OCCUPATIONAL HEALTH DISEASE SPECIFIC RECOMMENDATIONS

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Terence Summers
5 years ago
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1 Herpes simplex virus (HSV) Cold sores Genital herpes Herpetic whitlow OCCUPATIONAL HEALTH DISEASE SPECIFIC RECOMMENDATIONS contact with primary or recurrent lesions, infectious saliva or genital secretions 2-12 days. until lesions are healed. Asymptomatic viral shedding may occur. Influenza Droplet contact 1-3 days. 1 day before to 5 days after onset of symptoms. Meningococcus Neisseria meningitides Droplet and direct contact 2-10 days. Communicability is 7 days prior to onset of symptoms to 24 hours after start of effective therapy. Reinforce Routine Practices and importance of hand hygiene. Staff with orofacial or weeping lesions should wear protective dressing when providing care to residents. Dressing should remain until lesions are healed. Staff with herpetic whitlow should not provide direct care to residents until lesions are healed. Annual influenza immunization is the most important way to prevent influenza. Symptomatic staff should be excluded for at least 5 days after the onset of symptoms unless they have received antiviral therapy within the first 48 hours of symptoms starting. Staff presenting with symptoms of influenza should have the appropriate laboratory tests done to confirm the diagnosis. Reinforce Routine Practices and the consistent use of barrier precautions. Vaccine is available for some strains. Prophylactic medication is available for high-risk (significant) exposures. Public Health will assist with exposure assessment.

2 Droplet and direct 4-21 days. Reinforce Routine Practices. contact of oral or nasal Individual is no No work restrictions needed for ill mucous membranes longer infectious by staff. with the respiratory the time the rash secretions of infected appears. individuals Parvovirus B 19 Erythema infectiosum Fifth Disease Pediculosis and Phthiriasis Heand and Body Lice Pertussis Whooping cough Head lice direct headto-head contact with infested individual or indirectly by objects used by them (e.g. hats, brushes) Body lice direct skinto-skin contact or exchange of infested clothing or bedding Droplet contact of the oral or nasal mucous membranes with the respiratory secretions of an infected individual 7-10 days for nits to hatch. communicability continues until 24 hours after effective treatment of lice and ova. Nits may survive up to month. Body lice can survive for up to seven days without a human host. Head lice cannot survive for longer than 48 hours without a human host days. 1-2 weeks before the onset of paroxysmal cough until 3 weeks after cough onset if untreated or 5 days Exclude affected staff until the completion of effective therapy. Instruct affected staff to follow treatment directions exactly. Vaccine is available but immunity wanes over time. All staff should be considered susceptible unless they have received pertussis booster in adulthood, which is highly recommended. Exclude symptomatic or infected staff until 5 days after start of effective therapy or if untreated through the 3 rd

3 if treated. week after the onset of paroxysms, Staff contacts should be referred for prophylaxis. Salmonella typhi Ingestion of water. feces or urine days. long as the organism appears in feces. Exclude ill staff. Consult Peel Public Health regarding return to work. Scabies (typical or Norwegian) Group A Streptococcus (GAS) Strep throat Scarlet fever Invasive GAS Tinea Ringworm Direct skin-to-skin contact with an infested individual. It takes approximately 4 hours of contact for scabies to spread. Droplet, direct or indirect contact of oral or nasal mucous membrane with infectious respiratory or wound secretions skin contact with scalp or skin lesions of infectious individual or animal or contaminated environment 4-6 weeks after initial infestation. Repeat exposures: 1-4 days. long as person is infested and untreated. 1-3 days. from 7 days before until 24 hours after start of effective therapy. 5-7 weeks. long as lesions are present. Exclude affected staff until one application of effective treatment completed. Ensure staff follow treatment directions exactly. Exclude ill staff until completion of 24 hours of effective therapy. Cover lesions with an occlusive dressing. Reinforce hand hygiene. If lesions on hands or arms cannot be covered by a dressing, the staff member should not provide direct care. If facility has pets, assess pets to ensure that they are free of ringworm.

4 Tuberculosis Inhalation of airborne bacteria weeks. All staff should have documented TST. Staff member with active TB disease should be excluded from work until cleared by their physician and Peel Varicella-Zoster Virus (VZV) Chickenpox Refer to Section 4-12 Management of Varicella (Chickenpox) Inhalation of airborne virus or direct or indirect contact of oral or nasal mucous membranes with vesicle fluid or respiratory secretions from an infected individual days but may be extended to 28 days if VZIG is given. Communicable for 2 days before symptoms appear and until lesions are dry and crusted. Public Health for return to work. Staff members with chickenpox should be excluded from work until all lesions are dry and crusted. If staff member worked while they were considered to be infectious then the facility must identify any staff and/or residents who are not immune. Nonimmune staff should be excluded from work from 10 days after exposure until 21 days after exposure. All staff should be directed to be tested for immunity to Varicella. Vaccine is available and recommended for staff who are susceptible to chickenpox. Herpes Zoster (shingles) contact of oral or nasal mucous membranes with infectious vesicle fluid. Transmission causes chickenpox in susceptible individuals days. Communicable until lesions are crusted. Staff with localized lesions may work if lesions can be completely covered by a dressing and clothing. If lesions cannot be covered, then staff member should be excluded until lesions are dry and crusted. Staff with disseminated lesions should be excluded from work until all lesions have dried and crusted.

5 Hepatitis A (HAV) feces or by ingestion of water days. Communicable from 2 weeks before to 1 week after onset of symptoms. Vaccine is available. Staff members with HAV should be referred for confirmation of diagnosis and clinical management. Staff members should be excluded from work until cleared to return by Gastroenteritis Respiratory Infections feces or by ingestion of water. Airborne transmission has been suggested in some Norwalk-like virus outbreaks. Primarily by dropletcontact of the oral, nasal, or conjunctival mucous membranes with oropharyngeal secretions of an infected individual. Varies depending on organism. Varies depending on organism. Adapted from: Prevention and Control of Occupational Infections in Health Care. CCDR March 2002; Volume 28S1 Peel Public Health. Staff members with vomiting and/or diarrhea should be excluded from contact with residents and their environment and from food handling until no longer experiencing loose stools or staff member is cleared to return to work by Peel Public Health. Minimize contact of staff with acute respiratory infections with residents. Evaluate symptomatic staff on an individual basis for fitness to work based on type of work, hygiene measures and acuity of symptoms.

Chapter 6 Occupational Health. Occupational health program Staff immunization Communicable disease management Disease specific recommendations

Chapter 6 Occupational Health. Occupational health program Staff immunization Communicable disease management Disease specific recommendations Chapter 6 Occupational Health Occupational health program Staff immunization Communicable disease management Disease specific recommendations Region of Peel Public Health June 2011 Region of Peel Public