In the News

April 28, 2009

Getting Prepared to Fight the Swine Flu

The swine influenza that has been identified in Mexico patients and in several patients in the U.S. is a “H1N1” virus. Although the cases in the U.S. have appeared as milder than the cases in Mexico, the Center for Disease Control (CDC) has issued an alert notice and “Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting.”

Cases in the U.S. with the Swine H1N1 Virus have been identified in New York City, Texas, Kansas, Ohio and California with a total of 20 cases confirmed by serology (as of April 26, 2009). Guidelines from the CDC recommend that:

1) Patients with swine influenza virus infection should be considered potentially contagious for up to 7 days following the beginning of the disease. Those patients who continue to be sick after 7 days are continued to be considered contagious.

2) Patients ill with a flu-like illness confirmed or suspected to have the swine influenza are recommended to stay home for at least 7 days after the onset of the illness except when seeking medical care. Health care workers who are sick with suspected swine flu also should stay home and seek care with their primary care physicians or Employee Health Service to confirm the illness.

3) Patients with respiratory symptoms in the ED or ambulatory offices should wear masks, wash hands frequently, cover their coughs and sneezes with tissue (or forearm sleeve, when tissue not available) promptly discard tissues in the trash, and be seen quickly.

4) The working definition for a possible case now includes: ...influenza-like symptoms (fever, cough, sore throat, runny nose, chills, body aches, diarrhea) and recent travel to Mexico.

5) Swine influenza H1N1 can be confirmed by one of the following tests:

a. Real-time RT-PCR
b. Viral culture

6) For suspected cases, it is imperative that strict infection control practices in the health-care setting are followed to protect patients and health care workers. These include:

a. Frequent and conscientious hand hygiene
b. The patient should wear surgical mask when outside the negative pressure room for x-rays or other tests
c. Strict standard, droplet, and contact precautions should be followed including using disposable gowns, gloves and eye protection (goggles)
d. Strict use of respiratory protection when entering isolation room. The CDC recommends at this time respiratory protection when entering isolation room. The University of Connecticut Health Center has Positive Air Purifying Respirators (PAPRs) available for use in the isolation rooms and these do not require fit testing.

7) For confirmed cases admitted to the hospital additional requirements are:

• Isolation in a negative-pressure room following airborne isolation precautions