INCUBATION PERIOD. COMMUNICABILITY PERIOD 2-14 days Until symptoms cease. secretions - (direct/indirect) droplet Fecal/oral. Direct/Indirect contact

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Imogene McCormick
6 years ago
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1 Policy Name: Practices & Additional Precautions Adenovirus Abscess Amoebiasis Astrovirus (See Calicivirus) Bacillus cereus Caliciviruses (Calicivirus, Astro Norwalk, other small roundstructured viruses) Campylobacter CLINICAL PRESENTATION MODE OF Respiratory tract infection Conjunctivitis Gastroenteritis Localized collection of pus in a cavity formed by a disintegration of tissue. Staphylococcus aureus, Streptococcus grp A, other bacteria potential causative organisms Varies from acute or fulminating dysentery with fever, chills and bloody or mucoid diarrhea to mild abdominal discomfort with diarrhea containing blood or mucus alternating with periods of constipation or remission. Sudden onset of nausea and vomiting, abdominal pain and diarrhea. Illness generally persists no longer than 24 hours. Diarrhea, abdominal cramps, nausea & vomiting Sudden onset of nausea and vomiting, abdominal pain and diarrhea. * Major: Contact Minor: * * Respiratory secretions - (direct/indirect) droplet Direct/Indirect (direct/indirect) Ingestion of foods that have been improperly cooked and stored (direct/indirect) (direct/indirect) 2-14 Until symptoms cease A few to 2 to 4 weeks While cysts are present in the feces 6-24 hours Not communicable person to person 12 hours 4 Usually 3-5 range 1 10 Duration of excretion usually 2 after resolution of symptoms Throughout course of infection ( several to several weeks) Throat swab, stool for virus Stool for ova & parasites (using SAF preservative) Duration of drainage Major = drainage not contained by dressing. Stool for C&S Stool for virus Importance of education of food handlers. Stool for C&S January,

2 Policy Name: Practices & Additional Precautions Cellulitis Draining: see abscess CLINICAL PRESENTATION MODE OF A diffuse, acute infection of the skin Direct and subcutaneous tissue characterized most commonly by local heat, redness, pain and swelling Chickenpox (varicella-zoster virus) Sudden onset of fever, malaise coryza, rash with small blisters on top which become crusted & itchy, Airborne and Contact*, Airborne 10 to 21 2 prior to 5 after onset of rash. Vesicle fluid for virus Until all lesions are * Primary infection results in Chickenpox. Roommates and care-givers should be immune to chicken pox. Clostridium difficile Clostridium Perfringens Antimicrobial-associated diarrhea, pseudomembranous colitis Sudden onset of colic followed by diarrhea; nausea is common but vomiting and fever are usually absent Contact Ingestion of foods contaminated by soil or feces then held under conditions that permit growth of organism Common Cold Duration of excretion Stool for toxin testing 6-24 hours Not communicable person to person Duration of illness Until stools normal for 72 hours Bacterial spores present in the Pay special attention to cleaning. Stool for C&S Importance of education of food handlers. Conjunctivitis Coronavirus Common cold Possible large droplet Creutzfeldt-Jakob Disease Chronic encephalopathy * with Central nervous system tissues 2-4 Until symptoms cease Months to years CNS tissues are infectious throughout symptomatic illness Eye swab for viral culture and/or C & S Throat swab for viral culture Tissue for viral culture * Caution should be exercised when handling blood, brain tissue or spinal fluid. Special precautions required for autopsy, handling deceased body. January,

3 Policy Name: Practices & Additional Precautions Cryptosporidium Cytomegalovirus (CMV) Diarrhea Acute diarrhea of likely infectious cause Enteroviral Infections CLINICAL PRESENTATION MODE OF Diarrhea which may be profuse and watery often associated with cramping abdominal pain Usually asymptomatic congenital infection, retinitis, disseminated infection in immunocompromised host * Person to person, animal to person, waterborne and foodborne Virus containing secretions Direct Sexual Mother to infant (fecal/oral) 1 to 12 Oocysts appear in stool at onset of symptoms and are infectious on excretion Unknown Stool for ova and parasites Stool for C&S, virus, and ova and parasites Requires intimate direct personal for transmission. Echovirus Coxsackievirus E. Coli Verotoxigenic Acute febrile illness, aseptic meningitis, encephalitis, pharyngitis, herpangina, rash, pleurodynia Hand, Foot & Mouth Disease -May have fever, headache, red spots with small blisters on top may appear especially on hands, feet and inside mouth conjunctivitis Diarrhea Hemolytic uremic syndrome * Fecal /oral Respiratory, fecal/ oral Respiratory Eye/ respiratory contaminated food 3-6 Unknown CSF or stool for viral culture hrs Most infectious before onset of rash and can be excreted in the stool for a period of time 10 hours-8 Duration of shedding Viral culture of eye discharge Stool for verotoxin *Consider Contact Precautions January,

