To further protect the public against both seasonal and H1N1 flu strains, local hospitals are requiring medical staff who have not been immunized to wear a face mask when providing direct patient care.

Hobby Harmon, safety coordinator at Speare Memorial Hospital in Plymouth and chair of the hospital's H1N1 task force, said Speare has recommended all health-care workers be immunized for both seasonal and H1N1 flu.

"Given some of our health-care providers cannot, or choose not to be vaccinated for flu, wearing a standard surgical mask when providing direct patient care is an equally effective alternative for preventing the spread of flu. Doing so protects our patients and our providers," Harmon said.

He added that while approximately 85 percent of the medical staff who give direct patient care have been vaccinated, there are some who cannot be vaccinated for medical reasons. Medical reasons include egg allergies, as the vaccines for both seasonal and H1N1 flu strains are grown in an egg base, Harmon said.

Personal reasons for not being vaccinated include a "list that is as large as the day is long," Harmon said.

"Some are refusing on principal and others don't believe it works," Harmon said.

At Lakes Region General Hospital in Laconia and Franklin Regional Hospital — both run by LRGHealthcare — a similar masking protocol is in place.

"We have a policy in place that requires everyone to go get seasonal and H1N1 vaccinations," said Dr. Peter Walkley, chief of staff at Lakes Region General. "Those who can't or don't want to get vaccinated must sign a declination statement that requires them to agree to wear a mask when providing direct patient care."

Walkley said the masking requirement is important, as the hospital has not yet received enough H1N1 vaccination to inoculate all the direct care providers at both hospitals.

He said only a small percentage of direct-care staff has declined to be vaccinated and he noted that last year, Lakes Region General and Franklin Regional Hospitals had the third and fourth (respectively) highest staff vaccination rate in the state — at 76 percent and 78 percent — compared to the state average, which was 50 percent.

Walkley said patients are not required to don masks, but they are available for those who choose to wear them.

Those patients who are displaying flu-like symptoms are strongly urged to wear masks.

Harmon said the H1N1 task force reviewed Centers for Disease Control (CDC) guidelines and the policies of other hospitals before devising the masking protocol and simplest, most effective way to protect patients and staff.

"The masks will provide the same prophylactic protection for providers and patients as the vaccine does," Harmon said, adding that even vaccinated providers may choose to also wear a mask.

Masks will also be made available to visiting family members at the nurses station, as well as patients in both the Emergency Department and Outpatient Registration areas.

Should patients in greater numbers begin arriving with flu-like illness in the Emergency Department, a separate waiting area will be set up.

Other steps Speare Memorial Hospital is taking to help prevent the spread of illness is providing individual bottles of hand sanitizer to inpatients. Publicly accessible, free standing hand sanitizer units will also be placed in strategic locations throughout the hospital. Additionally, staff and volunteer education has been provided to further raise awareness about effective prevention measures.

"In addition to vaccine and masking, common, everyday actions can help keep you healthy," Andrea Harper, SMH infection prevention specialist, said.



Flu Prevention Tips

Cover you nose and mouth with a tissue, or use your elbow, when you cough or sneeze.

Wash your hands often with soap and water. Alcohol-based hand sanitizer are a good alternative when soap and water is not available.

Avoid touching your eyes, nose and mouth.

Avoid close contact with sick people.

Stay home if you are sick.



Emergency Warning Signs of Severe Illness

According to the CDC, symptoms of H1N1 flu are similar to those of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache and chills. Those who do get sick should stay home for at least 24 hours after the fever is gone. This means avoiding normal activities including work, school, travel, shopping, social events and public gatherings. Seek immediate medical attention if you or a family member has warning signs of severe illness.



Warning signs in children

Fast breathing or trouble breathing

Bluish skin color

Not drinking enough fluids

Not waking up or not interacting

Being so irritable that child does not want to be held

Flu-like symptoms improve but then return with fever and worse cough

Fever with rash



Warning signs in adults

Difficulty breathing or shortness of breath

Pain or sudden pressure in the chest or abdomen

Sudden dizziness

Confusion

Severe or persistent vomiting



For more information about seasonal and/or H1N1 flu and you, visit www.flu.gov