Infection control measures to prevent seasonal influenza in healthcare settings
- Anna R Thorner, MD
Anna R Thorner, MD
- Deputy Editor — Infectious Diseases
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
In order to optimally prevent or control influenza outbreaks, it is important to identify cases early and implement multiple infection control measures as soon as possible . Recommendations regarding infection control measures for seasonal influenza infection in healthcare settings have been provided by the United States Centers for Disease Control and Prevention and will be reviewed here . Other groups have also developed hospital disaster relief plans for influenza pandemics [3-5].
Healthcare settings include acute care hospitals, long-term care facilities (eg, nursing homes, skilled nursing facilities), physicians' offices, urgent care centers, outpatient clinics, and home healthcare .
Other prevention strategies for seasonal and avian influenza virus infections are discussed separately. (See "Seasonal influenza in children: Prevention and treatment with antiviral drugs" and "Prevention of seasonal influenza with antiviral drugs in adults" and "Treatment and prevention of avian influenza".)
The United States Centers for Disease Control and Prevention (CDC) has suggested that the following measures be undertaken to prevent the spread of seasonal influenza viruses in healthcare settings :
●Promote and administer the seasonal influenza vaccine to healthcare workers and emergency medical services personnel annually. This is the most important measure to prevent seasonal influenza infections. (See "Seasonal influenza vaccination in adults" and "Immunizations for healthcare providers", section on 'Influenza vaccine'.)
- Uyeki TM. 2009 H1N1 virus transmission and outbreaks. N Engl J Med 2010; 362:2221.
- Centers for Disease Control and Prevention. Prevention strategies for seasonal influenza in healthcare settings. http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm (Accessed on October 10, 2016).
- Daugherty EL, Carlson AL, Perl TM. Planning for the inevitable: preparing for epidemic and pandemic respiratory illness in the shadow of H1N1 influenza. Clin Infect Dis 2010; 50:1145.
- Sprung CL, Zimmerman JL, Christian MD, et al. Recommendations for intensive care unit and hospital preparations for an influenza epidemic or mass disaster: summary report of the European Society of Intensive Care Medicine's Task Force for intensive care unit triage during an influenza epidemic or mass disaster. Intensive Care Med 2010; 36:428.
- Hota S, Fried E, Burry L, et al. Preparing your intensive care unit for the second wave of H1N1 and future surges. Crit Care Med 2010; 38:e110.
- Talbot TR, Babcock H, Caplan AL, et al. Revised SHEA position paper: influenza vaccination of healthcare personnel. Infect Control Hosp Epidemiol 2010; 31:987.
- IDSA Policy on Mandatory Immunization of Health Care Workers Against Seasonal and Pandemic Influenza. August 2010. www.idsociety.org/HCWimmunization (Accessed on September 28, 2010).
- Babcock HM, Gemeinhart N, Jones M, et al. Mandatory influenza vaccination of health care workers: translating policy to practice. Clin Infect Dis 2010; 50:459.
- Rakita RM, Hagar BA, Crome P, Lammert JK. Mandatory influenza vaccination of healthcare workers: a 5-year study. Infect Control Hosp Epidemiol 2010; 31:881.
- Talbot TR, Schaffner W. On being the first: Virginia Mason Medical Center and mandatory influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol 2010; 31:889.
- Apisarnthanarak A, Mundy LM. Factors associated with health care-associated 2009 influenza a (H1N1) virus infection among Thai health care workers. Clin Infect Dis 2010; 51:368.
- Johnson DF, Druce JD, Birch C, Grayson ML. A quantitative assessment of the efficacy of surgical and N95 masks to filter influenza virus in patients with acute influenza infection. Clin Infect Dis 2009; 49:275.
- Daniels TL, Talbot TR. Unmasking the confusion of respiratory protection to prevent influenza-like illness in crowded community settings. J Infect Dis 2010; 201:483.
- Loeb M, Dafoe N, Mahony J, et al. Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial. JAMA 2009; 302:1865.
- United States Centers for Disease Control and Prevention. Interim guidance on infection control measures for 2009 h1n1 influenza in healthcare settings, including protection of healthcare personnel http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm (Accessed on October 14, 2011).
- Institute of Medicine of the National Academies. Respiratory protection for healthcare workers in the workplace against novel H1N1 influenza A. http://www.iom.edu/CMS/3740/71769/72967.aspx (Accessed on October 01, 2009).
- Shine KI, Rogers B, Goldfrank LR. Novel H1N1 influenza and respiratory protection for health care workers. N Engl J Med 2009; 361:1823.
- Aiello AE, Murray GF, Perez V, et al. Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. J Infect Dis 2010; 201:491.
- Noti JD, Lindsley WG, Blachere FM, et al. Detection of infectious influenza virus in cough aerosols generated in a simulated patient examination room. Clin Infect Dis 2012; 54:1569.
- IMMUNIZATION OF HEALTHCARE WORKERS
- GENERAL STEPS TO MINIMIZE EXPOSURES
- ISOLATION PRECAUTIONS
- Standard precautions
- - Hand hygiene
- - Gloves
- - Gowns
- Droplet precautions
- - Duration
- Aerosol-generating procedures
- Type of respiratory protection
- MANAGING VISITOR ACCESS
- MANAGING HEALTHCARE WORKERS
- Ill healthcare workers
- HCWs at increased risk for complications
- SUMMARY AND RECOMMENDATIONS