Abreviations

C

Contact isolation

CN

Culture negative x specified amount

D

Droplet precautions

DE

Decontamination of environment

DH

Duration of hospitalization

DI

Duration of Illness

LC

Lesions crusted

A

Airborne precautions

S

Standard precautions

SAPP

Special Administrative Policy and Procedure

U

Time specified in hours or days after initiation of effective antimicrobial therapy

U^R

Time specified in days after onset of rash

U^s

Time specified in days after onset of swelling

INFECTION/CONDITION

PRECAUTIONS

TYPE

DURATION

Abscess

-Draining, major

S,C

DI

-Draining, minor or limited

S

Acquired immunodeficiency syndrome (AIDS)

S

Actinomycosis

S

Adenovirus infection

-Conjunctivitis

S,C

DI

-Disseminated ( 2 or more sites) infection in immuno­compromised host

S,C

DI

-Gastroenteritis

S,C

DI

-Respiratory Infection

S,D

DI

Amebiasis

S

Anthrax

-Environmental aerosolizable spore containing pow­der

* Until decontamination of environment complete. Persons decontaminating the area must wear N95 mask and protec­tive clothing

S,,C

DE*

-Cutaneous *

* CP if contact with non-intact skin and with draining lesions

S,C

-Pulmonary

S,C

Antibiotic-associated colitis (see Clostridium difficile)

_

_

Arthropod borne viral encephalitidis (eastern, western, Venezuelean equine encephalomyelitis; St. Louis, California encephalitis, West Nile Virus,dengue, yellow fever)

S

Ascariasis

S

Aspergillosis

S

Avian Influenza A (H5N1 Virus)

S,A,C

14 days after onset of symptoms

Seasonal Influenza A or B ( H1N1 Virus )   

S, D

Babesiosis

S

Blastomycosis, North American, cutaneous or   pulmonary

S

Botulism

S

Bronchiolitis (see respiratory infection in infants and young children)

S, C

DI

Brucellosis (undulant, Malta, Mediterranean fever)

S

Cat-scratch fever (benign inoculation lymphoreticulosis)

S

Cellulitis, uncontrolled drainage

S,C

DI

Chancroid  (soft chancre)

S

Chickenpox (varicella)

S,A,C

DI/LC

Chlamydia trachomatis

-Conjunctivitis

S

-Genital (lymphogranuloma venerum )

S

-Pneumonia ( infants ≤3 months old )

S

Cholera (see gastroenteritis)

C

Closed-cavity infection

-Draining, (limited or minor ) not draining

S

-Copious, uncontrolled drainage

S,C

Clostridium

-C. Botulinum

S

-C. Difficile

S,C

U ^{48 hrs} after diar­rhea stops

-C. Perfringens

oFood poisoning

S

oGas gangrene

S

Coccidioidomycosis (valley fever)

-Draining lesions

S

-Pneumonia

S

Colorado tick fever

S

Congenital rubella

S,C

Until 1 yr of age

Conjunctivitis

-Acute bacterial

S

-Chlamydia

S

-Gonococcal

S

-Acute Viral (acute hemorrhagic)

S,C

DI

Corona Virus Associated with SARS (see SARS)

-Human corona virus (229E, NL63, OC43)

S,D

-Middle east Respiratory Syndrome Corona Virus (MERS CoV)

S,A,C

Coxsackie virus disease (see enteroviral infection)

Creutzfeldt-Jakob disease (CJD, VCJD)

S

Crimean- Congo Fever Virus

S,C,D

DI

Croup (see respiratory infections in infants and young chil­dren)

Cryptococcosis

S

Cryptosporidiosis (see gastroenteritis)

Cysticercosis

S

Cytomegalovirus infection, neonatal or immunosuppressed

S

Decubitis ulcer, infected

-Major

S,C

DI

-Minor or limited

S

Dengue Fever

S

Diarrhea, acute -inefective etiology supsected (see gastro­enteritis)

Diphtheria

-Cutaneous

S, C

CNx2^*

-Pharyngeal

* Until 2 cultures taken 24 hours apart negative

S, D

CNx2^*

Ebola viral Hemorrhagic fever

S, C,D

DI/ SAPP

Echinococcosis (hydatidosis)

S

Echovirus (see enteroviral infection)

Encephalitis or encephalomyelitis (see specific etiologic agents)

