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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