525. Screening for Novel H1N1 at a Tertiary Health System in Texas
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Influenza-like illness (ILI) & deaths were reported from Mexico, seven novel H1N1 cases and one death were reported in California and Texas, and public health closed two school districts in the San Antonio vicinity in April 2009. Four tertiary facility healthcare workers (HCW) developed ILI in the setting of (+) flu A tests and WHO elevated the pandemic level to phase 5.
Methods: The facility’s incident command center activated the active surveillance screening component of their pandemic flu policy to prevent nosocomial spread of novel H1N1. A retrospective description of this intervention was conducted.
Results: Access to the facility was decreased from 18 entrances to 4 and screening stations were placed at each entrance. Each station had 3-4 workers during open hours.
Activation included supply/medication inventory, scheduling/training staff, developing educational brochures, directional signs and treatment algorithms. Personnel were trained for station jobs: greeter, screener, or dot/tally person. All persons were screened for ILI with a questionnaire and a temporal thermal scanner. Persons with negative screens were identified with a color, day-specific tag. Persons who screened positive were referred for further triage.
In four days, 10,171 persons were screened. Averages of 38-65 were screened hourly at each site with a wait period of 0-15 minutes. Of 22 screened for ILI, 12 were referred for treatment. 17 employees who were exposed to persons with ILI received prophylaxis. At least one symptomatic visitor was referred to their physician. Screening was discontinued after 4 days due to lack of severe cases of novel H1N1, low number of subsequent ILI cases, and negative confirmatory laboratory tests.
Conclusion: Spread of pandemic flu of unknown severity may require active surveillance screening to prevent spread from the community to hospital patients and HCW, and to preserve workforce capacity. This can be done efficiently, with the collaboration of leadership, clinical personnel, and volunteers.
Jose Cadena, MD, Dept. of Med, Infectious Diseases and Ctr for Patient Safety and Health Policy,Univ. of Texas Health Science Ctr at San Antonio., San Antonio, TX, Patti Grota, PhD, RN, CIC, South Texas VA Health Care System, San Antonio, TX, Jan E. Patterson, MD, FIDSA, FSHEA, University of Texas Health Sciences Center, San Antonio, TX, Thomas Patterson, MD, FIDSA, The University of Texas Health Science Center, San Antonio, TX and  P. G. Grota, None..
J. Cadena, None. 
T. Patterson,
Basilea Role(s): Consultant, Grant Investigator, Received: Research Grant, Consulting Fee.
Pfizer Role(s): Grant Investigator, Speaker's Bureau, Received: Grant Recipient, Speaker Honorarium.
Schering Plough Role(s): Grant Investigator, Received: Research Grant.
Merck Role(s): Consultant, Speaker's Bureau, Received: Speaker Honorarium, Consulting Fee.
J. E. Patterson,
Basilea Role(s): Consultant, Grant Investigator, Received: Research Grant, Consulting Fee.
Pfizer Role(s): Grant Investigator, Speaker's Bureau, Received: Research Grant, Speaker Honorarium.
Schering Plough Role(s): Grant Investigator, Received: Grant Recipient.
Merck Role(s): Consultant, Speaker's Bureau, Received: Speaker Honorarium, Consulting Fee.