Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)

Abscess

No dressing or containment of drainage; until drainage stops or can be contained by dressing.

Abscess

Dressing covers and contains drainage.

Acquired human immunodeficiency syndrome (HIV)

Post-exposure chemoprophylaxis for some blood exposures [866].

Actinomycosis

Not transmitted from person to person.

Adenovirus infection (see agent-specific guidance under gastroenteritis, conjunctivitis, pneumonia)

Amebiasis

Person to person transmission is rare. Transmission in settings for the mentally challenged and in a family group has been reported [1045]. Use care when handling diapered infants and mentally challenged persons [1046].

Anthrax

Infected patients do not generally pose a transmission risk.

Anthrax

Transmission through non-intact skin contact with draining lesions possible, therefore use Contact Precautions if large amount of uncontained drainage. Handwashing with soap and water preferable to use of waterless alcohol based antiseptics since alcohol does not have sporicidal activity [983].

Anthrax

Not transmitted from person to person.

Anthrax

Antibiotic-associated colitis (see Clostridium difficile)

Arthropod-borne

Use DEET-containing mosquito repellants and clothing to cover extremities.

Ascariasis

Not transmitted from person to person.

Aspergillosis

Contact Precautions and Airborne if massive soft tissue infection with copious drainage and repeated irrigations required [154].

Avian influenza (see influenza, avian below)

Babesiosis

Not transmitted from person to person except rarely by transfusion.

Blastomycosis, North American, cutaneous or pulmonary

Not transmitted from person to person.

Botulism

Not transmitted from person to person.

Bronchiolitis (see respiratory infections in infants and young children)

Use mask according to Standard Precautions.

Brucellosis (undulant, Malta, Mediterranean fever)

Not transmitted from person to person except rarely via banked spermatozoa and sexual contact [1048, 1049]. Provide antimicrobial prophylaxis following laboratory exposure [1050].

Campylobacter gastroenteritis (see gastroenteritis)

Candidiasis, all forms including mucocutaneous

Cat-scratch fever (benign inoculation lymphoreticulosis)

Not transmitted from person to person.

Cellulitis

Chancroid (soft chancre) (H. ducreyi)

Transmitted sexually from person to person.

Chickenpox (see varicella)

Outbreaks in institutionalized populations reported, rarely [1051, 1052].

Cholera (see gastroenteritis)

Closed-cavity infection

Contact Precautions if there is copious uncontained drainage.

Closed-cavity infection

Not transmitted from person to person.

Clostridium difficile (see gastroenteritis, C. difficile)

Not transmitted from person to person.

Transmission from person to person rare; one outbreak in a surgical setting reported [1053]. Use Contact Precautions if wound drainage is extensive.

Coccidioidomycosis (valley fever)

Not transmitted from person to person except under extraordinary circumstances because the infectious arthroconidial form of Coccidioides immitis is not produced in humans [1054].

Coccidioidomycosis (valley fever)

Not transmitted from person to person except under extraordinary circumstances, (e.g., inhalation of aerosolized tissue phase endospores during necropsy, transplantation of infected lung) because the infectious arthroconidial form of Coccidioides immitis is not produced in humans [1054, 1055].

Colorado tick fever

Not transmitted from person to person

Congenital rubella

Standard Precautions if nasopharyngeal and urine cultures repeatedly neg. after 3 mos. of age.

Conjunctivitis

Conjunctivitis

Conjunctivitis

Conjunctivitis

Adenovirus most common; enterovirus 70 [1056], Coxsackie virus A24 [1057] also associated with community outbreaks. Highly contagious; outbreaks in eye clinics, pediatric and neonatal settings, institutional settings reported. Eye clinics should follow Standard Precautions when handling patients with conjunctivitis. Routine use of infection control measures in the handling of instruments and equipment will prevent the occurrence of outbreaks in this and other settings. [460, 814, 1058, 1059 461, 1060].

Corona virus associated with SARS (SARS-CoV) (see severe acute respiratory syndrome)

Coxsackie virus disease (see enteroviral infection)

Creutzfeldt-Jakob disease (CJD, vCJD)

Use disposable instruments or special sterilization/disinfection for surfaces, objects contaminated with neural tissue if CJD or vCJD suspected and has not been R/O; No special burial procedures. [1061]

Croup (see respiratory infections in infants and young children)

Crimean-Congo Fever (see Viral Hemorrhagic Fever)

Cryptococcosis

Not transmitted from person to person, except rarely via tissue and corneal transplant. [1062, 1063]

Cryptosporidiosis (see gastroenteritis)

Cysticercosis

Not transmitted from person to person.