4 Policy Name: Practices & Additional Precautions Epstein-Barr Virus Erysipelas (see Streptococcus) Food Poisoning Salmonella, Verotoxigenic E. Coli, Staphylococcus, Clostridium perfringens, Campylobacter Giardiasis Hepatitis A CLINICAL PRESENTATION MODE OF Infectious mononucleosis fever, sore throat, swollen glands, lethargy Infectious skin disease characterized by redness, swelling, vesicles, bullae, fever, pain and lymphadenopathy, caused by Grp A Streptococci Toxic processes that result from the ingestion of a food contaminated by toxic substances or bacteria that contain toxins. Intermittent diarrhea alternating with constipation and abdominal pain May have fever, loss of appetite, nausea, vomiting, and jaundice. * * * Close personal with respiratory secretions Occasionally blood transfusion Foodborne: or (fecal/oral) with feces Respiratory tract viral excretion may occur for several months 1-4 weeks May persist for months Two weeks before to 1 week after onset of symptoms; Stool for C&S and viral culture Stool for ova & parasites *Immune globulin for high risk January,

5 Policy Name: Practices & Additional Precautions s may be considered. Hepatitis B & C Hepatitis, often asymptomatic Herpes Zoster (Shingles) Localized: Immunocompromised host CLINICAL PRESENTATION MODE OF Mucosal or percutaneous exposure to infective body fluids. Vesicular skin lesions in dermatomal distribution Contact *Airborne, airborne Weeks to years Until 24 hrs after antiviral therapy started; then as for localized zoster in normal host disease - notify Public Health Prophylaxis may be indicated for s of Hep B See Integrated Post Exposure Protocol. and Preventing the Transmission of Blood borne Pathogens in Health Care and Public Services Settings. *Room-mates and caregivers should be immune to chickenpox. Susceptible highrisk s should be given VZIG as soon as possible, latest within 96 hours of exposure. For susceptible s airborne precautions should begin 8 after first exposure to rash and continue until 21 after last exposure (28 if VZIG given). Disseminated Localized: Normal host: Vesicular skin lesions. Vesicular skin lesions in dermatomal distribution Airborne and Contact and * Airborne and Airborne, direct and indirect, possibly airborne (aerosolization of vesicle fluid) Localized zoster may disseminate in immunocompromised host if not treated. After primary infection with chickenpox, the virus persists in a latent form. Reactivation (cause unknown) results in shingles. *See above January,

6 Policy Name: Practices & Additional Precautions HIV Impetigo Influenza ( see outbreak management protocol) Legionellosis Lice Head Body MRSA (see guideline) Measles (Rubeola) CLINICAL PRESENTATION MODE OF Asymptomatic, multiple clinical Mucosal or presentations percutanerous exposure to infective bodily fluids* Pustules or crusted rash on face or exposed parts of body (arms and/or legs). Respiratory tract infection Sudden onset of respiratory illness characterized by one or more of the following symptoms; fever > 38º, sore throat, athralgia, myalgia, prostration. Anorexia, malaise, myalgia, headache, progressing to fever, cough, diarrhea, can progress to respiratory failure, pneumonia Presence of lice and nits in the hair with scalp itching usually around the ears or nape of the neck or on the body. Moderately high fever, cough, runny nose, inflamed eyes for 1 to 3 before onset of rash. Rash begins as large red spots which join together. The rash starts on the face and spreads to entire body. Must see physician and notify Public Health. ( Droplet and Contact - optional) plus gloves for direct patient only Airborne Large droplets, direct and indirect (Possibly airborne) Inhalation of aerosolized water contaminated with Legionella Airborne Direct Weeks to years Depends on causative organism* From onset of infection Swab of drainage for C&S Throat swab for virus 2-10 Not transmitted person to person 6-10 Until effective treatment to kill lice and ova* 1 to 12 From onset of symptoms throughout catarrhal stage and 4 to 5 after the eruptive stage If Contact Precautions used, until 24 hours of effective antibiotic therapy. Until 24 hours after initiation of appropriate treatment 4 after start of rash. Duration of the illness in immunocompromised individuals. incorporates bloodborne pathogen precautions. Prophylaxis may be indicated. See Integrated Post Exposure Protocol. *Refer to "Preventing the Transmission of Bloodborne Pathogens in Health Care and Public Service Settings". *Staphylococcal or streptococcal infections. Consider Contact Precautions if lesions extensive, can t be covered by dressings. Outbreaks reportable to Public Health. Vaccine is provided for at risk groups. *Importance of nit removal. Exposed susceptible residents should be isolated for 5 after first possible exposure until 14 after last possible exposure. Susceptible persons should not be in with these January,

