Infection Control Trotter

Three Categories of Disease/Disorder  Infectious and Communicable Diseases  Chronic Diseases and conditions  Bleeding Disorders

Infectious and Communicable – 11 Groups  Animal-Related Diseases Animal-Related Diseases Animal-Related Diseases  Bioterrorism Agents/Diseases Bioterrorism Agents/Diseases Bioterrorism Agents/Diseases  Childhood Diseases Childhood Diseases Childhood Diseases  Drug Resistant Infections Drug Resistant Infections Drug Resistant Infections  Emerging Infectious Diseases Emerging Infectious Diseases Emerging Infectious Diseases  Food-Related Diseases Food-Related Diseases Food-Related Diseases  Healthcare-Related Infections and Issues Healthcare-Related Infections and Issues Healthcare-Related Infections and Issues  HIV/AIDS HIV/AIDS  Insects and Arthropod-Related Diseases Insects and Arthropod-Related Diseases Insects and Arthropod-Related Diseases  Sexually Transmitted Diseases Sexually Transmitted Diseases Sexually Transmitted Diseases  Water-Related Diseases Water-Related Diseases Water-Related Diseases

Chronic Diseases and Conditions  Arthritis Arthritis  Asthma & Allergies Asthma & Allergies Asthma & Allergies  Cancer Cancer  Chronic Fatigue Syndrome Chronic Fatigue Syndrome Chronic Fatigue Syndrome  Diabetes Diabetes  Epilepsy Epilepsy  Heart Disease Heart Disease Heart Disease  Hemochromatosis Hemochromatosis  Hepatitis B Hepatitis B Hepatitis B  Hepatitis C Hepatitis C Hepatitis C  Iron Overload Iron Overload Iron Overload  Osteoporosis Osteoporosis  Overweight and Obesity Overweight and Obesity Overweight and Obesity  Stroke Stroke

Animal Related Diseases  BSE, mad cow disease (Bovine spongiform encephalopthy): An infectious disease associated with cattle. BSE, mad cow disease (Bovine spongiform encephalopthy) BSE, mad cow disease (Bovine spongiform encephalopthy)  Brucellosis (Brucella spp.): A bacterial disease associated with farm animals and dogs. Brucellosis (Brucella spp.) Brucellosis (Brucella spp.)  Campylobacteriosis (Campylobacter spp.): A bacterial disease associated with cats, dogs, farm animals and improper food preparation. Campylobacteriosis (Campylobacter spp.) Campylobacteriosis (Campylobacter spp.)  Cat Scratch Disease or cat scratch fever (Bartonella henselae): A bacterial disease associated with cat scratches and bites. Cat Scratch Disease or cat scratch fever (Bartonella henselae) Cat Scratch Disease or cat scratch fever (Bartonella henselae)  Cryptococcosis (Cryptococcus spp.): A fungal disease associated with wild birds, especially pigeon droppings. Cryptococcosis (Cryptococcus spp.) Cryptococcosis (Cryptococcus spp.)  Cryptosporidiosis (Cryptosporidium spp.): A parasitic disease associated with cats, dogs, and farm animals. Cryptosporidiosis (Cryptosporidium spp.) Cryptosporidiosis (Cryptosporidium spp.)  Escherichia coli O157:H7: A bacterial disease associated with cattle and improper food preparation. Escherichia coli O157:H7 Escherichia coli O157:H7  Giardiasis (Giardia lamblia): A parasitic disease associated with various animals and water. Giardiasis (Giardia lamblia) Giardiasis (Giardia lamblia)  Hantavirus (Hantavirus Pulmonary Syndrome): A rare viral disease associated with wild mice. Hantavirus (Hantavirus Pulmonary Syndrome) Hantavirus (Hantavirus Pulmonary Syndrome)  Herpes B (Herpesvirus 1): A viral disease associated with Macaque monkeys. Herpes B (Herpesvirus 1) Herpes B (Herpesvirus 1)

