Providers need more protection from flu

Do face masks really guard against influenza?
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Healthcare workers are exposed to flu through routine patient care much more than previously thought. Patients with influenza can emit small virus-containing particles, potentially risking the health of caregivers, according to a new study published yesterday in The Journal of Infectious Diseases.

Researchers looked at patients admitted to the emergency department and inpatient unit at Winston-Salem, N.C.'s Wake Forest Baptist Medical Center, where flu vaccination is mandatory for healthcare providers. They took air samplers from within 1 foot, 3 feet and 6 feet of patients, and counted the number of patient coughs and sneezes.

Researchers found 65 percent of the surveyed patients tested positive for influenza virus, and 43 percent released the virus into the air. What's more, 19 percent (5 patients) were considered "super-emitters," who were more likely to transmit the flu than other patients, emitting 32 times more virus.

The study challenges the long-standing belief that the flu is spread by large particles traveling up to a maximum of 3 feet to 6 feet from an infected person. Even with face masks, healthcare providers may still be exposed to infectious dosages of up to 6 feet from patients with small, wide-spreading particles--potentially a larger exposure zone, researchers said.

In an accompanying editorial, Caroline Breese Hall of the University of Rochester (N.Y.) School of Medicine and Dentistry said the study means current infection control recommendations may need to be reevaluated.

William Schaffner, a professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn., who was not involved with the study, said the best prevention method is vaccination. "Influenza vaccination, although not perfect, is the best tool we have to protect healthcare workers --and their patients--from influenza illness."

Nevertheless, flu vaccination for healthcare workers remains a controversial measure that pits patient safety against individual rights.

The California Nurses Association encourages its members to get shots but objects to the mask requirement.

"Surgical masks are very flimsy, and they're not very effective," said CNA coPresident Malinda Markowitz, the Contra Costa Times reported.

Markowitz suggests a more effective flu protection method is utilizing housekeeping staff to regularly clean railings, door handles, computers and medication carts. However, she noted hospitals have cut back on such staff.

For more information:
- here's the announcement, study and accompanying editorial
- read the Contra Costa Times article

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