CDC panel: HCWs need not wear N95 facepiece respirators with avian flu
Surgical masks will prevent spread, experts say
Amid worldwide alarm about the spread of H5N1 avian influenza in bird populations, an advisory panel of the Centers for Disease Control and Prevention (CDC) issued a reassuring message: You don't need to stockpile N95 filtering facepiece respirators.
In fact, in most cases, you won't need to use N95s at all, says the Healthcare Infection Control Practices Committee (HICPAC).
With no evidence that avian influenza would spread among people any differently than seasonal influenza, the panel approved guidelines that call for standard and contact precautions — the use of gloves and surgical masks.
So far, human-to-human transmission of avian influenza has been very limited. But infectious disease experts fear that the virus could mutate and become more transmissible among people.
With an estimated mortality rate of about 50%, an outbreak of avian influenza would be an immediate public health emergency. The federal government is developing an avian influenza preparedness plan, which had not been released at HEH's presstime.
Even if avian influenza becomes transmissible, "there's no indication that [it] is transmitted through the airborne route," says Jane Siegel, MD, a professor of pediatrics and infectious disease specialist at the University of Texas Southwestern Medical Center in Dallas and an author of HICPAC's Guideline for Isolation Precautions: Preventing Transmission of Infectious Diseases in Healthcare Settings 2005.
With no evidence of airborne spread, "it would be hard to require everyone to use airborne precautions," she says. However, for aerosol-generating procedures, the guidelines recommend the use of goggles or a face shield in addition to the surgical mask or respirator.
In some other circumstances, hospitals may choose to use a higher level of protection, as well, she notes.
Some hospitals have begun stockpiling N95s as apart of their pandemic influenza preparedness. Repirator manufacturers, such as 3M Corp. in Minneapolis, have reported an increased demand for N95s.
"We do think it's because of hurricanes Katrina and Rita and preparations for avian influenza," says 3M spokeswoman Jacqueline Berry. "We've increased our production and we're meeting the demand."
Some hospitals may continue to prefer to use the N95s in the event of a flu pandemic. For example, the Clinical Center at the National Institutes of Health in Bethesda, MD, treats a large population of immunocompromised patients who would be at high risk for severe sequelae of influenza.
The center likely will use N95s, at least initially, during an influenza pandemic, says David Henderson, MD, deputy director for clinical care.
Henderson notes, "We really have never had an opportunity to study influenza transmission characteristics during an influenza pandemic, since the last pandemic — the so-called Hong Kong flu — occurred in 1968.
"My general strategy has always been to study what's going on with any epidemic — to start conservatively and then relax," he says.
Guidelines allow for flexibility, he notes. "You modify these guidelines based on internal risk assessments," he says.
Concern about avian influenza has risen since the virus was detected in birds in Turkey, Romania and Croatia in October.
Amid worldwide alarm about the spread of H5N1 avian influenza in bird populations, an advisory panel of the Centers for Disease Control and Prevention (CDC) issued a reassuring message: You don't need to stockpile N95 filtering facepiece respirators.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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