Hemorrhagic fever with renal syndrome secondary prevention
|
Hemorrhagic fever with renal syndrome Microchapters |
|
Differentiating Hemorrhagic fever with renal syndrome from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Hemorrhagic fever with renal syndrome secondary prevention On the Web |
|
American Roentgen Ray Society Images of Hemorrhagic fever with renal syndrome secondary prevention |
|
FDA on Hemorrhagic fever with renal syndrome secondary prevention |
|
CDC onHemorrhagic fever with renal syndrome secondary prevention |
|
Hemorrhagic fever with renal syndrome secondary prevention in the news |
|
Blogs on Hemorrhagic fever with renal syndrome secondary prevention |
|
Directions to Hospitals Treating Hemorrhagic fever with renal syndrome |
|
Risk calculators and risk factors for Hemorrhagic fever with renal syndrome secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
In conjunction with the World Health Organization, CDC has developed practical, hospital-based guidelines, titled Infection Control for viral Haemorrhagic Fevers In the African Health Care Setting. The manual can help health-care facilities recognize cases and prevent further hospital-based disease transmission using locally available materials and few financial resources.
Secondary Prevention
The following recommendations should be followed when caring for persons with suspected VHF:
- Patients who are hospitalized or treated in an outpatient healthcare setting should be placed in a private room and standard, contact, and droplet Precautions should be initiated. Patients with respiratory symptoms also should wear a face mask to contain respiratory droplets prior to placement in their hospital or examination room and during transport.
- Caretakers should use barrier precautions to prevent skin or mucous membrane exposure of the eyes, nose, and mouth with patient blood, other body fluids, secretions (including respiratory droplets), or excretions. All persons entering the patient's room should wear gloves and gowns to prevent contact with items or environmental surfaces that may be soiled. In addition, face shields or surgical masks and eye protection (e.g., goggles or eyeglasses with side shields) should be worn by persons coming within approximately 3 feet of the patient.
- Additional barriers may be needed depending on the likelihood and magnitude of contact with body fluids. For example, if copious amounts of blood, other body fluids, vomit, or feces are present in the environment, plastic apron, leg, and shoe coverings also may be needed.
- Nonessential staff and visitors should be restricted from entering the room of patients with suspected VHF. Maintain a log of persons entering the patient’s room.
- Before exiting the room of a patient with suspected VHF, safely remove and dispose of all protective gear, and clean and disinfect shoes that are soiled with body fluids as described in the section on environmental infection control below.
- To prevent per-cutaneous injuries, needles and other sharps should be used and disposed of in accordance with recommendations for Standard Precautions.
- If the patient requires a surgical or obstetric procedure, consult your state health department and CDC regarding appropriate precautions for these invasive procedures.
- Although transmission by the airborne route has not been established, hospitals may choose to use Airborne Precautions for patients with suspected VHF who have severe pulmonary involvement or who undergo procedures that stimulate coughing and promote the generation of aerosols (e.g. aerosolized or nebulized medication administration, diagnostic sputum induction, bronchoscopy, airway suctioning, endotracheal intubation, positive pressure ventilation via face mask [e.g., biphasic intermittent positive airway pressure ventilation, continuous positive airway pressure ventilation, and high-frequency oscillatory ventilation) to prevent possible exposure to airborne particles that may contain virus.
Specimen Handling:
- Alert laboratory staff to the nature of the specimens prior to sending them to the clinical laboratory. Specimens should remain in the custody of designated laboratory personnel until testing is completed. Due to the potential risks associated with handling infectious materials, laboratory testing should be limited to the minimum necessary for essential diagnostic evaluation and patient care.
- While obtaining clinical laboratory specimens from the patient, use infection control precautions for patient care outlined in this document. Place specimens in sealed plastic bags, then transport them in a clearly labeled, durable, leak-proof container directly to the specimen handling area of the laboratory. Care should be taken not to contaminate the external surfaces of containers.
- Process clinical specimens in a class II biological safety cabinet following biosafety level 3 practices. If possible, pretreat serum used in laboratory tests with the combination of heat-inactivation at 56° C and polyethylene glycol p-tert-octylphenyl ether (Triton(®) X-100)*; treatment with 10 uL of 10% Triton(®) X-100 per 1 mL of serum for 1 hour reduces the titer of hemorrhagic fever viruses in serum, although 100% efficacy in inactivating these viruses should not be assumed. For tests in which the validity is affected by the presence of a detergent in the serum, heat inactivation alone may be of some benefit in reducing infectivity.
- Blood smears (e.g., for malaria) are not infectious for VHF after fixation in solvents.
- Attempts to isolate or cultivate the virus should not be part of routine clinical laboratory diagnosis when VHF is suspected. If such procedures are done on specimens where VHF is suspected, biosafety level 4 facilities and procedures are required.
- Routine cleaning and disinfecting procedures can be used for automated analyzers; analyzers should be disinfected after use as recommended by the manufacturer or with a 500 parts per million solution (1:100 dilution) of sodium hypochlorite (1/4 cup of household bleach to 1 gallon water).
References