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Staff influenza prevention campaign launched

by Mary Allen, R.N., Beth Rhoton, R.N., and Linda Formby R.N.
As part of its mission to stem the spread of disease, especially in the face of the traditional flu season, MUSC employees are urged to receive a vaccine.
 
Infection Control's Mary Allen administers the flu vaccine to Dr. Jerry Reves, dean, College of Medicine on Sept. 24.

The flu vaccine is free to employees, students and volunteers of MUSC, MUHA and UMA and will be available Oct.15 and 16, at the tents set up at both the University Hospital and Ashley River Tower. Hours of operation will be 7 a.m. to 7 p.m. to cover all shifts.
 
Influenza vaccines also will be available at MUSC Employee and Student Health Services and at clinics at ART, IOP and Ambulatory Care locations. Clinical managers may opt to immunize their own staff. (Contact Employee Health Services for additional information.)
 
In addition, flu vaccines will be provided at Wellness Wednesdays beginning Oct. 22 and continuing through Nov. 26. Wellness Wednesdays are held from 10 a.m. to 1 p.m. in the Children’s Hospital lobby.
 
A flu vaccine consent form will be available online at the Employee Health Web site so that staff can print and complete the forms ahead of time. Those arriving at the vaccine tents on Oct. 15 and 16 with a completed and signed form may use the express lane.
 
Consent forms will also be available at all vaccine clinics and locations.

Breaking the cycle
Breaking the transmission cycle of influenza from health care worker-to-patient will prevent the spread of infection and significantly decrease complications due to illness.
 
Evidence-based methods of preventing cross transmission of influenza in the health care setting include:
  • health care worker influenza vaccination programs,
  • meticulous hand hygiene practices, and
  • consistent use of appropriate barriers.
Outbreaks of influenza typically occur in the United States during the late fall through the spring seasons. Influenza viruses can cause disease among persons in any age group, and people of any age who have medical conditions are at increased risk for complications from the flu. Influenza-associated pneumonia and other influenza complications can occur at any age. Medical conditions, such as underlying heart or lung disease, organ transplantation, and cancer with chemotherapy predispose patients to higher risk associated with the flu. Complications and death related to influenza are highest among children aged 2 years and younger, adults 65 years and older.
 
The most important reservoirs of influenza virus are infected people who are most contagious during the first three days of illness. These individuals also can shed the virus beginning the day before symptoms appear and up to seven or more days after onset of symptoms. Infected persons, children and severely immune compromised individuals may shed the virus for longer periods. Asymptomatic individuals who are infected with influenza virus, also can shed the virus and are likely infectious.
 
Annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications. In addition to vaccination, the use of hand hygiene and standard precautions become paramount as a first line of defense.
 
Health care workers are advised to review precautionary measures outlined in infection control policies.
 
Influenza viruses are transmitted by droplet spread from an infected person’s cough, sneeze, or speech. Virus-containing droplets can be directly deposited onto the moist surfaces of the upper respiratory tract of susceptible persons who are near the droplet source (up to 5 feet away). Transmission also may occur by direct (person to person) or indirect (person to object to person) contact. Influenza virus can survive for up to 48 hours on solid surfaces, and up to12 hours on porous surfaces such as paper or cloth; and can be transmitted to hands from these surfaces.
 
Therefore, droplet precautions are to be instituted once a patient is diagnosed with influenza. The addition of contact precautions when caring for infants and young children known or suspected to be infected with flu also is important. (http://www.musc.edu/clined/Unit%20Educators/Infection%20Control.pdf)
 
Other flu-prevention measures include cough etiquette, using a tissue or sleeve—not a bare hand—to cover one’s mouth during a sneeze or cough to prevent others from exposure. Patients and visitors also need to be taught to protect others by covering their mouths with a tissue when coughing or sneezing, coughing into their arms instead of into the room, and also by washing their hands with soap and water or alcohol gel after contact with respiratory secretions.
 
The flu vaccine must be re-formulated each year due to changes in the circulating viruses. These formulas are based on disease surveillance of source countries, normally in the Far East and Pacific Realm.
 
The 2008-09 influenza vaccine provides protection from Type A/Brisbane/59/2007, Type A/Brisbane/10/2007, and Type B/Florida/4/2006 strains.
 
In 2007-2008, a slight decrease in vaccine effectiveness was due to a miscalculation between the virus strains used to manufacture the vaccine and the circulating flu viruses. Officials at MUSC have concluded, based on observations, that the majority of healthcare staff who contracted influenza had denied receiving the flu vaccine that year.

Quick and painless
The flu vaccine is administered via intramuscular injection that is quick and causes little, if any, discomfort. This form of vaccine is an inactivated (killed) vaccine, which does not cause someone to become sick with the flu.
 
All health care workers should receive the vaccine, unless there are contraindications.
 
These contraindications include people with:
  • severe allergy to chicken eggs;
  • severe reaction to previous flu vaccine;
  • anaphylaxis (shock) to flu vaccination;
  • previous Guillain-Barré syndrome (GBS) within six weeks of getting a flu vaccine; and
  • a person with moderate or severe illness and fever should wait to get vaccinated until afebrile and symptoms lessen.
The benefits of getting a vaccine means avoiding illness, fever, severe joint aches and pains, lost time at work, and medical bills for treatment of the flu or its complications.
 
Complications of flu include pneumonia, ear and sinus infections, dehydration and worsening existing medical conditions, heart failure, asthma, COPD, bronchitis, or diabetes for starters. There is a high cost to individuals and the workforce when a large number of people are unable to work because of influenza.
 
There is the possibility of spreading flu to patients, children, teachers, and grandparents and other family members who may require hospitalization, expensive health care or die as a result of flu complications.

Friday, Oct. 10, 2008
Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.