Transmission of Pandemic (H1N1) 2009 Influenza to Healthcare Personnel in the United States

Abstract

After identification of pandemic 2009 influenza (pH1N1) in the United States, the Centers for Disease Control and Prevention (CDC) worked with state and local health officials to characterize infections among healthcare personnel (HCP). Detailed information, including likely routes of exposure, was reported for 70 HCP from 22 states. Thirty-five cases (50%) were classified as being infected in healthcare settings, 18 cases (26%) were considered to have been infected in community settings, and no definitive source was identified for 17 cases (24%). Of the 23 HCP infected by ill patients, only 20% reported using an N95 respirator or surgical mask during all encounters and more than half worked in outpatient clinics. In addition to community transmission, likely patient-to-HCP and HCP-to-HCP transmission were identified in healthcare settings, highlighting the need for comprehensive infection control strategies including administration of influenza vaccine, appropriate management of ill HCP, and adherence to infection control precautions.

Predictors of Nurses’ Intentions to Work During the 2009 Influenza A (H1N1) Pandemic

“…5,8,11,12,29 Recent studies suggest that during the 2009 influenza A (H1N1) pandemic, the virus was transmitted to health care workers most often through exposure resulting from inadequate PPE. [30][31][32] Concern for family safety is a widely recognized predictor of willingness to work during disasters, 11,16,25,28,[30][31][32][33] and we found it to be a powerful influence in this study. Willingness to work decreased if respondents lacked a personal family pandemic flu plan, if they weren't confident that their employer would ensure their family's safety while they cared for patients with pandemic flu, and even if vaccine and antiviral medication were provided for both nurse and family.…”

Hospital respiratory protection practices in 6 U.S. states: A public health evaluation study

“…5 Previous studies have found HCWs’ PPE usage, including respiratory protection, to be at suboptimal levels. 7–10 Common documented gaps in practice include improper use of respirators (eg, incorrect donning or doffing procedures) and failure to correctly use recommended types of respiratory protection. 11–14 …”

Willingness of Future Nursing Workforce to Report for Duty During an Avian Influenza Pandemic

“…Among these factors were listed nurses' insufficient theoretical and clinical knowledge of appropriate nursing practices during a pandemic, the fear of contracting the disease or infecting family members, and the concern of work overload during an outbreak as well as the need to work for additional hours (Cheong et al, 2007;Daugherty, Perl, Rubinson, Bilderback, & Rand, 2009;Ehrenstein, Hanses, & Salzberger, 2006;Martin, 2011;Qureshi et al, 2005;Wong et al, 2010;Yonge, Rosychuk, Bailey, Lake, & Marrie, 2007).…”