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Infection Prevention in the
Classroom Setting
USA Center for Rural Public Health Preparedness at
Texas A&M Health Science Center
School of Rural Public Health
Welcome!
Germs can spread rapidly in a classroom setting, so staying
informed and active to protect yourself and students from
infectious diseases is essential. Increased awareness will
minimize the risk of infection, prevent disease transmission, and
preserve a healthy and safe classroom environment.
The USA Center for Rural Public Health Preparedness at Texas
A&M Health Science Center School of Rural Public Health
designed this train-the-trainer activity for teachers and their
students. It provides information , ideas, and learning activities for
the classroom to help keep children healthy and prevent the
spread of infection in the classroom setting.
What is an Infectious Disease?
Infection
– An infection occurs when microorganisms, or germs,
enter and multiply in the body.
Infectious Disease
– An infectious disease occurs when the infection
damages the body and produces signs and symptoms
indicating the body is unhealthy.
Infectious Agent
– Infectious agents are microorganisms such as bacteria,
fungi, viruses, protozoa, and parasites that can cause
infectious disease.
www.mayoclinic.com/health/infectious-disease/ID0004
Infectious Disease Examples
Common Cold
Influenza
Meningitis
Chickenpox
Staph / Methicillin-resistant Staphylococcus aureus (MRSA)
Tuberculosis
Severe Acute Respiratory Syndrome (SARS)
Head lice
Ringworm
Salmonellosis
Chlamydia
Human Immunodeficiency Virus (HIV)
Hepatitis A, B, and C
www.go.mb.ca/health/publichealth/cdc/fs/infcontshelter.pdf
How Are Infectious Diseases Spread?
Understanding how infectious diseases are spread
is important for minimizing the risk of infection and
preventing disease transmission.
Three ways in which infectious diseases can be
transmitted:
Direct transmission
Indirect transmission
Airborne transmission
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Direct Transmission
Direct transmission occurs when an infectious agent is transferred
directly into the body such as through the eyes, nose, mouth, or
through a break in the skin such as a cut on the finger. Infectious
agents are spread directly in the following ways:
Person-to-person
– through physical contact including touching, biting, hugging, or
kissing
– Example: MRSA, Hepatitis
Animal-to-person
– through physical contact, bites, and scratches
– Example: Ringworm, Rabies
Infectious droplets
– during coughing, sneezing, talking, singing, and spitting
(spread is limited to approximately three feet)
– Example: Cold, Influenza
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Indirect Transmission
Infectious diseases are spread indirectly through vehicles and vectors.
Vehicle-borne transmission
– Some infectious agents can linger on inanimate objects, such as desks, chairs,
computer keyboards, doorknobs, faucets, toys, eating utensils, or clothing.
– Example: Touching a pencil used by a person infected with the flu and then
touching the eyes, nose, or mouth before performing hand hygiene.
– Other vehicles include food, water, and biological products such as blood and
body fluids.
– Example: Eating peanut butter contaminated with Salmonella, or pepperoni
contaminated with E. coli.
Vector-borne transmission
– Common vectors include insects, such as mosquitoes, ticks, and lice.
– Example: Becoming infected with West Nile Virus as a result of being bitten
by an infected mosquito, or sharing a comb with someone
who has head lice.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Airborne Transmission
Airborne transmission is the spread of infectious
agents as aerosols that usually enter the respiratory
tract. Unlike the infectious droplets, these tiny
particles have the ability to remain suspended in the
air for long periods of time and travel long distances.
Tuberculosis, chicken pox, and the measles are examples
of infectious diseases spread by airborne particles.
Example: An individual becomes infected with Severe Acute
Respiratory Syndrome (SARS) by inhaling infectious
airborne particles while on a crowded bus.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Importance of Hand Hygiene
Hand hygiene, including handwashing and the use of hand
sanitizer, is extremely important in preventing infectious
disease transmission in a classroom environment.