Endometritis

S

Enterobiasis (pinworm disease, oxyuriasis)

S

Enterococcus spp. (see multidrug-resistant organisms if epi­demiologically significant or vancomycin resistant)

Enterocolitis, Clostridium difficile 

S, C

DI

Enteroviral infections (group A & B coxackie and echo viruses- excluding polio virus)

-Adults

S

-Infants and young children

S,C

DI

Epiglottitis, due to Haemophilus influenza type b

S,D

U^24Hrs

Epstein-Barr virus infection, including infectious mononu­cleosis

S

Erythema infectiosum (also see parvovirus B19)

D

Escherichia coli gastroenteritis (see gastroenteritis)

Food poisoning

-Botulism

S

-Clostridium perfringens or Clostridium welchii

S

-Staphylococcal

S

Furunculosis-staphylococcal

-Infants and young children

S,C   

DI

Gangrene (gas gangrene)

S

Gastroenteritis ^*

* diapered or incontinent

   S,C

DI

-Adenovirus

S

-Campylobacter spp.

S

-Cholera

S,C

DI

-Clostridium difficile (See C. Difficile). Discontinue antibiotics if appropriate. Do not share electronic thermometers, ensure consistent environmental cleaning and disinfection using a Hypochlorite solu­tion. Hand washing with soap and water preferred.

S,C

DI

-Cryptosporidium spp.

S

-Escherichia coli

oEnterohemorrhagic 0157:H7

S

oOther species

S

-Giardia lamblia

S

DI

-Noroviruses

S

-Rotavirus

S,C

DI

-Salmonella spp. (inclduing S.typhi)

S

-Shigella spp.

S

oDiapered or incontinent

S,C

DI

-Vibrio parahaemolyticus

S

-Viral  (if not covered elsewhere)

S

-Yersinia enterocolitica

S

German measles (rubella)

S,D

U^Rx7

Giardiasis (see gastroenteritis)

Gonococcal ophthalmia neonatorum

(gonorrheal ophthalmia, acute conjunctivitis of newborn)

S

Gonorrhoea

S

Granuloma inguinale (donovanosis granuloma )

S

Guillain-Barre syndrome

S

Hand, foot, and mouth disease (see enteroviral infection)

Hantavirus pulmonary syndrome

S

Helicobacter pylori

S

S, C, A

DI/ SAPP

Hepatitis, viral

-Type A

S

oDiapered or incontinent patients

S, C

-Type B-HBsAg positive, acute or chronic

S

-Type C and other unspecified non-A, non-B

S

-Type E

S

oDiapered or incontinent patients

S, C

-Type G

S

Herpangina (see enteroviral infection)

Herpes simplex (Herpesvirus hominis)

-Encephalitis

S

-Neonatal *

* For asymptomatic, exposed infants delivered vaginally or by C-section and if mother has active infection and mem­branes have been ruptured for more than 4 to 6 hours until infant surface cultures obtained at 24-36 hours of age nega­tive after 48 hrs incubation

S, C

DI

-Mucocutaneous,disseminated or primary, severe

S, C

DI

-Mucocutaneous, recurrent (skin, oral, genital)

S, C

DI/LC

Herpes Zoster (varicella-zoster)^* 

*Non-immune staff should not enter room if immune care­givers are available.

-Disseminated in any patient

S, A, C

-Localized in immunocompromised patient

S, A, C

DI/LC

-Localized in normal patient

S

DI

Histoplasmosis

S

Hookworm disease (ancylostomiasis, uncinariasis)

S

Human immunodeficiency virus (HIV) infection

S

Impetigo

S, C

U^24Hrs

Infectious mononucleosis

S

Influenza

-Seasonal

S, D

DI

-Emerging influenza viruses including Avian and oth­ers

S,A,C

DI

-In immunocompromised patient

SD

DI

Kawasaki  syndrome

S

Lassa fever (see viral hemorrhagic fever)

Legionnaires’ disease

S

DI

Leprosy

S

Leptospirosis  

S

Lice (pediculosis)

S, C

U ^24Hrs

Listeriosis

S

Lyme disease

S

Lymphocytic choriomeningitis

S

Lymphogranuloma venereum

S

Malaria

S

Marburg virus disease (see viral hemorrhagic fever)

