Infection Control Infection Control in the School in the School

SettingSetting It’s In It’s In YourYour Hands Hands

What is an What is an Infection?Infection?

A condition resulting A condition resulting from the presence of, from the presence of, and invasion by, and invasion by, germsgerms

(microorganisms)(microorganisms)

For Infection to Occur For Infection to Occur an Organism Must:an Organism Must:

enter the enter the bodybody

grow and grow and multiplymultiply

cause a cause a responseresponse

Routes of Routes of TransmissionTransmission

Contact:Contact:

1. direct1. direct

2. indirect2. indirect

3. droplet3. droplet

(3 feet)(3 feet)

Routes of Routes of TransmissionTransmission

VehicleVehicle

AirborneAirborne

VectorVector

Chain of InfectionChain of Infection

HandwashingHandwashing(Hand Hygiene)(Hand Hygiene)

The The most most importantimportant measure you measure you can use to can use to prevent the prevent the spread of spread of infection.infection.

Hand Hygiene Hand Hygiene GuidelinesGuidelines

Hand HygieneHand Hygiene

When hands are When hands are visibly soiledvisibly soiled with with blood or other body blood or other body fluids: Wash hands fluids: Wash hands with either a with either a non- non-antimicrobial soap antimicrobial soap and waterand water ….. ….. OROR

An antimicrobial soap An antimicrobial soap and waterand water

Hand HygieneHand Hygiene

If hands are If hands are not not visibly soiled:visibly soiled:Use an alcohol-Use an alcohol-based hand rub based hand rub for routinely for routinely decontaminatindecontaminating hands.g hands.

Handwashing ProcedureHandwashing Procedure Wet hands.Wet hands. Apply soap.Apply soap. Rub hands together producing Rub hands together producing

friction.friction. Wash between fingers, tops of hands, Wash between fingers, tops of hands,

and around jewelry.and around jewelry. Wash for Wash for at least 15 secondsat least 15 seconds.. Rinse hands well.Rinse hands well. Dry hands with a paper towel then Dry hands with a paper towel then

use the towel to turn off faucet.use the towel to turn off faucet.

HandwashingHandwashing ….. …..

The #1 way to The #1 way to prevent the spread of prevent the spread of germs.germs.

Bloodborne PathogensBloodborne Pathogens

Bloodborne pathogens are bacteria Bloodborne pathogens are bacteria or viruses that are present in human or viruses that are present in human blood and body fluids and can be blood and body fluids and can be transmitted to other humans.transmitted to other humans.

The most common bloodborne The most common bloodborne pathogens are:pathogens are:

1.1. Human Immunodeficiency Virus Human Immunodeficiency Virus (HIV)(HIV)

2.2. Hepatitis B Virus (HBV)Hepatitis B Virus (HBV)

3.3. Hepatitis C Virus (HCV)Hepatitis C Virus (HCV)

Bloodborne Pathogen Bloodborne Pathogen TransmissionTransmission

SexuallySexually From mother-to-newborn at birthFrom mother-to-newborn at birth Sharing of needles or other sharpsSharing of needles or other sharps Accidental needlestick/cut/bite Accidental needlestick/cut/bite

(infected person to non-infected (infected person to non-infected person)person)

Blood transfusions (in the past)Blood transfusions (in the past)

HIVHIV

The virus which causes the The virus which causes the acquired immunodeficiency acquired immunodeficiency syndrome (AIDS)syndrome (AIDS)

HIV attacks the body’s HIV attacks the body’s immune system, weakening immune system, weakening it so that it cannot fight it so that it cannot fight other deadly diseases.other deadly diseases.

HIVHIV

The virus is very fragile and The virus is very fragile and will not live very long outside will not live very long outside of the human body.of the human body.

There is There is no cureno cure for AIDS for AIDS although there are various although there are various

anti-viral medications to anti-viral medications to prolong life.prolong life.

AIDS is a fatal disease.AIDS is a fatal disease.

Hepatitis B VirusHepatitis B Virus(HBV)(HBV)

Hepatitis means Hepatitis means “inflammation of the liver”.“inflammation of the liver”.

Hepatitis B is a virus that Hepatitis B is a virus that infects the liver.infects the liver.

In the U.S., approximately In the U.S., approximately 300,000 people are infected 300,000 people are infected annually.annually.

Hepatitis B Virus Hepatitis B Virus DiseaseDisease

HBVHBV Is a very durable virus and can Is a very durable virus and can

survive outside of the body for survive outside of the body for at least 7 days.at least 7 days.

