Transmission Based Precautions Guideline Questions: Contact Infection Control (ext 36596 or 36753)

Contact Droplet Airborne Isolation (door must be kept shut)

Infection / Disease
Abscess, wounds, pressure ulcer
(decubitis ulcer, pressure sore)
Burkholderia cepacia
Conjunctivitis acute viral
Diphtheria Cutaneous
Required PPE: Gown and gloves
Duration of precautions
Until drainage stops or can be
contained with dressing
Duration of hospitalization
Duration of illness (7-14 days)
Until completion of antibiotics (14
days) and 2 negative cultures 24
hours apart
Infection / Disease
Impetigo
Lice: Head (pediculosis) and body
*Multidrug-resistant organisms (MDROs):
MRSA, VRE, CRE, ESBL, MDR- Acinetobacter, have no open wounds/ulcers or indwelling
organism ≤ 2 susceptible
Poliomyelitis
Duration of precautions
24 hours after initiation of effective therapy Diphtheria Pharyngeal
Until 24 hrs after initiation of effective
therapy (when no lice is found)
48hrs after completion of antibiotics and
device with + MDRO
Duration of illness (3 weeks)
Required PPE: mask
Infection / Disease
Epiglottitis, due to H. influenzae b
Influenza
Meningitis: Haemophilus influenzae type b,
Neisseria meningitidis, meningococcal
disease (sepsis, pneumonia, meningitis)
daily check for negative air pressure
Duration of precautions Room must be unoccupied for a minimum of 69 minutes.
Until completion of antibiotics (14 days) and Terminal clean can occur during this time, but PPE must be worn
2 negative cultures 24 hours apart Required PPE: N95 Respirator or PAPR (located in AOD)
Visitors will wear mask
24 hours after initiation of effective therapy
Infection / Disease Duration of precautions
7 days after onset or 24 hours after not Tuberculosis (TB) M. tuberculosis: 3 consecutive negative AFB sputum smears
presenting with respiratory signs and pulmonary or laryngeal --> confirmed collected on separate days; patient has been
symptoms (which ever is longer) on effective treatment
24 hours after initiation of effective therapy Tuberculosis (TB) M. tuberculosis: When likelyhood of infectious TB disease is
pulmonary or laryngeal --> suspected deemed negligible, and EITHER: 1. another
diagnosis explains clinical syndrome, or
2. results of 3 sputum AFB smears are
negative and PCR negative

Furunculosis, staphylococcal
Herpes simplex (Herpesvirus
hominis): Mucocutaneous,
disseminated or primary, severe
Herpes zoster (shingles): localized Duration of illness (2-4 weeks)
in intact immune system
Until drainage stops or can be
contained with dressing
Until lesions dry and crusted (2-3
weeks)
Scabies and bed bugs 24 hours after initiation of effective therapy Mumps (infectious parotitis) 5 days after the onset of swelling Measles (rubeola) 14 days
Scalded skin syndrome Duration of illness (7-10 days) Mycoplasma pneumonia (IgM) Duration of illness (1-4 weeks) Contact and Airborne
door must be kept shut; daily check for negative air pressure; room must be unoccupied
for a minimum of 69 minutes. Terminal clean can occur during this time, but PPE must be
worn
Vaccinia: adverse events following Until lesions are dry and crusted over, scabs Pertussis (whooping cough) 5 days after initiation of effective antibiotic
Required PPE: Gown, N95 or PAPR (located in AOD or ED), and gloves
vaccination) have seperated therapy
Visitors will wear mask

Plague (Yersenia pestis ): pneumonic 48 hrs after initiation of effective antibiotic

