1 in 5 Contracted H1N1

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Approximately 57 million Americans have contracted swine flu since the pandemic began in 2009, according to the Centers for Disease Control and Prevention (CDC). The agency also reported 11,690 deaths as a result of swine flu, and 257,000 people in the United States were hospitalized as a result of the pandemic.

Analysis featured on WebMD Health News notes that CDC’s calculations reveal 2 million Americans caught swine flu between early December 2009 and mid-January of this year. The CDC’s Web site indicates that most recent flu cases were caused by H1N1.

CDC’s hierarchy of controls to prevent influenza transmission include the following steps listed in order of preference:

1. Elimination of potential exposures. Eliminating the potential source of exposure ranks highest in the hierarchy of controls. Examples of interventions in this category include taking steps to minimize outpatient visits for patients with mild influenza-like illness who do not have risk factors for complications, postponing elective visits by patients with suspected or confirmed influenza until they are no longer infectious, and denying entry to visitors who are sick.

2. Engineering controls. Engineering controls rank second in the hierarchy of controls. They are particularly effective because they reduce or eliminate exposures at the source and many can be implemented without placing primary responsibility of implementation on individual employees. In addition, these controls can protect patients as well as personnel. Examples of engineering controls include installing partitions in triage areas and other public spaces to reduce exposures to personnel and other patients, and using closed suctioning systems for airway suction in intubated patients.

3. Administrative controls. Administrative controls are required work practices and policies that prevent exposures. As a group, they rank third in the hierarchy of controls because their effectiveness is dependent on consistent implementation by management and employees. Examples of administrative controls include promoting and providing vaccination; enforcing exclusion of ill healthcare personnel, implementing respiratory hygiene/cough etiquette strategies; and setting up triage stations and separate areas for patients who visit emergency departments with influenza-like illness.

4. Personal protective equipment (PPE). PPE ranks lowest in the hierarchy of controls. It is a last line of defense for individuals against hazards that cannot otherwise be eliminated or controlled. While providing personnel with appropriate PPE and education in its use is important, effectiveness of PPE is dependent on a number of factors. PPE is effective only if used throughout potential exposure periods. PPE will not be effective if adherence is incomplete or when exposures to infectious patients or ill co-workers are unrecognized. In addition, PPE must be used and maintained properly, and must function properly, to be effective.

Careful attention to elimination of potential exposures, engineering controls, and administrative controls will reduce the need to rely on PPE, including respirators. This is an especially important consideration when respirators are in short supply.

View CDC’s guidelines for preventing H1N1 infection in healthcare facilities at http://www.cdc.gov/h1n1flu/clinicians.

FAC

Useful link related to this article:
• Don't Panic! How to Prepare Your Facility for the H1N1 Pandemic
http://www.workplacetrainingcenter.com/Prod-1374.aspx

• NSC Offers H1N1 Prevention Tips
http://www.facilitycare.com/ezinestory/2009/Dec/12292009Article3.htm

• Swine Flu Precautions for Healthcare Facilities Issued
http://www.facilitycare.com/ezinestory/2009/Nov/11242009Article4.htm