MANILA, 7 August 2009, 1600 hrs– As the front-line troops in any pandemic response, health care workers face potentially serious risks of infection and illness through the simple act of showing up for work. A key challenge for national and local authorities responding to Pandemic (H1N1) 2009 is to ensure these dedicated professionals receive the best possible protection so they stay well and can continue to play their crucial role in pandemic response.
WHO has called for health care workers worldwide to be the first recipients of the vaccine for Pandemic H1N1 2009. But the first and most crucial layer of protection should occur at the individual level, as health care workers can effectively protect themselves against the new flu virus simply by following basic infection-control practices and correctly using personal protective equipment, such as gloves and surgical masks.
Health care workers are strongly urged to follow infection-control guidelines to reduce the risk of transmission of Pandemic (H1N1) 2009. WHO advises precautions including thorough and frequent hand-washing, the proper use of protective equipment, and if necessary the use of face or eye protection. When performing aerosol-generating procedures such as intubations, WHO further advises the use of fit-tested particulate respirators. All procedures should be performed in adequately ventilated rooms.
Health care personnel in the WHO Western Pacific Region learnt vital lessons about infection control when working with patients with viral illness during the outbreak of severe acute respiratory syndrome (SARS) in 2003–2004. At one point during that outbreak, 41% of SARS patients in Singapore and 22% of cases in Hong Kong (China) were health care workers[1]. A later study found that the infection rate in health workers was tightly correlated to the inconsistent use of personal protection equipment and a poor understanding of infection-control procedures.
The Region has since enhanced its efforts to improve infection control at health facilities. Although progress has been made, health care workers still face the risk of being infected with Pandemic (H1N1) 2009. In the Western Pacific Region, 16 health workers are among the confirmed cases of the new flu virus, although it is not known how many were infected at work.
Elsewhere, in April and May of this year, 13 health care workers in the United States of America were reported to have contracted the new flu virus while on the job. Twelve of these workers were believed likely to have been infected by patients. By mid-June, the United States Centers for Disease Control noted that 81 health care workers had tested positive to the virus, with roughly half of the infections believed to have occurred in a health care setting.
Infections among health care workers can ripple through any health system. Illness in their ranks can reduce the number of medical staff and lead to extra strain on health systems during a pandemic. Obviously, consequences can become more serious if infected staff members infect their patients.
The problem is compounded if adequate protective equipment is unavailable, or if workers are not properly trained in its use. Additionally, potentially infectious patients are not always identified as soon as they arrive at a health facility, so health care workers may not instantly adopt protective measures until a patient is identified as a confirmed case.
To mitigate these risks, it is important that management at health facilities encourage staff to practise basic infection control on a daily basis, organize training courses to refresh staff knowledge and understanding of infection control, and ensure proper protocols are observed on a daily basis. Proper triage of patients with influenza-like illnesses should be practised at all health care facilities. Management is also advised to ensure administrative support so that unwell staff members are quickly identified, and measures such as sick leave are in place if a health care worker is infected.
More on the WHO Pandemic (H1N1) 2009 health care worker guidelines
More on Pandemic H1N1 2009