CDC issues avian influenza IC recommendations

All patients who present to a health care setting with fever and respiratory symptoms should be managed according to recommendations for respiratory hygiene and cough etiquette and questioned regarding their recent travel history. Patients with a history of travel within 10 days to a country with avian influenza activity and are hospitalized with a severe febrile respiratory illness, or are otherwise under evaluation for avian influenza, should be managed using isolation precautions identical to those recommended for patients with known severe acute respiratory syndrome (SARS). These include:

Standard precautions

• Pay careful attention to hand hygiene before and after all patient contact or contact with items potentially contaminated with respiratory secretions.

Contact precautions

• Use gloves and gown for all patient contact.

• Use dedicated equipment such as stethoscopes, disposable blood pressure cuffs, disposable thermometers, etc.

Eye protection (i.e., goggles or face shields)

• Wear when within 3 feet of the patient.

Airborne precautions

• Place the patient in an airborne isolation room. Such rooms should have monitored negative air pressure in relation to corridor, with six to 12 air changes per hour, and exhaust air directly outside or have recirculated air filtered by a high-efficiency particulate air (HEPA) filter. If an airborne isolation room is unavailable, contact the health care facility engineer to assist or use portable HEPA filters (see Environmental Infection Control Guidelines) to augment the number of air changes per hour.

• Use a fit-tested respirator, at least as protective as a National Institute of Occupational Safety and Health (NIOSH)-approved N-95 filtering face-piece (i.e. disposable) respirator, when entering the room.

For additional information regarding these and other health care isolation precautions, see the Guidelines for Isolation Precautions in Hospitals. These precautions should be continued for 14 days after onset of symptoms or until either an alternative diagnosis is established or diagnostic test results indicate that the patient is not infected with influenza A virus.

Patients managed as outpatients or hospitalized patients discharged before 14 days with suspected avian influenza should be isolated in the home setting on the basis of principles outlined for the home isolation of SARS patients (go to www.cdc.gov/ncidod/sars/guidance/i/pdf/i.pdf).

(Editor’s note: More information about avian influenza is available at www.cdc.gov/flu/avian.)