AORN is working daily with the Centers for Disease Control and Prevention (CDC) and other healthcare agencies and organizations to stay current with developments with novel influenza A (H1N1) virus and to provide input to these groups about the unique challenges perioperative professionals are facing. 

Look to this Web page for regular updates on novel influenza A (H1N1) information and send questions to aornnews@aorn.org.

---

                                                                         NEW

                  New information on healthcare workers and H1N1, including information on vaccinations

From The Joint Commission on 6/24/2009
Joint Commission Offers Seasonal Flu Immunization Strategies

From the CDC: June 19 issue of Morbidity and Mortality Weekly Report
Novel Influenza A (H1N1) Virus Infections Among Health-Care Personnel --- United States, April--May 2009

*Note: All healthcare workers need to be vaccinated for seasonal influenza.
                                                    
                                                         Pandemic alert raised for H1N1

From the World Health Organization (WHO): Influenza pandemic alert raised to phase 6 on 6/11/2009
The scientific criteria for an influenza pandemic have been met. Margaret Chan, MD, director-general of WHO has therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.
Read Chan's statement to the press.


                       Updated guidance from the Centers for Disease Control and Prevention (CDC):

Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission

Pregnant Women and Novel Influenza A (H1N1) Considerations for Clinicians

                                                       WHAT YOU NEED TO KNOW
 Listen to Joan Blanchard, RN, BSN, MSS, CNOR, CIC, infection control specialist in AORN's Center for Nursing Practice, share what perioperative professionals need to be thinking about when considering infection control and prevention of H1N1 in the perioperative setting. Read the transcript.

The CDC update to "Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting" is now available online. --4/30/2009 
                                                

— Pandemic Influenza Information from OSHA
http://www.osha.gov/dsg/topics/pandemicflu/index.html 

— Respiratory Hygiene/Cough Etiquette in Healthcare Settings
http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm 

 — Respiratory protection
All healthcare personnel who enter the rooms of patients in isolation for (H1N1) swine influenza should wear a fit-tested disposable N95 respirator or equivalent (e.g., powered air purifying respirator). Respiratory protection should be donned upon room entry. Note that this recommendation differs from current infection control guidance for seasonal influenza, which recommends that healthcare personnel wear surgical masks for patient care. The rationale for the use of respiratory protection is that a more conservative approach is needed until more is known about the specific transmission characteristics of this new virus. 

 —Additional information on N95 respirators and other types of respirators
http://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respfact.html

 —When caring for patients with confirmed or probable swine influenza, healthcare personnel should wear N95 respirators, eye protection and gown and gloves. Airborne and contact precautions should be used.
See the CDC Guideline for Isolation Precautions:
http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf

 —Perioperative staff members experiencing influenza-like illness should remain at home. 

 —Contact your Infection Preventionist or state/local public health department for futher information.        

---

Today's Update on H1N1 from CDC
http://www.cdc.gov/SwineFlu

APIC Information on H1N1
http://www.apic.org/SwineFlu/

CDC Guidance for Healthcare Professionals
http://www.cdc.gov/swineflu/guidance/

Additional CDC Recommendations for:
Respiratory Hygiene Practices
http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm

Isolation precautions
Standard and Contact precautions should be used for all patient care activities (i.e. including all healthcare personnel who enter the patient's room).

Maintain adherence to hand hygiene by washing with soap and water or using alcohol-based hand sanitizer immediately after removing gloves and other equipment and after any contact with respiratory secretions.  Non sterile gloves and gowns along with eye protection should be donned upon room entry for patients in isolation for H1N1 (swine influenza A). 

Find more information on isolation precautions in AORN's Recommended Practices for Prevention of Transmissible Infections in the Perioperative Practice Setting, Perioperative Standards and Recommended Practices, 2009 edition.

Respiratory protection
Interim Recommendations for Facemask and Respirator Use in Certain Community Settings Where Swine Influenza A (H1N1) Virus Transmission Has Been Detected
http://www.cdc.gov/swineflu/masks.htm?s_cid=tw_epr_76

Additional information on N95 respirators and other types of respirators http://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respfact.html
http://www.fda.gov/cdrh/ppe/masksrespirators.html

Cleaning
Environmental Infection Control
http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html

Antivirals
Use of antivirals for infection control
http://www.cdc.gov/swineflu/recommendations.htm

About novel influenza A (H1N1) virus
Investigations of human cases of H1N1 virus infection cases suggest that on-going human-to-human H1N1 virus is occurring.  Illness signs and symptoms have consisted of influenza-like illness - fever and respiratory tract illness (cough, sore throat, runny nose), headache, muscle aches - and some cases have had vomiting and diarrhea. Cases of severe respiratory disease, including fatal outcomes, have been reported in Mexico.

The H1N1 virus that has infected humans in the U.S. and Mexico is a novel influenza A virus that has not previously been identified in North America. This virus is resistant to the antiviral medications amantadine and rimantadine, but is sensitive to oseltamivir and zanamivir.