Health Care Workers Muffed H1N1 Flu Precautions

A snapshot of the health care workers who came down with the H1N1 flu in the first few weeks of the outbreak suggests that proper infection-control practices weren't uniformly followed, the U.S. Centers for Disease Control and Prevention said today.

Despite that, only a handful of health care workers contracted the disease while at work and most of those who did were not seriously ill, according to Dr. Michael Bell, associate director for infection control in the CDC's National Center for Preparedness, Detection, and Control of Infectious Diseases.

They may have dodged a bullet, though, as the pandemic strain has been less dangerous so far than many experts feared, Bell told a telephone news conference.

"I think we've been lucky that this first wave has not been as lethal as some people feared," Bell said.

He said flaws in infection control practices in the early weeks of the outbreak may be a "helpful learning experience."

Bell was referring to a report in the June 19 issue of Morbidity and Mortality Weekly Report, which gave data on 48 cases of H1N1 infection among health care workers up to May 13.

The report is a "snapshot of what we know up to that time," he said, although continuing surveillance now suggests that 81 health care workers have been infected in the course of the outbreak.

But the jump does not reflect a "sudden or alarming change in pattern," Bell said. "We're not seeing anything that would indicate that health care personnel are overly represented among recognized cases in this country."

On the other hand, the lessons from the first 48 cases suggest that rigorous application of the CDC guidelines for infection control is vital to control transmission in health care settings.

A key is rapid recognition that a patient may be infected, he said.

"Probably the single most important thing is that infection patients be identified at the front door" so that health care workers can take the appropriate precautions, he said. "Identifying them up front is essential."

Health Care Workers May Not Have Followed Swine Flu Precautions

The report in MMWR found that many of those infected in health care settings reported incomplete or improper use of personal protective equipment, such as masks, gowns, gloves and respirators.

The findings "highlight the need to maintain adherence to comprehensive infection control strategies to prevent transmission of novel H1N1 in health care settings," the agency said.

As of May 13, there were confirmed or probable infections with the pandemic H1N1 virus in health care workers in 11 states. Two workers -- one of whom had an underlying medical condition -- required inpatient care, but not intensive care.

None of the 48 died.

Of the 48 reports, 26 had information regarding risk factors that might have led to infection, the CDC said; 13 were deemed to have taken place in a health care setting, including 12 cases where the infection was passed from patient to worker and one case of transmission between health care personnel.

Community transmission was deemed most likely for 11 others; the remaining two had no reported exposures in either health care or community settings.

Among the 26 for whom there was information, a dozen reported caring for patients with an H1N1 infection or a respiratory illness and six reported contacts or family members with either H1N1 or respiratory illness. Four reported recent travel to Mexico.

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