Download Infection Control Strategies for an

Infection Control Strategies for an
Unknown Respiratory Aerosol Transmissible (RAT) Disease
When the organism or the mode of transmission is new or unknown, but may include a
respiratory component, assume that the organism can be transmitted via all modes: standard,
droplet, contact, and airborne and utilize the recommendations below.
A.
Public Strategies for an Unknown RAT Disease
Hand hygiene and respiratory etiquette should be encouraged at all times during a RAT event.
Additional strategies may include:
Social Distancing. Implementation and timing of this strategy will depend on the morbidity and
mortality of the disease, availability of treatment or prophylaxis, and other epidemiological
characteristics. Strategies include:
 Minimize close contact to a specified distance.
 Minimize personal contact at work (e.g. encourage work from home or telecommuting,
replace face-to-face meetings with teleconferences, stagger work shifts)
 Utilize engineering controls or structural alterations that can decrease the spread of infection
(e.g. set up physical barriers like glass windows, modify ventilation system, reduce sharing of
equipment).
 Minimize crowding (e.g. limit or cancel public gatherings/activities, limit use of public
transportation)
 Close schools and/or dismiss students from day care, schools, and/or universities.
Respiratory Protection. Utilize a mask when people who are potentially infectious have to
congregate in a confined space or members of the public must be in contact with ill individuals.
Disinfect
 Increase frequency and enhance cleaning techniques to ensure disinfection of surfaces that
may be touched and spread disease.
B.
Non-Healthcare Responder Strategies for an Unknown RAT Disease
Guidance should be provided to responders who are not working in a healthcare settings but are
in field situations or have contact with potentially ill persons (e.g. PODS, Isolation & Quarantine
facility). Recommendations may include:



Personal Protective Equipment (PPE). Responders should don a mask, gloves, and/or
other PPE when they may come into close contact with cases.
Vehicle transport. If possible, transport the individual in a vehicle that has separate driver
and patient compartments with separate ventilation systems. When possible, vehicle should
be cleaned, disinfected, and ventilated between uses.
Prophylaxis. Depending on the disease, responders should be given pre or post-exposure
prophylaxis if the disease is known and effective prophylaxis is available.
C.
Exposed Person (Contact) Strategies for an Unknown RAT Disease
If effective prophylaxis is unavailable, an individual should be closely monitored and excluded
from the work setting, monitored for signs and symptoms of the disease, and if they become
symptomatic, evaluated and isolated immediately. The Isolation and Quarantine Group should be
notified of specific infection control guidelines. The appropriateness of quarantine should be
carefully evaluated based on emerging clinical and epidemiological evidence.
D.
Healthcare Setting Strategies for an Unknown RAT Disease
Healthcare personnel should follow all the infection control recommendations for the public and
when in healthcare settings may need to add the following:


E.
Medical Isolation. Immediately isolate suspect cases in a private room to prevent secondary
spread. Utilize airborne, contact, droplet and standard precautions and eye protection when
in contact with a suspected or confirmed infectious person. If available an Infection Control
Professional should be consulted in situations in which there are inadequate single bedded
rooms, or to assist in creating a plan for cohorting patients who are diagnosed with the same
disease.
Personal Protective Equipment (PPE). Healthcare workers entering an airborne isolation
precaution room, cleaning the infected person’s environment, discarding trash of a potentially
infected person, and handling used linens should wear respiratory protection. If there is a
possibility of contact transmission, or if the modes of transmission are unknown, the health
worker should don gloves, gown, and eye protection in addition to respiratory protection.
Utilize a higher level of respiratory protection when performing invasive respiratory
procedures such as intubation, bronchoscopy, or other aerosolizing procedures involving
tissue or body fluid, or other potentially infectious material.
Home Isolation or Quarantine Strategies for an Unknown RAT Disease
When cases or exposed contacts are isolated or quarantined in the home setting, they should
utilize infection control strategies recommended for the public (see above) when in contact with
others. Additional infection control measures may be appropriate.
F.
Congregate Living Situation (eg. dormitories, jails, shelters) Strategies for an
Unknown RAT Disease
People who reside in congregate living situations should utilize the infection control strategies
recommended for the public (see above.). If available, an Infection Control Professional should
evaluate the appropriateness of continuing the congregated setting, whether to place individuals
in alternate settings, and/or if it is appropriate for isolation or quarantine.