CDC report: Follow recommendations or risk swine flu infections

By: June 23rd, 2009 Email This Post Print This Post

A CDC report links instances of patient-to-healthcare professional (HCP) infection of novel influenza H1N1 to improper personal protective equipment (PPE) usage.

Though covering only a small number of potential or probable causes of infection, “Novel Influenza A (H1N1) Virus Infections Among Health-Care Personnel — United States, April–May 2009” states: “Most of the probable or possible patient-to-HCP transmissions in this report occurred in situations where the use of PPE was not in accordance with CDC recommendations.”

The report, which appears in the June 19 Morbidity and Mortality Weekly Report analyzes healthcare worker usage of gloves, surgical masks, N95 respirators, and eye protection when caring for flu patients. It also examines worker characteristics and facility types. Here are some of the highlights.

  • Among 11 infected workers, only three used either a surgical mask or N95 respirator at all times.
  • Among those three workers was a physician who always wore an N95 respirator but was not fit tested for it.
  • Of the reported infections, 20% were registered nurses, followed by 16% both nursing assistants and physicians.
  • More healthcare worker infections occurred in outpatient or ambulatory settings than in inpatient settings.
  • Despite being at a higher risk, no evidence suggests that healthcare workers are overrepresented among reported cases of persons infected with novel influenza A (H1N1) virus in the United States.

“These results highlight the need to maintain adherence to comprehensive infection-control strategies to prevent transmission of novel H1N1 in health-care settings,” the report concludes.

Any surprises here—not wearing PPE, not fit testing for respirators, more report of wokrer infections in ambulatory than inpatient settings? Let us know in the comment section below.


Well the information on who is getting infected is a big “DUH”. The ambulatory health system is seeing a significant higher number of H1N1 patients.
With this particular disease, it is sometimes hard to know when to put on PPE.

CDC guidelines are still confusing. Does a receptionist need to wear ALL the PPE? They have patients in less than three feet of them and are the ones that normally have to identify and mask the patient. Ever try talking on the telephone with an N95 on?

Do they wear the PPE all day? Do they change it between each patient that comes up to the window?

Not saying that employees are not having some issues in wearing PPE, just saying that these questions should have been reviewed and published early on.

That’s why you use common sense when you come to work. If you have patient’s coughing, the employee should ask the patient to wear a mask.

By T. Mabalon on June 23rd, 2009 at 1:06 pm

There was a recent article re: SHEA’s position of using a surgical mask > N95. Is this a final recommendation re: PPE during this pandemic? Would there be more compliance if surgical masks are used since they are easier to use (ie. w/o fit testing)comfortable, more affordable and accessible?

By Sarah, MSN on June 24th, 2009 at 8:40 am

I agree with Bruce and T. Mabalon. The guidelines need to be specific- are regular masks adequate? There are not enough N95 available right now to use those and there will only be resentment if N95 are required but not available. Help us do our jobs! Ambulatory settings, urgent care and possibly ED are going to encounter more patients with symptoms than hospitals. Give us practical steps e.g.-
hand hygiene, don’t come to work sick, patients need to cover their mouth when they cough and clear up the issue of masks, which one to wear, when to put them on and how often they need to be changed.


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