None of 26 health care workers infected with the novel influenza A (H1N1) virus fully followed the Centers for Disease Control and Prevention's recommended infection control practices, based on data from the CDC's Morbidity and Mortality Weekly Report presented at a press briefing on June 18.
“The single most important thing is that infectious patients be identified at the front door,” said Dr. Michael Bell of the CDC's National Center for Preparedness, Detection, and Control of Infectious Diseases. “Identifying them up front is essential to let health care personnel know that they should be doing the things that we recommend,” he said.
The CDC investigators determined that 13 (50%) of the 26 cases were contracted in health care settings, with 12 cases of transmission from patients to health care providers and 1 case of transmission from one health care provider to another.
A total of 11 providers of the 12 cases of patient-to-provider transmission reported their use of protective equipment when caring for a patient infected with the H1N1 virus. None reported always using gloves, gowns, and either a mask or an N95 respirator. Only three said they always wore a mask or N95 respirator, five said they always wore gloves, and none said they used eye protection.
The CDC's recommendations for health care personnel include staying home when ill; washing hands frequently; and using protective gear including surgical masks, N95 respirators, gloves, and surgical gowns, as well as eye protection.
The results suggest that health care providers aren't over-represented among reported cases of the H1N1 virus so far. The data emphasize the need for health care facilities to adhere to infection control recommendations, identify and triage potentially infectious patients, provide infection control resources, and train staff in infection control practices, the CDC researchers noted.
The study was limited by several factors, however, including potential recall bias, the small number of cases, and the lack of information about several infection control practices, including hand hygiene.
Data on additional cases in health care providers are under review, Dr. Bell said.
The complete report on the novel influenza A (H1N1) cases in the 26 health care workers will be available in the CDC's June 19 Morbidity and Mortality Weekly Report (2009;58:641-5).
Transmission of the H1N1 virus in the United States is expected to continue throughout the summer and increase in the fall, Dr. Daniel Jernigan, a medical epidemiologist in the CDC's Influenza Division, said during the briefing.
The CDC has posted H1N1 guidance for summer camps on its Web site, Dr. Jernigan said. “It's important than aspirin not be used in children with influenza-like illness,” he added, because of the potential for complications.