Health workers unprotected against avian influenza

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.