NORTHWESTERN MEMORIAL HOSPITAL INF 8.11 Appendix A: Disease Specific Isolation Precautions Chart. Infective Materials. Duration of Precautions

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1 Abscess Draining, Major Wound drainage Duration of illness. Abscess Draining, Minor or Limited Standard Acinetobacter baumannii Carbapenem-intermediate or -resistant The patient, their body fluids and their environment. Duration of hospitalization. All glove boxes must be removed from patient room following patient discharge or transfer. Acquired Immunodeficiency Syndrome (AIDS) Standard IC reports newly identified cases to. Actinomycosis Standard Adenovirus Conjuntivitis Eye Duration of illness. Adenovirus Feces Duration of illness. Adenovirus infection -Infants and Children, Glove & Duration of illness. Amebiasis (Entamoeba histolytica ) Standard Anthrax Cutaneous or Pulmonary Standard Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Aspergillosis Standard 1

2 Avian Influenza, Glove, & Eye Protection 14 days after onset of symptoms, an alternate diagnosis is confirmed or diagnostic tests confirm patient is not infected with Influenza A Virus. Negative airflow room required. Staff must wear goggles or face shield when within 3 feet of patient. Discard all PPE after each use. Patient must have dedicated equipment; stethoscope, blood pressure cuff, thermometer, etc. See Policy # INF 8.08 Care of Prentice Patient Requiring for patients residing in PWH. Babesiosis Standard Blastomycosis Standard Botulism Standard Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Brucellosis Standard Burkholderia cepacia Standard Patients with Cystic fibrosis (CF) colonized or infected must not be admitted to a unit where another CF patient resides. Persons with CF who visit must wear a mask when within 3 feet of a colonized or infected patient. Campylobacter gastroenteritis Standard Feces Candidiasis (all forms including mucocutaneous) Standard Cellulitis Uncontrolled draining Duration of illness. 2

3 Chancroid (soft chancre) Standard Chicken pox (Varicella zoster virus), Glove &, vesicular lesion fluid Until lesions are dry and crusted. Policy # 8.08 INF Care of Chlamydia trachomatis infection Standard Cholera (Vibrio cholerae) Standard Clostridium difficile- associated disease Feces Until patient has formed stool or duration of hospitalization. Conjunctivitis Bacterial Chlamydia Gonococcal Standard Conjunctivitis Viral (Keratoconjunctivitis) Eye Duration of illness. Coxsackie Virus (an Enterovirus) Infants and Children and feces Duration of illness. Coxiella burnetti (Q fever) Standard Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Patients without associated diarrhea do not require. Consider if type of infection is unknown. Please notify & Prevention Department if >2 patients on the same unit are on precautions for conjunctivitis. Please notify & Prevention Department if >2 patients on the same unit are on precautions for conjunctivitis. Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. 3

4 Creutzfeldt-Jakob disease (CJD) Standard High infectivity tissues; brain, spinal cord and eyes. Low infectivity tissues; CSF, kidneys, liver, lungs, lymph nodes, spleen, and placenta. Please refer to Surgical Services Policy # 1.12 SS Creutzfeld-Jakob Disease (CJD)/Prions: Operating Room Guidelines Croup See Additional Comments Croup is caused by a diverse group of organisms, please refer to causative agent for specific isolation precautions. Cryptococcosis Standard Cryptosporidiosis Standard Cyclosporiasis Standard Cytomegalovirus infection Standard Decubitus ulcer Infected, major Wound drainage While drainage is present. Decubitus ulcer Infected, minor Standard Dengue Fever Standard 4

5 Diphtheria (Corynebacterium diptheriae ) Cutaneous and skin lesions and articles soiled by skin lesions. Two negative cultures from throat, nose and lesions obtained 24 hours after completion of appropriate antibiotic therapy and taken not less than 24 hours apart. Diphtheria (Corynebacterium diptheriae ) Pharyngeal Two negative cultures from throat and nose obtained 24 hours after completion of appropriate antibiotic therapy and taken not less than 24 hours apart. Policy # 8.08 INF Care of Donavanosis (Granuloma inguinale, Granuloma venereum) Standard Ebola Virus (Viral Hemorrhagic Fever), Glove & Blood, body fluids, organs, respiratory Duration of illness. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to policy 8.08 INF Care of Prentice Patient Requiring Echinococcosis Standard Echovirus (an Enterovirus) Infants, feces Duration of illness. Echovirus (an Enterovirus) Adults Standard 5