Enteric Contact Isolation (TruD upon discharge) Contact and Droplet
therapy Infection / Disease Duration of precautions
Pneumonia: Meningococcal, pneumococcal, 24 hrs after initiation of effective therapy Aspergillosis: Massive soft tissue infection
Required PPE: Gown and gloves Required PPE: Gown, mask, and gloves
Strep Group A (Not from respiratory tract)
Rhinovirus (common cold) Duration of illness (7-10 days) Herpes zoster (varicella - zoster), shingles: Duration of illness (2-4 weeks)
Disseminated in any patient, localized in
Infection / Disease Duration of precautions Infection / Disease Duration of precautions immunocompromised
Clostridium difficile 48 hours after completion of Human metapneumovirus (if not presenting Duration of illness (7 days) Rubella (German measles) 7 days after onset of rash Monkeypox Until lesions crusted (4 weeks)
(C. diff) antibiotics and no complaints of with respiratory signs & symptoms Contact
diarrhea. Patient must be transferred only)
to a new room.
Rotavirus After 48 hrs of symptom free Multidrug-resistant organisms (MDROs): 48hrs after completion of antibiotics and Parvovirus B19 (Erythema infectiosum) Immunocompromised: Hospital duration Severe acute respiratory syndrome (SARS) 10 days after resolution of fever if
MRSA,VRE,CRE,ESBL,MDR- Acinetobacter, have no open wounds/ulcers or indwelling Others: 7 days respiratory symptoms are absent or
organism ≤2 suspectible with positive device with + MDRO improving
respiratory track results
Noroviruses After 48 hrs of symptom free Parainfluenza virus infection: Duration of illness (approx 4 months) Streptococcal group A Toxic shock syndrome 24 hours after initiation of effective therapy Smallpox (variola) All scabs have crusted and separated (3-4
immunocompromised (TSS) weeks)
Hepatitis A 3 weeks Pneumonia: Adenovirus Duration of illness (3 weeks) Tuberculosis (TB) M. tuberculosis, When patient on effective therapy, drainage
Extrapulmonary, draining lesion has ceased or has 3 consecutive negative
Contact time: AFB sputum smears collected on separate
Contact time: 4 minutes days
Hepatitis E 30 days Respiratory syncytial virus (RSV): Duration of illness (4 weeks) 2 minutes Chickenpox (varicella zoster) Until lesions dry and crusted (4-7 days)
immunocompromised
Anthrax cutaneous Duration of illness (12 days); Hand Group A Streptococcus: pneumonia, skin, 24 hours after initiation of effective therapy Viral hemorrhagic fevers: Duration of hospitalization
washing with soap and water 60 wound, or burn, invasive disease and until drainage stops or can be contained Lassa, Ebola, Marburg, Crimean-Congo
seconds by dressing
Bleach protocol (TruD upon discharge) Upon initiation of isolation, PPE should be made available at all times
Amebiasis diapered/incontinent patients Use dedicated or single use disposable patient equipment. When this is not possible, disinfection of common use items must be performed
Gastroenteritis: Bacterial/viral not diapered/incontinent patients Masks should be not worn around the neck; isolation gowns must be fastened on the back
listed under Enteric Contact Gown and gloves should not be worn in the hallway
Unexplained diarrhea: patients After 48 hrs of symptom free Linen: Should be double bagged for bed bugs, lice, and scabies
who do not meet Cdiff testing Prior to patient transport, transport equipment should have clean linen and be wiped down. Patients should wear a mask and be changed into a clean hospital gown
If contact isolation is discontinued, patient should be moved to a new room; Isolation sign will be removed by EVS after room has been cleaned

MRSA nares:No isolation required; Nozin BID

MDRO history: follow MDRO history isolation guideline
https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines-H.pdf CDIFF history: No isolation required unless presenting with diarrhea

