Himachal Dental

Preventive Protocol In Dental Setting Against H1N1

With the new H1N1 virus continuing to cause illness, hospitalizations and deaths the world over, it is wise for us to stay informed and practice standard precautions to protect ourselves and our patients.

Influenza A (H1N1) virus is a subtype of influenza virus A and the most common cause of influenza (flu) in humans. Some strains of H1N1 are endemic in humans and cause a small fraction of all influenza-like illness and a small fraction of all seasonal influenza. H1N1 strains caused a few per cent all human flu infections in 2004-2005 [1]. Other strains of H1N1 are endemic in pigs (swine influenza) and in birds (avian influenza).In June 2009, World Health Organization declared that flu due to a new strain of swine-origin H1N1 was responsible for the 2009 flu pandemic. This strain is often called “swine flu” by the public media.An October 11, 2009 worldwide update by the U.N.’s World Health Organization (WHO) states that “74 countries have officially reported over 399,234 laboratory confirmed cases of the influenza pandemic H1N1 infection, including 4,735 deaths.”

Persons with swine influenza A (H1N1) virus infection should be considered potentially contagious from day one to seven days following illness onset or until resolution of symptoms,whichever is longer. Children especially young kids might be infectious for longer period.Those carrying the virus can reveal typical flu like symptoms i.e. fever,chills,headaches,fatigue,cough,stuffy nose,sore throat,vomiting and diarrhea with serious illness such as pneumonia or breathlessness.

Preventive protocol for dental professionals :
* Dental team should screen patients for recent travel history and for symptoms of influenza like illness and must segregate patients with respiratory symptoms and who have traveled to an affected area in last 7 days and should consider them as suspected cases.
* Posters for educating the patients regarding swine flu can be displayed in the dental office reception area or waiting room.
* Dental team should be prepared with proper attention to hand hygiene and coughing etiquette’s.
* Dental health care personnel assessing a patient with influenza-like illness should wear a fit tested disposable N95 respirator or equivalent as a standard precaution along with non sterile gloves,gown and eye protection to prevent direct skin and conjuctival exposure.
* In suspected or confirmed cases ,elective dental treatment should be deferred and the patient should be advised to contact their general health care provider.
* If a patient requires urgent or emergency treatment ,standard precautions are to be taken and treatment to be provided in a hospital with dental care capabilities,that provides air borne infection isolation room(AIIR) ie. negative pressure air handling with 6 to 12 air changes per hour. Air to be recirculated after filtration by a high efficiency particulate air (HEPA) filter.
* For cleaning and disinfection strategies, choose a product which is effective against “Influenza A virus” and follow label instructions for these products.
* Dental staff experiencing influenza like symptoms should not report to work and should receive treatment.

Respiratory hygiene,cough etiquette and infection control measures along with contact precautions are currently recommended for preventing transmission of swine influenza in a dental health care setting.

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