By Shannon Eliot
EMS1 Editor
ATLANTA — The CDC has released updated interim guidance on infection control measures to help prevent transmission of 2009 H1N1 influenza in health care facilities.
Its revisions from its earlier H1N1 guidance include:
• Criteria for identification of suspected influenza patients
• Recommended time away from work for health care personnel
• Changes to isolation precautions based on tasks and anticipated exposures
• Expansion of information on the hierarchy of controls which ranks preventive interventions in the following order of preference:
o elimination of exposures
o engineering controls
o administrative controls
o personal protective equipment
• Changes to guidance on use of respiratory protection
“Although the severity, amount and timing of illness that 2009 H1N1 influenza and seasonal influenza will cause is uncertain, as with any influenza season, some people will require medical care as a result of their influenza virus infections,” the guidance stated. “In view of these and other uncertainties, health care facilities will need to be ready to adjust their pandemic influenza plans as dictated by changing conditions.”
More communities are being affected by 2009 H1N1 influenza this fallthan in the spring/summer, according to the guidelines on H1N1. Further, the report recommends that health care providers should take extra precautions in light of the current pandemic’s unique circumstances by conserving supplies of disposable N95 respirators.
According to the report, N95 respirators can be conserved by employing the following steps:
• Minimize the number of individuals who need to use respiratory protection through the use of engineering and administrative controls
• Use alternatives to disposable N95 respirators where feasible
• Extend the use, and consider reuse of disposable N95 respirators
• Prioritize the use of N95 respirators for those personnel at highest risk of exposure
Earlier this month, a Canadian study said surgical masks appear to protect health care workers from catching the flu as well as N95 respirators do in most settings.
Commenting on the use of N95s when dealing with suspected H1N1 cases, Mike McEvoy told EMS1 that “supplies of N95 masks are all but depleted.”
He added, “There continue to be illnesses, such as tuberculosis, that require caretakers to protect themselves from exposure with N95 masks. It makes little sense to stress an already exhausted supply chain by adopting an essentially unproven recommendation to use this level of protection for a virus that causes only mild illness.”
U.S. government doctors stopped counting swine flu cases in July, when they estimated more than 1 million were infected in this country. According to a recent CDC study, one quarter of Americans who were hospitalized with swine flu last spring were sent to intensive care, and 7 percent of them died. While the numbers are slightly higher than seasonal flu, the biggest difference is that nearly half of those hospitalized with H1N1 are children and teens.