Measles (rubeola), all presentations

S, A

DI

Melioidosis, all forms

S

Meningitis

-Aseptic (nonbacterial or viral meningitis) (also see enteroviral Infections)

S

Infants and young children

S,C

-Bacterial, gram-negative enteric, in neonates

S

-Fungal

S

-Haemophilus influenzae type b, known or suspected

S, D

U^24Hrs

-Listeria monocytogenes

S

-Neisseria meningitidis (meningococcal)known or sus­pected

S, D

U^24Hrs

-Streptococcus Pneumoniae

S

-Tuberculosis  (See Tuberculosis)

S

-Other diagnosed bacterial

S

Meningococcal Disease ( Sepsis, Pneumoniae, Meningitis)

S, D

U^24Hrs

Meningococcemia (meningococcal sepsis)

S, D

U^24Hrs

Methichillin Resistant Staphylococcus Aureus (MRSA)

S, C

Molluscum contagiosum

S

Monkeypox

S,A,C

LC

Mucormycosis

S

Multidrug-resistant orgnaism, infection or colonization ^*  (e.g MRSA, VRE, GNR)

* Discontinue CP after consultation with the IP

-Gastrointestinal

S, C

-Respiratory

S, C

-Skin, wound, or burn

S, C

Mumps (infectious parotitis )

S, D

U^S9 days

Mycobacteria, non-tuberculosis (atypical)

-Pulmonary

S

-Wound

S

Mycoplasma pneumonia

S, D

DI

Necrotizing enterocolitis

S

Nocardiosis, draining lesions, or other presentations

S

Orf Virus Disease

S

Parainfluenza virus infection, respiratory in infants and young children

S, C

DI

Parvovirus B19

S, D

DH

Pediculosis (lice)

S, C

U^24Hrs

Pertussis (whooping cough)

S, D

U^5DAYS

Pharyngitis ( Streptococcus group A )

S, D

U^24Hrs

Pinworm infection

S

Plague (Yersinia pestis)

-Bubonic (without cough and chest x-ray negative)

S

-Pneumonic

S, D

U^{48 hours}

Pleurodynia (see enteroviral infection)

Pneumonia

-Adenovirus^*

S, D, C

DI

-Bacterial not listed elsewhere (including gram-nega­tive bacterial)

S

-Burkholderia cepacia in cystic fibrosis patients, including respiratory tract colonization ^**

* Avoid placement in the same room with CF patients with­out B. cepacia

S,C

-Chlamydia

S

-Fungal

S

-Haemophilus influenzae, Type b

oAdults

S

oInfants and children (any age)

S, D

U^24Hrs

-Legionella

S

-Meningococcal

S, D

U^24Hrs

-Mycoplasma (primary atypical pneumonia)

S, D

DI

-Pneumocystis jiroveci ( carnii )^*

^* Avoid placement in the same room with immunocompro­mised patient

S

-Streptococcus, group A

oAdults

S,D

U^24Hrs

oInfants and small children

S,D

U^24Hrs

-Varicella zoster

S,A

DI

Viral

-Adults

S

-Infants and young children (see respiratory infec­tious disease, acute)

Poliomyelitis ( Acute )

S,C

DI

Q fever

S

Rabies

S

DI

Rat-bite fever

(Streptobacillus moniliformis disease, Spirillum minus dis­ease)

S

Relapsing fever

S

Respiratory infectious disease, acute (if not covered else­where)

-Adults

S

-Infants and young children

S,C

DI

Respiratory syncytial virus infection, in infants and young children, and immunocompromised adults *

* In immunocompromised patients, extend the duration of contact precaution due to prolonged shedding.

S, C

DI

Reye’s syndrome

S

Rheumatic fever

S

Rickettsial fevers, tickborne (Rocky Mountain spotted fever, tickborne typhus fever)

S

Rickettsialpox (vesicular rickettsiosis)

S

Ringworm (dermatophytosis, dermatomycosis, tinea)

S

Ritter’s disease (staphylococcal scalded skin syndrome)

S,C

DI

Rocky Mountain spotted fever

S

Roseola infantum (exanthem subitum)

S

Rotavirus infection (see gastroenteritis)

S,C

DI

Rubella (German measles) ( also see congenital rubella)

S, D

U^7DAYS

Rubeola

S,A

DI

Salmonellosis (see gastroenteritis)

S,C

DI

SARS (Severe Acute Respiratory Syndrome) *

* Airborne precautions, preferred; D if AIIR not available. N95 or higher respiratory protection; surgical mask if N95 unavailable; eye protection (goggles, face shield); aerosol-generating procedures highest risk for transmission via small droplet nuclei and large droplets; vigilant disinfection.