It is very important to clean up It is very important to clean up any blood or body fluid spills.any blood or body fluid spills.

(Can use a 1:10 bleach solution – (Can use a 1:10 bleach solution – which is 1 part household bleach which is 1 part household bleach to to 99 parts water.) parts water.)

Hepatitis B VaccineHepatitis B Vaccine To prevent hepatitis B.To prevent hepatitis B. A 3-dose vaccine A 3-dose vaccine

series given at series given at

0, 1, 6 months 0, 1, 6 months intervals.intervals.

96% of people who 96% of people who take the vaccine will take the vaccine will develop antibody develop antibody (protection) against (protection) against the hepatitis B virus.the hepatitis B virus.

Hepatitis C Virus (HCV):Hepatitis C Virus (HCV):“The Silent Epidemic”“The Silent Epidemic”

Another cause of viral Another cause of viral hepatitis.hepatitis.

It is usually slow-spreading and It is usually slow-spreading and silent, but lasts a long time.silent, but lasts a long time.

It is one of the major causes of It is one of the major causes of cirrhosis in the U.S.cirrhosis in the U.S.

It is a major cause of liver It is a major cause of liver cancer worldwide.cancer worldwide.

HCV DiseaseHCV Disease Approximately 8-12,000 Approximately 8-12,000

people die annually from people die annually from hepatitis C-related disease.hepatitis C-related disease.

There is There is nono vaccine for HCV. vaccine for HCV. Anti-viral medications are Anti-viral medications are

available for treatment for available for treatment for some HCV-infected persons.some HCV-infected persons.

MRSA MRSA

First recognized in 1961- one year First recognized in 1961- one year after the antibiotic Methicillin was after the antibiotic Methicillin was introduced for treating S. Aureaus introduced for treating S. Aureaus infections.infections.

Methicillin Resistant Staphylococcus Methicillin Resistant Staphylococcus Aureaus- a type of bacteria not killed Aureaus- a type of bacteria not killed by common antibiotics including by common antibiotics including penicillin and cephalosporins (i.e. penicillin and cephalosporins (i.e. Amoxil and KeflexAmoxil and Keflex))

MRSAMRSA

Colonization-the microorganism is Colonization-the microorganism is living in or on the body without living in or on the body without causing disease or harmcausing disease or harm

Infection- the body is invaded by a Infection- the body is invaded by a microorganism, the organism microorganism, the organism multiplies and causes injury or illnessmultiplies and causes injury or illness

MRSAMRSA

Most infections caused by S. Aureus Most infections caused by S. Aureus are skin and soft tissue infectionsare skin and soft tissue infections

MRSA is being seen in increasing MRSA is being seen in increasing numbers among healthy persons of numbers among healthy persons of all agesall ages

This is referred to as Community This is referred to as Community Acquired MRSAAcquired MRSA

Signs and SymptomsSigns and SymptomsFeverFever

Local Swelling, redness, heatLocal Swelling, redness, heat

Painful lesion or pimple with or without Painful lesion or pimple with or without drainagedrainage

Boil- tender red lump with a white Boil- tender red lump with a white “head“head””

BOILBOIL

CELLULITISCELLULITIS

MRSAMRSA

S. Aureus is most often spread S. Aureus is most often spread to others by contaminated to others by contaminated handshands

Touching skin, wounds, Touching skin, wounds, sharing towels, athletic sharing towels, athletic equipment and other personal equipment and other personal itemsitems

MRSAMRSA

PreventionPrevention HandwashingHandwashing Good personal hygieneGood personal hygiene Regularly clean commonly touched surfaces, Regularly clean commonly touched surfaces,

such as door knobs, bathrooms, nap mats, etc., such as door knobs, bathrooms, nap mats, etc., with any EPA approved disinfectant.with any EPA approved disinfectant.

Cheapest and very good disinfectant is Cheapest and very good disinfectant is household bleach and water in a 1:9 solutionhousehold bleach and water in a 1:9 solution(1 Tbsp. bleach to 1 quart of water mixed fresh (1 Tbsp. bleach to 1 quart of water mixed fresh daily).daily).

MRSAMRSA Prevention (continued)Prevention (continued)

Clean toys and classroom items at least Clean toys and classroom items at least daily and anytime they become soileddaily and anytime they become soiled

Wash any cuts, scrapes, lesions, insect Wash any cuts, scrapes, lesions, insect bites and sores with soap and waterbites and sores with soap and water

Keep lesions clean and dry and cover Keep lesions clean and dry and cover them with bandages until they are them with bandages until they are healed. If drainage cannot be contained healed. If drainage cannot be contained by a dressing, student should be by a dressing, student should be excluded from class until healed or excluded from class until healed or drainage decreases.drainage decreases.