6 E. coli - Escherichia coli 0157:H7 () Feces Duration of illness. E. coli - Enterohemorrhagic Escherichia coli, EHEC () Feces Duration of illness. E. coli - Enterotoxigenic Escherichia coli, ETEC () Feces Duration of illness. E. coli - Enteropathogenic Escherichia coli, EPEC (Gastoenteritis) Feces Duration of illness. E. coli - Shiga Toxin-Producing Escherichia coli STEC, () Feces Duration of illness. E. coli - Escherichia coli () Standard Encephalitis Standard Entamoeba histolytica (Enteritis, Amebiasis) Standard Feces Enterobiasis (Pinworm, Oxyuriasis) Standard Enterococcus species Vancomycin-resistant (VRE) Colonization or The patient, their body fluids and their environment. Duration of hospitalization. Patient placed in VRE Flagging System by IC; automatic order for precautions triggered every subsequent admission. Removal from system; 3 negative rectal cultures or two negative stool cultures obtained at least one week apart while patient off therapeutic antibiotics. Negative cultures may accumulate across admissions. Enterovirus Infants and Children and feces. Duration of illness. 6

7 Enterovirus Adults Standard Enterovirus (Hand, Foot and Mouth Disease) Infants and Children and feces. Duration of illness. Enterovirus (Hand, Foot and Mouth Disease) Adults Standard Epiglottitis due to Haemophilus influenzae Until 24 hours following appropriate antibiotic therapy. Policy # 8.08 INF Care of Epstein-Barr virus infection Including mononucleosis Standard Erlichiosis (Rickettsial Fever) Standard Erythema infectiosum (Parvovirus B19, Fifth's Disease) 7 days from onset of illness. Extended Spectrum beta lactamase (ESBL) Gram-negative organisms The patient, their body fluids and their environment. Duration of hospitalization. Bacteria that produce extended spectrum betalactamases (ESBLs), making them resistant to 3rd generation cephalosporins and monobactams and can make infections harder to treat. Most common ESBL producers are E. coli and K. pneumoniae. Fifth's Disease (Erythema infectiosum, Parvovirus B19) 7 days from onset of illness. - all organisms, suspected or confirmed, for continent patients unless otherwise specified. Standard Please notify & Prevention Department if >2 patients on the same unit are on precautions for gastroenteritis. 7

8 NORTHWESTERN MEMORIAL HOSPITAL - all organisms, suspected or confirmed, for patients diapered or incontinent unless otherwise specified. Feces Duration of illness. Adenovirus Diapered or Incontinent Patients Feces Duration of illness. Campylobacter Diapered or Incontinent Patients Feces Duration of illness. Cholera Diapered or Incontinent Patients Feces Duration of illness. Clostridium difficile (C. diff ) Feces Until patient has formed stool or Duration of hospitalization. Cryptosporidiosis Diapered or Incontinent Patients Feces Duration of illness. E. coli 0157:H7 infection Diapered or incontinent patients Feces Duration of illness. E. coli Standard Please notify & Prevention Department if >2 patients on the same unit are on precautions for gastroenteritis. Giardia lamblia Standard rovirus Diapered or incontinent patients Feces Duration of illness. Rotavirus Diapered or incontinent patients Feces Duration of illness. Ensure consistent environmental cleaning and disinfection; prolonged shedding may occur in immunocompromised patients. Ensure consistent environmental cleaning and disinfection; prolonged shedding may occur in immunocompromised patients. 8

9 Salmonellosis Diapered or incontinent patients Feces Duration of illness. Shigellosis Diapered or incontinent patients Feces Duration of illness. Staphylococcus aureus Standard Vibrio parahaemolyticus Standard Yersinia enterocolitica Standard German Measles (Rubella) German Measles (Rubella) Congenital 7 days after onset of rash. and urine. Any admission before the first birthday unless pharyngeal and urine cultures are negative after 3 months of age. Policy # 8.08 INF Care of Giardiasis () Diapered or Incontinent Patients Feces Duration of illness. Gonorrhea Standard Granuloma inguinale (Donovanosis, Granuloma venereum) Standard 9

