New York Takes Additional Steps to Protect People Against the Flu. New Regulation Aims to Protect Patients, Health Care Workers.

U.S. and New York Experiencing Worst Flu Season in a Decade; Hospitalizations Higher than During Fall 2009 H1N1 Pandemic

ALBANY, N.Y. ( February 7, 2013) – In light of the unusually high number of seasonal influenza cases in New York and across the nation, New York State is taking additional steps to reduce the risk of people contracting the flu, including a proposed measure that will protect health care workers and their patients against infection.

The New York State Department of Health (DOH) is proposing a new regulation that will require personnel in regulated settings, including but not limited to: hospitals, nursing homes, diagnostic and treatment centers, home care agencies and hospices, who have not received a flu vaccination to wear a surgical or procedure mask in areas where patients may be present. The regulation was presented for information only at today's meeting of New York State Public Health and Health Planning Council (PHHPC). The proposed regulation will be published in the State Register next week and the public will be provided an opportunity to comment prior to a PHHPC vote to adopt the regulation.

"Flu vaccinations are the best way to protect against influenza and we strongly urge everyone who has not received a vaccination yet to do so as soon as possible," said State Health Commissioner, Nirav R. Shah, M.D., M.P.H. "As caregivers to patients, including many who have chronic conditions or are more susceptible to flu infections and complications, it is vital that all health care workers be vaccinated against influenza. This regulation will enable health care workers to meet their obligation to do no harm to patients."

Recognizing that health care worker vaccination rates are typically below recommended levels, requiring masks for unvaccinated workers will provide an important layer of protection against influenza transmission. This requirement will take effect during the 2013-2014 influenza season and will protect these workers and their families from acquiring influenza.

New York State and the nation are experiencing the worst seasonal influenza season in a decade, with widespread influenza activity since early December, an unusually early start. DOH's most recent Influenza Surveillance report shows (during the week ending February 2, 2013), 2,178 laboratory confirmed influenza cases were reported. However, at the peak of this season, (during the week ending January19, 2013) more than five thousand cases of laboratory confirmed influenza were reported. More than 1,120 hospitalizations with laboratory confirmed influenza were also reported during that week, a higher weekly total than during the fall 2009 H1N1 influenza pandemic.

To date, there have been more than 33,000 cases of positive laboratory confirmed influenza cases in all 57 counties and New York City and five influenza-associated pediatric deaths in the State. Although adult influenza deaths are not reportable, the federal Centers for Disease Control and Prevention (CDC) estimates that approximately 1,440 New Yorkers die each year as a result of influenza in an average influenza season. Infants, seniors and individuals who are chronically ill experience the greatest morbidity and mortality from influenza.

For the past two decades, the CDC and the Advisory Committee on Immunization Practices (ACIP) have strongly recommended that all health care personnel be vaccinated for influenza. Health care personnel are at increased risk of acquiring influenza because of their contact with ill patients, and workers who are ill can also transmit influenza to their patients. Preventing influenza transmission from health care personnel to patients is a serious patient safety issue, yet the statewide hospital health care worker influenza rate for the 2011-12 influenza season was 48.4 percent.

The regulatory requirement that health care workers wear masks will be in effect during the time when influenza is categorized as prevalent in New York State as determined by the State Health Commissioner. It will apply in health care settings regulated by DOH, including general hospitals, nursing homes, diagnostic and treatment centers, certified home health agencies, long term home health care programs, acquired immune deficiency syndrome (AIDS) home care programs, licensed home care service agencies, limited licensed home care service agencies, and hospices.

Although masks are not as effective in preventing influenza transmission as vaccination, evidence indicates that masks decrease transmission from people experiencing respiratory symptoms. In addition, because persons incubating influenza may shed influenza virus before they have noticeable symptoms, wearing a mask is expected to lessen the transmission without imposing a burden on health care personnel.

Medical Society of the State of New York (MSSNY) President Robert Hughes, M.D., said: "We must do all we can to ensure that every individual be immunized, and MSSNY calls upon each and every health care worker to be immunized during this crisis, or to wear a mask to prevent the spread of the virus. Health care providers have an obligation to lead by example, and there is no better way to do so than by immunizing ourselves and our families."

Greater New York Hospital Association President Kenneth E. Raske said: "This decision was made with the singular goal of protecting the health and well being of both patients and health care workers during a particularly intense flu season. New York's hospitals strongly support this sensible measure."

1199 SEIU President George Gresham said: "We are steadfast in our commitment to protecting the health of our patients and the communities where we work. We strongly support this measure as a sensible precaution to prevent influenza transmission."

Healthcare Association of New York State (HANYS) President Daniel Sisto said: "HANYS member hospitals are committed to providing the highest quality care to their patients. For many days, health care providers have been responding to a tremendous surge of hospital admissions caused by one of the worst flu seasons in recent memory, making even more clear the imperative for preventing further transmission of the virus. HANYS commends and supports the Commissioner of Health's decision to enact this important protocol to enhance our ability to fight this deadly illness."

Visiting Nurse Service of New York President and CEO Mary Ann Christopher, M.S.N., R.N., F.A.A.N., said: "These important measures will help minimize the risk of influenza diseases for the health care team, their own families and the patients they serve. We support DOH taking such additional precautions, and we will implement these measures alongside the many steps we have already taken in our practice areas to reduce the spread of disease."

For more flu-related information, please visit the DOH website at