title: Impact of the 2009 influenza A (H1N1) pandemic on healthcare workers at a tertiary care center in New York City.
abstract: OBJECTIVE
  Assessing the impact of 2009 influenza A (H1N1) on healthcare workers (HCWs) is important for pandemic planning.
  
  
  METHODS
  We retrospectively analyzed employee health records of HCWs at a tertiary care center in New York City with influenza-like illnesses (ILI) and confirmed influenza from March 31, 2009, to February 28, 2010. We evaluated HCWs' clinical presentations during the first and second wave of the pandemic, staff absenteeism, exposures among HCWs, and association between high-risk occupational exposures to respiratory secretions and infection.
  
  
  RESULTS
  During the pandemic, 40% (141/352) of HCWs with ILI tested positive for influenza, representing a 1% attack rate among our 13,066 employees. HCWs with influenza were more likely to have fever, cough, and tachycardia. When compared with the second wave, cases in the first wave were sicker and at higher risk of exposure to patients' respiratory secretions (P=.049). HCWs with ILI--with and without confirmed influenza--missed on average 4.7 and 2.7 work days, respectively (P=.001). Among HCWs asked about working while ill, 65% (153/235) reported they did so (mean, 2 days).
  
  
  CONCLUSIONS
  HCWs in the first wave had more severe ILI than those in the second wave and were more likely to be exposed to patients' respiratory secretions. HCWs with ILI often worked while ill. Timely strategies to educate and support HCWs were critical to managing this population during the pandemic.
authors.affiliation: Department of Medicine, Boston University Medical Center, Boston, Massachusetts 02118, USA. nbhadeli@bu.edu
authors.forename: Nahid
authors.initials: N
authors.lastname: Bhadelia
authors.forename: Rajiv
authors.initials: R
authors.lastname: Sonti
authors.forename: Jennifer Wright
authors.initials: JW
authors.lastname: McCarthy
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Vorenkamp
authors.forename: Haomiao
authors.initials: H
authors.lastname: Jia
authors.forename: Lisa
authors.initials: L
authors.lastname: Saiman
authors.forename: E Yoko
authors.initials: EY
authors.lastname: Furuya
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D016273:Occupational Exposure / Q000009:adverse effects*; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data; D062606:Tertiary Care Centers / Q000458:organization & administration / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir