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MASSACHUSETTS NURSE NEWSLETTER :: July/August
2005
Infection control and avian influenza recommendations
The Centers for Disease Control and Prevention has
issued recommendations for infection control in health care facilities
to prevent possible spread of avian influenza: Patients who present
to a health care setting with fever and respiratory symptoms should
be managed according to recommendations for respiratory hygiene
and cough etiquette and questioned regarding recent travel history.
Those with a history of travel within 10 days to a country with
avian influenza activity and hospitalized with a severe febrile
respiratory illness—or are under evaluation for avian influenza—should
be managed using isolation precautions identical to those recommended
for known severe acute respiratory syndrome (SARS). These include:
Standard precautions
- Pay careful attention to hand hygiene before
and after patient contact or contact with items potentially contaminated
with respiratory secretions
Contact precautions
- Use gloves and gowns for all patient contact
- Use dedicated equipment such as stethoscopes,
disposable blood pressure cuffs, disposable thermometers, etc.
Eye protection (i.e., goggles or faceshields)
- Wear protection when within three feet of patients
Airborne precautions
- Place patient in an airborne isolation room
(AIR). These should have monitored negative air pressure in relation
to corridor, with six to 12 air changes per hour (ACH), and exhaust
air directly outside or recirculated air filtered by a high-efficiency
particulate air (HEPA) filter. If an AIR is unavailable, contact
facility engineer to assist or use portable HEPA filters to augment
the number of ACH
- Use a fit-tested respirator, at least as protective
as a National Institute of Occupational Safety and Healthapproved
N-95 filtering facepiece (ie., disposable) respirator, when entering
the room
These precautions should be continued for 14 days
after onset of symptoms or until either an alternative diagnosis
is established or diagnostic test results indicate the patient is
not infected with influenza A virus. Patients managed as outpatients
or hospitalized patients discharged before 14 days with suspected
avian influenza should be isolated in the home setting on the basis
of principles outlined for the home isolation of SARS patients (see
www.cdc.gov/ncidod/sars/guidance/i/pdf/i.pdf).
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