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Health care professionals who return to work after influenza illness may still shed virus
Kay M. Emerg Infect Dis. 2011.doi:10.3201/eid1704.100866.
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Although additional information is needed about the association between the detection of influenza virus in recovering patients and the transmission of infection to others, health care personnel should be vaccinated against influenza, stay home from work while ill, and practice good hand and respiratory hygiene and cough etiquette, said Meagan Kay, DVM, MPVM.
Few studies have described the duration of 2009 H1N1 pandemic virus shedding among healthy individuals, therefore, Kay, CDC Epidemic Intelligence Service Officer of Public Health, and colleagues pooled data from the outbreak among health care personnel who attended a work retreat at a hospital in Seattle between Sept. 21-25, 2009.
The researchers aimed to distinguish the influenza outbreak and describe changes in viral load, duration of shedding, and the association with fever in 46 retreat participants.
Active surveillance identified 20 people with respiratory symptoms, of which 19 were core participants and one a retreat facilitator. Seventeen cases were virus positive (53%), seven of which measured a fever of 100.5·F or higher and reported a cough or sore throat.
Within 2 days of symptom onset, infected health care workers were treated with 75 mg oral oseltamivir (Tamiflu, Roche) twice-daily for 5 days. All patients were excluded from work for 7 days after symptom onset. Those who did not become infected were assigned 75 mg oral oseltamivir once-daily for 10 days and were not excluded from work.
When health care personnel met CDC criteria for returning to work, 12 of the 16 personnel (95% CI, 48-93) had virus detected by PCR test, and virus was detected by culture in nine (95% CI, 30-80). Fever was not associated with shedding duration (P=.65), suggesting that health care personnel may shed virus even after meeting CDC exclusion guidelines, according to the researchers.
“Because health care providers might be returning to work while they are still shedding influenza virus, health care providers should be vaccinated against influenza each year to prevent influenza transmission in the health care setting,” Kay, told Infectious Disease News. “Health care providers should also practice hand and respiratory hygiene and cough etiquette at all times, particularly when returning to work after influenza infection.” – by Ashley DeNyse
Disclosure: Dr. Kay reports no relevant financial disclosures.
The findings of this study reinforce the need for health care providers to adhere to recommended infection control practices including hand hygiene and respiratory hygiene/cough etiquette at all times when taking care of patients. The study also supports the recommendation for annual influenza vaccination for health care providers. In addition to helping prevent transmission of microbes that any of us may carry without manifesting symptoms, infection control measures are also critical to prevent transmission of health care associated infections between patients. - Rima F. Khabbaz, MD Deputy director, infectious diseases, CDC Disclosure: Dr. Khabbaz reports no relevant financial disclosures
– Rima F. Khabbaz, MD
Deputy director of infectious diseases, CDC
Disclosure: Dr. Khabbaz reports no relevant financial disclosures.
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