Animal Related Diseases  Histoplasmosis (Histoplasma spp.): A fungal disease associated with bat guano (stool). Histoplasmosis (Histoplasma spp.) Histoplasmosis (Histoplasma spp.)  Hookworm (Ancylostoma caninum, Ancylostoma braziliense, Uncinaria stenocephals): A parasitic disease associated with dogs and their environment. Hookworm (Ancylostoma caninum, Ancylostoma braziliense, Uncinaria stenocephals): Hookworm (Ancylostoma caninum, Ancylostoma braziliense, Uncinaria stenocephals):  Leishmaniasis (Leishmania spp.): A parasitic disease associated with dogs and sand flies. Leishmaniasis (Leishmania spp.) Leishmaniasis (Leishmania spp.)  Leptospirosis (Leptospira spp.): A bacterial disease associated with livestock, dogs, rodents, wildlife and contaminated water. Leptospirosis (Leptospira spp.) Leptospirosis (Leptospira spp.)  Lyme Disease (Borrelia burgdorferi Infection): A bacterial disease associated with dogs and ticks. Lyme Disease (Borrelia burgdorferi Infection) Lyme Disease (Borrelia burgdorferi Infection)  Lymphocytic Choriomeningitis: A viral disease associated with rodents such as rats, guinea pigs and house mice. Lymphocytic Choriomeningitis Lymphocytic Choriomeningitis  Monkeypox: A viral disease recently suspected to be associated with prairie dogs, Gambian rats, and rabbits. Monkeypox  Plague (Yersinia pestis): A rare bacterial disease associated with wild rodents, cats, and fleas. Plague (Yersinia pestis): Plague (Yersinia pestis):

Animal Related Diseases  Psittacosis (Chlamydia psittaci): A bacterial disease associated with pet birds, including parrots and parakeets. Q fever (Coxiella burnetti): A bacterial disease associated with cattle, sheep, goats, dogs and cats Psittacosis (Chlamydia psittaci) Q fever (Coxiella burnetti) Psittacosis (Chlamydia psittaci) Q fever (Coxiella burnetti)  Rabies: A viral disease associated with mammals, including dogs, cats, horses, and wildlife. Rabies:  Raccoon roundworm Infection (Baylisascaris procyonis): A parasitic disease associated with raccoons. Raccoon roundworm Infection (Baylisascaris procyonis) Raccoon roundworm Infection (Baylisascaris procyonis)  Ringworm (Microsporum spp. and Trichophyton spp.): A fungal disease associated with mammals including dogs, cats, horses and farm animals. Ringworm (Microsporum spp. and Trichophyton spp.): Ringworm (Microsporum spp. and Trichophyton spp.):  Rocky Mountain Spotted Fever (Rickettsia rickettsii) : A rickettsial disease associated with dogs and ticks. Roundworm (Toxocara canis, T. cati and Toxocaris leonina): A parasitic disease associated with cats, dogs and their environment. Salmonellosis (Salmonella spp.): A bacterial disease associated with reptiles, birds, dogs, cats, horses, farm animals, and improper food preparation. Rocky Mountain Spotted Fever (Rickettsia rickettsii) Roundworm (Toxocara canis, T. cati and Toxocaris leonina) Salmonellosis (Salmonella spp.) Rocky Mountain Spotted Fever (Rickettsia rickettsii) Roundworm (Toxocara canis, T. cati and Toxocaris leonina) Salmonellosis (Salmonella spp.)