Cytomegalovirus infection, including in neonates and immunosuppressed patients

No additional precautions for pregnant HCWs.

Decubitus ulcer (see Pressure ulcer)

Dengue fever

Not transmitted from person to person.

Diarrhea, acute-infective etiology suspected (see gastroenteritis)

Diphtheria

Until 2 cultures taken 24 hours apart negative.

Diphtheria

Until 2 cultures taken 24 hours apart negativ.e

Ebola virus (see viral hemorrhagic fevers)

Echinococcosis (hydatidosis)

Not transmitted from person to person.

Echovirus (see enteroviral infection)

Encephalitis or encephalomyelitis (see specific etiologic agents)

Endometritis (endomyometritis)

Enterobiasis (pinworm disease, oxyuriasis)

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

Enterocolitis, C. difficile (see C. difficile, gastroenteritis)

Enteroviral infections (i.e., Group A and B Coxsackie viruses and Echo viruses) (excludes polio virus)

Use Contact Precautions for diapered or incontinent children for duration of illness and to control institutional outbreaks.

Epiglottitis, due to Haemophilus influenzae type b

See specific disease agents for epiglottitis due to other etiologies.

Epstein-Barr virus infection, including infectious mononucleosis

Erythema infectiosum (also see Parvovirus B19)

Escherichia coli gastroenteritis (see gastroenteritis)

Food poisoning

Not transmitted from person to person.

Food poisoning

Not transmitted from person to person.

Food poisoning

Not transmitted from person to person.

Furunculosis, staphylococcal

Contact if drainage not controlled. Follow institutional policies if MRSA.

Furunculosis, staphylococcal

Gangrene (gas gangrene)

Not transmitted from person to person.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks for gastroenteritis caused by all of the agents below.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Discontinue antibiotics if appropriate. Do not share electronic thermometers; [853, 854] ensure consistent environmental cleaning and disinfection. Hypochlorite solutions may be required for cleaning if transmission continues [847]. Handwashing with soap and water preferred because of the absence of sporicidal activity of alcohol in waterless antiseptic handrubs [983].

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks. Persons who clean areas heavily contaminated with feces or vomitus may benefit from wearing masks since virus can be aerosolized from these body substances [142, 147 148]; ensure consistent environmental cleaning and disinfection with focus on restrooms even when apparently unsoiled [273, 1064]). Hypochlorite solutions may be required when there is continued transmission [290-292]. Alcohol is less active, but there is no evidence that alcohol antiseptic handrubs are not effective for hand decontamination [294]. Cohorting of affected patients to separate airspaces and toilet facilities may help interrupt transmission during outbreaks.

Gastroenteritis

Ensure consistent environmental cleaning and disinfection and frequent removal of soiled diapers. Prolonged shedding may occur in both immunocompetent and immunocompromised children and the elderly [932, 933].

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks

Gastroenteritis

Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

German measles (see rubella; see congenital rubella)

Giardiasis (see gastroenteritis)

Gonococcal ophthalmia neonatorum (gonorrheal ophthalmia, acute conjunctivitis of newborn)

Gonorrhea

Granuloma inguinale (Donovanosis, granuloma venereum)

Guillain-Barre’ syndrome

Not an infectious condition.

Haemophilus influenzae (see disease-specific recommendations)

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

Hansen’s Disease (see Leprosy)

Hantavirus pulmonary syndrome

Not transmitted from person to person.

Hepatitis, viral

Provide hepatitis A vaccine post-exposure as recommended. [1065]

Hepatitis, viral

Maintain Contact Precautions in infants and children <3 years of age for duration of hospitalization; for children 3-14 yrs. of age for 2 weeks after onset of symptoms; >14 yrs. of age for 1 week after onset of symptoms [833, 1066, 1067].

Hepatitis, viral

See specific recommendations for care of patients in hemodialysis centers. [778]

Hepatitis, viral

See specific recommendations for care of patients in hemodialysis centers. [778]

Hepatitis, viral

Hepatitis, viral

Use Contact Precautions for diapered or incontinent individuals for the duration of illness. [1068]

Hepatitis, viral

Herpangina (see enteroviral infection)

Hookworm

Herpes simplex (Herpesvirus hominis)

Herpes simplex (Herpesvirus hominis)

Herpes simplex (Herpesvirus hominis)

Herpes simplex (Herpesvirus hominis)

Also, 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 hours incubation. [1069, 1070]

Herpes zoster (varicella-zoster) (shingles)

Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for protection of immune HCWs; no recommendation for type of protection, i.e. surgical mask or respirator; for susceptible HCWs.