10 Haemophilus influenzae Epiglottitis Meningitis Pneumonia in infants and children Hand, Foot and Mouth Disease (Enterovirus) Infants and Children 24 hours after the start of effective therapy. and feces. Duration of illness. Policy # 8.08 INF Care of Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other patients with visable barrier in place. Hand, Foot and Mouth Disease (Enterovirus) Adult Standard Hantavirus Pulmonary Syndrome Standard Hemmorrhagic Fevers, viral (Ebola Virus, Lassa Virus, Machupo Virus, Marburg Virus), Glove and Blood, body fluids, respiratory. Duration of illness. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Hepatitis, viral Type A Continent person Standard Hepatitis, viral Type A Diapered or incontinent patient Feces Duration of hospitalization. for children <3 years of age; until 2 weeks after onset of symptoms in childern 3-14 years of age; until 1 week after onset of symptoms for all others. 10

11 Hepatitis, viral Type B-HBsAg positive Standard Hepatitis, viral Type C and other unspecified non-a, non-b Standard Hepatitis, viral Type E Standard Herpes simplex virus (HSV) Encephalitis Standard Herpes simplex virus (HSV) Skin, Oral, Genital Standard Herpes simplex virus (HSV) Disseminated or primary, severe Drainange from lesions. Duration of illness. Herpes simplex virus (HSV) Neonatal Exposure Drainange from lesions, if lesions are present. Duration of hospitalization. Infants born vaginally or by C-Section to women with active HSV lesions and ROM >4 hours should be placed on or room-in continuously with the mother. Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other Herpes simplex virus (HSV) Neonatal Illness Drainage from lesions. Duration of illness. Infants born vaginally or by C-Section to women with active HSV lesions and ROM >4 hours should be placed on or room-in continuously with the mother. Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other Recurrence can occur, monitor for rash or other symtpoms. 11

12 Herpes zoster virus (Shingles/Varicella zoster virus) Localized in immunocompromised patient or disseminated in any patient, Glove & Drainange from lesions, respiratory. Until lesions are dry and crusted. Policy # 8.08 INF Care of Persons susceptible to varicella are also at risk for developing varicella infection when exposed to patients with herpes zoster lesions; susceptible caregivers should not enter the room if other immune caregivers are available. Herpes zoster virus (Shingles/Varicella zoster virus) Localized in immunocompetent patient Standard Drainage from lesions. Once lesions are determined to be localized in an immunocompetent patient,, Glove and may be discontinued and Standard applied. Affected area must be covered if patient leaves room/unit. Persons susceptible to varicella are also at risk for developing varicella infection when exposed to patients with herpes zoster lesions; susceptible caregivers should not enter the room if other immune caregivers are available. Histoplasmosis Standard Human Immunodeficiency virus (HIV) Standard Human Metapneumovirus (hmpv) Duration of illness. Impetigo Drainange from lesions. Until 24 hours after start of effective therapy. Infectious mononucleosis Standard 12

13 Influenza Lassa Virus (Viral Hemorrhagic Fever, Lassa Fever), Glove and Duration of illness. A negaitive rapid antigen test does not rule out diagnosis of influenza. Blood, body fluids, respiratory. Duration of illness. Negative airflow room required for all patients with confirmed or suspected influenza. If a negative airflow room is not available, patients should be admitted to a general unit (NOT 16E, 15E, 15W or 11E), placed on and the room door remain closed at all times. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Prentice Patient Requireing Legionnaires disease Standard Leprosy (Hansen's Disease) Standard Leptospirosis Standard Lice (Pediculosis) Until 24 hours after start of effective therapy and observed to be free of adult and immature lice. Clothes should be bagged for 10 days or discarded. If a washer/dryer is available, clothes must be washed in hot water cycle and placed in the dryer on hot setting. Listeriosis Standard Lyme Disease Standard Malaria Standard 13

14 Machupo Virus (Viral Hemorrhagic Fever) Marburg Virus (Viral Hemorrhagic Fever) Measles (Rubeola, all presentations), Glove and, Glove and Blood, body fluids, organs, respiratory. Duration of illness. Blood, body fluids, organs, respiratory. Duration of illness. Duration of illness. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Policy # 8.08 INF Care of Meningitis Asceptic Standard Meningitis Fungal Standard Meningitis Haemophilus influenzae, known or suspected Until 24 hours after start of effective therapy. Policy # 8.08 INF Care of Meningitis Listeria monocytogenes Standard 14

