In April of 2009, we experienced a global outbreak of novel influenza A (H1N1), formerly known as "swine flu." In any epidemic, it is critical that healthcare professionals (HCPs) are protected so that they can continue to provide care to the seriously ill. When H1N1 spread to the United States, the Centers for Disease Control and Prevention (CDC) worked with healthcare institutions to reduce the risk of transmission to HCPs from exposure to patients infected with the virus. Healthcare professionals were reminded to use personal protective equipment (PPE) at all times, report any flu-like symptoms, and stay home if they were ill.

In spite of these steps, between mid-April and May 13, the CDC received 48 reports from 18 states of confirmed or probable H1N1 virus infection among HCPs.1 Detailed information about these exposures was available for 26 of these cases. Affected HCPs included 5 nurses (20%), 4 nursing assistants (16%), 4 physicians (16%), and 12 others in different occupations. Two of the infected HCPs were hospitalized, but none died. Of these 26 HCP infections, 50% were deemed to have been acquired in the healthcare setting. Most of the exposures were patient to HCP, and one was from HCP to HCP. The remaining HCP infections were most likely acquired in the healthcare setting. The use of PPE, such as masks, gowns, gloves, and eye protection, was inconsistent among the HCPs exposed in the healthcare setting. Only 3 HCPs reported always using either a surgical mask or an N95 respirator, 5 always used gloves, and none used eye protection.

It is highly likely that cases of HCP infection were underreported during the recent epidemic because many exposed individuals were only mildly affected by the virus. Still, among those who were confirmed as being infected with the virus, an alarming number of HCPs failed to adequately protect themselves. These findings point to a lack of understanding among HCPs of the importance of using PPE during a breakout of influenza. Barriers to adherence might include the belief that PPE is unnecessary or burdensome, lack of availability of PPE, or inadequate training in the use of PPE. Furthermore, it is clear that HCPs are just as likely to acquire the virus in the community as they are in the healthcare setting and must be alert to the possible symptoms of infection in themselves or family members.

Reference