Infection / Disease
Abscess: If dressing covers and
contains drainage
Acquired human
immunodeficiency syndrome
(AIDS/HIV)
Actinomycosis
Anthrax: Pulmonary
Arthropod-borne: viral
encephalitides (eastern, wester,
Venezuelan equine
encephalomyelitis; St. Louis,
California encephalitis;West Nile
Virus) and viral fevers (dengue,
yellow fever, Colorado tick fever)
Ascariasis
Babesiosis
Blastomycosis: North American
cutaneous or pulmoary
Brucellosis: undulant, Malta,
Mediterranean fever
Candidiasis: all forms including
mucocutaneous
Cat-scratch fever: benign
inoculation lymphoreticulosis
Cellulitis
Chancroid: soft chancre; H.
ducreyi
Chlamydia trachomatis:
Conjunctivitis, genital, pneumonia (puerperal sepsis)
(infants ≤3 months)
Closed-cavity infection: no drain or Group B Streptococcus : Neonatal
closed drainage system
Coccidioidomycosis (Valley fever): Guillain-Barre syndrome
Draining lesions, pneumonia
https://www.cdc.gov/infectioncontrol/pdf/guidelines/isolation-guidelines-H.pdf
Infection / Disease
Colorado Tick fever
Conjuctivitis: Acute bacterial -
Chlamydiaand gonococcal
Creutzfeldt-Jakob disease (CJD, vCJD), Hepatitis viral: Type B, C, D, G
Prion disease, Transmissible
spongiform encephalopathy
Cryptococcosis
Cysticercosis
Cytomegalovirus (CMV) infection
Echinococcosis (hydatidosis)
Endometritis (endomyometritis)
Enterobiasis (pinworm disease,
oxyuriasis)
Epstein-Barr virus infection, including Leptospirosis
infectious mononucleosis
Food poisoning: Botulism, C.
perfringens, C. welchii , staphlococcal
Gonorrhea
Granuloma inguinale (Donovanosis,
granuloma venereum)
Group A Streptococcus : Endometritis Lymphocytic choriomeningitis
Transmission Based Precautions Guideline Questions: Contact Infection Control (ext 36596 or 36753)
Standard Precautions Infants/young children
Universal PPE: what you think is required for the task being performed Bronchiolitis Contact/Droplet
Enteroviral (Group A and B Coxsackie viruses Contact
Infection / Disease Infection / Disease Infection / Disease Infection / Disease and Echo viruses)
Hantavirus pulmonary syndrome Meliodiosis: all forms Rickettsial fevers: tickborne (Rocky Trichuriasis: whipworm disease Contact
Mountain spotted fever, tickborne Typhus
fever) Necrotizing enterocolitis
Helicobacter pylori Meningitis: fungal, Listeria monocytogenes, Rickettsial pox (vesicular rickettsiosis) Tularemia: draining lesion, pulmonary Contact/Droplet
Streptococcus pneumoniae
Parainfluenza virus infection
Molluscum contagiosum Ringworm (dermatophytosis, Typhus: Rickettsia prowazekii (Epidemic or Pneumonia: H. influenzae, type b Droplet
dermatomycosis, tinea) If an outbreak, use Louse-borne Typhus), R. typhi
Contact precautions
Histoplasmosis Mucormycosis Roseola infantum (exanthem subitum; Zygomycosis (phycomycosis, mucormycosis) Droplet
caused by HHV 6) Group A Strep: pharyngititis, scarlet fever
Hookworm Mycobacteria (nontuberculosis): atypical, Schistosomiasis (bilharziasis) Contact
Pulmonary, wound
Congenital rubella
Herpes simplex (Herpesvirus hominis ): Nocardiosis: draining lesions or other Sporotrichosis Enteroviral (all etiologies ie, group A and B Contact
encephalitis, mucocutaneous, recurrent presentations Coxsackie viruses except, polio)
(oral, skin, genital) Hand, foot, and mouth disease (diapered /
incontinent children)
Kawasaki syndrome Orf Strongyloidiasis
Legionnaires' disease Plague (Yersinia pestis ): Bubonic Syphilis
Leprosy (Hansen's disease) Pneumonia: Chlamydia, fungal, Haemophilus Tapeworm disease: Hymenolepis nana,
influenzae (type b) adults, Legionella spp, Taenia solium (pork), other
Pneumocystitis jiroveci/carinii, S. aureus,
Psittacosis (ornithosis): Chlamydia psittaci Tetanus
Lice: Pubic Q fever Toxic shock syndrome (TSS): S. aureus
Listeriosis (Listeria monocytogenes ) Rabies Toxoplasmosis
Lyme disease Rat-bite fever: Streptobacillus moniliformis Trachoma: acute
disease, Spirillum minus disease
Relapsing fever Trench mouth: Vincent's angina
Lymphogranuloma venereum Reye's Syndrome Trichinosis
Malaria Rheumatic fever Trichomoniasis
MRSA nares:No isolation required; Nozin BID
MDRO history: follow MDRO history isolation guideline
CDIFF history: No isolation required unless presenting with diarrhea