15 Meningitis Neisseria meningitidis Until 24 hours after start of effective therapy. Policy # 8.08 INF Care of Meningitis Pneumococcal Standard Meningitis Other bacterial Standard Meningococcemia (Meningococcal sepsis) Until 24 hours after start of effective therapy. Policy # 8.08 INF Care of Molluscum contagiosum Standard Monkeypox (Monkeypox Virus), Glove &, vesicular lesion fluid. If vesiculopustular rash is present, until lesions crust over. For symptoms w/o rash, until 7 days after fever onset. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Eye protection or face shield should be worn if spraying or splashing is anticipated. Refer to Policy # 8.08 INF Care of MRSA Staphylococcus aureus m ethicilin-resistant The patient, their body fluids and their environment. Duration of hospitalization. Mucormycosis Standard Multi-drug resistant organisms (MDROs), infection or colonization Duration of hospitalization. Please see specific organism, e.g. MRSA, ESBL, VRE. 15

16 Mumps (Infectious parotitis) 9 days after onset of swelling/parotitis. Negative airflow room required for all patients with confirmed or suspected mumps. If a negative airflow room is not available, patients should be admitted to a general unit (NOT 16E, 15E, 15W or 11E), placed on and the room door remain closed at all times. Mycobacteria, nontuberculosis (atypical) Standard Mycobacteria tuberculosis Extrapulmonary, draining lesions Standard Mycobacteria tuberculosis Extrapulmonary, meningitis Standard Myctobacteria tuberculosis Pulmonary confirmed or suspected Laryngeal disease confirmed or suspected Suspected disease: until ruled out with 3 negative AFB sputum smears or 1 negative AFB BAL smear. Active disease: Until at least 14 days after the start of effective therapy with documented clinical improvement. Policy # 8.08 INF Care of Mycobacteria tuberculosis skin test positive with no evidence of active pulmonary disease Standard Mycoplasma pneumoniae Duration of illness. Policy # 8.08 INF Care of Necrotizing enterocolitis (NEC) Standard 16

17 cardiosis Standard rovirus Diapered or incontinent patients Feces Duration of illness. Ensure consistent environmental cleaning and disinfection; prolonged shedding may occur in immunocompromised patients. Ornithosis (Psittacosis) Standard Oxyuriasis (Enterobiasis, Pinworm) Standard Parainfluenza Virus Infants and Children Immunocompromised Adults Duration of illness. Policy # 8.08 INF Care of Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other patients with visable barrier in place. Parainfluenza Virus Adults Standard Parainfluenza Virus Type 3 Infants and Children Immunocompromised Adults Duration of illness. Policy # 8.08 INF Care of Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other patients with visable barrier in place. Parvovirus B19 (Erythema infectiosum, Fifth's Disease) 7 Days after onset of illness. 17

18 Pertussis (Whooping cough) Until 5 days after start of effective therapy. Policy # 8.08 INF Care of Pinworm (Enterobiasis, Oxyuriasis) Standard Plague Bubonic Standard Plague Pneumonic Until 72 hours after start of effective therapy. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Pneumococcus (Streptococcus pneumoniae ) Resistant to penicillin or cephalosporins, colonization or infection Standard Pneumonia Adenovirus, Glove & Duration of illness. Policy # 8.08 INF Care of Pneumonia Bacterial not listed elsewhere Standard 18

19 NORTHWESTERN MEMORIAL HOSPITAL Pneumonia Burkholderia cepacia Standard Pneumonia Chlamydia Standard Pneumonia Fungal Standard Pneumonia Haemophilus influenzae - Adults Standard Patients with Cystic fibrosis (CF) colonized or infected must not be admitted to a unit where another CF patient resides. Persons with CF who visit must wear a mask when within 3 feet of a colonized or infected patient. Pneumonia Haemophilus influenzae - Infants Until 24 hours after start of effective therapy. Pneumonia Legionella Standard Pneumonia Meningococcal Pneumonia Mycoplasma pneumoniae Until 24 hours after start of effective therapy. Duration of illness. policy 8.08 INF Care of Policy # 8.08 INF Care of Pneumonia MRSA Duration of illness. Pneumonia Neisseria meningitidis Until 24 hours after start of effective therapy. Policy # 8.08 INF Care of 19

