Advice for hospital visitors with the flu: Please stay home

To prevent a bad flu season from becoming worse, some Orange County health providers have put in place several restrictions in recent weeks, most of them common-sense requests of visitors who might unknowingly spread the virus.
“If you’re ill, please come to the hospital,” said Dr. Philip Robinson, medical director of infection prevention and hospital epidemiology at Hoag Hospital’s Newport Beach and Irvine campuses. “But if you’re just here to visit and you’re ill, please stay home.”
Flu cases, and deaths, are way up in the county and the state compared with this time last year, fueled by a resurgence of the virulent H1N1 strain of the virus. That strain killed 57 Orange County residents during the 2009-10 season. The flu ebbed in severity the past three years, but so far this season eight adults in the county have died. Last year, there were six fatal cases.
As happened four years ago, this flu is hitting young people – including teens and young adults – particularly hard, instead of the elderly. A UC Irvine study showed that older adults are less vulnerable to H1N1 because they had built up immunity from previous exposures. Between 1918 and 1957, H1N1 dominated all flu viruses.
With 2009-10 fresh in their minds, hospital administrators and other medical professionals are urging visitors to wash hands frequently; screening more of them for symptoms of illness upon their arrival; and asking the ones who are sick but absolutely have to visit loved ones to wear surgical masks, which are available (along with hand sanitizer) in many medical-center lobbies.
At Kaiser Permanente’s hospitals in Anaheim and Irvine, patients with flu-like symptoms are given masks and are separated from the general waiting room whenever possible, said Dr. Anu Singh, chief of emergency medicine.
Adolescents, who don’t have a great track record of washing their hands or coughing the proper way (into their sleeve), are banned in some places. UC Irvine Medical Center says people under 14 are not allowed to wait in the lobby without adult supervision, and they can’t visit patients.
MemorialCare Health System, which operates six hospitals in the region, won’t let the under-14 crowd in to see “vulnerable” patients, like at the maternity ward, and that age group isn’t allowed to visit at all at Long Beach Memorial and Miller Children’s Hospital.
At Children’s Hospital of Orange County, only two parents or guardians who are healthy can visit a patient.
“The use of masks, gowns and gloves will be enforced as appropriate,” says an advisory posted on the hospital’s website Jan. 7. And patients “in isolation” and their families can’t go into common areas such as play rooms.
Visitors who aren’t showing signs of illness can still be contagious: The virus can be spread about 24 hours before any symptoms appear, and for about a week after, according to the Centers for Disease Control and Prevention.
After that deadly 2009-10 season, many facilities pushed harder to have their employees get vaccinated. Hoag achieved 95 percent compliance, Robinson said. MemorialCare says a policy that requires all employees, including physicians, to get inoculated or else wear a mask has brought full compliance.
“We’ve really locked down the virus from getting in during flu season,” said Helen Macfie, a pharmacist and chief transformation officer at MemorialCare Health System.
Robinson’s colleague Barbara Goss-Bottorff, a registered nurse who is director of infection prevention at Hoag, said the flu typically peaks in February, but two years ago it lasted well into March. CHOC’s restrictions are in place through March 30, although that could be amended.
Given the long transmission period, vaccination is still the best way to prevent the flu, Robinson said. The H1N1 strain is included among the three that are in the vaccine, but it takes two weeks after injection to reach full potency.
“This particular year’s vaccine is proving to be a good match to the strain that’s circulating,” said Linda Dickey, a registered nurse and director of infection control at UC Irvine Medical Center.
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