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Pandemic Influenza Plan - Questar III

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Section 4: Infection Control<br />

I. Overview<br />

The intention of this document is to assist healthcare settings in the planning for<br />

pandemic influenza and to enhance infection control precautions according to the current<br />

global and local epidemiology of influenza. Covered in this section are basic infection<br />

control principles, infection control management of infectious patients, occupational<br />

health guidance, and setting specific guidance. Users of this document should also refer<br />

to the vaccine and antiviral, healthcare planning, and clinical guidelines sections of the<br />

NYSDOH <strong>Pandemic</strong> <strong>Influenza</strong> <strong>Plan</strong>.<br />

Guidance for infection control and prevention for influenza is developed and updated<br />

yearly by the NYSDOH, and can be found on the NYSDOH Public Web site at<br />

http://www.health.state.ny.us/diseases/communicable/influenza/guidelines/index.htm or<br />

the NYSDOH Health Provider Network at<br />

https://commerce.health.state.ny.us/hpn/ctrldocs/alrtview/postings/doc050915_0.pdf .<br />

<strong>Influenza</strong> virus circulates yearly, with the season in the United States identified as<br />

October through May. Early identification of novel influenza strains is integral for early<br />

identification and intervention to prevent a global epidemic, or pandemic.<br />

II.<br />

Background<br />

Despite the prevalence of influenza every year, the amount of empirical data on influenza<br />

transmission is very limited. Based on observed epidemiological patterns, it is thought<br />

that influenza is primarily transmitted by large infectious respiratory droplets that are<br />

deposited on the oral, nasal or conjunctival mucosa of a susceptible host. Transmission<br />

via large-particle droplets requires close contact between the infectious host and<br />

susceptible persons. Special air handling and ventilation are not required to prevent<br />

droplet transmission, as large-particle droplets do not remain suspended in the air and<br />

generally travel only short distances (about three feet) through the air.<br />

The significance of direct contact, indirect contact and airborne transmission has not been<br />

well established. Therefore, these modes of transmission remain theoretical in nature.<br />

Conservatively, these modes of transmission should be considered if host factors (i.e.,<br />

diarrhea) or treatments (i.e., aerosolizing procedures) increase the theoretical potential<br />

risk of transmission.<br />

The incubation period for routine seasonal influenza is 1 – 4 days, with an average of 2<br />

days. The incubation period for novel types of influenza is currently unknown and may<br />

be longer. Therefore, the maximum interval between potential exposure and symptom<br />

onset for pandemic influenza is set conservatively at 10 days.<br />

<strong>Influenza</strong> is contagious during the 24 hours before the onset of symptoms and during<br />

most of the symptomatic period. Children and persons with compromised immune<br />

February 7, 2006 4-3

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