# 3836
This afternoon the CDC released two new guidance documents for HCWs (Health Care Workers) and Health Care Facilities on infection Control measures when dealing with the H1N1 virus.
This guidance updates, and in some cases, reaffirms previous guidance on the H1N1 virus from the CDC.
I’ve excerpted, reparagraphed, and in some cases highlighted or bolded some selections from the guidance below.
This is quite a large, and informative document. Follow the link to read it in its entirety
October 14, 2009, 2:00 PM ET
Symptoms of Influenza and Viral Shedding
The symptoms of influenza, including 2009 H1N1 influenza, can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue, nausea, diarrhea, and vomiting. Depending on the case series, the proportion of persons who have laboratory confirmed 2009 H1N1 infection and do not have fever can range from about 10 to 50%.
Because influenza symptoms are nonspecific, it can be difficult to determine if a person has influenza based on symptoms alone. Nonetheless, decisions for clinical management, particularly for outpatients, in most cases can be made on the basis of clinical and epidemiological information. Information on diagnostic testing for 2009 H1N1 viral infection can be found at http://www.cdc.gov/h1n1flu.
In general, the incubation period for influenza is estimated to range from 1 to 4 days with an average of 2 days. Influenza virus shedding (the time during which a person might be infectious to another person) begins the day before illness onset and can persist for 5 to 7 days, although some persons may shed virus for longer periods, particularly young children and severely immunocompromised persons. The amount of virus shed is greatest in the first 2-3 days of illness and appears to correlate with fever, with higher amounts of virus shed when temperatures are highest.
Modes of 2009 H1N1 Influenza Transmission
2009 H1N1 influenza virus appears to be transmitted from person to person through close contact in ways similar to other influenza viruses. Although the relative contribution of each mode is uncertain, influenza virus can potentially be transmitted through:
- Droplet exposure of mucosal surfaces (e.g., nose, mouth, and eyes) by respiratory secretions from coughing or sneezing;
- Contact, usually of hands, with an infectious patient or fomite (a surface that is contaminated with secretions) followed by self-inoculation of virus onto mucosal surfaces such as those of the nose, mouth, and eyes; and
- Small particle aerosols in the vicinity of the infectious individual.
Transmission of influenza through the air over longer distances, such as from one patient room to another, is thought not to occur. All respiratory secretions and bodily fluids, including diarrheal stools, of patients with 2009 H1N1 influenza are considered to be potentially infectious.
Respiratory Protection –
Recommendation: CDC continues to recommend the use of respiratory protection that is at least as protective as a fit-tested disposable N95 respirator for healthcare personnel who are in close contact with patients with suspected or confirmed 2009 H1N1 influenza. This recommendation applies uniquely to the special circumstances of the current 2009 H1N1 pandemic during the fall and winter of 2009-2010 and CDC will continue to revisit its guidance as new information becomes available, within this season if necessary
The CDC has also released a Q&A document on the highlights of this guidance, which is a bit easier to navigate.
I’ve excerpted just a couple of 19 Questions & Answers provided on this page.
October 14, 2009, 4:00 PM ET
Q. How can healthcare facilities eliminate sources of infection and transmission within their facilities?
Healthcare facilities will want to use a multi-level approach, called the hierarchy of controls, that includes both administrative controls and engineering controls to eliminate sources of infection and prevent transmission within their facility. Examples of these strategies are detailed in Table 1 of the guidelines.
To ensure a comprehensive infection control strategy, healthcare facilities will want to:
- Vaccinate their workforce with seasonal and 2009 H1N1 vaccines.
- Keep sick workers at home.
- Enforce respiratory hygiene and cough etiquette.
- Enhance hand hygiene compliance.
- Establish facility access control measures and triage procedures.
- Manage visitor access and movement within the facility.
- Control patient placement and transport.
- Apply isolation precautions.
Q. What personal protective equipment should be worn by healthcare personnel?
Standard precautions should be followed for all patient care. For any activity that might generate splashes of respiratory secretions, gowns along with eye protection should be worn. Healthcare workers who are in close contact with patients suspected or confirmed to have 2009 H1N1 influenza should wear a fit-tested, disposable N95 respirator.
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