By Rajesh : H1N1 flu spreads by droplets of cough generated while coughing or sneezing. Since the droplets are larger in size, they can not travel beyond 6 feet / 1 meter. They settle down on the surfaces around the patient (table, chair, bed sheet, hand rails, door knobs, computer keyboard, mobile handsets etc). Since they do not remain suspended in the air for a long time a simple mask, worn by the patient, would take care of the spread. This mask needs to be replaced when wet and should be discarded carefully. If you have symptoms of flu, you should be wearing a mask to prevent droplet spread. If it is not possible, use disposable tissues/ hankies while coughing or sneezing. Wash hands after coughing or sneezing. Wash infected clothing separately. Avoid shaking hands with infected persons. The contaminated tissues should be properly disposed. Wearing the mask when on the road or moving outdoors is not recommended for the general public as it does not serve any purpose.
The person taking care of a proven H1N1 influenza should use mask and change it if it is wet or after 8-10 hours. Patient of confirmed H1N1 infection should also change the mask and dispose it properly every 8-10 hours. It is not mandatory even for these persons to use N 95 masks. A simple triple layered surgical mask, along with droplet precautions is sufficient.
Remember that an ill fitting mask or a mask not properly worn is more dangerous than not wearing a mask at all. In case nothing is available any cotton cloth can be tied around the face to cover both mouth and nose.
For the patient with proven H1N1 infection a simple surgical mask is sufficient. For the persons/nursing staff/ hospital staff caring for these patients a triple layered surgical mask is sufficient. It prevents virus transmission from the patient to the caregiver.
N 95 masks are recommended for nursing personnel or health care workers engaged in taking care of seriously ill patients on ventilators, who can not wear masks and where procedures like intubation, suctioning and nebulization need to be performed on H1N1 influenza patients. Health care works coming in casual contact with an infected patient wearing a mask should not insist on N 95 mask as a triple layered surgical mask is good enough to prevent droplet infection.
The other precautions need to be taken by everyone coming in contact with a suspected / confirmed cases of H1N1 influenza are very simple. Avoid shaking hands or wash hands immediately after hand shake or touching any surface while in a closed area with an infected person. The virus can survive in atmosphere on the surface for up to 8 hours. Repeated cleaning of the area where infected patients are kept, decreases the virus transmission. Keeping a distance of 1 meter / 6 feet from an infected patient can prevent exposure.
Dr Ashish Bhalla
Associate Professor (Tropical Medicine)
Department of Internal Medicine,
Post Graduate Institute of Medical Education and Research, Chandigarh . India . 160012