7 Policy Name: Practices & Additional Precautions Meningococcal Invasive Disease Mycobacterium See Tuberculosis Parvovirus B19 Fifth Disease- Erythema Infectiosum Pertussis (Whooping Cough) Rash - see scabies, varicella, meningococcal disease Respiratory Syncytial Virus (RSV) Vaccine preventable CLINICAL PRESENTATION MODE OF Meningococcemia, meningitis, sudden Droplet Large droplet onset with fever, intense headache, Direct nausea, vomiting, stiff neck, petechial rash Mild fever, flu-like symptoms, a rash (with a lacy appearance) will appear 1 week after onset of symptoms. The rash on the face appears as a slapped cheek and spreads to the rest of the body Begins with cold symptoms and cough - progresses to spasms that may result in vomiting Acute respiratory tract infection Rhinovirus Respiratory tract infection Droplet Person to person. Virus present in respiratory secretions Droplet Contact with respiratory secretions Droplet*, droplet Usually prior to onset of symptoms to 24 hours of appropriate therapy have been received 4 to 14 Most infectious before onset of rash weeks after onset of paroxysm 2-8 Until symptoms cease 2-3 Until symptoms cease Throat, blood, CSF for C&S Throat swab for C&S Throat swab for virus Throat swab for virus Until 24 hours of appropriate antibiotic therapy received To 3 weeks after onset of paroxysms if not treated or until 5 of appropriate antibiotic therapy received residents. Close may require chemoprophylaxis. Contacts may require prophylaxis. *Consider in an outbreak. Rotavirus Fever and vomiting precede watery diarrhea * 1-3 Duration of excretion Stool for virus Consider Contact Precautions for incontinent residents if stool cannot be contained or for residents with poor hygiene who contaminate their January,

8 Policy Name: Practices & Additional Precautions Salmonella Non typhoidal Scabies Shigella CLINICAL PRESENTATION MODE OF Diarrhea, * Foodborne (fecal/oral) Very itchy rash - usually appears on fingers, elbows, armpits, and abdomen. Diarrhea profuse, watery Fever Contact * * 6-72 hours; Duration of fecal excretion 4 to 6 weeks after first exposure 1-4 if reinfestation 24 hours after initiation of appropriate therapy 1-7 Usually 4 weeks if not treated Stool for C&S cannot be contained or Identification Until 24 hours after * For extensive or Norwegian of mites, eggs treatment with (crusted) scabies only. for appropriate scabicide parasitology * For typical scabies, use gloves and gown for direct resident only; other wise routine. Apply scabicide as directed on label. Wash clothing and bedding in hot water, dry clean or seal in a plastic bag and store for 1 week. Household s should be treated. Stool for C&S Treatment with effective antibiotic shortens period of infectivity Shingles (See Herpes zoster) Skin Infection See abscess cannot be contained or Small Round January,

9 Policy Name: Practices & Additional Precautions Enteric Virus (See Calicivirus) Streptococcus Group A CLINICAL PRESENTATION MODE OF Wound or burn infection, skin infection, impetigo, cellulitis, necrotizing fasciitis, myositis, endometritis Minor: * Major: Contact* Pneumonia Large droplets, variable direct Scarlet fever, pharyngitis Large droplets 2 to 5 While organism is draining Blood, tissue, CSF for C&S If Contact Precautions used until 24 hours of appropriate antibiotic therapy received Major= drainage not contained by dressings. * Need for masks controversial. Consider using droplet precautions for all residents with invasive disease until 24 hrs of antibiotic received. Toxic shock syndrome Streptococcus pneumoniae Sinusitus, pneumonia, meningitis, bacteremia Tinea Ringworm, athletes foot Tuberculosis Confirmed or suspected pulmonary or Airborne laryngeal disease 1-3 Direct Unknown White lesion present Airborne Weeks to While organisms in years sputum Blood, sputum for C&S Early morning sputum on 3 consecutive, gastric wash etc. Until declared noninfectious by therapy, negative culture and clinical improvement Pneumoccocal vaccine is provided to at risk groups. See policy on TB. VRE- see guidelines Varicella Varicella Zoster (Chickenpox) Shingles (Herpes Zoster) January,

Cleaning for Additional Precautions Table symptom based

Cleaning for Additional Precautions Table symptom based for Additional Precautions Table symptom based The need to wear personal protective equipment () for Routine Practices is dependent on the risk of contact or contamination with blood or body fluids. should