Reports highlight need for children, HCWs to protect themselves against influenza A (H1N1)

Two reports released today call attention to two groups – children and health care workers — that should take special care to avoid the novel influenza A (H1N1) virus and get the vaccine when it becomes available.

CDC Director Thomas Frieden said during a press conference that the studies, published in the Morbidity and Mortality Weekly Report and by the Institute of Medicine, emphasize why these groups have been designated as priority groups to receive the vaccine.

In the MMWR, CDC researchers wrote about the first 36 children that died since last spring from the novel virus; of those, two-thirds had underlying medical conditions like cerebral palsy, muscular dystrophy, asthma, diabetes or cardiovascular problems. Some of the other children who died had bacterial illnesses in addition to this novel influenza, so Frieden cautioned physicians that children who have been treated for fever and return with a high fever should be treated with antibiotics.

Frieden said certain states where children have already begun returning to school, like Georgia and other parts of the Southeast, are noticing an uptick in cases of the novel influenza.

The IOM report, meanwhile, said the experience with this novel influenza makes the issue of respiratory protection for health care workers “urgent.” In the report, IOM researchers encourage health care workers to use fit-tested N95 respirators. They also encourage the CDC, the NIH and other federal agencies to undertake additional research to explore other technologies devoted to respiratory protection.

“Protecting health care workers is extremely important,” Frieden said. “They are the first line of defense, so we are looking at ways to reduce their risk of becoming ill.”

He noted that preventing the spread of virus is extremely important, by using common sense approaches like frequent hand washing and covering coughs and sneezes. Frieden also noted that employers should encourage employees to stay home from work when they are sick and to encourage telecommuting for those who are mildly ill. Other tips for businesses and schools are available at www.flu.gov.

Discussing vaccine development, Frieden said a vaccine is expected in mid-October and will be free in the public health system, but some providers may charge an administration fee. Schools will likely be a venue for vaccine distribution. Frieden cautioned about the potential for adverse events, and urged physicians to report any of these in connection with the vaccine when it becomes available. CDC officials are examining data on whether or not people will need one or two doses of the vaccine. Novartis just reported in a small study that a vaccine plus adjuvant gave immunity in one dose, but Frieden said it is very likely that two doses of vaccine will be required, in at least the pediatric population. — by Colleen Zacharyczuk

MMWR. 2009, 58(34);941-947

IOM. Respiratory protection for healthcare workers in the workplace against novel H1N1 influenza A. Sept. 3, 2009.