Warm-up Questions What is a Pathogen? List the 5 Pathogens. Mononucleosis, Common Cold, and Ebola are examples of what? Athlete’s Foot, Ringworm, and Jock Itch are example of what? Ticks are linked to what type of Pathogen?

Communicable Disease Basics

Objectives Describe three ways infectious agents can be transmitted Describe at least three ways to decrease risk of infections in public settings List three examples of common infectious diseases and how to reduce risk of infection

Chain of Infection

Chain of Infection Model used to understand the infection process Each link represents step in transmission of infection Each link has to be present and in order for an infection to occur

1 - The Infectious Agent -any disease causing microorganism (pathogen)

Infectious agents are: Bacterial Viral Fungal Parasitic

2 - The Reservoir -Where a microorganism normally lives and reproduces

Examples of reservoirs: Humans Animals Water Food

3 - The Portal of Exit -route of escape of the pathogen from the reservoir.

Examples of portals of exit: Flu or cold - mucous secretions West Nile Virus - when the mosquito bites and feeds on the bird’s blood Hepatitis A - stool SARS - droplet, contact

4 - The Route of Transmission (Spread) -the way the pathogen gets from the reservoir to the new host

Transmission: Respiratory Droplets From respiratory tract (i.e., nose, mouth) secretions of infected person E.g. cough, sneeze Do not circulate in air for long time or travel far (mostly < 3 feet) Many diseases spread by respiratory droplets; e.g. flu, cold, pertussis, SARS Can spread germs directly or indirectly

Agent is coughed or sneezed out into the air Droplet Transmission Agent is coughed or sneezed out into the air and floats on droplets

Direct Spread by Droplets Close contact with infected person (<3 ft) Infected person coughs, sneezes, talks, sings Droplets land directly on mucous membranes (eyes, nose, mouth) of susceptible person

Indirect Spread by Droplets Droplets with the infectious agent land on a table, doorknob etc.

Indirect Spread by Droplets Someone touches contaminated object

Indirect Spread by Droplets Touch nose, mouth, eyes with contaminated hand

Airborne Transmission Germs stay suspended in air on small particles Uncommon method of transmission Only occurs for certain germs, such as tuberculosis Less commonly for flu, SARS

Airborne - This Needs to be Breathed in to be Infectious

Other Methods of Transmission Food/water/hands contaminated with stool from infected person; e.g., norovirus Blood exposures, sexual contact a.k.a. blood-borne; e.g. HIV, hepatitis B and C Vector-borne E.g. Mosquitoes and West Nile virus, malaria Unlikely methods of spread in courtroom

5 - The Portal of Entry -route through which the pathogen enters its new host

Respiratory System Inhale germs

Breaks in Protective Skin Barrier Other Portals of Entry Sexual contact Ingestion Breaks in Protective Skin Barrier

6 - The Susceptible Host -A person who can get sick when they are exposed to a disease causing pathogen. . I love wesley he penis is huge

How to Break the Chain of Infection

What Is the Purpose of Respiratory Hygiene? To reduce the transmission of airborne diseases

Hand Hygiene Wash hands frequently with soap and warm water for at least 20 seconds Alcohol hand gels

Use gloves where contact with body secretions and excretions is taking place

Cover Your Cough!

Cough Etiquette Limit close contact (<3 feet) with coughing clients Cover cough/sneeze with tissue Offer mask to coughing clients

Keep a clean environment Clean contaminated surfaces with commercial germicidal cleanser or wipes

Maintain vaccinations for employees Flu shot- every year for age >50 and high-risk groups Tetanus shot every 10 years Hepatitis B for persons who may contact objects contaminated with blood Pneumovax (“pneumonia” vaccine) for age ≥65 Hepatitis A NOTE: MORE DETAILS ON FLU RECS LATER

What Are Some of the Airborne Diseases of Concern? Pertussis Tuberculosis Influenza Common colds

Pertussis (Whooping Cough) Droplet and contact transmission Runny nose and prolonged severe cough A bacterial infection Most dangerous for babies Vaccine preventable for children aged 7 and under

Tuberculosis Agent Caused by bacterium, Mycobacterium tuberculosis Reservoir Humans

TB in King County

Latent TB Infection vs. Active TB Disease

Latent TB Infection Person infected with TB bacteria Bacteria kept dormant by person’s immune system Not sick or contagious 10% develop TB disease over life time Infection detected by TB skin test

TB Skin Test (PPD)

Active TB Disease Usually involves lung infection Cough >3 weeks, fevers, weight loss, night sweats Can cause serious illness but is treatable with antibiotics Contagious until appropriately treated

Preventing Spread of TB Patients with TB disease should delay court appearance until appropriate duration of therapy Patients with active TB are no longer contagious after 2-3 weeks of appropriate therapy should be cleared by doctor

Influenza (Flu) Agent Virus Reservoir Humans Animals (e.g. birds, pigs) Generally different strains

Flu Transmission: Respiratory Droplets Direct: Close contact (<3 feet) Droplets from cough/sneeze enter mouth, nose, eyes of susceptible person Indirect: Contaminated surfaces Cases peak each winter in U.S.

How Do I Protect Myself From the Flu? Flu Vaccine Recommended for: Persons >50 years old Anyone with a chronic illness, such as asthma or diabetes Children age 6-23 months Women who will be pregnant during flu season

Habits for Good Health Avoid close contact with people who are sick Stay home when sick Cover mouth/nose with tissue when coughing/sneezing Avoid touching nose, mouth, eyes Wash hands often with soap/water or alcohol rub

What Can You Do to Reduce Your Chances of Getting Sick? Encourage coughing clients to wash their hands (or use alcohol hand rub) Wash your own hands frequently Wipe down counters, pens, phones, computer keyboards, etc. with disinfectant cleaner as needed Cough etiquette- cover with tissue Offer mask to coughing clients

Recommendations Staff and clients should have access to: Hand washing facilities Tissues Trash cans for disposing of tissues Consider having alcohol hand rub available

QUESTIONS???