Many people tend to minimize the significance of hand
hygiene, often forgetting or eliminating hand washing due to
busy schedules, lack of available soap and water, and
inconvenience, but this is the single most important practice
to prevent the spread of infectious disease. It is also the best
method to protect children from infection in the classroom
setting.
www.cdc.gov/cleanhands
Handwashing
Three necessary components of proper
handwashing include:
– Soap
– Clean water
– Friction
www.cdc.gov/cleanhands/
Proper Handwashing Technique
1.
2.
3.
4.
5.
6.
7.
Wet hands with clean warm water.
Apply soap and rub hands together to create a lather.
Scrub all surfaces of the hands including the palms, back of
hands, wrists, between fingers, and under fingernails.
Continue washing hands for 20 seconds, about the time it
takes to sing the “Happy Birthday” song twice.
Rinse hands well to remove all soap.
Dry hands completely with a towel or air dryer.
If available, use a towel to turn off the faucet and open the
door to avoid recontamination.
www.cdc.gov/cleanhands/
Easy to Miss Areas
Using proper technique is essential to sanitizing hands
effectively. Inadequate handwashing causes significant
areas of the hands to be missed. All areas of the fingers,
hands, and wrists must be covered during hand hygiene.
By imagining the rapid method generally used when washing
hands, it is easy to understand which places are most
frequently ignored. Insufficient handwashing often involves
rubbing the palms together with soap and water and possibly
a quick swipe across the back of each hand. This is clearly
depicted in the following diagram of frequently missed areas
during handwashing.
www.foodlink.org.uk/factfile_c.asp?file=2&chapter=2 /
Frequently Missed Areas
www.foodlink.org.uk/factfile_c.asp?file=2&chapter=2 /
When to Wash Hands
After blowing the nose, sneezing, or coughing
After going to the bathroom
After contact with blood or body fluids, such as saliva, nasal
secretions, urine, feces, or vomit
After PE or playing sports
After playing outside at recess
After handling garbage or waste
When hands appear soiled
Before preparing medicine or handling contact lenses
www.cdc.gov/cleanhands/
When to Wash Hands (2)
Before preparing, serving, or handling food
Before eating lunch or snacks
Frequently when sick or after contact with others who are
sick
Before and after touching a cut or wound
Before and after touching the eyes, nose, or mouth
After handling animals, animal waste, or their belongings,
such as toys or a leash
After changing a diaper
www.cdc.gov/cleanhands/
Waterless Alcohol-based
Hand Sanitizer
When to Use
–
–
–
–
–
Substitute when soap and water are not available.
Ineffective for cleaning hands that are visibly dirty.
Do not substitute when handling or preparing food.
Do not overuse; traditional handwashing is best.
Supervise children while they use hand sanitizer.
Two necessary components
– Alcohol-based hand sanitizer
– Friction
www.health.state.mn.us/handhygiene/clean.html
Waterless Alcohol-based
Hand Sanitizer Continued
Proper Technique
– Apply small amount of hand sanitizer to the palm.
– Rub hands together covering all surfaces, much like when
washing hands with soap and water.
– Rub until hand sanitizer is absorbed completely and hands
become dry.
www.health.state.mn.us/handhygiene/clean.html
Handwashing Compliance
100%
90%
80%
70%
% Washed
60%
60%
50%
55%
46%
50%
Female
Male
40%
30%
20%
10%
0%
Middle School (n=60)
High School (n=60)
Comparison of handwashing compliance
between middle school students and high school
students and male and female students.
Am J Infect Control 1997; 25: 424-5
Classroom Handwashing
Activity Ideas
Practice washing hands properly with students. Have them
identify or write a song, poem, or saying that they can use
when washing hands that lasts 20 seconds.
Have a contest for students to create posters and fliers with
handwashing facts that can be posted bathroom stalls or
published in the school newspaper or newsletter.