Animal Related Diseases  Salmonellosis (Salmonella spp.): A bacterial disease associated with reptiles, birds, dogs, cats, horses, farm animals, and improper food preparation. Salmonellosis (Salmonella spp.) Salmonellosis (Salmonella spp.)  Tapeworm Infection (Dipylidium caninum): A parasite associated with flea infections in cats and dogs. Tapeworm Infection (Dipylidium caninum) Tapeworm Infection (Dipylidium caninum)  Toxoplasmosis (Toxoplasma gondii): A parasitic disease associated with cats and their environment. Toxoplasmosis (Toxoplasma gondii): Toxoplasmosis (Toxoplasma gondii):  Tuberculosis or TB (Mycobacterium tuberculosis): A bacterial disease associated with deer, elk, bison and cattle. Tuberculosis or TB (Mycobacterium tuberculosis) Tuberculosis or TB (Mycobacterium tuberculosis)  Tularemia (Francisella tularensis): A bacterial disease associated with sheep and wildlife, especially rodents and rabbits. Tularemia (Francisella tularensis) Tularemia (Francisella tularensis)  West Nile Virus: A viral disease spread by mosquitoes which can affect birds, horses, and other mammals. West Nile Virus West Nile Virus  Yersiniosis (Yersinia enterocolitica): A bacterial disease associated with dogs, cats, and farm animals. Also associated with improper preparation of chitterlings. Yersiniosis (Yersinia enterocolitica) Yersiniosis (Yersinia enterocolitica)

Bioterrorism  Anthrax (Bacillus anthracis) Anthrax  Arenaviruses Arenaviruses  Bacillus anthracis (anthrax) Bacillus anthracis Bacillus anthracis  Botulism (Clostridium botulinum toxin) Botulism  Brucella species (brucellosis) Brucella species Brucella species  Brucellosis (Brucella species) Brucellosis  Burkholderia mallei (glanders)  Burkholderia pseudomallei (melioidosis)  Chlamydia psittaci (psittacosis)  Cholera (Vibrio cholerae) Cholera  Clostridium botulinum toxin (botulism) Clostridium botulinum toxin Clostridium botulinum toxin  Clostridium perfringens (Epsilon toxin)  Coxiella burnetii (Q fever) Coxiella burnetii Coxiella burnetii

Bioterrorism  Ebola virus hemorrhagic fever Ebola virus hemorrhagic fever Ebola virus hemorrhagic fever  E. coli O157:H7 (Escherichia coli) E. coli O157:H7 E. coli O157:H7  Emerging infectious diseases such as Nipah virus and hantavirus  Epsilon toxin of Clostridium perfringens  Escherichia coli O157:H7 (E. coli) Escherichia coli O157:H7 Escherichia coli O157:H7  Food safety threats (e.g., Salmonella species, Escherichia coli O157:H7, Shigella) Food safety threats Food safety threats  Francisella tularensis (tularemia) Francisella tularensis Francisella tularensis  Glanders (Burkholderia mallei)  Lassa fever Lassa fever Lassa fever  Marburg virus hemorrhagic fever Marburg virus hemorrhagic fever Marburg virus hemorrhagic fever  Melioidosis (Burkholderia pseudomallei)  Plague (Yersinia pestis) Plague  Psittacosis (Chlamydia psittaci)  Q fever (Coxiella burnetii) Q fever Q fever  Ricin toxin from Ricinus communis (castor beans) Ricin toxin Ricin toxin  Rickettsia prowazekii (typhus fever)

Bioterrorism  Salmonella species (salmonellosis) Salmonella species Salmonella species  Salmonella Typhi (typhoid fever) Salmonella Typhi Salmonella Typhi  Salmonellosis (Salmonella species) Salmonellosis  Shigella (shigellosis) Shigella  Shigellosis (Shigella) Shigellosis  Smallpox (variola major) Smallpox  Staphylococcal enterotoxin B  Tularemia (Francisella tularensis) Tularemia  Typhoid fever (Salmonella Typhi) Typhoid fever Typhoid fever  Typhus fever (Rickettsia prowazekii)  Variola major (smallpox) Variola major Variola major  Vibrio cholerae (cholera) Vibrio cholerae Vibrio cholerae  Viral encephalitis (alphaviruses [e.g., Venezuelan equine encephalitis, eastern equine encephalitis, western equine encephalitis])  Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg] and arenaviruses [e.g., Lassa, Machupo]) Viral hemorrhagic fevers Viral hemorrhagic fevers  Water safety threats (e.g., Vibrio cholerae, Cryptosporidium parvum)  Yersinia pestis (plague) Yersinia pestis Yersinia pestis