S,A,D,C

DI

Scabies

S, C   

U^24Hrs

Scalded skin syndrome, staphylococcus (Ritter’s disease)

S,C

D,I

Scarlet Fever

S, C   

U^24Hrs

Schistosomiasis (bilharziasis)

S

Shigellosis (see gastroenteritis)

Small Pox (variola) *

* Non immune HCWs should not care when immune caregiv­ers are available. N95 or higher respiratory protection for­susceptible and successfully vaccinated individuals; post exposure vaccine within 4 days of exposure for protection

S,C,A

DI

Sporotrichosis

S

Spirillum minus disease (rat-bite fever)

S

Staphylococcal disease (S. aureus)

-Pneumonia

S

-Skin, wound, or burn

oMajor

S, C

DI

oMinor or limited

S

oMRSA  (see MRSA)

Stretobacillus moniliformis disease (rat-bite fever)

S

Streptococcal disease (group A Streptococcus)

-Skin, wound, or burn

oMajor

S, C

U^24Hrs

oMinor or limited

S

-Endometritis (puerperal sepsis)

S

-Pharyngitis in infants and young children

S, D

U^24Hrs

-Pneumonia in infants and young children

S, D

U^24Hrs

-Scarlet fever in infants and young children

S, D

U^24Hrs

-Severe invasive disease (necrotizing fascitis, toxic shock syndrome)

S,D

U^24Hrs

Streptococcal disease (group B Streptococcus), neonatal

S

Streptococcal disease  (not group A or B) unless covered elsewhere

S

Strongyloidiasis

S

Syphilis

-Skin and mucous membrane, including congenital, primary, secondary

S

-Latent (tertiary) and seropositvity without lesions

S

Tapeworm disease

-Hymenolepis nana (fish)

S

-Taenia solium (pork)

S

-Saginata (beef)

S

Tetanus

S

Tinea (fungus infection dematophytosia, dermatomycosis, ringworm)

S

Toxoplasmosis

S

Toxic shock syndrome (staphylococcal disease, Streptococ­cal desease)

S

Trachoma, acute

S

Trench mouth (Vincent’s angina)

S

Trichinosis

S

Trichomoniasis

S

Trichuriasis (whipworm disease)

S

Tuberculosis ( MycobacteriumTuberculosis)

-Extrapulmonary ( no draining lesions, meningitis)

S

-Extrapulmonary ( Draining lesions ) *

S, A, C

-Pulmonary, confirmed or suspected or laryngeal dis­ease ^*

* Discontinue isolation (confirmed cases) when 14 days anti-TB therapy; 3 sputum smears negative for AFB; and, clinical improvement. Discontinue isolation (suspected cases) if patient has 3 sputum smears negative for AFB.

S, A

-Skin-test positive with no evidence of current pulmo­nary disease

S

Tularemia

-Draining lesion

S

-Pulmonary

S

Typhoid (Salmonella typhi) fever (see gastroenteritis)

Typhus, endemic and epidemic

S,C

DI

Urinary tract infection (including pyelonephritis, with or without urinary catheter),  except multi drug resistant organisms

S

Varicella (see chickenpox)

Vibrio parahaemolyticus (see gastroenteritis)

Vincent’s angina (see trench mouth)

Viral Hemorrhagic Fevers (refer to policy) ( Lassa, Ebola, Marburg, Crimean-Congo fever viruses)

S,C,D

DI

Viral Respiratory disease

-Adults

S

-Infants and young children (see respiratory infec­tious disease, acute)

Whooping cough (see pertussis)

S, D

U^5DAYS

Wound infections

-Major

S, C

DI

-Minor or limited

S

Yersinia enterocolitica gastroenteritis (see gastroenteritis)

Zoster (varicella-zoster), shingles (see chicken pox)

-Disseminated in any patient

S, A, C

DI/LC

-Localized in immunocompromised patient

S, A, C

DI/LC

-Localized in normal patient

S

Zygomycosis (phycomycosis, mucormycosis)

S