The Lancet Infectious Disease
Jan 2010  Volume 10  Number 1   Pages 1 – 66
http://www.thelancet.com/journals/laninf/issue/current

Reflection and Reaction
Mandatory influenza immunisation of health-care workers
Gwendolyn L Gilbert, Ian Kerridge, Paul Cheung

Preview
Seasonal influenza imposes an enormous but poorly defined burden of excess deaths, hospital admissions, and health-care costs, and often spreads within health-care facilities. Hospital patients with influenza are a potential source of infection for health-care workers that are not immunised, with attack rates among health-care workers of 18–24%.1 Unfortunately, health-care workers infected with influenza often continue to work, despite symptoms, with potentially devastating consequences for high-risk patients, including those who are very young, elderly, or immunocompromised—for example, patients receiving bone-marrow transplants have a high risk of pneumonia and death from influenza.