1. Infection Control in the School Setting It’s In Your Hands

2. What is an Infection? A condition resulting from the presence of, and invasion by, germs A condition resulting from the presence of, and invasion by, germs (microorganisms) (microorganisms)

3. For Infection to Occur an Organism Must: enter the body enter the body grow and multiply grow and multiply cause a response cause a response

4. Routes of Transmission Contact: Contact: 1. direct 2. indirect 3. droplet (3 feet)

5. Routes of Transmission Vehicle Vehicle Airborne Airborne Vector Vector

6. Chain of Infection

7. Handwashing (Hand Hygiene) The most important measure you can use to prevent the spread of infection. The most important measure you can use to prevent the spread of infection.

8. Hand Hygiene Guidelines

9. Hand Hygiene When hands are visibly soiled with blood or other body fluids: Wash hands with either a non- antimicrobial soap and water ….. OR When hands are visibly soiled with blood or other body fluids: Wash hands with either a non- antimicrobial soap and water ….. OR An antimicrobial soap and water An antimicrobial soap and water

10. Hand Hygiene If hands are not visibly soiled: If hands are not visibly soiled: Use an alcohol- based hand rub for routinely decontaminating hands.

11. Handwashing Procedure Wet hands. Wet hands. Apply soap. Apply soap. Rub hands together producing friction. Rub hands together producing friction. Wash between fingers, tops of hands, and around jewelry. Wash between fingers, tops of hands, and around jewelry. Wash for at least 15 seconds. Wash for at least 15 seconds. Rinse hands well. Rinse hands well. Dry hands with a paper towel then use the towel to turn off faucet. Dry hands with a paper towel then use the towel to turn off faucet.

12. Handwashing ….. The #1 way to prevent the spread of germs. The #1 way to prevent the spread of germs.

13. Bloodborne Pathogens Bloodborne pathogens are bacteria or viruses that are present in human blood and body fluids and can be transmitted to other humans. Bloodborne pathogens are bacteria or viruses that are present in human blood and body fluids and can be transmitted to other humans. The most common bloodborne pathogens are: The most common bloodborne pathogens are: 1. Human Immunodeficiency Virus (HIV) 2. Hepatitis B Virus (HBV) 3. Hepatitis C Virus (HCV)

14. Bloodborne Pathogen Transmission Sexually Sexually From mother-to-newborn at birth From mother-to-newborn at birth Sharing of needles or other sharps Sharing of needles or other sharps Accidental needlestick/cut/bite Accidental needlestick/cut/bite (infected person to non-infected person) (infected person to non-infected person) Blood transfusions (in the past) Blood transfusions (in the past)

15. HIV The virus which causes the acquired immunodeficiency syndrome (AIDS) The virus which causes the acquired immunodeficiency syndrome (AIDS) HIV attacks the body’s immune system, weakening it so that it cannot fight other deadly diseases. HIV attacks the body’s immune system, weakening it so that it cannot fight other deadly diseases.

16. HIV The virus is very fragile and will not live very long outside of the human body. The virus is very fragile and will not live very long outside of the human body. There is no cure for AIDS although there are various There is no cure for AIDS although there are various anti-viral medications to prolong life. anti-viral medications to prolong life. AIDS is a fatal disease. AIDS is a fatal disease.

17. Hepatitis B Virus (HBV) Hepatitis means “inflammation of the liver”. Hepatitis means “inflammation of the liver”. Hepatitis B is a virus that infects the liver. Hepatitis B is a virus that infects the liver. In the U.S., approximately 300,000 people are infected annually. In the U.S., approximately 300,000 people are infected annually.

18. Hepatitis B Virus Disease

19. HBV Is a very durable virus and can survive outside of the body for at least 7 days. Is a very durable virus and can survive outside of the body for at least 7 days. It is very important to clean up any blood or body fluid spills. It is very important to clean up any blood or body fluid spills. (Can use a 1:10 bleach solution – which is 1 part household bleach to 9 parts water.) (Can use a 1:10 bleach solution – which is 1 part household bleach to 9 parts water.)