Herpes zoster (varicella-zoster) (shingles)

Susceptible HCWs should not provide direct patient care when other immune caregivers are available.

Histoplasmosis

Not transmitted from person to person.

Human immunodeficiency virus (HIV)

Post-exposure chemoprophylaxis for some blood exposures [866].

Human metapneumovirus

HAI reported [1071], but route of transmission not established [823]. Assumed to be Contact transmission as for RSV since the viruses are closely related and have similar clinical manifestations and epidemiology. Wear masks according to Standard Precautions.

Impetigo

Infectious mononucleosis

Influenza

See Prevention Strategies for Seasonal Influenza in Healthcare Settings [Current version of this document may differ from original.] for current seasonal influenza guidance.

Influenza

See [This link is no longer active: www.cdc.gov/flu/avian/professional/infect-control.htm. Similar information may be found at Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease, accessed May 2016.] for current avian Influenza guidance.

Influenza

See [This link is no longer active: http://www.pandemicflu.gov. Similar information may be found at Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease, accessed May 2016.] for current pandemic Influenza guidance.

Kawasaki syndrome

Not an infectious condition.

Lassa fever (see viral hemorrhagic fevers)

Legionnaires’ disease

Not transmitted from person to person.

Leprosy

Leptospirosis

Not transmitted from person to person

Lice

See [This link is no longer active: https://www.cdc.gov/ncidod/dpd/parasites/lice/default.htm. Similar information may be found at CDC’s Parasites – Lice, accessed May 2016.]

Lice

Transmitted person to person through infested clothing. Wear gown and gloves when removing clothing; bag and wash clothes according to CDC guidance Parasites – Lice.

Lice

Listeriosis (listeria monocytogenes)

Person-to-person transmission rare; cross-transmission in neonatal settings reported. [1072, 1073 1074, 1075]

Lyme disease

Not transmitted from person to person.

Lymphocytic choriomeningitis

Not transmitted from person to person.

Lymphogranuloma venereum

Malaria

Not transmitted from person to person except through transfusion rarely and through a failure to follow Standard Precautions during patient care. [1076-1079] Install screens in windows and doors in endemic areas. Use DEET- containing mosquito repellants and clothing to cover extremities.

Marburg virus disease (see viral hemorrhagic fevers)

Measles (rubeola)

Measles [November 2011]
Update: Recommendations for healthcare workers can be found at Immunization of Healthcare Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP) [PDF - 705 KB].

 

Susceptible HCWs should not enter room if immune care providers are available; no recommendation for face protection for immune HCW; no recommendation for type of face protection for susceptible HCWs, i.e., mask or respirator [1027, 1028]. For exposed susceptibles, post- exposure vaccine within 72 hours or immune globulin within 6 days when available [17, 1032, 1034]. Place exposed susceptible patients on Airborne Precautions and exclude susceptible healthcare personnel.

Melioidosis, all forms

Not transmitted from person to person.

Meningitis

Contact for infants and young children.

Meningitis

Meningitis

Meningitis

Meningitis

Meningitis

See meningococcal disease below.

Meningitis

Meningitis

Concurrent, active pulmonary disease or draining cutaneous lesions may necessitate addition of Contact and/or Airborne; For children, Airborne Precautions until active tuberculosis ruled out in visiting family members (see tuberculosis below). [42]

Meningitis

Meningococcal disease: sepsis, pneumonia, Meningitis

Postexposure chemoprophylaxis for household contacts, HCWs exposed to respiratory secretions; postexposure vaccine only to control outbreaks. [15, 17]

Monkeypox

See CDC’s Monkeypox website  [Current version of this document may differ from original.] for most current recommendations. Transmission in hospital settings unlikely [269]. Pre- and post-exposure smallpox vaccine recommended for exposed HCWs.

Mucormycosis

Multidrug-resistant organisms (MDROs), infection or colonization (e.g., MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)

MDROs judged by the infection control program, based on local, state, regional, or national recommendations, to be of clinical and epidemiologic significance. Contact Precautions recommended in settings with evidence of ongoing transmission, acute care settings with increased risk for transmission or wounds that cannot be contained by dressings. See recommendations for management options in Management of Multidrug- Resistant Organisms In Healthcare Settings, 2006 [870]. Contact state health department for guidance regarding new or emerging MDRO.

