Screening for Pandemic (H1N1) 2009 Virus among Hospital Staff, Spain

To the Editor: After the emergence of pandemic (H1N1) 2009 virus, measures for its control were taken quickly (e.g., isolation of affected patients and use of gowns, gloves, and N95 respirators) when a clinical suspicion of pandemic infl uenza was established (1). One population group frequently exposed to this virus is health care staff. These circumstances prompted us to implement a screening program for the pandemic (H1N1) 2009 virus among personnel working at our hospital in Marbella, Spain. Costa del Sol Hospital is a 250-bed, second-level center located on the Mediterranean coast. A proposal was made to staff working in the emergency and internal medicine areas that nasal and pharyngeal samples to identify the virus by real-time PCR should be taken weekly over 12 consecutive weeks, from the third week of September 2009 to the third week of December. In addition to providing samples, each worker would be asked to complete a health-status questionnaire regarding his or her vaccination record and the presence of signs or symptoms. Signs and symptoms to be reported in the questionnaires included fever, runny indisposition; 1 question also asked whether, during the previous week, a confi rmed diagnosis of infl uenza with a positive PCR for pandemic (H1N1) 2009 virus had been made in the respondent's household. At the outset, 60 members of the hospital staff volunteered to participate. Those who missed >4 sample tests, or >2 consecutive ones, were considered to have abandoned the study. Of the 36 staff members who completed the study, 27 were women (75%). The participants' average age was 37 years (CI 95%: 34.8–39.4). Sixteen were doctors, 16 were nurses, 2 were nursing auxiliary staff, and 2 were hospital orderlies. During the monitoring period, 5 (13%) subjects exhibited coughing, 7 (20%) had runny noses, 3 (8%) experienced painful swallowing, 6 (16%) had headaches, and 1 (2%) felt generally unwell. Nearly 75% stated they washed their hands with antiseptic lotion >20×/d. Three workers were vaccinated against seasonal and pandemic infl uenza, while only 1 was vaccinated against pandemic (H1N1) 2009 alone. None took oseltamivir. Five positive samples were identifi ed (13.8% of the study population) being obtained from four doctors and one nurse, all women. The 4 doctors had signs and symptoms for 24–48 hours consisting of fever, general indisposition, and coughing; none of the 4 required hospitalization. The nurse was a woman 26 years of age with no infl uenza …