BRAINZ POLICY AND PROCEDURE ON COMMUNICABLE DISEASES PURPOSE: To prevent the spread of communicable diseases to client and staff of Brainz Home care Agency from staff with contagious illnesses. POLICY: Persons with communicable diseases or who are susceptible and exposed to communicable disease shall be restricted from direct contact with residents when: 1. Transmission of the disease to the recipients of care or others in the workplace can occur in that particular job environment. 2. The disease can cause serious illness. All Brainz staff, students, volunteers, and all persons who work with Brainz are covered by these guidelines. Employee Health Nurses (EHN) or EHN Representatives should be consulted if there are questions concerning the safety of allowing a person to return to work. Guidelines for managing employees are listed below. Please note that there are two sections--one for employees with communicable illnesses and the other for employees exposed to a communicable disease to which they are susceptible. Disease Chicken Pox /Signs Fever and skin rash that comes in crops. Rash begins on the chest, back, under arms, neck, and face; changes to blisters and then scabs. Incubation period Usually 10-21 ; can be as long as 3 weeks Work action and comments on communicability until blisters have dried into scabs, usually about 6 after rash appears Source of infection and Mode of transmission Virus spread by direct contact with the blisters by droplets small particles of fluid that are expelled from nose and throat of an infected person during sneezing and coughing. Readily communicable. One attack usually confers immunity. Medical Documentation Required to Return to Work Cold Sores Common Cold Respiratory Infections (Viral) Cold Sores (fever blisters) appear on the lips and face, less often in the mouth. Sores usually crust and heal within a few. May be confused with Impetigo. Runny nose, sneezing, chills, tiredness, fever, muscle aches, 2-12 No exclusion necessary for mild oral herpes in people who are in control of their mouth secretions Colds: 1-3 Other acute respiratory until no fever and person is well enough to Virus is transmitted by direct contact with infected persons, a majority of whom have no apparent infections. Different viruses spread directly through coughing, sneezing, explosive manner of NO NO
sore throat, cough, which last more than 2-7. illness: up to 10 participate in normal activities. speech in which droplets are cast; indirectly through articles freshly soiled by discharges of infected person. Gastroenteritis H1N1 (Swine Flu) Acute onset of vomiting, diarrhea with abdominal cramps, and nausea. In addition, headache, fever/chills, and muscle aches are commonly reported. include: fever (above 100 F), chills AND one of these other symptoms: cough, sore throat, stuffy nose, in some cases, diarrhea and vomiting 12-48 hours from exposure usually last 24-60 hours People infected with the seasonal or H1N1 (Swine) flu may be able to infect others from 1 day before getting sick to 5 to 7 after. Exclude nutrition & culinary staff from work for 72 hours after their vomiting or diarrhea has ended. for at least 7 after illness onset or up to 24 hours after resolution of fever whichever is longer Highly contagious. Spread person to person or by fecally contaminated food or water. Most often spread through hand transfer of the virus to the mouth from contact with materials, and environmental surfaces that have been contaminated by the virus. Mainly from person to person through coughing or sneezing by infected persons. Sometimes people may become infected by touching something such as a surface or object with flu viruses on it and then touching their mouth or nose. if more than 3 of absence, OR Physical onsite assessment by EHN or EHN Rep prior to return to work to determine that employee is asymptomatic Influenza (Confirmed Case) Impetigo All types of flu can cause: Fever, chills Coughing and/or sore throat. Runny or stuffy nose. Headaches and/or body aches. Fatigue Blister-like sores that form an oozing, sticky, yellow crust; itchy. 1-3 until no fever, and person is well enough to participate in normal activities. Encourage good hand washing. Avoid close contact with other people. Usually 1-10 until person has been treated with antibiotics for at least a full 24 hours. Encourage good hand washing. Avoid close contact with other Virus spread directly through coughing, sneezing, and contact with nose or throat discharges of patient. Bacteria spread by direct contact with persons or with articles freshly soiled with discharges from nose or throat of patient; airborne transmission also occurs. Usually caused staphylococcus or streptococcus.