20. Hepatitis B Vaccine To prevent hepatitis B. To prevent hepatitis B. A 3-dose vaccine series given at A 3-dose vaccine series given at 0, 1, 6 months intervals. 0, 1, 6 months intervals. 96% of people who take the vaccine will develop antibody (protection) against the hepatitis B virus. 96% of people who take the vaccine will develop antibody (protection) against the hepatitis B virus.

21. Hepatitis C Virus (HCV): “The Silent Epidemic” Another cause of viral hepatitis. Another cause of viral hepatitis. It is usually slow-spreading and silent, but lasts a long time. It is usually slow-spreading and silent, but lasts a long time. It is one of the major causes of cirrhosis in the U.S. It is one of the major causes of cirrhosis in the U.S. It is a major cause of liver cancer worldwide. It is a major cause of liver cancer worldwide.

22. HCV Disease Approximately 8-12,000 people die annually from hepatitis C-related disease. Approximately 8-12,000 people die annually from hepatitis C-related disease. There is no vaccine for HCV. There is no vaccine for HCV. Anti-viral medications are available for treatment for some HCV-infected persons. Anti-viral medications are available for treatment for some HCV-infected persons.

23. MRSA First recognized in 1961- one year after the antibiotic Methicillin was introduced for treating S. Aureaus infections. First recognized in 1961- one year after the antibiotic Methicillin was introduced for treating S. Aureaus infections. Methicillin Resistant Staphylococcus Aureaus- a type of bacteria not killed by common antibiotics including penicillin and cephalosporins (i.e. Amoxil and Keflex ) Methicillin Resistant Staphylococcus Aureaus- a type of bacteria not killed by common antibiotics including penicillin and cephalosporins (i.e. Amoxil and Keflex )

24. MRSA Colonization-the microorganism is living in or on the body without causing disease or harm Colonization-the microorganism is living in or on the body without causing disease or harm Infection- the body is invaded by a microorganism, the organism multiplies and causes injury or illness Infection- the body is invaded by a microorganism, the organism multiplies and causes injury or illness

25. MRSA Most infections caused by S. Aureus are skin and soft tissue infections Most infections caused by S. Aureus are skin and soft tissue infections MRSA is being seen in increasing numbers among healthy persons of all ages MRSA is being seen in increasing numbers among healthy persons of all ages This is referred to as Community Acquired MRSA This is referred to as Community Acquired MRSA

26. Signs and Symptoms Fever Local Swelling, redness, heat Painful lesion or pimple with or without drainage Boil- tender red lump with a white “head ”

27. BOIL

28. CELLULITIS

29. MRSA S. Aureus is most often spread to others by contaminated hands S. Aureus is most often spread to others by contaminated hands Touching skin, wounds, sharing towels, athletic equipment and other personal items Touching skin, wounds, sharing towels, athletic equipment and other personal items

30. MRSA Prevention Prevention Handwashing Handwashing Good personal hygiene Good personal hygiene Regularly clean commonly touched surfaces, such as door knobs, bathrooms, nap mats, etc., with any EPA approved disinfectant. Regularly clean commonly touched surfaces, such as door knobs, bathrooms, nap mats, etc., with any EPA approved disinfectant. Cheapest and very good disinfectant is household bleach and water in a 1:9 solution Cheapest and very good disinfectant is household bleach and water in a 1:9 solution (1 Tbsp. bleach to 1 quart of water mixed fresh daily).

31. MRSA Prevention (continued) Prevention (continued) Clean toys and classroom items at least daily and anytime they become soiled Clean toys and classroom items at least daily and anytime they become soiled Wash any cuts, scrapes, lesions, insect bites and sores with soap and water Wash any cuts, scrapes, lesions, insect bites and sores with soap and water Keep lesions clean and dry and cover them with bandages until they are healed. If drainage cannot be contained by a dressing, student should be excluded from class until healed or drainage decreases. Keep lesions clean and dry and cover them with bandages until they are healed. If drainage cannot be contained by a dressing, student should be excluded from class until healed or drainage decreases.

