Abstract
The Centers for Disease Control and Prevention (CDC) recommends that health care personnel (HCP) infected with pandemic influenza (H1N1) 2009 virus not work until 24 hours after fever subsides without the use of antipyretics. During an influenza outbreak, we examined the association between viral shedding and fever among infected HCP. Participants recorded temperatures daily and provided nasal wash specimens for 2 weeks after symptom onset. Specimens were tested by using PCR and culture. When they met CDC criteria for returning to work, 12 of 16 HCP (75%) (95% confidence interval 48%–93%) had virus detected by PCR, and 9 (56%) (95% confidence interval 30%–80%) had virus detected by culture. Fever was not associated with shedding duration (p = 0.65). HCP might shed virus even when meeting CDC exclusion guidelines. Further research is needed to clarify the association between viral shedding, symptoms, and infectiousness.
Highlights
The Centers for Disease Control and Prevention (CDC) recommends that health care personnel (HCP) infected with pandemic influenza (H1N1) 2009 virus not work until 24 hours after fever subsides without the use of antipyretics
The Centers for Disease Control and Prevention (CDC) created guidelines for infection control in health care settings to prevent influenza transmission from infected HCP to patients and other HCP. [1] These guidelines for the 2009 influenza season (2009 CDC criteria) recommend that HCP who have a fever and respiratory symptoms stay home from work for 24 hours after fever subsides without the use of fever-reducing medications
A limited number of studies have described the duration of pandemic (H1N1) 2009 virus shedding among healthy persons, as estimated by the presence of viral RNA detected by real-time reverse transcription–PCR (RT-PCR) or viable virus detected by culture
Summary
The Centers for Disease Control and Prevention (CDC) recommends that health care personnel (HCP) infected with pandemic influenza (H1N1) 2009 virus not work until 24 hours after fever subsides without the use of antipyretics. Health care personnel (HCP) with influenza infections can transmit virus to patients. Understanding the duration of shedding of pandemic (H1N1) 2009 virus detected by rapid culture and real-time reverse transcription–PCR (RT-PCR) among HCP is useful in developing infection prevention measures for the health care setting. A limited number of studies have described the duration of pandemic (H1N1) 2009 virus shedding among healthy persons, as estimated by the presence of viral RNA detected by real-time RT-PCR or viable virus detected by culture. We conducted an investigation to characterize the influenza outbreak and describe viral load changes, shedding duration, and the association between these factors and fever
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