MRSAMRSA Use a barrier between skin and Use a barrier between skin and

shared equipment e.g. exercise shared equipment e.g. exercise machines and massage tables machines and massage tables

If you change a dressing WEAR If you change a dressing WEAR GLOVES, dispose of dressing in a GLOVES, dispose of dressing in a ziplock baggie and discard. Wash ziplock baggie and discard. Wash hands after removing gloves.hands after removing gloves.

HANDWASHING IS YOUR BEST HANDWASHING IS YOUR BEST DEFENSE AGAINST INFECTIONSDEFENSE AGAINST INFECTIONS

Standard Standard PrecautionsPrecautions

Consider the blood Consider the blood and body fluids of and body fluids of everyoneeveryone to be to be potentially potentially infectious.infectious.

DoDo notnot:: Share razors, Share razors,

toothbrushes, toothbrushes, eating utensils eating utensils and drinking and drinking containers with containers with other people.other people.

Share needles or Share needles or other sharps with other sharps with others.others.

Do:Do: Be careful when providing Be careful when providing first aid or dressing the first aid or dressing the wounds of others.wounds of others.

Always keep sores or Always keep sores or open wounds covered open wounds covered with band aid or dressing.with band aid or dressing.

Do:Do: Always immediately Always immediately

clean up any spills clean up any spills of blood or body of blood or body fluids (wear gloves).fluids (wear gloves).

Always carefully Always carefully clean household clean household when someone is ill when someone is ill in the home.in the home.

Tuberculosis (TB)Tuberculosis (TB)

A disease transmitted from A disease transmitted from person-to-person through person-to-person through the air when an infected the air when an infected person repeatedly comes in person repeatedly comes in contact with an uninfected contact with an uninfected person.person.

TB usually affects the lungs, TB usually affects the lungs, but may attack almost any but may attack almost any part of the body.part of the body.

Tuberculosis (TB)Tuberculosis (TB)

Tuberculosis SymptomsTuberculosis Symptoms General Symptoms:General Symptoms:1.1. Weight lossWeight loss2.2. WeaknessWeakness3.3. Fever and/or Night SweatsFever and/or Night Sweats

TB of the Lung:TB of the Lung:1.1. CoughCough2.2. Chest painChest pain3.3. Coughing up bloodCoughing up blood

TB Skin TestingTB Skin Testing

TB Infection vs. TB TB Infection vs. TB DiseaseDisease

TB Infection:TB Infection:

1.1. Germs in body, Germs in body, but but not not sick and sick and no symptoms.no symptoms.

2.2. Skin test is Skin test is usually positive.usually positive.

3.3. Most people Most people (90%) do (90%) do notnot develop disease.develop disease.

TB Disease:TB Disease:

1.1. Person is sick, Person is sick, has symptoms, has symptoms, and can and can spread disease spread disease to others.to others.

2.2. Treatment is Treatment is needed in needed in order to get order to get well.well.

Respiratory Respiratory HygieneHygiene

Respiratory HygieneRespiratory Hygiene

Cover the nose/mouth when Cover the nose/mouth when coughing or sneezing;coughing or sneezing;

Use tissues to contain Use tissues to contain respiratory secretions & dispose respiratory secretions & dispose of them in the nearest waste of them in the nearest waste receptacle after use;receptacle after use;

Perform hand hygiene after Perform hand hygiene after having contact with respiratory having contact with respiratory secretions & contaminated secretions & contaminated objects/materials.objects/materials.

Antibiotic UseAntibiotic Use

Antibiotics are for treatment Antibiotics are for treatment of bacteria – of bacteria – notnot viruses. viruses.

Always take the antibiotic Always take the antibiotic exactly exactly as prescribed.as prescribed.

Do Do notnot save antibiotics for save antibiotics for “next time”.“next time”.

Do Do notnot share antibiotics with share antibiotics with others.others.

Employee HealthEmployee Health

Practice good personal Practice good personal hygiene.hygiene.

Be sure you are up-to-date Be sure you are up-to-date on all of your immunizations.on all of your immunizations.

Seriously consider taking the Seriously consider taking the influenza vaccine annually.influenza vaccine annually.

Do Do notnot come to work when come to work when you are sick.you are sick.

Practice good handwashing!Practice good handwashing!