Mumps (infectious parotitis)

Note: (Recent assessment of outbreaks in healthy 18-24 year olds has indicated that salivary viral shedding occurred early in the course of illness and that 5 days of isolation after onset of parotitis may be appropriate in community settings; however the implications for healthcare personnel and high-risk patient populations remain to be clarified.)

Mycobacteria, nontuberculosis (atypical)

Not transmitted person-to-person.

Mycobacteria, nontuberculosis (atypical)

Mycobacteria, nontuberculosis (atypical)

Mycoplasma pneumonia

Necrotizing enterocolitis

Contact Precautions when cases clustered temporally [1080-1083].

Nocardiosis, draining lesions, or other presentations

Not transmitted person-to-person.

Norovirus (see gastroenteritis)

Norwalk agent Gastroenteritis (see gastroenteritis)

Orf

Parainfluenza virus infection, respiratory in infants and young children

Viral shedding may be prolonged in immunosuppressed patients [1009, 1010]. Reliability of antigentesting to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.

Parvovirus B19 (Erythema infectiosum)

Maintain precautions for duration of hospitalization when chronic disease occurs in an immunocompromised patient. For patients with transient aplastic crisis or red-cell crisis, maintain precautions for 7 days. Duration of precautions for immunosuppressed patients with persistently positive PCR not defined, but transmission has occurred [929].

Pediculosis (Lice)

Pertussis (whooping cough)

Single patient room preferred. Cohorting an option. Post-exposure chemoprophylaxis for household contacts and HCWs with prolonged exposure to respiratory secretions [863]. Recommendations for Tdap vaccine in adults under development.

Pinworm infection (Enterobiasis)

Plague (Yersinia pestis)

Plague (Yersinia pestis)

Antimicrobial prophylaxis for exposed HCW [207].

Pneumonia

Outbreaks in pediatric and institutional settings reported [376, 1084-1086]. In immunocompromised hosts, extend duration of Droplet and Contact Precautions due to prolonged shedding of virus. [931]

Pneumonia

Pneumonia

Avoid exposure to other persons with CF; private room preferred. Criteria for D/C precautions not established. See CF Foundation guideline. [20]

Pneumonia

Pneumonia

Pneumonia

Pneumonia

Pneumonia

Pneumonia

Pneumonia .

See meningococcal disease above.

Pneumonia

Pneumonia

Pneumonia

Use Droplet Precautions if evidence of transmission within a patient care unit or facility. [196-198, 1087]

Pneumonia

Avoid placement in the same room with an immunocompromised patient.

Pneumonia

For MRSA, see MDROs.

Pneumonia

See streptococcal disease (group A streptococcus) below
Contact precautions if skin lesions present.

Pneumonia

Contact Precautions if skin lesions present.

Pneumonia

Pneumonia

Pneumonia

Poliomyelitis

Pressure ulcer (decubitus ulcer, pressure sore) infected

If no dressing or containment of drainage; until drainage stops or can be contained by dressing.

Pressure ulcer (decubitus ulcer, pressure sore) infected

If dressing covers and contains drainage.

Prion disease (See Creutzfeld-Jacob Disease)

Psittacosis (ornithosis) (Chlamydia psittaci)

Not transmitted from person to perso.n

Q fever

Rabies

Person to person transmission rare; transmission via corneal, tissue and organ transplants has been reported [539, 1088]. If patient has bitten another individual or saliva has contaminated an open wound or mucous membrane, wash exposed area thoroughly and administer postexposure prophylaxis. [1089]

Rat-bite fever (Streptobacillus moniliformis disease, Spirillum minus disease)

Not transmitted from person to person.

Relapsing fever

Not transmitted from person to person.

Resistant bacterial infection or colonization (see multidrug-resistant organisms)

Respiratory infectious disease, acute (if not covered elsewhere)

Respiratory infectious disease, acute (if not covered elsewhere)

Also see syndromes or conditions listed in Table 2.

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

Wear mask according to Standard Precautions [24] CB [116, 117]. In immunocompromised patients, extend the duration of Contact Precautions due to prolonged shedding [928]). Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.

Reye’s syndrome

Not an infectious condition.

Rheumatic fever

Not an infectious condition.

Rhinovirus

Droplet most important route of transmission [104 1090]. Outbreaks have occurred in NICUs and LTCFs [413, 1091, 1092]. Add Contact Precautions if copious moist secretions and close contact likely to occur (e.g., young infants) [111, 833].

