Under Viral Attack

[indigo girl]

I am working my 3 twelve hour weekend shifts so I have not much time to spend between working, and getting the sleep that I need to get thru it.

My Psych unit is under attack. The enemy is as yet identified. It snuck in with a patient transferred from a medical floor in our hospital. The patient came to us with uncontrolled diarrhea and vomiting a few days ago. He is feeling better now, but two staff are down, and another patient was transferred to ICU, a medically fragil anorexic weighing about 82 pounds with the same diarrhea and vomiting. Another patient developed the same s/s last night with staff gowned, masked and gloved, having to clean up stool, vomitus etc last night.

Add to this, staff members with sick kids with flu s/s at home (toddlers with high temps, congestion, cough etc). We are under major stress, and it is only August! We have no way to isolate anyone in our environment. This only works with stable, cooperative patients, but luckily most of our current residents are like this. We are wiping door knobs, and anything touchable like hallway phones, the community coffee pot with Cavicide. Anyone that gets served a food tray gets hands scrubbed with alcohol gel.

I don't believe that this is swine flu even though it has a GI component, but I don't know for sure. Patients have no UR s/s. I have to worry that it doesn't help the immune status of everyone here to be hit with this while flu is making its way thru our hospital, and the region. Maybe these other viral invaders help to weaken immune systems, helping the flu to overcome us.

I cannot believe that this is a noro/norwalk virus in August. What the heck is going on?

Trying to keep our heads above water...

[oramar]

Well, if what happened duriing the last outbreak on our unit was really swine flu, then most of the staff should be immune by now, but not this group of patients.

During the few days this woman spent on the unit, she was not coughing or sneezing while out amongst the others on the unit. It is importantt to note that we are still learning how influenza is transmitted, and if anyone tells you that they know how for sure, it is simply not true. The IOM meeting and recommendations to the CDC a few weeks ago should have made that abundantly clear.

Influenza is most likely transmitted via the airborne route, and as well as via droptlets with fomites being the least method of spread to worry about. All of this talk about disinfecting and wiping down surfaces in the schools is similar to telling the expectant father to go boil water during his wife's delivery. It serves to look like it is helping, and gives you something to do, but is not that helpful. Wearing a mask is what really works.

This is yet another point that was emphasized at the recent CIDRAP Conference in Minneapolis on keeping the world working during the pandemic. The science does not support handwashing as a prevention of swine flu. This is not to say that handwashing is not

worth doing. It is, but mostly for other reasons, but, do not expect it to prevent influenza or that it will slow down the transmission rate in the schools.

Everything you mention here has crossed my mind.

[Circejane]

Thanks for posting all of this, it's incredibly informative.