20 Pnemonia Pneumocystis carinii Standard Pneumonia Staphylococcus aureus Standard Pneumonia Viral Standard Psittacosis (Ornithosis) Standard Q fever (Coxiella burnetii ) Standard Rabies CSF, saliva, tears, urine and body tissues. Duration of illness. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of Prentice Patient Requiring for patients in PWH. Rat-bite fever (Streptobacillus moniliformis, Spirillum minus disease) Standard Respiraory Syncitial Virus (RSV) Infants Young children Immunocompromised adults, Glove & Duration of illness, followed by 2 negative antigen tests taken at least one week apart. Negative airflow room required. Eye protection is indcated is indicated when 3 feet or closer to patient. Refer to Policy # 8.08 INF Care of Prentice Patient Requiring Infants in PWH NICU or Newborn Nurseries will require placement at least 6 feet from other patients with visable barrier in place. Rheumatic Fever (see Streptococcus) 20

21 Rickettsial Fever (Rickettsia rickettsii) Standard Ringworm (Trichophyton tonsurans, Dermatophytosis, Dermatomycosis, Tinea) Standard Ritter's Disease (Staphylococcal Scalded Skin Syndrome) Scalded skin and drainage Duration of illness. Rocky Mountian Spotted Fever (Rickettsia rickettsii) Rickettsial Fever Standard Roseola infantum (Exanthem subitum) Standard Rubella (German Measles) Rubella (German Measles) Congenital 7 days after onset of rash. and urine Any admission before the first birthday unless pharyngeal and urine cultures are negative after 3 months of age. Salmonellosis Diapered or incontinent patients Feces Duration of illness. Policy # 8.08 INF Care of 21

22 Severe Acute Syndrome (SARS), Glove, & Eye Protection, feces Duration of illness. Contact and Prevention Department immediately. Negative airflow room required. Staff must wear goggles or face shield when within 3 feet of patient. Discard all PPE after each use. Patient must have dedicated equipment:stethoscope, blood pressure cuff, thermometer, etc. See policy INF 8.08 Care of for patients residing in PWH. Scabies Affected area, clothing/bedding that had contact with affected area. Until 24 hours after the start of effective therapy. Clothes should be bagged for 10 days or discarded. If a washer/dryer is available, clothes must be washed in the hot water cycle and placed in the dryer on hot setting. Scalded Skin Syndrome, Staphylococcal (Ritter's disease) Scalded skin and drainage. Duration of illness. Schistosomiasis (Schistosoma mansoni, Schistosoma japonicum ) Standard Shigellosis () Diapered or incontinent patients Feces Duration of illness. Shingles (Herpes zoster virus/varicella zoster virus) Localized, immunocompromised patient or disseminated in any patient, Glove & Drainange from lesions, respiratory. Until lesions are dry and crusted. Policy # 8.08 INF Care of Persons susceptible to varicella are also at risk for developing varicella when exposed to patients with herpes zoster lesions; susceptible caregivers should not enter the room if other immune caregivers are available. 22

23 Shingles (Herpes zoster virus/varicella zoster virus) Localized in immunocompetent patient Standard Smallpox (Variola virus), Glove & and vesicular lesion fluid. Until all lesions are crusted. Staphylococcus aureus infection Diapered or incontinent patients Standard Affected area must be covered if patient leaves room/unit. Persons susceptible to varicella are also at risk for developing varicella when exposed to patients with herpes zoster lesions; susceptible caregivers should not enter the room if other immune caregivers are available. Negative airflow room required. All protective clothing including patient bedding and gowns should be disposed of in plastic biohazardous bags. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Staphylococcus aureus infection Major skin, wound or burn Wound drainage Until drainage stops. Infants <28 days Staphylococcus aureus infection Minor or limited skin wound or burn Standard Infants <28 days Staphylococcus aureus Pneumonia Standard Staphylococcus aureus infection Toxic shock syndrome Standard 23

24 Staphylococcus aureus Vancomycin-resistant or -intermediate (VRSA/VISA) colonization or infection The patient, their body fluids and their environment. Duration of hospitalization. Streptococcal infection - Group A Streptococcus Endometritis (Puerperal sepsis) Standard Streptococcal infection - Group A Streptococcus Major skin, wound or burn Wound drainage Until 24 hours after the start of effective therapy. Streptococcal infection - Group A Streptococcus Minor or limited Standard Streptococcal infection - Group A Streptococcus Pharyngitis Standard Streptococcal infection - Group A Streptococcus Pneumonia Standard tify & Prevention Department immediately. Dedicated staff to care for patient. Patient must have dedicated, non-disposable patient care equipment, i.e., any equipment that cannot be cleaned or disinfected between patients. Use a mask, goggles or face sheild when performing splash-generating procedures; when caring for patients with open tracheostomies and potential for projectile and in circumstances where there is evidence of transmission from heavily colonized sources. s are not needed for entry into the room. Refer to Policy # 8.05 Prevention and of Staphylococcal s with Reduced Susceptibility to Vancomycin. Consider continuing beyond infectious period to protect patient with large open lesions. 24

