Frequently Asked Questions from dental providers about Swine Influenza A (H1N1)

[Krenar Papraniku]

Frequently Asked Questions

1) What to do if a patient presents for routine treatment and has acute respiratory symptoms with or without fever?

If the dentist suspects the illness could be due to swine influenza (symptoms include fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea), elective dental treatment should be deferred and the patient should be advised to contact their general health care provider. The health care provider will determine whether influenza testing or treatment is needed. Refer to http://www.cdc.gov/swineflu/guidelines_infection_control.htm for case definition and other information.

2) What to do if a patient with acute respiratory symptoms requires urgent dental care?

If urgent dental care is required and swine influenza A (H1N1) has either been confirmed or is suspected, the care should be provided in a facility (e.g., hospital with dental care capabilities) that provides airborne infection isolation (i.e., airborne infection isolation room with negative pressure air handling with 6 to 12 air changes per hour).

For aerosol-generating procedures, use a procedure room with negative pressure air handling. Personnel providing direct patient care for suspected or confirmed swine influenza A (H1N1) cases should wear a fit-tested disposable N95 respirator when entering the patient room and when performing dental procedures. Respirator use should be in the context of a complete respiratory protection program in accordance with Occupational Safety and Health Administration (OSHA) regulations. Information on respiratory protection programs and fit test procedures can be accessed at www.osha.gov/SLTC/etools/respiratory .

3) What to do if staff report to work with acute respiratory symptoms?

• Staff experiencing influenza-like-illness (ILI) (fever with either cough or sore throat, muscle aches) should not report to work.
• Staff who experience ILI and wish to seek medical care should contact their health care providers to report illness (by telephone or other remote means) before seeking care at a clinic, physician’s office, or hospital.
• Staff who were not using appropriate personal protective equipment during close contact with a confirmed, probable, or suspect case of swine influenza A (H1N1) virus infection during the case’s infectious period should receive chemoprophylaxis according to CDC guidance (http://www.cdc.gov/swineflu/recommendations.htm ).
• Staff who have difficulty breathing or shortness of breath, or are believed to be severely ill, should seek immediate medical attention.

Summary

Respiratory hygiene/cough etiquette infection control measures along with contact precautions are currently recommended for preventing transmission of swine influenza in a dental healthcare setting.