Other Learning Activities
Use fluorescent hand lotion to test hand washing
effectiveness and to observe how germs spread
between hands, surfaces, pens, etc.
Swab high-traffic surfaces and culture on agar in a
Petri dish or touch fingers to the agar and then
incubate to demonstrate the growth of
microorganisms.
Share infection prevention training with parents at
parent-teacher meetings to disseminate education to
the home.
Additional Activities & Material
Please take a moment to explore the following online resources for
helpful teaching materials about infection prevention. Some of the
links include suggestions for infection prevention related lesson plans,
a classroom experiment, printable classroom activity sheets, and other
fun learning activities for students.
HANDWASHING PROJECT IDEAS
Multidisciplinary activities for teachers and students to promote handwashing
HAND HYGIENE EXPERIMENT
Classroom science experiment to demonstrate persistence of bacteria and
proper handwashing technique
Clean Classroom Environment
Maintaining a clean classroom environment reduces
the presence of germs and the spread of infectious
diseases, and therefore, protects the health of
students, teachers, school staff, and parents.
General Infection Prevention
Following general infection prevention measures and
maintaining personal hygiene reduces the spread of
infectious diseases in a school setting.
Encourage children, teachers, and all school personnel to
wash hands frequently using soap and water for 15-20
seconds and to assist children as needed.
Substitute alcohol-based hand sanitizer when clean water
and soap are unavailable.
Promote appropriate respiratory etiquette: Cover coughs and
sneezes with tissue. Throw away tissues immediately and
use hand hygiene. If a tissue is not available, sneeze or
cough into the elbow or upper sleeve.
General Infection Prevention (2)
Teach children to properly dispose of used tissues.
Provide tissues and trash receptacles in classrooms and on
school buses.
Advise parents to keep sick children home from school.
Remain at home when ill and encourage others to do the
same.
Avoid close contact (less than 3 feet of space) with those
who are sick.
Maintain and promote good personal hygiene; bathe and
wash hands regularly.
Discourage touching the eyes, nose, and mouth.
Maintain a clean classroom environment.
Ensure commonly used areas such as door handles, eating
surfaces, and desks are clean and disinfected.
General Infection Prevention (3)
Keep open wounds clean and covered with a bandage until
healed.
Avoid contact with other people’s wounds and bandages.
Discourage sharing eating utensils, glassware, or personal
items such as toothbrushes, combs, razors, towels, clothing
or other items that come into contact with bare skin.
Clean shared sports equipment with antiseptic before each
use or use a cloth or a towel as a barrier between the skin
and the equipment.
Avoid skin-to-skin contact with anyone who has a Staph
infection.
Encourage a healthy lifestyle that includes a nutritious diet
and adequate sleep.
Additional Considerations
The incorporation of animals into the classroom environment can
provide many beneficial learning experiences for children. It is
important to keep in mind the risks of Zoonotic Diseases, or those
that are transmissible from animals to humans.
The following considerations are important when dealing with
animals in a classroom:
– Always wash hands very thoroughly after touching animals or their
belongings
– Ensure animals have current vaccinations and receive annual veterinary
exams
– Bathe animals regularly
– Avoid contact with animal waste or food
– Only handle a new animal with permission and supervision
– Teach children the proper way to handle the animal
The End
This concludes the train-the-trainer activity, “Infection Prevention
in the Classroom Setting.” We hope you have enjoyed this
presentation and will utilize and share this information with your
schools to help keep children healthy and prevent the spread of
infection in the classroom setting.
Contact Information
USA Center for Rural Public Health Preparedness
Texas A&M Health Science Center
School of Rural Public Health
1266 TAMU
College Station, Texas 77843-1266
Phone: (979) 845-2387
E-mail: [email protected]
The CDC-funded Centers for Public Health Preparedness are a
national network of academic institutions working in collaboration
with state and local public health departments and other community
partners to provide life-long learning opportunities to the public
health workforce in order to handle the next public health crisis.