Depending on your situation in life we look at illness in many different ways. As an irritant - your spouse or significant other or your children ALWAYS get sick when you have the least time to deal with their whining shenanigans. As an impediment - you do not have the time nor the patience to feel under the weather due to work or family commitments. As an inconvenience - your colleagues insist upon coming to work or your friends or family insist on coming for a visit without the forethought that they may spread their illness to you or your family.
In my blog from two weeks ago "Cleaning, Hand Hygiene & Vaccination a few of my Interventions for Flu Season" I have already captured the key tips (Interventions) for limiting the spread of the flu, but after reading an article recently published in AJIC by Mitchell et al titled "Understanding the burden of influenza infection among adults in Canadian hospitals: A comparison of the 2009-2010 pandemic season with the prepandemic and postpandemic seasons", I realized that the impact to me, my family, my colleagues or the burden of influenza on our healthcare system was not touched upon and is something of great importance and worthy of consideration.
The truth of the matter is that Influenza infections are costly. They cause substantial morbidity and mortality and are strain on every country's healthcare resources. However, the impact or burden to our healthcare system varies greatly year to year depending on the Influenza strains in circulation. The study reviewed lab-confirmed inpatient characteristics, treatment and outcomes of the pandemic season (2009-2010) with the prepandemic (2006-2007 & 2008-2009) and postpandemic (2010-2011) seasons. Of the 2868 cases identified, 629 cases were from the prepandemic season, 1132 cases from the pandemic season and 1107 cases from the postpandemic season. Of interest was the fact that the healthcare-associated influenza cases was lower during the pandemic than the pre and post pandemic seasons. Also of interest was the fact that the Healthcare-associated Influenza cases was higher in acute care facilities than long term care facilities during the pandemic season as compared with pre and post pandemic seasons.
With respect to patient characteristics, during the pandemic season the median age of those inflicted during the pandemic season was significantly lower than the pre and post pandemic season (hence the lower infection rates seen in LTC's!). Similarly, during the pandemic season inpatients were more apt to have pulmonary disease whereas in the postpandemic season they were more likely to have chronic heart and kidney disease. Possibly as expected, more severe outcomes were reported during the pandemic season as vaccination rates were lower.
Of particular interest was the impact of infection prevention and control practices during the pandemic season. With knowledge that vaccines were not readily available, ensuring effective interventions were in place (hand hygiene, cleaning and disinfection, isolation etc) likely helps limit healthcare-associated transmission. If this is true, then the ugly truth is that the increase of healthcare-associated infections in the postpandemic season could be directly related to a lapse and complacency around in infection prevention practices.
We cannot underestimate the flu and its significant impact on the resources needed to effectively limit its spread. Being prepared to combat Influenza should not be relegated as a response to an outbreak or a pandemic. The threat of infection and the threat of transmission is an ongoing annual concern and should be an automatic response on a daily basis during Flu Season. Influenza is an enveloped, easy to kill virus. Ensuring that environmental surfaces and patient care equipment are cleaned and disinfected daily (and of course after each patient use!) will go a long way to minimizing transmission from environmental surfaces. Of course, getting vaccinated and washing your hands helps too!