Infection Prevention
in the Workplace
USA Center for Rural Public Health Preparedness
at the
Texas A&M Health Science Center
School of Rural Public Health
Next Slide
Exit
COURSE OUTLINE
1. Disease Definitions
2. Infectious Disease Examples
3. Highlight: Influenza
3.1
3.2
3.3
3.5
What is Influenza
Types of Influenza
Transmission and symptoms
Influenza vs. Common Cold
4. Routes of Exposure
5. Types of Transmission
6. Infection Prevention in the University Setting
6.1 Watch for Signs and Symptoms
6.2 Hand Hygiene
6.3.1 Easy to Miss Spots
6.3.2 Proper Handwashing Technique
6.2.3 Alcohol-Based Waterless Hand Sanitizers
6.2.4 When to use Hand Hygiene
6.2.5 Disinfection
7. Review
INTRODUCTION
The School of Rural Public Health at the Texas A&M Health Science
Center cares about keeping employees and students healthy. No
one likes to catch a respiratory illness or other infectious disease
from someone at work.
Germs can spread rapidly in an office or other workplace setting so
it is very important to stay informed and active in protecting yourself
and others from the common cold, flu, and other infectious diseases.
We all know that simple steps like hand washing are most important
in preventing infection but sometimes it is easy to forget exactly how
to stay healthy, especially with increased stress at work and school.
This course is intended to be a reminder about how to prevent the
spread of infectious diseases and maintain a healthy environment in
the university setting.
DISEASE DEFINITIONS
Infectious Disease
a disease that is caused by microorganisms such as bacteria,
fungi, viruses, protozoa, and parasites that can successfully
spread, invade, establish, and grow within a host’s tissues
Contagious Disease
an infectious disease that is easily transmitted from one
person to another
INFECTIOUS DISEASE
EXAMPLES
Influenza
Cold
Tuberculosis
Chicken Pox
Meningitis
Severe Acute Respiratory Syndrome (SARS)
Salmonellosis and other foodborne illnesses
Human Immunodeficiency Virus (HIV)
Hepatitis A, B and C
HIGHLIGHT: INFLUENZA
What is Influenza?
An acute illness caused by the influenza virus from the family
Orthomyxoviridae, much different than the common cold virus
Highly infectious disease that can spread rapidly from person to
person through airborne droplets of saliva or other body fluids as
well as from contaminated surfaces or objects
Some strains cause more severe illnesses than others
TYPES OF INFLUENZA
There are three types of influenza that we hear about today:
Seasonal Flu – mild to severe respiratory illness caused by the
influenza virus. It is easily transmitted from human to human. Most
people have some immunity. The best protection against seasonal flu
is vaccination. 30,000 people die each year from seasonal flu.
Avian Flu (Bird Flu) – an infection caused by the avian influenza virus
that occurs naturally among birds worldwide.
Pandemic Flu – global outbreaks of a new strain of influenza. Three
pandemics occurred within the last century; the worst killed 20-40
million people worldwide. There is no way to predict what the strain
will be or to create vaccinations until it appears.
EPIDEMIC VS. PANDEMIC
Epidemic
Serious disease outbreak in a single community,
population, or region.
Example: Meningitis outbreak within a high school
Pandemic
Epidemic spreading around the world affecting hundreds
of thousands of people, across many countries.
Example: HIV/AIDS
TRANSMISSION AND SYMPTOMS
Influenza is easily passed from person to person and is transmitted through
breathing in virus containing droplets that are produced when an infected person
talks, coughs, or sneezes.
You may also spread the flu virus through touching an infected person or surface
contaminated with the virus and then touching your own or someone else’s face.
Sudden onset of symptoms include fever, headache, aching muscles, severe
weakness and respiratory symptoms, i.e. cough, sore throat, difficulty breathing.
Incubation estimates vary. The range is generally from 1 to 14 days
with most in the range of 2 to 3 days.
