Infectious Diseases Bill Edstrom, Epidemiologist Spokane Regional Health District

1. Infectious DiseasesBill Edstrom, EpidemiologistSpokane Regional Health District

2. Bloodborne Pathogen Standard Designed to eliminate or minimize employees’ exposure to human blood and other potentially infectious materials (OPIM) in the workplace OSHA

3. Who is Covered? • All employees who may reasonably expect to be exposed to blood and OPIM that may contain pathogens • Anyone whose job involves handling or possibly being exposed to blood or blood products, or OPIM

4. What are pathogens? Germs transmitted from one person to another through contact with blood or OPIM

5. Caution! You do NOT need to directly contact someone carrying a bloodborne pathogen to be at risk for exposure! Risks also come from: • Clinical specimens • Biohazardous trash • Blood- or body fluid-soaked laundry • Needles or sharps

6. Annual Training Required: • How diseases are transmitted and their symptoms • Protective measures to prevent exposure • Procedures to be followed if exposed

7. Exposure Control Plan • OSHA requirement • Must describe: • Exposure prevention • Engineering and work practice controls • Universal precautions • Personal protective equipment

8. Infectious Disease Transmission • Stages of Disease Transmission: • Someone has an infection • The infectious pathogen leaves the Infected person’s body

9. Infectious Disease Transmission: • The infectious pathogen reaches another person and enters his or her body. Transmission:- Bloodborne- Airborne - Vector - Direct or indirect contact 4. The second person develops the infection.

10. Serious Bloodborne Pathogens • Hepatitis B virus (HBV) • Hepatitis C virus (HCV) • Human immunodeficiency virus (HIV)

12. Measures • Measures you take to prevent HBV, HCV, and HIV also help prevent diseases caused by other bloodborne pathogens

13. Whether pathogens are present in the source blood or body fluid The number of pathogens present The type of injury or exposure Your current health and immunization status NO The risk of infection after an exposure depends on: Do Exposures Always Cause Infection?

14. HIV and AIDS • Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV) • There are almost one million HIV-positive people in the U.S.

15. HIV and AIDS • AIDS damages cells essential for immune function • People with AIDS are more susceptible to opportunistic infections • The disease is eventually fatal

16. HIV and AIDS

17. Prevention

18. OSHA Standard • Requires employers to use strategies to reduce occupational exposures: • Engineering controls • Work practice controls • Personal protective equipment • Universal precautions

19. Engineering Controls • Needleless systems • Eye wash stations • Handwashing facilities • Biohazard labels

20. Work Practice Controls • Use of personal protective equipment (PPE) • Handwashing • Decontamination and sterilization of equipment and areas

21. Personal Protective Equipment • Gloves • Jumpsuits, aprons • Eye shields, goggles • Face masks, face shields • Caps • Booties

22. OSHA Standard Requires that your employer: • Provide PPE at no cost • Train you how to use equipment • Must clean, repair, or replace it as needed

23. For Unexpected Exposure • If blood or OPIM splashes in your eyes or other mucous membranes, flush area with running water for 20 minutes • Wash any exposed area well with soap, using an antibacterial soap • Gently treat any scabs and sores • Report the exposure to your supervisor • Save any potentially contaminated object for testing purposes • Seek medical care

24. Employer Responsibilities • Identify and document source of blood or OPIM • Obtain consent and arrange to test the source blood • Inform you of the test results • Arrange for you to have your blood tested • Arrange counseling and medical care for you as needed

25. Airborne Pathogens

26. Three Types of Airborne Pathogens • Viral • Bacterial • Fungal

27. Airborne Pathogens • Precautions for tuberculosis also lower the risk for other airborne pathogens • Meningitis • Influenza • Pneumonia • Tuberculosis

28. Airborne Pathogens • Spread by inhaling the germ • Coughing or sneezing tiny droplets of moisture into the air containing pathogens • Pathogens can remain airborne for several hours

29. Airborne Transmission • Depends On: • How contagious the infectious person is • Where the exposure occurs • How long the exposure lasts • How healthy you are at the time of the exposure

30. Tuberculosis

31. H1N1 (“Swine Flu”)

32. H1N1 and EMS • EMS personnel should stay more than 6 feet away from patients and bystanders with symptoms and exercise appropriate routine respiratory droplet precautions while assessing all patients for suspected cases of swine-origin influenza. • Assess all patients for symptoms of acute febrile respiratory illness (fever plus one or more of the following: nasal congestion/ rhinorrhea, sore throat, or cough).

33. H1N1 and EMS • If no acute febrile respiratory illness, proceed with normal EMS care. • If symptoms of acute febrile respiratory illness, then assess all patients for travel to a geographic area with confirmed cases of swine-origin influenza within the last 7 days or close contact with someone with travel to these areas.

34. H1N1 and EMS • If travel exposure, don appropriate PPE for suspected case of swine-origin influenza. • If no travel exposure, place a standard surgical mask on the patient (if tolerated) and use appropriate PPE for cases of acute febrile respiratory illness without suspicion of swine-origin influenza (as described in PPE section).

35. Questions

36. Contact: Renee Anderson509-232-81551-866-630-4033andersr@inhs.org Fax: 509-232-8168