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

Not transmitted from person to person except through transfusion, rarely.

Rickettsialpox (vesicular rickettsiosis)

Not transmitted from person to person.

Ringworm (dermatophytosis, dermatomycosis, tinea)

Rarely, outbreaks have occurred in healthcare settings, (e.g., NICU [1093], rehabilitation hospital [1094]. Use Contact Precautions for outbreak.

Ritter’s disease (staphylococcal scalded skin syndrome)

See staphylococcal disease, scalded skin syndrome below.

Rocky Mountain spotted fever

Not transmitted from person to person except through transfusion,

Roseola infantum (exanthem subitum; caused by HHV-6)

Rotavirus infection (see gastroenteritis)

Rubella (German measles) ( also see congenital rubella)

Susceptible HCWs should not enter room if immune caregivers are available. No recommendation for wearing face protection (e.g., a surgical mask) if immune. Pregnant women who are not immune should not care for these patients [17, 33]. Administer vaccine within three days of exposure to non-pregnant susceptible individuals. Place exposed susceptible patients on Droplet Precautions; exclude susceptible healthcare personnel from duty from day 5 after first exposure to day 21 after last exposure, regardless of post-exposure vaccine.

Rubeola (see measles)

Salmonellosis (see gastroenteritis)

Scabies

Scalded skin syndrome, staphylococcal

See staphylococcal disease, scalded skin syndrome below.

Schistosomiasis (bilharziasis)

Severe acute respiratory syndrome (SARS)

Airborne preferred; D if AIIR unavailable. N95 or higher respiratory protection; surgical mask if N95 unavailable; eye protection (goggles, face shield); aerosol-generating procedures and “supershedders” highest risk for transmission via small droplet nuclei and large droplets [93, 94, 96]. Vigilant environmental disinfection (see [This link is no longer active: www.cdc.gov/ncidod/sars. Similar information may be found at CDC Severe Acute Respiratory Syndrome (SARS), accessed May 2016.])

Shigellosis (see gastroenteritis)

Smallpox (variola; see Vaccinia for management of vaccinated persons)

Until all scabs have crusted and separated (3-4 weeks). Non-vaccinated HCWs should not provide care when immune HCWs are available; N95 or higher respiratory protection for susceptible and successfully vaccinated individuals; postexposure vaccine within 4 days of exposure protective [108, 129, 1038-1040].

Sporotrichosis

Spirillum minor disease (rat-bite fever)

Not transmitted from person to person.

Staphylococcal disease (S aureus)

No dressing or dressing does not contain drainage adequately.

Staphylococcal disease (S aureus)

Dressing covers and contains drainage adequately.

Staphylococcal disease (S aureus)

Use Contact Precautions for diapered or incontinent children for duration of illness.

Staphylococcal disease (S aureus)

Staphylococcal disease (S aureus)

Staphylococcal disease (S aureus)

Consider healthcare personnel as potential source of nursery, NICU outbreak [1095].

Staphylococcal disease (S aureus)

Streptobacillus moniliformis disease (rat-bite fever)

Not transmitted from person to person.

Streptococcal disease (group A streptococcus)

No dressing or dressing does not contain drainage adequately.

Streptococcal disease (group A streptococcus)

Dressing covers and contains drainage adequately.

Streptococcal disease (group A streptococcus)

Streptococcal disease (group A streptococcus)

Streptococcal disease (group A streptococcus)

Streptococcal disease (group A streptococcus)

Streptococcal disease (group A streptococcus)

Outbreaks of serious invasive disease have occurred secondary to transmission among patients and healthcare personnel [162, 972, 1096-1098]
Contact Precautions for draining wound as above; follow rec. for antimicrobial prophylaxis in selected conditions [160].

Streptococcal disease (group B streptococcus), neonatal

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

Strongyloidiasis

Syphilis

Syphilis

Tapeworm disease

Not transmitted from person to person.

Tapeworm disease

Tapeworm disease

Tetanus

Not transmitted from person to person.

Tinea (e.g., dermatophytosis, dermatomycosis, ringworm)

Rare episodes of person-to-person transmission.

Toxoplasmosis

Transmission from person to person is rare; vertical transmission from mother to child, transmission through organs and blood transfusion rare.

Toxic shock syndrome (staphylococcal disease, streptococcal disease)

Droplet Precautions for the first 24 hours after implementation of antibiotic therapy if Group A streptococcus is a likely etiology.