INFLUENZA VS. COMMON COLD
The flu and common cold are respiratory illnesses with shared symptoms but are
caused by different viruses. Influenza is a more severe illness than the common
cold.
Virus
Commonly
Responsible
Fever
Headache
Cough
Sneezing/
Stuffy
Nose
Sore
Throat
Flu
Orthomyxovirus
(infects nose,
throat, bronchial
tubes, and
sometimes lungs)
High,
quick onset,
3 – 4 days
Prominent
May linger,
generally
unproductive
Sometimes
Red and
irritated
Cold
Rhinovirus
(infects nose and
throat)
Sometimes
Rare
Hacking
Usual
Scratchy,
irritated,
not as red
http://www.tamiflu.com/consumer_recognizing.asp
EXPOSURE
Infectious diseases can be transmitted (or spread)
through four routes of exposure:
INGESTION
INHALATION
CONTACT
– DIRECT
– INDIRECT
INJECTION
ROUTES OF EXPOSURE:
INGESTION
Ingestion
Taking an infectious agent into the mouth by consuming
contaminated food or water or through hand to mouth
route.
Example: eating unwashed fruit or vegetables
ROUTES OF EXPOSURE:
INHALATION
Inhalation
Breathing in droplets of an infectious agent
Example: Invisible droplets from the cough of an
employee infected with influenza are inhaled by a
coworker
ROUTES OF EXPOSURE:
CONTACT
Contact
Direct Contact: contact of eyes, nose, mouth, genitals,
skin, cut, or other open wound with an infectious
agent or an infected person’s blood, or other body
fluid
Indirect Contact: infectious agent on inanimate object
such as a desk, keyboard, or phone is picked up and
introduced into the body
ROUTES OF EXPOSURE:
INJECTION
Injection
Introduction of an infectious agent by way of syringe or
needle stick contaminated with infected blood or body
fluid, or some other means of skin puncture
TRANSMISSION
There are three types of transmission:
Direct Transmission – Infectious agents can be spread directly from
person to person, animal to person, or through droplet transmission
(Ex: Infected person coughs or sneezes).
Indirect Transmission – Infectious diseases can be transmitted via
vector borne transmission (Ex: bite from a mosquito transmits
Malaria) or vehicle borne transmission (Ex: bacteria on a pencil is
ingested when pencil is placed to lips).
Airborne Transmission - Spread of infectious agents through tiny
aerosol particles that are smaller than droplet particles and can
remain suspended in the air for long periods of time (Ex:
Tuberculosis and Chicken Pox).
PREVENTION
MAINTAINING A CLEAN AND INFECTION FREE
ENVIRONMENT IN THE UNIVERSITY SETTING:
High traffic surfaces in a university setting can be a source of many
growing pathogens. Main areas should be cleaned when visibly
soiled and on a regular basis:
Kitchen, food preparation areas, and bathrooms should be
cleaned daily.
Spills should be cleaned up immediately.
Common or break areas should be cleaned at least weekly.
Desk, keyboard, mouse, door handles or other furniture should
be cleaned occasionally or when needed.
PREVENTION CONTINUED
Employees and students should make good choices about
personal hygiene and illness prevention.
Keep a clean living environment at home
Bathe regularly
Do not share eating utensils, glassware, or personal toilet articles
such as combs, razors, towels, or toothbrushes
Wash clothes on a regular basis
Use appropriate respiratory etiquette – cover your cough or sneeze
with a tissue, or cough or sneeze into your upper sleeve if you do not
have a tissue
Wash hands regularly
Avoid touching eyes, nose, and mouth
Practice other good health habits
Avoid close contact with people who are sick
Stay at home when you are sick
Receive flu shots when available
DO NOT BE A TRANSMITTER OF
INFECTIOUS DISEASE!
Hand hygiene is extremely important in preventing the spread
of infectious diseases.
Cleanse your hands regularly and encourage frequent
handwashing among everyone.
Wash hands using soap and water 15-20 seconds several
times a day.
