SIOUX CITY | If you're a health care worker and haven't gotten a flu shot, you'll likely have to mask up at hospitals and clinics in Sioux City.

Catching the flu while hospitalized with another medical condition puts patients at higher risk for a longer hospital stay and even death, according to Dr. Bertha Ayi, medical director of Global Infectious Disease Services and epidemiology at Mercy Medical Center -- Sioux City.

That's why the hospital has enforced strict policies for staff and visitors during influenza season, which is beginning to ramp up in Siouxland.

"That is why all health care workers should get vaccinated," Ayi said. "And if you don't get the vaccine, especially when the illness becomes more prevalent in the community, you'll have to put on a mask before you'll be allowed into patient care areas."

The Iowa Department of Public Health has upgraded influenza activity in the state from regional to widespread. So far this season, the State Hygienic Laboratory confirmed 513 cases of influenza. The virus has led to 310 hospitalizations in the state.

Shelly Bennett, service line manager for Family Health Care of Siouxland Imaging Center, said the influenza vaccine isn't mandated at the independent network's seven clinics, but it is "strongly recommended" that all employees, especially those in immediate contact with patients, get immunized.

Faye Tompkins, manager of employee health and wellness at UnityPoint Health -- St. Luke's, said the hospital's policy requires employees to be "disease-free."

"You're coming in contact with other patients and other personnel. You can actually spread the influenza virus up to 72 hours prior to experiencing any symptoms," she said. "That means I could pass it on to somebody else and not even think I'm sick myself."

When influenza mists and intradermals became available, Tompkins said the hospital began requiring employees and volunteers to get the influenza vaccine or wear a mask if they opt out for medical or religious reasons. She said the hospital's goal is to strive for 100 percent compliance.

Masks, Tompkins said, must be worn while influenza is present in the community. Nurses, who haven't been vaccinated, explain to patients why they're wearing a mask. Patients, she said, are understanding.

"If you explain why you're wearing a mask, they don't see a problem with that," she said. "Imagine being a patient and having somebody come in and cough all over you. They might ask to have a different nurse."

Joni Sokolowski, employee health coordinator, said Mercy's policy requires staff to get vaccinated against influenza every fall or apply for a medical or religious exemption.

"It is a patient-safety protective goal that our staff take these vaccinations," she said. "It's all to protect us, as well as our loved ones."

According to Sokolowski, the Sioux City hospital's current vaccination rate is more than 99 percent. Only seven employees, she said, have opted out, mainly for medical reasons.

"They're allergic to some type of component of the vaccine," she said. "This year we had three individuals who were held back from taking it in previous years because of an egg allergy. We now have the egg-free vaccine, and so three of our staff were able to take it."

Last year, Joan Rothwell, manager of Infection Control for Mercy, said the Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services began requiring hospitals to send questionnaires to all independent physicians and practitioners who practice at their facilities to learn if they've been vaccinated.

"It was an excellent vaccination rate for the physicians and the physician assistants who aren't our employees," she said.


The obese, pregnant women and patients with diabetes or chronic lung problems, Ayi said, suffer influenza symptoms that are severe enough to land them in the hospital on a ventilator.

She said hospitals do everything they can to make sure health care workers are healthy enough to take care of patients.

"Most people who come into the hospital they're already ill. They're trying to battle something, so their body reserves ... they need more to be able to fight one condition," she said.

The predominant strain of influenza currently circulating in the United States is H1N1. The symptoms being produced by this year's strain, Ayi said, are similar to the H1N1 strain that caused the 2009 flu pandemic.

She doesn't think the hospital setting itself causes the flu virus to spread any faster than in other public places per se, but the close contact that health workers have with patients is a factor.

"We're right in the patients' faces," she said. "We have more contact with a patient than any other business, so it's extremely important that we take the necessary measures to prevent infections."

Other precautions taken by the hospital include stations stocked with masks for children and adults, hand sanitizer and tissues. Signs on the wall remind passers-by to "cover your cough."

Ayi said signage posted in the hospital's emergency room warns would-be visitors, who are ill, to stay home.

"We put that in the emergency rooms all the time," she said. "If you're not there because you're ill and coming to see a physician, and you're just visiting and you're ill, please don't come into the hospitals."

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