City of Milwaukee Health Department (MHD)
2009 Influenza Type A (H1N1) Virus Response

Recommendations for Management of Exposed Health Care Workers (HCWs)
Updated 10/20/2009)

Background:  It is essential to minimize risk of transmission of 2009 Influenza Type A (H1N1) virus within healthcare settings, especially to high-risk patients.  Influeza 2009 H1N1 has an incubation period of typically 1-4 days, is infectious from 1 day of symptom onset until 7 days after symptom onset, and is at increased prevalence in our community.  After review of existing guidance from various national, state, and local public health authorities and from public and private-sector healthcare institutions, MHD makes the following recommendations.  Read more.

City of Milwaukee Health Department (MHD)
Recommendations for Clinicians - Updated October 13, 2009

Testing for Novel 2009 Influenza Type A (H1N1) Virus

A. Executive Sumary:  1) Influeza-like illness (ILI) - defined as fever plus either cough or sore throat - and novel 2009 H1N1 influenza are currently at relatively high prevalence in our community; 2) Almost all circulating influenza is the 2009 Novel H1N1 strain; 3) Rapid tests are unreliable for 2009 H1N1 Influenza diagnosis; 4) Delaying antiviral decisions while waiting for accurate test results is not recommended, because antivirals are most effective if started within 48 hours of symptom onset; 5) Therefore, most patients with influenza-like illness (ILI) should be managed empirically and will not need diagnostic influenza testing for clinical management.  Read more.

Community Infection Control Measures

Current surveillance has not identified an increase in severity of illness with respect to the Novel Influenza A (H1N1) Virus. For this reason, MHD will continue to recommend that schools or child care centers should NOT close due to suspected or confirmed cases of Novel Influenza A (H1N1).

Health care workers who are experiencing influenza like illness — defined as fever plus either cough or sore throat — should stay home from work and avoid exposing others in the community. This self-isolation should continue for seven days after symptom on-set or 24 hours after resolution of fever without use of anti-fever medications, whichever is longer.

• Health care workers who have been exposed — defined as close contact to a suspect, probable or confirmed case of Novel Influenza A (H1N1) without proper personal protective equipment — but are asymptomatic can continue to work, if they have been provided with post exposure prophylactic (PEP) antiviral treatment within 7 days of the known exposure.

• Health care workers who have been exposed and are asymptomatic but are not taking PEP antiviral treatment should remain out of work until 10 days have elapsed since the last exposure.

For the general population should stay home from work or school and avoid exposing others in the community if they are experiencing influenza like illness. This self-isolation should continue until 24 hours after the fever has resolved without use of anti-fever medications.

• Individuals who develop symptoms while at work or school should be encouraged to wear a surgical mask until the individual can be removed from settings where other individuals may be exposed.