst symptoms of the disease. If you were vaccinated as a child, you will not need another shot as an adult. Measles is highly contagious and spreads more easily than the flu, COVID-19 and even Ebola, according to Harvard Medical School. Anyone with a fever of more than 101 degrees Fahrenheit with an associated rash and cough, and if they traveled internationally or to a measles hotspot in the U.S., should be tested for measles.
The Advisory Committee on Immunization Practices (ACIP) recommends that people who don’t have presumptive evidence of immunity to measles, mumps and rubella should get vaccinated against these diseases.
Presumptive evidence of immunity can be established in any of the following ways:
Although birth before 1957 is considered acceptable evidence of immunity for healthcare personnel in routine circumstances, healthcare facilities should consider vaccinating healthcare personnel born before 1957 who lack laboratory evidence of immunity or laboratory confirmation of disease.
Healthcare providers should not accept verbal reports of vaccination without written documentation as presumptive evidence of immunity.
People exposed to measles who can’t readily show that they have adequate presumptive evidence of immunity against measles should be offered post-exposure prophylaxis (PEP). Public health officials can help identify eligible persons, assess any contraindications and weigh benefits.
There are two types of PEP for measles. To potentially provide protection or modify the clinical course of disease among susceptible persons, administer one of these:
Don’t administer MMR vaccine and IG simultaneously. This practice invalidates the vaccine.
Most older adults don’t need to worry if they had measles before or received a full vaccination are protected. For those unsure about their immunity, they should check their records, get tested or get a second dose.
Older adults who have already had measles or received two doses of the vaccine are protected. If you were born after 1957 and received one or two doses of the measles vaccine, you are considered protected. One dose is about 93% effective, while two doses provide around 97% protection.
If you only had one dose, your healthcare provider may recommend a second dose if you:
Avian flu
Avian flu is on the radar for the public health sector. This virus is being detected in wild birds, livestock and humans. While the risk of avian flu to senior living communities may vary based on local circumstances, it’s a necessity for communities to have preparedness plans to address potential outbreaks and to protect residents and staff.
Based on data from other countries, the risk of getting extremely sick from bird flu increases with age, such as in older adults. Human cases are rare, but symptoms can be severe and like other types of flu, symptoms may include high fever, coughing and sore throat, muscle aches, eye infections and shortness of breath. If residents have had an exposure to infected birds or traveled to areas populated with infected birds, it’s important to provide medical attention immediately to prevent complications and limit the virus spread.
In the U.S., people with job- or recreational-related exposures to birds, dairy cows or other avian influenza A virus-infected animals or to contaminated products (e.g., raw milk) from infected animals are at greater risk of infection.
Senior living communities should take precautions now, ensuring symptomatic residents and staff are screened and isolated as needed. There currently is no vaccine for avian flu and some sensitive influenza A tests may detect avian flu since it’s a subtype.
Best-practice tips for detecting community infections include screening, isolation and ensuring good community infection control surveillance and control practices are in place.
| Myth | Fact |
|---|---|
| Eating chicken or eggs from infected chickens can cause avian flu. | Properly cooking poultry and eggs are safe to eat. Cooking food at appropriate temperatures kills the virus, making it impossible to contract avian flu through consumption. |
| Bird flu only affects birds. | Human infections are rare but can occur, especially among those who have had close contact with infected birds. There have been cases reported in a range of mammals, including cows, dogs, cats. |
| Avian flu is the same as seasonal flu or common cold. | Avian flu and seasonal flu are caused by different viruses. Seasonal flu typically affects humans while avian flu primarily spreads among birds and has different strains not easily transmitted to humans. Bird flu spreads through direct contact of infected birds, while seasonal flu spreads through coughs, sneezes or touching contaminated surfaces. |
| A mask of gloves can fully protect you from bird flu. | Protection depends on a level of exposure and hygiene practices. Protective gear can help reduce the risk of exposure, especially for those working closely with birds. It isn’t a foolproof solution. Proper hygiene and sanitation matter just as much as wearing a mask. The real key to protection is avoiding direct contact with sick birds, washing hands after handling animals and ensuring that pets don’t come into contact with infected wildlife |
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While bird flu and measles may not be a considerable risk exposure to senior living communities, senior living communities should continue to be vigilant in executing sound infection prevention and control plans.
Based on the CDC’s experience, senior living communities can take several steps to prevent the spread of infectious disease.
Listeria outbreaks linked to supplement shakes
The CDC, FDA and public health officials in several states are investigating a multistate outbreak of Listeria infections linked to supplement shakes. Many people in the outbreak lived in long-term care facilities or were hospitalized before becoming sick. On February 22, 2025, Lyons Magnus LLC recalled frozen supplement shakes that were distributed to food service operators of long-term care facilities.
Listeria infections can be especially harmful to people over the age of 65 and people with weakened immune systems and it can spread beyond the gastrointestinal system to other parts of the body resulting in a severe condition known as invasive listeriosis, which can lead to hospitalizations and sometimes death.
Symptoms usually occur within two weeks after eating food contaminated with Listeria but may start as early as the same day or as late as 10 weeks after. Symptoms of Listeria include headache, stiff neck, confusion, loss of balance and convulsions, in addition to fever, muscle aches and tiredness.
Unlike most bacteria, L. monocytogenes can grow at refrigeration temperatures and freezing won’t eliminate or reduce the pathogen. The FDA recommends that time and temperature controls to reduce the opportunity for the growth of L. monocytogenes. It can also cross-contaminate other food that’s been cut and served on the same cutting board or stored in the same area.
Communities should check with their states for specific guidance. More information can be found in the 2022 FDA Food Code.
While bird flu, measles outbreaks and food-borne illness pose a significant public health challenge, and because older adults have a unique vulnerability due to age and existence of comorbidities and compromised health conditions, senior living communities require a focused approach to maintaining infection control practices and immunization efforts.
It’s imperative that senior living communities establish a collaborative relationship with public health authorities to mitigate risk an protect residents and staff from infectious disease outbreaks. Routine monitoring and preparedness plans are essential and an operational responsibility to manage potential outbreaks effectively.
WTW hopes you found the general information provided in this publication informative and helpful. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal advisors. In the event you would like more information regarding your insurance coverage, please do not hesitate to reach out to us. In North America, WTW offers insurance products through licensed entities, including Willis Towers Watson Northeast, Inc. (in the United States) and Willis Canada Inc. (in Canada).
