The Centers for Disease Control and Prevention provides important and up-to-date information to the public and healthcare providers on the recent outbreak of swine influenza in humans. Interim CDC Guidance for Clinicians & Public Health Professionals regarding case identification, Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting, mask and respirator use, and other topics pertinent to dental healthcare providers can be found by going to the main CDC swine flu Web site at http://www.cdc.gov/swineflu/ in the section titled Guidance for Professionals. This information will be updated regularly and may change on a daily basis; check the Web site frequently.
Dental healthcare providers are urged to view the main CDC swine flu Web site for the latest updates, but Frequently Asked Questions from dental providers have been:
1. What to do if a patient presents for routine treatment and has acute respiratory symptoms with or without fever?
2. What to do if a patient with acute respiratory symptoms requires urgent dental care?
3. What to do if staff report to work with acute respiratory symptoms?
Overview
Prevention of Disease Transmission in the Dental Healthcare Setting
Patients with an acute respiratory illness may present for dental treatment at outpatient dental settings. The primary infection control goal is to prevent transmission of disease. Early detection of a suspected or confirmed case of swine influenza and prompt isolation from susceptible persons will reduce the risk of transmission. To prevent the transmission of respiratory infections in healthcare settings, including influenza, respiratory hygiene/cough etiquette infection control measures should be implemented at the first point of contact with a potentially infected person (http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm).
Infection control issues during patient assessment:
· Patients with an acute respiratory illness should be identified at check-in and placed in a single-patient room with the door kept closed.
· Offer a disposable surgical mask to persons who are coughing, or provide tissues and no-touch receptacles for used tissue disposal.
· The ill person should wear a surgical mask when outside the patient room.
· Dental healthcare personnel assessing a patient with influenza-like illness should wear disposable surgical facemask*, non-sterile gloves, gown, and eye protection (e.g., goggles) to prevent direct skin and conjunctival exposure. These recommendations may change as additional information becomes available. Check the CDC swine flu Web site for updates at http://www.cdc.gov/swineflu/guidelines_infection_control.htm.
· Patient and dental healthcare workers should perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.
· Routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management of swine influenza. More information can be found at http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html.
*Until additional specific information is available regarding the behavior of swine influenza A (H1N1), the guidance provided in the October 2006 “Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic” http://www.pandemicflu.gov/plan/healthcare/maskguidancehc.html is being recommended at this time, and is reflected in the above recommendations. These interim recommendations will be updated as additional information becomes available.
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