Health Department Has New Regulations to Stop the Flu

Caregivers Required To Wear Masks

In light of the unusually high number of seasonal influenza cases in New York and across the nation, New York State is taking additional steps to reduce the risk of people contracting the flu, including a proposed measure that will protect health care workers and their patients against infection.

The state Department of Health (DOH) is proposing a new regulation that will require personnel in regulated settings, including but not limited to: hospitals, nursing homes, diagnostic and treatment centers, home care agencies and hospices, who have not received a flu vaccination to wear a surgical or procedure mask in areas where patients may be present. The regulation was presented for information only at today’s meeting of New York State Public Health and Health Planning Council (PHHPC).

The proposed regulation will be published in the State Register next week and the public will be provided an opportunity to comment prior to a PHHPC vote to adopt the regulation.

“Flu vaccinations are the best way to protect against influenza and we strongly urge everyone who has not received a vaccination yet to do so as soon as possible,” said State Health Commissioner Nirav R. Shah. “As caregivers to patients, including many who have chronic conditions or are more susceptible to flu infections and complications, it is vital that all health care workers be vaccinated against influenza. This regulation will enable health care workers to meet their obligation to do no harm to patients.”

Recognizing that health care worker vaccination rates are typically below recommended levels, requiring masks for unvaccinated workers will provide an important layer of protection against influenza transmission. This requirement will take effect during the 2013-2014 influenza season and will protect these workers and their families from acquiring influenza.

New York State and the nation are experiencing the worst seasonal influenza season in a decade, with widespread influenza activity since early December, an unusually early start. DOH’s most recent Influenza Surveillance report shows (during the week ending Feb. 2), 2,178 laboratory confirmed influenza cases were reported. However, at the peak of this season, (during the week ending Jan. 19) more than 5,000 cases of laboratory confirmed influenza were reported.

More than 1,120 hospitalizations with laboratory confirmed influenza were also reported during that week, a higher weekly total than during the fall 2009 H1N1 influenza pandemic.

To date, there have been more than 33,000 cases of positive laboratory confirmed influenza cases in all 57 counties and New York City and five influenza-associated pediatric deaths in the state. Although adult influenza deaths are not reportable, the federal Centers for Disease Control and Prevention (CDC) estimates that approximately 1,440 New Yorkers die each year as a result of influenza in an average influenza season. Infants, seniors and individuals who are chronically ill experience the greatest morbidity and mortality from influenza.

For the past two decades, the CDC and the Advisory Committee on Immunization Practices (ACIP) have strongly recommended that all health care personnel be vaccinated for influenza. Health care personnel are at increased risk of acquiring influenza because of their contact with ill patients, and workers who are ill can also transmit influenza to their patients. Preventing influenza transmission from health care personnel to patients is a serious patient safety issue, yet the statewide hospital health care worker influenza rate for the 2011-12 influenza season was 48.4 percent.

The regulatory requirement that health care workers wear masks will be in effect during the time when influenza is categorized as prevalent in New York State as determined by the State Health Commissioner. It will apply in health care settings regulated by DOH, including general hospitals, nursing homes, diagnostic and treatment centers, certified home health agencies, long term home health care programs, acquired immune deficiency syndrome (AIDS) home care programs, licensed home care service agencies, limited licensed home care service agencies, and hospices.

Although masks are not as effective in preventing influenza transmission as vaccination, evidence indicates that masks decrease transmission from people experiencing respiratory symptoms. In addition, because persons incubating influenza may shed influenza virus before they have noticeable symptoms, wearing a mask is expected to lessen the transmission without imposing a burden on health care personnel.

For more flu-related information, visit the DOH website at https://www.health.ny.gov/diseases/co mmunicable/influenza/seasonal/.

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