Got the Flu? Stay Home!

Pharmacists have become champions of influenza immunization, advertising heavily, recruiting patients, and administering these life-saving vaccines in a wide array of settings. Pharmacists are also at high risk for contracting influenza because they are constantly exposed to patients who are ill and may be carrying this virus.

Healthy People 2020's goal is that 90% of all health care personnel will receive an influenza vaccination annually. However, in the 2014-2015 influenza season, only 77.3% of health care personnel actually received a vaccination. Previous studies have looked at a number of different health occupations and identified those with low vaccination uptake; a previous summary discussed emergency personnel in particular, a group of health care providers who often skip their flu shots.

Researchers from the CDC at locations across the United States examined health care personnel uptake of influenza vaccine, and their propensity to report to work while experiencing flulike symptoms. Their results, published in the American Journal of Infection Control, indicate that more than 40% of health care providers who develop flulike illnesses continue to report to work.

This study included more than 1900 health care providers and found that of these, 414 (22%) indicated that they had experienced a flulike illness in the 2014-2015 influenza season. Affected personnel reported missing an average of 2 days of work. More than half visited a medical provider for symptomatic relief, and more than 1 quarter had confirmed influenza.

Clinical professional health care providers were more likely to work than nonprofessional health care providers. Pharmacists and physicians had similar rates of working while ill, with 67% of pharmacists and 63% of physicians reporting that they had gone to work while ill.

Approximately 45% of health care providers who reported working with symptoms of influenza had received the influenza vaccination. In comparison, approximately 29% had not received a flu shot. A limitation to this finding is that the authors did not examine timing of flu vaccine receipt and illness development.

When asked to provide reasons for why they had gone to work while ill, 5 themes emerged among health care providers:

• I could still perform my job duties.
• I wasn't feeling bad enough to miss work.
• I did not think I was contagious.
• I have a professional obligation to my coworkers.
• It is difficult for me to find someone to cover for me.

As professionals, we need to practice what we preach. Managers should be sure to communicate workplace policies and expectations about sick leave especially with regard to possible influenza. They can frame this message as an infection control imperative. The authors noted that some institutions actually triage employees who report to work with symptoms, send employees home if they are ill, and require absences of 7 days if employees test positive for influenza.

Reference

Chiu S, Black CL, Yue X, Greby SM, Laney AS, Campbell AP, de Perio MA. Working with influenza-like illness: Presenteeism among US health care personnel during the 2014-2015 influenza season. Am J Infect Control. 2017 May 16. pii: S0196-6553(17)30300-0. doi: 10.1016/j.ajic.2017.04.008. [Epub ahead of print]