Information for Pregnant Women Working in Education, Child Care, and Health Care Settings Concerning 2009 H1N1 Influenza Virus

November 9, 2009, 6:30 PM ET

Recommendations for workplace infection control and prevention strategies related to pregnant women who work in education, child care and healthcare can be found at the following websites:

• CDC Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses to Influenza during the 2009-2010 School Year
• CDC Guidance on Helping Child Care and Early Childhood Programs Respond to Influenza during the 2009-2010 Influenza Season
• Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel
• What Should Pregnant Women Know About 2009 H1N1 Flu (Swine Flu)?
• Interim Guidance for 2009 H1N1 Flu (Swine Flu): Taking Care of a Sick Person in Your Home

All 2009 H1N1 guidance is interim and subject to review and revision as more is learned about this novel influenza virus. This guidance may be revised in the event that the 2009 H1N1 pandemic increases in severity compared with the situation in spring/summer 2009.

The key message for employers and employees in work settings where pregnant employees are likely to be exposed to 2009 H1N1 is to take every precaution to prevent infection. Recommended strategies to decrease the likelihood of employee exposure to 2009 H1N1 influenza virus include implementation of infection control strategies in the work place and work policies that support sick employees being away from the workplace. Implementation of employee education about influenza symptoms will support early self-recognition of possible illness and may help decrease overall exposure to the virus in the workplace.

Pregnant employees can also take steps to prevent both exposure and illness. Vaccination is the single best way to prevent influenza illness. As soon as possible, all pregnant women should get both 2009 H1N1 and seasonal flu shots. In addition, everyday precautions such as hand washing and covering your mouth and nose when you cough or sneeze, and encouraging others to do so, are important ways to stay healthy and to not spread germs that cause illness. Finally, pregnant women who have signs or symptoms of influenza-like illness need to call their healthcare provider right away, because they may require prompt treatment with antiviral medications.

Antiviral medications are used in some situations to prevent influenza infection after close contact with someone with a confirmed, probable, or suspected influenza infection. Pregnant women who believe that they may have had close contact with someone with influenza illness should call their healthcare provider for advice. More information about post-exposure antiviral medication use is available.

Schools and Child Care Workers

Pregnant women who work in school and child care settings, such as teachers and child care professionals, should follow guidance for school and child care personnel and the general public. In these settings, ill individuals should be identified and promptly separated from healthy individuals. Pregnant women in school and child care settings should not provide care to children who have symptoms of influenza-like illness. In addition they should be familiar with recommendations for infection control in their workplace settings.

• Guidance for Schools K-12
• Guidance for Child Care and Early Childhood Programs
  

Pregnant Healthcare Personnel

Healthcare personnel are defined as all persons whose activities involve contact with patients or contaminated material in a healthcare, home healthcare, or clinical laboratory setting, including students, trainees and volunteers. Healthcare personnel are engaged in a range of occupations, many of which include patient contact even though they do not involve direct provision of patient care, such as dietary and housekeeping services. Pregnant healthcare personnel treating patients with suspected or known 2009 H1N1 infection should follow facility infection control policies. Current interim CDC guidance for healthcare personnel is available on the CDC website. This guidance applies uniquely to the special circumstances of the 2009-2010 influenza season and will be updated as necessary as new information becomes available throughout the course of this influenza season.

All healthcare personnel, including pregnant women, who will likely be in direct contact with patients with confirmed or suspected 2009 H1N1 flu (e.g., a nurse, physician, or respiratory therapist caring for hospitalized patients), should carefully adhere to standard precautions which includes performing hand hygiene before and after all patient contact, contact with respiratory secretions, and before putting on and upon removal of personal protective equipment (PPE). Soap and water or alcohol-based hand rubs should be used. Standard precautions also state that for any activity that might generate splashes of respiratory secretions, gowns along with eye protection should be worn. In addition to standard precautions healthcare workers should wear a fit-tested, disposable N95 respirator when within 6 feet of the patient.

No special precautions are needed for pregnant doctors and nurses to administer the nasal spray vaccine. All healthcare personnel should wash their hands or use an alcohol-based hand rub before and after giving the vaccine.

Facilities and organizations providing healthcare services should consider offering alternative work environments as an accommodation for pregnant personnel and those at high-risk for complications during periods of increased influenza activity or if influenza severity increases.

For additional guidance for health care providers at higher risk for complications of influenza infection, please visit: Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting.

Information on the correct use of PPE is available on the CDC website.