Trachoma, acute

Transmissible spongiform encephalopathy (see Creutzfeld-Jacob disease, CJD, vCJD)

Trench mouth (Vincent’s angina)

Trichinosis

Trichomoniasis

Trichuriasis (whipworm disease)

Tuberculosis (M. tuberculosis)

Discontinue precautions only when patient is improving clinically, and drainage has ceased or there are three consecutive negative cultures of continued drainage [1025, 1026]. Examine for evidence of active pulmonary tuberculosis.

Tuberculosis (M. tuberculosis)

Examine for evidence of pulmonary tuberculosis. For infants and children, use Airborne until active pulmonary tuberculosis in visiting family members ruled out. [42]

Tuberculosis (M. tuberculosis)

Discontinue precautions only when patient on effective therapy is improving clinically and has three consecutive sputum smears negative for acid-fast bacilli collected on separate days (MMWR 2005; 54: RR-17 Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005) [12].

Tuberculosis (M. tuberculosis)

Discontinue precautions only when the likelihood of infectious TB disease is deemed negligible, and either

Tuberculosis (M. tuberculosis)

Tularemia

Not transmitted from person to person.

Tularemia

Not transmitted from person to person.

Typhoid (Salmonella typhi) fever (see gastroenteritis)

Typhus

Transmitted from person to person through close personal or clothing contact.

Typhus

Not transmitted from person to person.

Urinary tract infection (including pyelonephritis), with or without urinary catheter

Vaccinia

HCWs without contraindications to vaccine may provide care.

Vaccinia

Vaccination recommended for vaccinators; for newly vaccinated HCWs: semi-permeable dressing over gauze until scab separates, with dressing change as fluid accumulates, ~3-5 days; gloves, hand hygiene for dressing change; vaccinated HCW or HCW without contraindication to vaccine for dressing changes. [205, 221, 225].

Vaccinia (adverse events following vaccination)

For contact with virus-containing lesions and exudative material.

Vaccinia (adverse events following vaccination)

For contact with virus-containing lesions and exudative material.

Vaccinia (adverse events following vaccination)

For contact with virus-containing lesions and exudative material.

Vaccinia (adverse events following vaccination)

For contact with virus-containing lesions and exudative material.

Vaccinia (adverse events following vaccination)

Vaccinia (adverse events following vaccination)

Use Contact Precautions if there is copious drainage.

Vaccinia (adverse events following vaccination)

Vaccinia (adverse events following vaccination)

Not an infectious condition.

Vaccinia  (adverse events following vaccination)

Follow organism-specific (strep, staph most frequent) recommendations and consider magnitude of drainage.

Varicella Zoster

Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for face protection of immune HCWs; no recommendation for type of protection, i.e., surgical mask or respirator for susceptible HCWs. In immunocompromised host with varicella Pneumonia, prolong duration of precautions for duration of illness. Post- exposure prophylaxis: provide post-exposure vaccine ASAP but within 120 hours; for susceptible exposed persons for whom vaccine is contraindicated (immunocompromised persons, pregnant women, newborns whose mother’s varicella onset is <5days before delivery or within 48 hours after delivery) provide VZIG, when available, within 96 hours; if unavailable, use IVIG, Use Airborne for exposed susceptible persons and exclude exposed susceptible healthcare workers beginning 8 days after first exposure until 21 days after last exposure or 28 if received VZIG, regardless of postexposure vaccination. [1036]

Variola (see smallpox)

Vibrio parahaemolyticus (see gastroenteritis)

Vincent’s angina (trench mouth)

Viral hemorrhagic fevers due to Lassa, Ebola, Marburg, Crimean-Congo fever viruses

Single-patient room preferred. Emphasize:

Use N95 or higher respirators when performing aerosol-generating procedures. Largest viral load in final stages of illness when hemorrhage may occur; additional PPE, including double gloves, leg and shoe coverings may be used, especially in resource-limited settings where options for cleaning and laundry are limited. Notify public health officials immediately if Ebola is suspected [212, 314, 740, 772]. Also see Table 3 for Ebola as a bioterrorism agent.

 

Viral respiratory diseases (not covered elsewhere)       Standard

Whooping cough (see pertussis)

Wound infections

No dressing or dressing does not contain drainage adequately.

Wound infections

Dressing covers and contains drainage adequately.

Yersinia enterocolitica Gastroenteritis (see gastroenteritis)

Zoster (varicella-zoster) (see herpes zoster)

Zygomycosis (phycomycosis, mucormycosis)

Not transmitted person-to-person.