Childhood Diseases  amebiasis amebiasis  bacterial meningitis bacterial meningitis bacterial meningitis  bilharzia bilharzia  campylobacteriosis campylobacteriosis  Chagas disease Chagas disease Chagas disease  chickenpox chickenpox  CMV CMV  cold, common cold, common cold, common  croup croup  cryptosporidiosis cryptosporidiosis  cyclosporiasis cyclosporiasis  cytomegalovirus (CMV) infection cytomegalovirus (CMV) infection cytomegalovirus (CMV) infection

Childhood Diseases  diarrhea diarrhea  diphtheria diphtheria  dog and cat flea tapeworm infection dog and cat flea tapeworm infection dog and cat flea tapeworm infection  dwarf and rat tapeworm infection dwarf and rat tapeworm infection dwarf and rat tapeworm infection  ear infection ear infection ear infection  E. Coli infection E. Coli infection E. Coli infection  Epstein-Barr Virus infection Epstein-Barr Virus infection Epstein-Barr Virus infection  fifth disease fifth disease fifth disease  flu flu  German measles German measles German measles  giardiasis giardiasis  group B streptococcal disease group B streptococcal disease group B streptococcal disease

Childhood Diseases  hand, foot, and mouth disease hand, foot, and mouth disease hand, foot, and mouth disease  head lice head lice head lice  hepatitis A and B hepatitis A and B hepatitis A and B  Hib disease Hib disease Hib disease  hookworm hookworm  human parainfluenza virus infection human parainfluenza virus infection human parainfluenza virus infection  influenza influenza  intestinal Roundworms intestinal Roundworms intestinal Roundworms  Kala-azar Kala-azar  Kawasaki syndrome Kawasaki syndrome Kawasaki syndrome

Childhood Diseases  leishmaniasis leishmaniasis  lice infestation lice infestation lice infestation  listeriosis listeriosis  lockjaw lockjaw  malaria malaria  measles measles  meningitis (bacterial and viral) meningitis (bacterial and viral) meningitis (bacterial and viral)  mite infestation mite infestation mite infestation  mononucleosis, infectious mononucleosis, infectious mononucleosis, infectious  mumps mumps  non-polio enterovirus infections non-polio enterovirus infections non-polio enterovirus infections

Childhood Diseases  parvovirus B19 infection parvovirus B19 infection parvovirus B19 infection  pertussis pertussis  pinworm infection pinworm infection pinworm infection  pneumonia pneumonia  polio polio  racoon roundworm racoon roundworm racoon roundworm  ringworm ringworm  rotavirus infection rotavirus infection rotavirus infection  roundworm infection, zoonotic roundworm infection, zoonotic roundworm infection, zoonotic  RSV infection RSV infection RSV infection  rubella rubella  rubeola rubeola

Childhood Diseases  salmonellosis salmonellosis  scabies scabies  scarlet fever scarlet fever scarlet fever  schistosomiasis schistosomiasis  shigellosis shigellosis  streptococcal infections (including strep throat) streptococcal infections (including strep throat) streptococcal infections (including strep throat)  tetanus tetanus  thrush thrush  toxoplasmosis toxoplasmosis  tuberculosis tuberculosis  whipworm infection whipworm infection whipworm infection  whooping cough whooping cough whooping cough

Drug Resistant Infections  unity/tools.htm unity/tools.htm unity/tools.htm  Nosocomial infections  URI  STD  Malaria  TB

Emerging Infectious Diseases  drug-resistant infections (antimicrobial resistance) drug-resistant infections (antimicrobial resistance) drug-resistant infections (antimicrobial resistance)  bovine spongiform encephalopathy (Mad cow disease) and variant Creutzfeldt-Jakob disease (vCJD) bovine spongiform encephalopathy (Mad cow disease) and variant Creutzfeldt-Jakob disease (vCJD) bovine spongiform encephalopathy (Mad cow disease) and variant Creutzfeldt-Jakob disease (vCJD)  campylobacteriosis campylobacteriosis  Chagas disease Chagas disease Chagas disease  cholera cholera  cryptococcosis cryptococcosis  cryptosporidiosis (Crypto) cryptosporidiosis (Crypto) cryptosporidiosis (Crypto)  cyclosporiasis cyclosporiasis  cysticercosis cysticercosis  dengue fever dengue fever dengue fever  diphtheria diphtheria  Ebola hemorrhagic fever Ebola hemorrhagic fever Ebola hemorrhagic fever  Escherichia coli infection Escherichia coli infection Escherichia coli infection

