Posted by: mkirschmd | May 8, 2009

Does Nurse Returning from Mexico Carry Swine Flu?

200px-Newborn-incubator-toronto[1]Yikes! Will she put our patients at risk? I already posted about my nurse Adrienne who had the misfortune of planning to travel to Mexico last week just as swine flu, now called influenza A(H1N1), was rearing its ugly snout. As newspaper headlines become more ominous, and our own government counseled against non-essential travel, and I advised against it, she wisely decided to postpone the excursion. As the end of last week, however, she resolutely announced her reversal – she’s going! So much for my influence.

As I write this, she is in Cancún with her kids and, so far, she is enjoying a fluless experience. But, what precautions do we need to take when she returns? She doesn’t work in an isolated cubicle in an offsite office building. She works at our front desk, greeting patients and escorting them into exam rooms. Obviously, we don’t want any of our patients or staff to be at risk. So, what do we do? Do we quarantine her for a week watching for symptoms? Should she wear a mask? (Won’t that make everyone around her feel relaxed?) Should she use a new pair of surgical gloves for each patient as surgeons do in the operating room? Should she have Tamiflu with her morning coffee, just in case? Should we just fire her for exercising poor medical judgment?

We will rely upon science and cold facts, not emotional hysteria, for information on swine flu. If she is feeling well, and had no known flu contacts, then we will welcome her back to her job on Tuesday. Before you accuse us of negligence by allowing her to work, keep in mind that every doctor and nurse in America every day of the year may be unknowingly harboring a virus or germ that could be transmitted to patients. The CDC has not advised any specific measures for travelers returning from Mexico who feel well. What should Adrienne do? She should wash her hands frequently, as everyone else who is in contact with patients should do. In other words, it should be medical business as usual.

Adrienne, like all of us in the medical profession, is at much higher risk of getting sick from a patient than she is of infecting one. We need to resist swine flu hysteria such as banning pork products or forcibly quarantining Mexican tourists in China who feel well. Of course, hysteria can be fun. For example, if Adrienne e-mails me some of her vacation photos, can I safely upload them? Could these photos be contaminated? What if one of the photos includes an actual swine flu sufferer? Could I catch it by breathing too close to the computer monitor? Relax, I should be protected. My computer is equipped with an excellent antiviral program. I just hope that the software recognizes swine flu.



  1. What about giving her a rapid flu test before she comes back to work, just to be safe?

  2. Ariella, It is not recommended to test for influenza on individuals without symptoms. In fact, most swine flu sufferers today are suspected, but not proven, to be infected with the influenza A(H1N1) virus. (Most authorities are no longer using the name swine flu as pigs do not appear to be involved.) Testing for the current strain of virus can only be performed at a few specialized medical centers. Your question is certainly rational and I hope that I have answered it for you.

  3. Thanks for the calming common sense.

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