[MCOH-EH] Influenza exposure

Waite, Starla swaite at childrensomaha.org
Thu Jan 11 09:02:38 PST 2018
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Please see below for our Influenza exposure and Tamiflu propylaxsis per CDC guidelines

We do not treat with Tamiflu for an exposure unless you are diagnosed with influenza or in a High Risk category.
     If someone in your office meets that criteria,they need to contact Employee Health.

Significant Exposure:
1.   Within in 6 feet without an ear loop mask for normal care
2.  Without N95 mask when doing a procedure producing aerosolization
3. Direct mucous membrane contact with oral or respiratory secretions
4. Direct contact with articles contaminated with nasopharyngeal secretions.

Per CDC guidelines:
No treatment is recommended for those who do not have s/s or did not have a significant exposure.  There are new guidelines out that state you should start treatment before the results of the respiratory viral panel is back if you are highly suspicious of influenza and not wait because Tamiflu has shown to be very effective treatment.  

Children's Protocol:
A mask needs to be worn if there was and exposure and  during the incubation period which is 4 days. If the individual that was diagnosed was wearing a mask,no one is considered exposed.
If s/s develop  within the 4 day incubation period,they should notify Employee Health.
S/S:
-Notify Employee Health
-Must be off work for 7 consecutive days from symptom onset or 24 hours after symptom resolution, whichever is longer
-Must be cleared by EH before returning to work

High Risk Categories for treatment IF an exposure occurred(refer to above guidelines)
1. 65 years and older
2.  Chronic disease or immunosuppressed
3. American Indian/Alaska Native
4. Morbidly Obese
5. Pregnant or within 2 weeks post-partum

Starla Waite RN
Employee Health Supervisor

Children's Hospital & Medical Center
8200 Dodge Street * Omaha, NE 68114-4113
402.955.6021 * 402.955.6025 FAX
swaite at ChildrensOmaha.org 

We know children. * ChildrensOmaha.org

-----Original Message-----
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Sent: Thursday, January 11, 2018 10:38 AM
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Subject: MCOH-EH Digest, Vol 253, Issue 14

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Today's Topics:

   1. Re:  Flu (Thanassi, Wendy)
   2. Re:  Flu (Deborah A. Pruim)
   3. Re:  Flu Masking (Birkholz, Brenda M)


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Message: 1
Date: Wed, 10 Jan 2018 20:29:15 +0000
From: "Thanassi, Wendy" <Wendy.Thanassi at va.gov>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Flu
Message-ID:
	<1C146C062A1C154EB3FC66642F006D63164628F3 at VAPNSMSGD51S09.vha.med.va.gov>
	
Content-Type: text/plain; charset="us-ascii"

Yes, liberally with contacts.

From: MCOH-EH [mailto:mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net] On Behalf Of Susan Higgins
Sent: Wednesday, January 10, 2018 4:22 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] Flu

Hello
On a rare occasion if the employee indicates direct contact without the use of appropriate PPE with a confirmed flu positive patient.
Sue
Susan Higgins RN, BSN, COHN
Sturdy Memorial Occupational Health Manager P  508-236-7505 F  508-222-0796


From: MCOH-EH [mailto:mcoh-eh-bounces+shiggins=sturdymemorial.org at mylist.net] On Behalf Of Isakari, Marcia
Sent: Tuesday, January 09, 2018 2:15 PM
To: 'mcoh-eh at mylist.net'
Subject: [MCOH-EH] Flu

Hi,
Does your organization provide influenza prophylaxis (Tamiflu) to health care workers?


Marcia Isakari, MD, MPH
Medical Director

Center for Occupational and Environmental Medicine UC San Diego Health
200 W. Arbor Drive #8800
San Diego, CA 92103-8800
T: 858-657-1600 F: 619-543-7065
misakari at ucsd.edu<mailto:misakari at ucsd.edu>
health.ucsd.edu<https://urldefense.proofpoint.com/v2/url?u=https-3A__health.ucsd.edu_specialties_occ_Pages_default.aspx&d=DwICAg&c=DnANjVtvz6soFAeufrdBN-5Q9R87-pGPRepzsRZj-u0&r=io3z7ejX5xHmtFjzRweNnl7TO6LMNp5spbAGaColQ2U&m=0Hw63OuA86-hC-B5OV-nwfsz-kB-uHPkKBBLC3I5U2g&s=4QXmbBzmhZbwPGbPh9ECzjJdksgK8fVKyX8yb-Z2tjQ&e=>

PLEASE TAKE NOTICE: The information transmitted is intended only for the person or entity to which it is addressed and may contain information that is confidential, privileged and/or otherwise exempt from disclosure under applicable state and federal law, including, but not limited to, privacy standards imposed pursuant to the Federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you receive this transmission in error, please contact the sender immediately and delete the material from any computer. Thank you.



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s). The information contained in this message is private and confidential, may contain legally protected health information and may be subject to one or more non-disclosure agreements, HIPAA privacy regulations and other laws. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail, delete it from your computer, and destroy all copies of the original message.

Thank you.
Sturdy Memorial Hospital.

  
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Message: 2
Date: Thu, 11 Jan 2018 12:50:01 +0000
From: "Deborah A. Pruim" <dpruim at lcmh.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Flu
Message-ID:
	<697444D27F6F654CBC2FA6417AA0D6DB607E6332 at ZEXCHMB1.LCMH.ORG>
Content-Type: text/plain; charset="us-ascii"

PPE is required with all respiratory patients at this time.  We do not give Tamiflu to staff.
Deborah Pruim, RN, MSN, APN, CNS
Employee Health Services
Little Company of Mary Hospital
2800 W. 95th Street
Evergreen Park, IL  60805
Monday - Friday
6:30am-3pm
Phone:  708-229-5623
Fax:  708-229-6618
dpruim at lcmh.org<mailto:dpruim at lcmh.org>
[cid:image001.png at 01D2A32C.E73F4EA0]



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thanassi, Wendy
Sent: Wednesday, January 10, 2018 2:29 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Flu

Yes, liberally with contacts.

From: MCOH-EH [mailto:mcoh-eh-bounces+wendy.thanassi=va.gov at mylist.net] On Behalf Of Susan Higgins
Sent: Wednesday, January 10, 2018 4:22 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [EXTERNAL] Re: [MCOH-EH] Flu

Hello
On a rare occasion if the employee indicates direct contact without the use of appropriate PPE with a confirmed flu positive patient.
Sue
Susan Higgins RN, BSN, COHN
Sturdy Memorial Occupational Health Manager P  508-236-7505 F  508-222-0796


From: MCOH-EH [mailto:mcoh-eh-bounces+shiggins=sturdymemorial.org at mylist.net] On Behalf Of Isakari, Marcia
Sent: Tuesday, January 09, 2018 2:15 PM
To: 'mcoh-eh at mylist.net'
Subject: [MCOH-EH] Flu

Hi,
Does your organization provide influenza prophylaxis (Tamiflu) to health care workers?


Marcia Isakari, MD, MPH
Medical Director

Center for Occupational and Environmental Medicine UC San Diego Health
200 W. Arbor Drive #8800
San Diego, CA 92103-8800
T: 858-657-1600 F: 619-543-7065
misakari at ucsd.edu<mailto:misakari at ucsd.edu>
health.ucsd.edu<https://urldefense.proofpoint.com/v2/url?u=https-3A__health.ucsd.edu_specialties_occ_Pages_default.aspx&d=DwICAg&c=DnANjVtvz6soFAeufrdBN-5Q9R87-pGPRepzsRZj-u0&r=io3z7ejX5xHmtFjzRweNnl7TO6LMNp5spbAGaColQ2U&m=0Hw63OuA86-hC-B5OV-nwfsz-kB-uHPkKBBLC3I5U2g&s=4QXmbBzmhZbwPGbPh9ECzjJdksgK8fVKyX8yb-Z2tjQ&e=>

PLEASE TAKE NOTICE: The information transmitted is intended only for the person or entity to which it is addressed and may contain information that is confidential, privileged and/or otherwise exempt from disclosure under applicable state and federal law, including, but not limited to, privacy standards imposed pursuant to the Federal Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you receive this transmission in error, please contact the sender immediately and delete the material from any computer. Thank you.



CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s). The information contained in this message is private and confidential, may contain legally protected health information and may be subject to one or more non-disclosure agreements, HIPAA privacy regulations and other laws. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail, delete it from your computer, and destroy all copies of the original message.

Thank you.
Sturdy Memorial Hospital.

  
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Message: 3
Date: Thu, 11 Jan 2018 16:37:29 +0000
From: "Birkholz, Brenda M" <BBirkholz at hutchhealth.com>
To: "'mcoh-eh at mylist.net'" <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Flu Masking
Message-ID:
	<MWHPR14MB17754D5642FD6EB9A22975FAAA160 at MWHPR14MB1775.namprd14.prod.outlook.com>
	
Content-Type: text/plain; charset="iso-8859-1"

Replies after questions below.  Thanks, Brenda

Brenda Birkholz, MPH, RN, COHN-S
Manager, Occupational Health and Out-Patient Education Hutchinson Health
1095 Hwy #15 S
Hutchinson, MN? 55350
Ph: 320-484-4502
Fax: 320-484-4643

----------------------------------------------------------------------

Message: 1
Date: Tue, 9 Jan 2018 14:55:39 +0000
From: "Weaver  Meredith" <weaverm at wvumedicine.org>
To: "'mcoh-eh at mylist.net'" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Flu Masking
Message-ID:
	<1281DAFA0298594E94534568B2F5A551014BA39E6D at NT-EX1.wvuhs.com>
Content-Type: text/plain; charset="us-ascii"

Good morning, I have a few questions for the group about your influenza vaccination programs, in particular masking of exempted employees.  We require all exempted employees to wear masks while working on health system owned or leased property, regardless of whether they have patient contact.  Based upon lab confirmed influenza rates in our hospital, we invoked our masking protocol on Friday, December 29th and are looking for feedback from other hospitals on how you handle your programs.


*         Organization Name  Hutchinson Health

*         Does your organization have a mandatory flu vaccination program?  Yes

*         Does your organization allow employees to submit medical and/or religious exemptions to the flu vaccine? Employees can simply decline - we ask their reason and do some tracking of reason but no formal collection of medical and/or religious exemptions

*         Who in your organization is responsible for reviewing religious exemptions, i.e. EH, HR? NA

*         Do you require exempted employees to wear masks while working? Yes

o   If yes, when are they required to start masking? All employees who have not been vaccinated are required to mask once our Infection Preventionist (IP) or Medical Director "call" the flu season start....then masking continues until the flu season end is "called" (via all employee email, manager alerts)

o   If yes, do you differentiate masking requirements for patient care versus non-patient care areas? NO

o   If yes, how does your organization ensure that exempted employees are actually wearing the masks? Managers receive reports of employees who have not been vaccinated on a frequent basis during flu season and are responsible for enforcement.

o   If yes, are there any times that exempted employees are permitted to not wear masks while working?  In patient care areas - must mask at all times; in office work stations  (non-patient care) - must mask when within three feet of any other people but if working solo at a workstation without people contact, can work without a mask; no masking required in cafeteria or break rooms.

o   If yes, do you have any lessons learned that have made your masking requirement efforts successful?  Lots of newsletter articles, email messages, talking points for managers were provided prior to starting the mandatory vaccine or mask program.  CEO stresses importance of flu vaccination or masking, during Employee Forums and via all employee messages, Medical director sends all employee message announcing start of flu season which also promotes vaccination or masking.  This is our 3rd year of mandatory vaccine or mask policy - at 95% flu vaccination of staff at this time.  We are a small organization - about 650 employees.




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