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Other Infections and Conditions


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Respiratory Illnesses – [Overview] [Prevention Strategies] [Tools and resources] | Norovirus –[Overview] [Prevention Strategies] [Tools and resources] | Scabies –[Overview] [Prevention Strategies] [Tools and resources]
Tuberculosis (TB) –[Overview] [Prevention Strategies] [Tools and resources]


Overview

Several other infections or conditions such as influenza, norovirus, scabies, and tuberculosis (TB) may be transmitted in healthcare facilities. It is important that both the patient and the healthcare providers take the appropriate steps to help prevent the spread of these infections and conditions.


Flu and Respiratory Illnesses
Respiratory illnesses are infections that affect the respiratory system, which includes the nose, sinuses, throat, and lungs. Respiratory illnesses can be caused by viral or bacterial pathogens and range in severity from mild head colds to severe influenza or pneumonia infections. Symptoms may include nasal congestion, runny nose, sore throat, cough, shortness of breath, chest congestion, wheezing, fever, headaches, and/or body aches.

Influenza (flu) is a respiratory illness caused by the influenza virus. Flu is spread when droplets containing the virus are spread into the air when an ill person coughs, sneezes, talks, or sings. Influenza can also be spread through direct and indirect contact with respiratory secretions. Comprehensive information and resources on influenza is available at the Office of Epidemiology’s flu site – click here.

Patients with seasonal influenza and other respiratory illnesses that can be spread through close respiratory contact or mucous membrane contact with respiratory secretions require droplet precautions.

Norovirus and Gastrointestinal Illnesses
Gastrointestinal (GI) illnesses are infections that affect the gastrointestinal system, most commonly the stomach, small intestine, and large intestine, causing symptoms such as nausea, vomiting, and/or diarrhea. Fever, abdominal cramps, and headache or body aches may also occur.

Norovirus is one type of GI illness. The virus is found in the stool and vomit of infected people and spreads easily from person to person. People can become infected in several ways, including eating food or drinking liquids that are contaminated with norovirus, touching surfaces or objects contaminated with norovirus and then touching one’s mouth, or having direct contact with another person who is infected (a healthcare worker, visitor, or another patient) and then touching one’s mouth. In an outbreak, and in some other situations, patients with norovirus in an outbreak require contact precautions.

Scabies
Scabies is an infestation of the skin caused by a small mite that burrows under the skin in order to feed and reproduce. Intense itching, often at night, is the most common symptom of scabies infestation. The skin may appear red and bumpy and blisters or rashes may appear. Most often, infestation will occur in areas of skin that have folds or webs such as the underarms, genitalia, thighs, and between fingers and toes. Symptoms appear two to six weeks after infection, but may appear much faster in those who have had scabies before.

Scabies is most commonly transmitted through direct person-to-person skin contact. Mites do not jump from one person to another, but it is possible to transfer mites on clothing, bedding, or furniture that has been contaminated by an infested person. Patients with scabies require contact precautions.

Tuberculosis
Tuberculosis (TB) is a disease caused by a bacterium called Mycobacterium tuberculosis that is spread from person-to-person through the air when a person with TB disease of the lungs or throat coughs, sneezes, talks, or sings.  TB usually affects the lungs, but it can also affect other parts of the body.  If a person inhales air containing M. tuberculosis droplets, he or she may become infected.  However, not everyone infected with TB bacteria becomes sick or can spread the disease. Patients with TB require airborne precautions.


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Prevention Strategies

To prevent the spread of respiratory illnesses in healthcare facilities:
  • Promote good respiratory hygiene practices.
    • Provide tissues, face masks, and hand hygiene supplies.
    • Encourage people with respiratory symptoms to distance themselves from others.
    • Instruct patients, visitors, and healthcare workers to cover their nose and mouth when coughing or sneezing.
  • Monitor and manage ill healthcare workers.
    • If sick with flu-like illness, healthcare workers should stay home for at least 24 hours after your fever has gone away (without the use of a fever-reducing medicine) and limit contact with other people.
  • Implement droplet precautions for patients with respiratory illnesses as appropriate.
  • Administer antiviral treatment and chemoprophylaxis of patients and healthcare personnel when appropriate.

To prevent the spread of norovirus in healthcare facilities:

  • Follow hand hygiene guidelines, and carefully wash hands with soap and water after contact with patients with norovirus infection.
  • Implement contact precautions.
    • Use gowns and gloves when in contact with, or caring for patients who are symptomatic with norovirus.
  • Routinely clean and disinfect high touch patient surfaces and equipment with an Environmental Protection Agency-approved product with a label claim for norovirus, or use a freshly prepared dilute bleach solution.  CDC recommends a minimum concentration of 1,000 ppm (i.e., 1 part household bleach solution to 50 parts water) with a one minute contact time. However, areas with high levels of soiling may require up to 5,000 ppm chlorine bleach (i.e., 1 part bleach to 9 parts water) and a contact time of up to 10 minutes.
  • Remove and wash contaminated clothing or linens.
  • Healthcare workers who have symptoms consistent with norovirus should be excluded from work.

To prevent the spread of scabies infestation in healthcare facilities:

  • Avoid contact with people with scabies until 24 hours after the completion of treatment.
  • Asymptomatic, close (skin-to-skin) contacts should receive chemoprophylaxis (a scabicide).   Asymptomatic contacts should also monitor for symptoms of infestation for up to six weeks after treatment.
  • Those with scabies should not share personal items, clothing, bedding, linens, or furniture with other people.
  • Potentially contaminated items should be washed in hot water and dried in a hot dryer or placed in a sealed plastic bag for at least 7 days.

To prevent the spread of TB in healthcare facilities:

  • Implement administrative measures to ensure prompt detection of TB, including (but not limited to) conducting a TB risk assessment, implementing effective work practices for the management of patients with suspected or confirmed TB disease, and screening and evaluating healthcare workers who are at risk for TB disease or who might be exposed to M. tuberculosis.
  • Use environmental controls to prevent the spread and reduce the concentration of M. tuberculosis particles in the air.
    • Primary environmental controls
      • Use local exhaust ventilation.
      • Dilute and remove contaminated air by using general ventilation.
    • Secondary environmental controls
      • Control the airflow to prevent contamination of air in areas near the source [airborne infection isolation (AII) rooms].
      • Clean the air by using high efficiency particulate air (HEPA) filtration or ultraviolet germicidal irradiation.
  • Follow airborne precautions and use appropriate respiratory protective equipment in situations that pose a high risk of exposure to M. tuberculosis.

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Tools and Resources

Influenza and Respiratory Illnesses

For resources on influenza for healthcare professionals and facilities, click here.

Fact sheets

Other resources

Norovirus and Gastrointestinal Illnesses
Fact sheets:

Guidelines:

Websites:

 

Scabies

 

Tuberculosis
Fact sheets:

Guidelines:

Websites:

For more patient resources, please see the Consumer and Public Information page.


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Last Updated: 10-30-2013

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