An aggressive infection control program and thorough screening measures would protect cancer patients from acquiring H1N1 influenza, say researchers.
The study led by researchers from Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Centre showed that aggressive infection control resulted in no corresponding increase in H1N1 cases.
"Our experience shows that aggressive infection control procedures can minimize transmission within the immunocompromised patient population and also reduce acquisition from sources outside the system," said the authors.
"Lessons learned here are important ones because the majority of cancer care is provided in an outpatient setting," said researcher Corey Casper.
The SCCA infection control program follows recommendations set forth by the federal Centres for Disease Control and Prevention.
The cornerstone of the program is early identification of individuals with potential influenza infection.
Each person who enters the SCCA outpatient clinic building is met with hand hygiene stations and information about respiratory infections and respiratory etiquette.
An electronic surveillance system allows for real-time quantification of the numbers of patients and staff who are infected with influenza, which is reviewed daily by the infection control team.
Patients who have respiratory symptoms have their appointments rescheduled; those who cannot be rescheduled are given masks and placed in either an isolation area or private room until they can be assessed by their clinical care team.
The infection control program is rounded out with the requirement that staff receive annual influenza vaccinations (or sign a written declination waiver), a sick leave policy that is tolerant of absences for respiratory illnesses, redundant work plans for staff at all levels should absences be required, helping families and caregivers identify resources for furloughing caregivers and a plan for giving antiviral drugs to exposed patients and staff.
The authors urge that healthcare institutions caring for immunocompromised patients require that all of their staff receive influenza vaccination as key goal to control influenza.
The authors said that while vaccination is a primary prevention tool, healthcare staff who have significant exposure to confirmed cases of influenza who have not been vaccinated or who received a vaccination less than three weeks prior to the time of exposure should be considered for preventive antiviral therapy.
The findings appear in this week's online version of the journal Blood.