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Transcript
Aerosol Transmitted
Diseases
What is Aerosol
Transmission?
A disease that is transmitted via a gaseous
suspension of a fine solid or liquid particles.
May require droplet or airborne precautions.
Standard precautions should always be
implemented as well.
(Gold, 2010)
Droplet Precautions
Droplet Precautions
• Used to prevent transmission of pathogens
spread through close respiratory contact or
mucous membrane contact with infected
respiratory secretions
• Not infectious over long distances
• Single patient rooms are preferred
• Masks are worn upon entry to patient room
• If patient needs to be transported, the patient
wears a mask
(Center for Disease Control and Prevention [CDC], 2007)
Droplet Transmission
• Contact with mucous membranes or
conjunctivae with infected large particles (>5 um
in size)
• Requires close contact
• Travel short distances (< 3 feet)
• Do not remain suspended in the air
• No special air handling or ventilation is required
(CDC, 1996)
Droplet transmitted diseases
and length of isolation
• Pharyngeal Diptheria - until 2 sets of cultures
are negative 24 hours apart
• Epiglottis from H. influenzae type B - 24 hours
• Seasonal influenza - 5 days
• Pandemic influenza- 5 days from onset of
symptoms
• H1N1- 7 days from onset or 24 hours after
symptoms resolve *whichever is longer
(CDC, 2007)
• Meningitis (H. influenzae type B)- 24 hours
• Meningitis (Neisseria Meningitidis)- 24 hours
• Meningococcal disease; sepsis, pneumonia, or
meningitis - 24 hours
• Mumps- 9 days
• Mycoplasma pnuemonia
• Parvovirus B19- up to 7 days in
immunocompromised patients with chronic
conditions
• Pertussis (Whooping cough)- 5 days
(CDC, 2007)
• Yersinia Pestis (Pneumonic)- 48 hours
• Pneumonia (Adenovirus)-duration of illness
• Pneumonia (H. Influenzae type B) infants and
chlidren- 24 hours
• Pneumonia (Streptococcus type A) adults and
children- 24 hours
• Rhinovirus- duration of illness
• Rubella (German measles)- 7 days after onset of
rash
• Severe Acute Respiratory Syndrome (SARS)duration of illness plus 10 days
(CDC, 2007)
Airborne Precautions
Airborne Precautions
• Used to prevent transmission of infectious
agents that remain infectious over long distances
when suspended in the air
• Single-patient, negative pressure room
• Wear a mask or respirator (N95 mask or
higher) prior to entry
• Non-immune healthcare workers should not
care for patients with vaccine-preventable
airborne diseases
(CDC, 2007)
Airborne Transmission
• Small-particle residue (<5 um in size)
• Dissemination of droplet nuclei, evaporated
droplets, or dust particles
• Dispersed widely by air currents
• Inhaled
• Special air handling and ventilation is required
(CDC, 1996)
Airborne diseases and
duration of isolation
• Herpes Zoster (Shingles, chicken pox)- duration
of illness from unvaccinated healthcare
personnel
• Measles (Rubeola)- 4 days after onset of rash,
duration of illness from for
immunocompromised people
• Monkeypox- until confirmed and small pox
excluded
(CDC, 2007)
• Severe Acute Respiratory Syndrome (SARS)duration of illness plus 10 days after resolution
of illness
• Smallpox- duration of illness
• Tuberculosis (Extrapulmonary with draining
lesion, pulmonary or laryngeal confirmed or
suspected)- until clinically improving or 3
consecutive negative wound cultures. For
confirmed pulmonary or laryngeal, 3 negative
AFB smears collected 8-24 hours apart.
(CDC, 2007)
Precautions in Health Care
Settings
Cough Etiquette
Cover mouth/nose when coughing or sneezing
Throw tissues away immediately after use
Wash hands
Ensure alcohol rubs are conveniently placed for
patients and staff if sinks are not readily
available
• Offer masks to patients who are coughing in
waiting areas
• Wear a mask with close patient contact if a fever
and signs of respiratory infections are present
•
•
•
•
(CDC, 2009)
Standard precautions
• Implemented to decrease the risk of
transmission of disease from recognized and
unrecognized sources.
• Hand hygiene is an important component and
one of the most important aspects of standard
precautions
• Use of Personal Protective Equipment (PPE)
(World Health Organization [WHO], 2007)
Personal Protective
Equipment (PPE)
• Gloves
• Gowns
• Facial Protection (masks, goggles, face shield,
etc.)
(WHO, 2007)
Vaccine Preventable
Aerosol Transmitted
Disease
Available Vaccines
•
•
•
•
•
•
•
•
Diptheria
Measles/mumps/rubella (MMR)
Influenza
Pnuemonia
Varicella
Pertussis
Meningococcal
H1N1
(CDC, 2010)
References
Center for Disease Control and Prevention. (1996). Guidelines for isolation
precautions in hospitals hospital infection control advisory committee. Retreived from:
http://wonder.cdc.gov/wonder/prevguid/p0000419/P0000419.asp#head003
003002000000
Center for Disease Control and Prevention. (2007). 2007 Guideline for isolation
precautions: preventing transmission of infectious agents in healthcare settings. Retrieved
from: http://www.cdc.gov/hicpac/2007IP/2007ip_part3.html
Center for Disease Control and Prevention. (2009). Respiratory hygiene/cough
etiquette in healthcare settings. Retrieved from:
http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm
Center for Disease Control and Prevention. (2010). Vaccines and preventable diseases.
Retrieved from: http://www.cdc.gov/vaccines/vpd-vac/default.htm
Gold, D. (2010). The Cal/OSHA aerosol transmissible disease regulation. Retrieved
from: http://www.cdph.ca.gov/programs/ohb/Documents/HCRespATDStandard.pdf
World Health Organization. (2007). Standard precautions in health care. Retrieved
from: http://www.who.int/csr/resources/publications/EPR_AM2_E7.pdf