Surveillance and Monitoring of HCWs and Exposure Management

[Editor’s note: This excerpt from the Harborview Medical Center’s (HMC) plan addresses the surveillance of health care workers who are exposed to patients infected with avian influenza. So far, there have been no cases of avian influenza detected in the United States in birds or people.]  

All persons entering the Level 3 Isolation room must sign the Avian Influenza Contact Log, which will be collected by Infection Control. This log will be initiated and posted by the charge nurse in the area. Screening and follow-up will be coordinated between Infection Control, Employee Health, and Public Health. Employee Health will maintain a list of staff who have contact with any patient and perform provider screening.

Staff who have cared for patients with avian influenza and adhered to infection control precautions should perform self-checks at least daily for: fever, respiratory symptoms, and/or conjunctivitis until seven days following the last contact with any patient suspected or confirmed with avian influenza.

Staff who had unprotected high-risk exposures to patients with suspect or confirmed avian influenza should be monitored twice daily for development of fever, respiratory symptoms, and/or conjunctivitis (eye infection) until seven days after last exposure to the patient.

• Unprotected high-risk exposure is defined as presence in the same room as a probable avian influenza-infected patient during a high-risk aerosol-generating procedure or event and where infection control precautions were either absent or breached.

• Health care workers who have cared for patients with avian influenza should report any fever event and, if ill for any reason, should be removed from patient care. They should should seek medical care and, prior to arrival, notify their health care provider that they may have been exposed to avian influenza. In addition, employees should notify Employee Health or Infection Control at HMC.

With the exception of visiting a health care provider, health care workers who become ill should be advised to stay home until 24 hours after resolution of fever, unless an alternative diagnosis is established or diagnostic tests are negative for influenza A virus.