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Health care personnel (HCP) infected with influenza (H1N1) 2009 virus who return to work 24 hours after defervescence may still be shedding virus, according to a study published online March 16 in Emerging Infectious Diseases.

Meagan Kay, D.M.V., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined the link between viral shedding and fever in infected HCP during an influenza outbreak. A group of 16 HCP infected with H1N1 provided nasal wash specimens for two weeks, which were tested using polymerase chain reaction (PCR) and culture. Temperatures were also recorded on a daily basis. HCP returned to work when they met the CDC criteria of waiting 24 hours after fever.

The investigators found that 12 of 16 HCP had virus detected by PCR, and nine had virus detected by culture when they returned to work. Neither the presence of fever nor viral load were correlated with shedding duration.

"HCP who return to work after other influenza infections might continue to excrete viable virus and reinforce the need for adherence to infection control measures to prevent transmission in the workplace. All HCP who return to work after influenza infection should practice frequent hand and respiratory hygiene and cough etiquette," the authors write.

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