Health workers unprotected against avian influenza
Tantri Yuliandini, The Jakarta Post, Jakarta
Health care workers are at the forefront of the fight against communicable diseases, and while daily exposure does not make them immune to the diseases, hospitals' readiness to accept patients with infectious diseases makes all the difference.
The Ministry of Health's director of human-animal communicable diseases Hariadi Wibisono said in handling infectious diseases, all hospitals should adhere to universal precaution guidelines.
"All hospitals have implemented universal precautions, meaning that for airborne infectious diseases health care workers are to be equipped with masks, and for diseases that are transmitted through skin contact, workers must use rubber gloves," he told The Jakarta Post on Tuesday.
Yet, despite these precautions, at least one nurse had developed bird flu-like symptoms after treating a confirmed avian influenza patient.
The nurse from the Usada Insani Hospital in Tangerang was admitted to Sulianti Saroso Hospital for infectious diseases earlier this month. She and 10 others had been assigned to treat Ina Sholati, a bird flu patient, from the time she was admitted to the hospital until her death on Oct. 28.
Meanwhile, several nurses and doctors from a hospital in Central Jakarta raised concern for their own safety after treating a possible bird flu patient who died on Saturday.
"Some of the nurses who treated the patient had high fever and chills immediately after the patient was transferred to Sulianti Saroso Hospital on Friday," a nurse said.
While health care workers at Sulianti Saroso Hospital were fully equipped with World Health Organization standard equipment such as protective clothing, rubber gloves, surgical masks and rubber boots, these nurses only have surgical masks to rely on.
"When we developed symptoms, we were all given Tamiflu, but later on the hospital wanted us to pay for it. Only after we protested and demanded free medicine did the hospital give us the medicine for free," another nurse told the Post.
She also said that the nurses were getting better after taking the antiviral prophylactic drug Tamiflu, generically known as oseltamivir.
Meanwhile, the Ministry of Health has developed guidelines for dealing with possible infection of health care workers in hospitals other than the two referral hospitals -- Sulianti Saroso and Persahabatan Hospital in East Jakarta.
Hariadi said that hospitals that have handled confirmed avian influenza patients should immediately report to the Health Agency who would then conduct investigations that would include identifying the number of health care workers who handled bird flu patients and whether they are showing clinical symptoms.
"Only after all this is confirmed will we take blood samples and provide antiviral prophylaxis to the workers," he said.
The investigation itself could take several days while avian influenza has been known to have a two- to four-day incubation period. But Hariadi said that the investigation was needed to prevent misuse of an already limited drug.
"After all, human to human transmission of avian influenza has not been proven," he added.
The World Health Organization, on the other hand, has advised that health care workers in potential contact with respiratory secretions or droplets from a patient with confirmed bird flu, or for whom an H5N1 virus diagnostic test result was pending, to be considered for bird flu prophylaxis.