Based on the current state of knowledge, IDSA and the Association for Professionals in Infection Control and Epidemiology (APIC) have endorsed the Society for Healthcare Epidemiology of America’s (SHEA) Position Statement: Interim Guidance on Infection Control Precautions for Novel Swine-Origin Influenza A H1N1 in Healthcare Facilities. This science-based statement expresses strong support for updating CDC guidance on recommended infection prevention and control in health care settings for the current wave of the novel H1N1 outbreak. The statement specifically endorses implementing the same practices recommended to prevent the transmission of seasonal influenza. Specifically, SHEA recommends:

• identifying suspected cases of novel H1N1 as soon as possible
• using standard and droplet precautions for suspected or confirmed cases
• placing surgical masks on patients with suspected or confirmed novel H1N1 infection at the point of contact with the health care facility
• putting such patients in a single room, if available, or placing them with other infected patients (negative pressure rooms are not routinely needed)
• adhering strictly to hand hygiene, respirator hygiene, and cough etiquette
• restricting visitors and health care workers with febrile respiratory illness
• the use of surgical masks by health care workers for respiratory protection during routine patient care activities, as opposed to continued universal use of N95 particulate respirators

The SHEA document does support current recommendations for enhanced respiratory protection when performing certain aerosol-generating procedures on patients with suspected or confirmed infection, including wearing a fit-tested N95 particulate respirator, gloves, eye protection, and a gown when performing these activities. However, SHEA notes these recommendations should be re-evaluated as more data become available.

SHEA has provided its statement to Thomas Frieden, MD, director of the Centers for Disease Control and Prevention (CDC), and to a top official at the Occupational Safety and Health Administration. A federal advisory group, the Healthcare Infection Control Practices Advisory Committee, is also expected to weigh in the months ahead regarding the use of surgical masks and respirators.

In addition to other recommendations, CDC officials continue to urge that health care workers with influenza symptoms stay home from work. (See this related item from the Morbidity and Mortality Weekly Report (MMWR).) For updated guidance documents from CDC and other sources on diagnostics, infection control, antiviral use, and related matters, see the H1N1 page on the IDSA website. To sign up to receive the latest notices from CDC’s Health Alert Network and the Food and Drug Administration—on H1N1 and other timely topics—click here (you must be logged in to have access to this link).

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