Airborne infections

How are airborne transmitted infections created?

Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue [5 µm or smaller in size] of evaporated droplets that may remain suspended in the air for long periods of time) or dust particles containing the infectious agent. 2

How are airborne infections contracted?

Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors 2

How to avoid airborne infections?

Use the following precautions, or the equivalent, to help avoid airborne infections

Respiratory Protection Wear respiratory protection (FFP3 respirator) when entering the room of a patient with a known or suspected infectious respiratory condition (e.g. pulmonary tuberculosis.) Susceptible persons should not enter the room of patients known or suspected to have measles (rubeola) or varicella (chickenpox) if other immune caregivers are available. If susceptible persons must enter the room of a patient known or suspected to have measles (rubeola) or varicella, they should wear respiratory protection (FFP3 respirator). Persons immune to measles (rubeola) or varicella need not wear respiratory protection. 2

Handwashing Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn. Wash hands immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other patients or environments. 1

Gloves Wear gloves (clean, nonsterile gloves are adequate) when touching blood, body fluids, secretions, excretions, and contaminated items. Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms. Remove gloves promptly after use, before touching noncontaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments. 1

Eye Protection Wear eye protection to protect mucous membranes of the eyes, during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions. 1

Gown Wear a gown (a clean, nonsterile gown is adequate) to protect skin and to prevent soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions. Select a gown that is appropriate for the activity and amount of fluid likely to be encountered. Remove a soiled gown as promptly as possible, and wash hands to avoid transfer of microorganisms to other patients or environments. 1

Patient-Care Equipment Handle used patient-care equipment soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients and environments. Ensure that reusable equipment is not used for the care of another patient until it has been cleaned and reprocessed appropriately. Ensure that single-use items are discarded properly. 1

Environmental Control Ensure that adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces, beds, bedrails, bedside equipment, and other frequently touched surfaces, and ensure that these procedures are being followed.

Linen Handle, transport, and process used linen soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures and contamination of clothing, and that avoids transfer of microorganisms to other patients and environments. 1

Occupational Health and Bloodborne Pathogens Take care to prevent injuries when using needles, scalpels, and other sharp instruments or devices; when handling sharp instruments after procedures; when cleaning used instruments; and when disposing of used needles. Never recap used needles, or otherwise manipulate them using both hands, or use any other technique that involves directing the point of a needle toward any part of the body; rather, use either a one-handed "scoop" technique or a mechanical device designed for holding the needle sheath. Do not remove used needles from disposable syringes by hand, and do not bend, break, or otherwise manipulate used needles by hand. Place used disposable syringes and needles, scalpel blades, and other sharp items in appropriate puncture-resistant containers, which are located as close as practical to the area in which the items were used, and place reusable syringes and needles in a puncture-resistant container for transport to the reprocessing area.

Use mouthpieces, resuscitation bags, or other ventilation devices as an alternative to mouth-to-mouth resuscitation methods in areas where the need for resuscitation is predictable. 1

Patient Placement Place a patient who contaminates the environment or who does not (or cannot be expected to) assist in maintaining appropriate hygiene or environmental control in a private room. 1

The room should have:
  1. monitored negative air pressure in relation to the surrounding areas,
  2. 6 to 12 air changes per hour, and
  3. appropriate discharge of air outdoors or monitored high-efficiency filtration of room air before the air is circulated to other areas in the hospital.
Keep the room door closed and the patient in the room. When a private room is not available, place the patient in a room with a patient who has active infection with the same microorganism, unless otherwise recommended, but with no other infection. Cohorting is not desirable, consultation with infection control professionals is advised before patient placement.1

Patient Transport Limit the movement and transport of the patient from the room to essential purposes only. If transport or movement is necessary, minimize patient dispersal of droplet nuclei by placing a mask on the patient, if possible. 2

Which infections are airborne?

A number of airborne infections is listed here although this is not an exhaustive list

Influenza
Avian influenza (bird flu)
Measles
Smallpox
SARS,
A viral haemorrhagic fever e.g. Lassa fever, Marburg and Ebola
TB
Anthrax
Legionnaires' Disease
Respiratory Syncytial Virus
Psittacosis (ornithosis)
Herpes Zoster (shingles) in an immunocompromised patient 3

 

References and sources

  1. http://www.cdc.gov/ncidod/dhqp/gl_isolation_standard.html
  2. http://www.cdc.gov/ncidod/dhqp/gl_isolation_airborne.html
  3. http://www.mass.gov/dph/cdc/epii/sars/infosheets/infection_control.htm

 

 

All information supplied here is done so freely and Adveticus Limited takes no responsibility for the outcome if any or all of this advice is taken. All advice used from these pages is at your own risk.