Update on Approaches to Understanding Human Influenza Transmission

Background for Meeting

David N. Weissman, MD

Director, Division of Respiratory Disease Studies

National Institute for Occupational Safety and Health

Centers for Disease Control and Prevention

Morgantown, WV

(The findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy.)

(Slide 2)

Employment in Health Care and Social Assistance Sector

Private, government and self-employed workers:

Ambulatory Healthcare Services6.39 million

Hospitals6.27 million

Nursing and Residential Care Facilities 2.57 million

Social Assistance 3.15 million

Total18.38 million

Source: BLS Current Population Survey, 2009

(Slide 3)

Healthcare Workers Feel at Risk

This graphic is a table with the title, “Question 1: Do you feel safe from work-related injury or illness in your current working environment?

The table headers are: Response option, Total Selected and Percentage. There is an asterisk by percentage, however it is not labeled in a key on this slide.

Response option: Moderately safe

Total selected: 1727

Percentage: 35.9

Response option: Somewhat safe

Total selected: 1553

Percentage: 32.3

Response option: Very safe

Total selected: 938

Percentage: 19.5

Response option: Not safe at all

Total selected: 584

Percentage: 12.1

Total answered: 4802

(End table)

88% of nurses reported that health and safety concerns influenced their decision to remain in nursing and the kind of work they chose to perform

Source: American Nurses Association.

NursingWorld.org Health & Safety

Survey. September, 2001.

Next is a pie chart split into 4 parts. Dark pink is 35.9 percent. Lighter pink is 32.3 percent. The lightest pink slice is 12.1 percent. The red slice is 19.5 percent, labeled less than 20 percent feel very safe at work.

(Slide 4)

This slide is titled “Need for Influenza Transmission Research Recognized by IOM” and shows two graphics, one depicted under the year 2007 and another depicted under the year 2009.

For 2007, the graphic shows a cover of a publication entitled “Preparing for an Influenza Pandemic – Personal Protective Equipment for Healthcare Workers”.

For 2009, the graphic shows an introductory page of another publication entitled “Respiratory Protection for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A – A Letter Report”, which was authored by the Committee on Respiratory Protection for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A, the Board on Health Sciences Policy, and edited by Cathryn T. Liverman, Tracy A. Harris, M.E. Bonnie Rogers, and Kenneth I. Shine, Institute of Medicine of the National Academies. Text under both graphics reads “Both reports note uncertainties and indicate great need for influenza transmission research”.

(Slide 5)

Research to Reduce Uncertainty

•Fundamental transmission research

–Relative contributions of modes of transmission

–Necessary to form conceptual basis for development of interventions

•Efficacy research: randomized controlled trials of preventive interventions

•Effectiveness research: “real-world” trials of preventive interventions