Emerging Diseases  group B streptococcal infection group B streptococcal infection group B streptococcal infection  hantavirus pulmonary syndrome hantavirus pulmonary syndrome hantavirus pulmonary syndrome  hepatitis C hepatitis C hepatitis C  hendra virus infection hendra virus infection hendra virus infection  histoplasmosis histoplasmosis  HIV/AIDS HIV/AIDS  influenza influenza  Lassa fever Lassa fever Lassa fever  legionnaires' disease (legionellosis) and Pontiac fever legionnaires' disease (legionellosis) and Pontiac fever legionnaires' disease (legionellosis) and Pontiac fever  leptospirosis leptospirosis  listeriosis listeriosis  Lyme disease Lyme disease Lyme disease

Emerging Diseases  malaria malaria  Marburg hemorrhagic fever Marburg hemorrhagic fever Marburg hemorrhagic fever  measles measles  meningitis meningitis  monkeypox monkeypox  MRSA (Methicillin Resistant Staphylococcus aureus) MRSA (Methicillin Resistant Staphylococcus aureus) MRSA (Methicillin Resistant Staphylococcus aureus)  Nipah virus infection Nipah virus infection Nipah virus infection  norovirus (formerly Norwalk virus) infection norovirus (formerly Norwalk virus) infection norovirus (formerly Norwalk virus) infection  pertussis pertussis  plague plague

Emerging Diseases  polio (poliomyelitis) polio (poliomyelitis) polio (poliomyelitis)  rabies rabies  Rift Valley fever Rift Valley fever Rift Valley fever  rotavirus infection rotavirus infection rotavirus infection  salmonellosis salmonellosis  SARS (Severe acute respiratory syndrome) SARS (Severe acute respiratory syndrome) SARS (Severe acute respiratory syndrome)  shigellosis shigellosis  smallpox smallpox  sleeping Sickness (Trypanosomiasis) sleeping Sickness (Trypanosomiasis) sleeping Sickness (Trypanosomiasis)  tuberculosis tuberculosis  tularemia tularemia  valley fever (coccidioidomycosis) valley fever (coccidioidomycosis) valley fever (coccidioidomycosis)  VISA/VRSA - Vancomycin-Intermediate/Resistant Staphylococcus aureus VISA/VRSA - Vancomycin-Intermediate/Resistant Staphylococcus aureus VISA/VRSA - Vancomycin-Intermediate/Resistant Staphylococcus aureus  West Nile virus infection West Nile virus infection West Nile virus infection  yellow fever yellow fever yellow fever

Food Borne Illness  The U.S. Public Health Service has identified the following microorganisms as being the biggest culprits of foodborne illness, either because of the severity of the sickness or the number of cases of illness they cause. Beware of these pathogens: Fight BAC! LEARN WHERE THEY ARE AND HOW TO AVOID THEM  Campylobacter Most common bacterial cause of diarrhea in the United States; Sources: raw and undercooked meat and poultry, raw milk and untreated water Clostridium botulinum This organism produces a toxin which causes botulism, a life-threatening illness that can prevent the breathing muscles from moving air in and out of the lungs. Sources: home-prepared foods and herbal oils; honey should not be fed to children less than 12 months old CampylobacterClostridium botulinumCampylobacterClostridium botulinum

Foodborne Illness  E. coli O157:H7 A bacterium that can produce a deadly toxin and causes approximately 73,000 cases of foodborne illness each year in the U.S.; Sources: meat, especially undercooked or raw hamburger, produce and raw milk Listeria monocytogenes Causes listeriosis, a serious disease for pregnant women, newborns and adults with a weakened immune system; Sources: soil and water. It has been found in dairy products including soft cheeses as well as in raw and undercooked meat, in poultry and seafood, and in produce Norovirus This virus is the leading cause of diarrhea in the United States. Any food can be contaminated with norovirus if handled by someone who is infected with this virus. E. coli O157:H7Listeria monocytogenesNorovirusE. coli O157:H7Listeria monocytogenesNorovirus