32. MRSA Use a barrier between skin and shared equipment e.g. exercise machines and massage tables Use a barrier between skin and shared equipment e.g. exercise machines and massage tables If you change a dressing WEAR GLOVES, dispose of dressing in a ziplock baggie and discard. Wash hands after removing gloves. If you change a dressing WEAR GLOVES, dispose of dressing in a ziplock baggie and discard. Wash hands after removing gloves. HANDWASHING IS YOUR BEST DEFENSE AGAINST INFECTIONS HANDWASHING IS YOUR BEST DEFENSE AGAINST INFECTIONS

33. Standard Precautions Consider the blood and body fluids of everyone to be potentially infectious. Consider the blood and body fluids of everyone to be potentially infectious.

34. Do not: Share razors, toothbrushes, eating utensils and drinking containers with other people. Share razors, toothbrushes, eating utensils and drinking containers with other people. Share needles or other sharps with others. Share needles or other sharps with others.

35. Do: Be careful when providing first aid or dressing the wounds of others. Be careful when providing first aid or dressing the wounds of others. Always keep sores or open wounds covered with band aid or dressing. Always keep sores or open wounds covered with band aid or dressing.

36. Do: Always immediately clean up any spills of blood or body fluids (wear gloves). Always immediately clean up any spills of blood or body fluids (wear gloves). Always carefully clean household when someone is ill in the home. Always carefully clean household when someone is ill in the home.

37. Tuberculosis (TB) A disease transmitted from person-to-person through the air when an infected person repeatedly comes in contact with an uninfected person. A disease transmitted from person-to-person through the air when an infected person repeatedly comes in contact with an uninfected person. TB usually affects the lungs, but may attack almost any part of the body. TB usually affects the lungs, but may attack almost any part of the body.

38. Tuberculosis (TB)

39. Tuberculosis Symptoms General Symptoms: General Symptoms: 1. Weight loss 2. Weakness 3. Fever and/or Night Sweats TB of the Lung: TB of the Lung: 1. Cough 2. Chest pain 3. Coughing up blood

40. TB Skin Testing

41. TB Infection vs. TB Disease TB Infection: TB Infection: 1. Germs in body, but not sick and no symptoms. 2. Skin test is usually positive. 3. Most people (90%) do not develop disease. TB Disease: TB Disease: 1. Person is sick, has symptoms, and can spread disease to others. 2. Treatment is needed in order to get well.

42. Respiratory Hygiene

43. Cover the nose/mouth when coughing or sneezing; Cover the nose/mouth when coughing or sneezing; Use tissues to contain respiratory secretions & dispose of them in the nearest waste receptacle after use; Use tissues to contain respiratory secretions & dispose of them in the nearest waste receptacle after use; Perform hand hygiene after having contact with respiratory secretions & contaminated objects/materials. Perform hand hygiene after having contact with respiratory secretions & contaminated objects/materials.

44. Antibiotic Use Antibiotics are for treatment of bacteria – not viruses. Antibiotics are for treatment of bacteria – not viruses. Always take the antibiotic exactly as prescribed. Always take the antibiotic exactly as prescribed. Do not save antibiotics for “next time”. Do not save antibiotics for “next time”. Do not share antibiotics with others. Do not share antibiotics with others.

45. Employee Health Practice good personal hygiene. Practice good personal hygiene. Be sure you are up-to-date on all of your immunizations. Be sure you are up-to-date on all of your immunizations. Seriously consider taking the influenza vaccine annually. Seriously consider taking the influenza vaccine annually. Do not come to work when you are sick. Do not come to work when you are sick. Practice good handwashing! Practice good handwashing!