25 Streptococcal infection Group A Streptococcus Rheumatic fever - Infants & young children Until 24 hours after the start of effective therapy. Streptococcal infection Group A Streptococcus Scarlet fever - Infants & young children Until 24 hours after the start of effective therapy. Streptococcal infection, Group A Streptococcus Toxic shock syndrome Until 24 hours after start of effective therapy. Streptococcal infection Group B Streptococcus Neonatal Standard Infants <3 months old Streptococcus pneumoniae (Pneumococcus ) Resistant to penicillin or cephalosporins, colonization or infection Standard Syphilis Standard Tapeworm Disease (Hymenolepis nana, Taenia solium ( pork), other) Standard Tetanus Standard Tinea (Trichophyton tonsurans Dermatophytosis, Dermatomycosis, Ringworm) Standard Toxic shock syndrome Stahylococcus aureus Standard Toxic shock syndrome Streptococcal, Group A Until 24 hours after start of effective therapy. 25

26 Trachoma, acute - Chlamydia trachomatis Standard Trichinosis Standard Trichomoniasis Standard Tuberculosis (All types - see Mycobacteria ) Tularemia (Francisella tularensis) Draining lesion Pulmonary Standard Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Typhoid fever Standard Typhus Standard Vancomycin-resistant Enterococcus (VRE) Colonization or The patient, their body fluids and their environment. Duration of hospitalization. Patient placed in VRE Flagging System by IC; automatic order for precautions every subsequent admission. Removal from system; 3 negative rectal cultures or two negative stool cultures obtained at least one week apart. Negative cultures may accumulate across admissions. 26

27 Vancomycin intermediate Staphylococcus aureus - VISA Colonization or infection The patient, their body fluids and their environment. Duration of hospitalization. tify & Prevention Department immediately. Dedicated staff to care for patient. Patient must have dedicated, non-disposable patient care equipment, i.e., any equipment that cannot be cleaned or disinfected between patients. Use a mask, goggles or face sheild when performing splash-generating procedures; when caring for patients with open tracheostomies and potential for projectile and in circumstances where there is evidence of transmission from heavily colonized sources. s are not needed for entry into the room. Refer to Policy # 8.05 Prevention and of Staphylococcal s with Reduced Susceptibility to Vancomycin. Vancomycin resistant Staphylococcus aureus - VRSA Colonization or infection The patient, their body fluids and their environment. Duration of hospitalization. tify & Prevention Department immediately. Dedicated staff to care for patient. Patient must have dedicated, non-disposable patient care equipment, i.e., any equipment that cannot be cleaned or disinfected between patients. Use a mask, goggles or face sheild when performing splash-generating procedures; when caring for patients with open tracheostomies and potential for projectile and in circumstances where there is evidence of transmission from heavily colonized sources. s are not needed for entry into the room. Refer to Policy # 8.05 Prevention and of Staphylococcal s with Reduced Susceptibility to Vancomycin. 27

28 Varicella zoster virus (Chicken pox) Variola virus (Smallpox), Glove &, Glove &, vesicular lesion fluid. Until lesions are dry and crusted. and vesicular lesion fluid. Until all lesions are crusted. Policy # 8.08 INF Care of Negative airflow room required. All protective clothing including patient bedding and gowns should be disposed of in plastic biohazardous bags. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Venereum (Donovanosis, Granuloma, Granuloma inguinale) Standard Vibrio cholerae (Cholera) Standard Viral Hemorrhagic Fever (Ebola Virus, Lassa Virus, Machupo Virus, Marburg Virus), Glove and Blood, body fluids, organs, respiratory. Duration of illness. Potential agent of bioterrorism, contact & Prevention Department ( or ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Negative airflow room required. Potential agent of bioterrorism, contact & Prevention (6-2729; ) immediately. Refer to Safety Management Policy # SFTY BioTerrorism Response Plan. Refer to Policy # 8.08 INF Care of West Nile Virus Standard Whooping cough (Pertussis) Until after 5 days after start of effective therapy. Policy # 8.08 INF Care of 28

29 Wound infections Major Wound drainage Duration of illness. Wound infections Minor Standard Zygomycosis (Phycomycosis, Mucormycosis) Standard 29