people. Infectious Mononucleosis Lice (head) Fever, sore throat, tiredness, and swollen glands, especially behind the neck. Sometimes there is a rash. Often children show no symptoms at all. Itching of the scalp. Look for: 1) crawling lice in the hair, 2) eggs (nits) glued to the hair near the scalp, and 3) scratch marks on scalp or back of neck as hairline. 4-6 weeks Exclude person from work until the person is well enough to return to normal activities. Nits (eggs) hatch in 6-10 until first treatment is completed and no live lice are seen. Considered communicable until treated. Advise exam of household contacts for nits and lice. Epstein-Barr virus is spread by person to person through saliva; also direct contact such as kissing. Louse transmitted primarily by direct contact with an infected person. Lice can also be transmitted through combs, brushes, bedding, wearing apparel, headwear including ornaments, helmets, and sleeping bags. Measles Rash, low grade fever, cold, malaise, headache Mumps Fever 100-103 degrees for 3-4, pain in parotid glands or other glands, headache; May be testes involvement. Pertussis (whooping cough) Pink Eye Starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. But after 1 2 weeks, severe coughing begins. Bacterial: pink or red conjunctiva with pus that Commonly 10 ; 7-18 until fever; 14 until rash 6 before swelling to 9 after. Onset between 2-3 weeks after exposure 6-20. The disease is most contagious in the early stages before the severe cough begins. until symptoms subside and rash fades. until temperature is normal and no signs of glandular edema or pain until 5 after the start of antibiotic treatment. 1-3 treatment begins. Transmitted by contact with nasal secretions. Transmitted by direct contact with saliva of infected person. Transmitted by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. May be spread with hand-eye contact.
Conjunctivitis Ringworm Scabies causes matting of the eyelids. Viral: pink conjunctiva with clear watery discharge and without pain or redness of eyelids. Body: Ringworm appears flat, spreading ringshaped lesions. The edge of the lesion may be dry and scaly or moist and crusty. As the lesion spreads outward, the center often becomes clear. Scalp: Ringworm may be hard to detect in the early stages. It often begins as a small scaly patch on the scalp. Mild redness and swelling may occur. Infected hairs become brittle and break off easy. Rash and intense itching which may be more severe at night. Common locations to see the rash are folds of skin between fingers, around wrists, elbows and armpits. Other areas where rash may appear are knees, waistline, thighs, male genitals, abdomen chest, and lower portion of buttocks. Infants may be infected on head, Body: 4-10 Scalp: 10-14 2 weeks- 2 months; may appear in less than 2 weeks if the person has had scabies before. If viral (without pus): no exclusions. treatment has been started. When at work area of ringworm must be covered. until treatment has been completed. Most are viral with etiology; some bacterial. May be spread through hand-eye contact. Fungus spread by contact of infected person, animal, or contaminated articles. Mite is transferred by direct contact with skin or through bedding, towels, and clothing of person with scabies. Treat all members of household at the same time. NO
Shingles (Herpes Zoster) neck, palms, and soles of feet. Localized fluid filled vesicles (blisters) with a reddened base. Vesicles usually appear in clusters and tend to follow a nerve pathway. Moderate to severe pain in the affected area is often present. None. This is a reactivation of a latent varicella (Chicken Pox) infection. No work restrictions are necessary if the vesicles can be covered. If the vesicles are located in a place that cannot be covered, exclusion from work is required until the vesicles are scabbed over. This could take up to 7. Chicken pox and Shingles are caused by the same virus. After an infection with Chicken pox, the virus lies dormant in the dorsal root ganglia of the nerves. Shingles appear when that virus is for some reason released from the ganglia. With Shingles, the virus can be spread when there is direct contact with the fluid in the vesicles. No. See EHN or Nursing Supervisor prior to work. Skin Rashes- With or without drainage on exposed skin Skin rashes vary in appearance depending on the cause. They usually involve redness with or without raised, blistered or draining areas. Varies Any rash or open, draining lesion on exposed skin must be evaluated by the EHN or Nursing Supervisor before working with residents. Source of rash will vary. Mode of transmission is most often direct contact with the affected area. Check with EHN or Nursing Supervisor. Streptococcal Sore throat / Scarlet Fever Sudden onset of fever, sore throat, swollen glands, headache, abdominal pain, nausea and vomiting in severe cases. With scarlet fever a very fine rash is present. A fuzzy, white tongue may occur. The rash appears most often on the neck, chest, in folds of armpit, elbow, groin and inner thigh. Later on there may be peeling of skin on the fingertips and toes Usually 1-3 until throat culture report is received. If positive for strep, exclude from work antibiotic treatment is started and until clinically well. Communicable treatment is started. Exclude from work temp has reached normal. Bacteria spread directly from nose and throat discharges of infected persons. Yes