Foodborne Illness  Salmonella Most common cause of foodborne deaths. Responsible for millions of cases of foodborne illness a year; Sources: raw and undercooked eggs, undercooked poultry and meat, dairy products, seafood, fruits and vegetables Staphylococcus aureus This bacterium produces a toxin that causes vomiting shortly after ingesting; Sources: cooked foods high in protein (e.g. cooked ham, salads, bakery products, dairy products) Shigella Causes an estimated 300,000 cases of diarrhea illnesses. Poor hygiene causes Shigella to be easily passed from person to person. Sources: salads, milk and dairy products, and unclean water. SalmonellaStaphylococcus aureusShigellaSalmonellaStaphylococcus aureusShigella

Foodborne Illness  Toxoplasma gondii A parasite that causes toxoplasmosis, a very severe disease that can produce central nervous system disorders particularly mental retardation and visual impairment in children. Pregnant women and people with weakened immune systems are at higher risk; Sources: meat, primarily pork Vibrio vulnificus Causes gastroenteritis or a syndrome known as primary septicemia. People with liver diseases are especially at high risk; Sources: raw or undercooked seafood Toxoplasma gondiiVibrio vulnificusToxoplasma gondiiVibrio vulnificus  For more information on these and other foodborne pathogens, check out the "Bad Bug Book" on the World Wide Web at:

Medical Assistant Role in Infection Control  Keep medical facility clean  Reception area  Waiting areas – ill/well  Children  Exam rooms  Stocking supplies  Inspection of facility

Asepsis  A state of being free of microorganisms  Aseptic techniques include hand washing, disinfection, sanitization, sterilization, anything to prevent spread of microorganisms  Medical office NOT sterile – is clean

Routine Cleaning Tasks  What are the things in the medical office that should be monitored and attended to on a daily basis?  Name several items that should be on hand to assist in housekeeping duties in the medical office.  What benefit is there to patients and medical staff in ensuring that these things are completed regularly?

Disinfection of Body Fluids  What solution should be utilized?  How can odor be controlled? What kinds of odors might be a problem in a medical office? Be specific!  What considerations should be made when choosing a deodorant?

Waiting Areas  Describe the characteristics of an effective waiting room  Give rationale

Pediatric vs Adult Patients  Waiting room issues – compare and contrast  Describe solutions – why ?

Gloves  Non-sterile  Sterile  Latex  Non-latex  Powdered  Powder free  Sizes

Gloves  Three reasons for wearing them  When are they needed?  What kind should be worn depends upon situation  Hand washing critical before and after  Glove removal  Sterile glove procedures

Accidents  Potential problems  Reports  Liability  Prevention  Medical assistant prime person to monitor for safety issues  Signage

Disease Transmission - Prevention  Pathogens – microorganisms that cause disease  Protect yourself and your patients  Procedural safety  Lab safety  OSHA  CLIA

Disease Prevention  Personal habits that can spread disease  Nail biting  Things in mouth  Touching face  Tissues  Bathroom

Hand Washing  Remove jewelry  Warm water  Liquid soap  Paper towel  Don’t touch sink  Don’t touch faucets/handles  Nail brush  Lotion

Hand Washing  2 minutes at beginning and end of the day  20 seconds all other times  6 minutes for surgery prep  Lotion – no petroleum or oil  Minimal jewelry  No artificial nails

Lab Safety  Hand washing  Gloves  Cover breaks in skin  No eating, drinking, smoking, gum chewing, items in mouth  PPE equipment  Avoid spills

Lab Safety  Clean up spills correctly  Record test results immediately  Keep environment clutter free  Biohazard containers  Never recap or break needles  Careful with broken glass

Lab Safety  Eyewash station  Gases  Pressurized tanks  Flame  Liquid nitrogen  Disposable items