Use alcohol-based waterless hand sanitizer when soap and
water are not available.
Practice good personal hygiene at work and at home.
Always follow sanitary practices when preparing food.
WATCH FOR SYMPTOMS OF
INFECTIOUS DISEASES
Fever
Chills
Extreme exhaustion
Bad cough or inflamed throat
Open sore(s)
Skin rash
Vomiting
Diarrhea
Use discretion when experiencing these or other symptoms of
sickness. It is more beneficial to stay home and recover than to
provoke symptoms further or spread disease to others.
HAND HYGIENE
EASY TO MISS
Many adults tend to minimize the importance of
handwashing but this is one of the best
defenses against the spread of infectious
disease. Using proper technique is essential to
sanitizing hands effectively. Inadequate
handwashing can cause significant areas of
the hands to be missed. It is important to cover
all areas of your fingers, hands, and wrists.
MOST FREQUENTLY MISSED AREAS
http://www.foodlink.org.uk/factfile_c.asp?file=2&chapter=2
PROPER HANDWASHING
Handwashing is the most important step to prevent the
spread of infectious agents. Proper handwashing has
three necessary ingredients:
Soap
Water
Friction
PROPER HANDWASHING TECHNIQUE
1.
2.
3.
4.
5.
6.
Wet hands with warm water
Add soap
Rub hands vigorously for at least 15-20 seconds (as
long as it takes to sing the “Happy Birthday” song
twice). Wash all surfaces: backs of hands, wrists,
between fingers, finger tips, and under fingernails.
Remember, jewelry can harbor microorganisms.
Rinse well under running water
Dry with clean towel
Use towel when turning off water and opening door
to avoid recontamination
WATERLESS ALCOHOL –
BASED HAND PRODUCTS
Use when soap and water are not available
Not effective in cleaning hands that are visibly dirty
Convenient for keeping at your work station
Apply product in the palm of one hand, rub hands
together, covering all surfaces of hands and fingers, as
when washing hands, until hands are dry
WHEN TO USE HAND HYGIENE
Before preparing, serving, handling, or eating food
After using the bathroom
After handling raw meat, poultry, or fish
After coughing, sneezing, or blowing your nose
Frequently any time you are sick
Before and after touching eyes, nose, or mouth
After handling an animal or animal waste
After handling garbage
WHEN TO USE HAND HYGIENE
Before preparing medication
Before and after treating a cut or wound
After handling unwashed clothing or bedding
Before and after providing assistance to someone ill
After working outside
Any time hands appear soiled
When you arrive at work/school, before and after going
on break, and before leaving work/school
DEFINITIONS
MICROORGANISMS - living agents such as bacteria, fungi, viruses,
protozoa, and parasites that can cause infectious diseases
CLEANING - to remove dirt
DISINFECT - to remove or destroy microorganisms
DISINFECTANT - chemical that removes or destroys
microorganisms
DETERGENT - cleaning agent that removes dirt and debris
DISINFECTION TECHNIQUE
Spray
Wipe
Spray
Air dry
RULES FOR DISINFECTION
If you are responsible for cleaning in the university
setting, or if you choose to do extra disinfecting of your
own workspace, it is important to be informed about the
correct usage of disinfectants and cleaners.
Too weak of a solution will be ineffective. A stronger
solution than is recommended is wasteful and may lead
to problems of corrosion with equipment and surfaces,
as well as health problems. Residue may also harm
feet, eyes, and other sensitive areas.
RULES FOR DISINFECTION
CONTINUED
Equipment and receptacles used with disinfectants
should be thoroughly cleaned and rinsed after use. Any
organic material present may reduce the effectiveness of
the disinfectant.
A disinfectant should have no substance other than
water added. Combination of chemicals can negate the
effect of active ingredients in products as well as
produce harmful fumes or cause corrosion.
CONCLUSION
It is vital to live a healthy lifestyle to protect against
illness. This includes eating nutritious foods,
getting enough rest, and exercising in addition to
the infection prevention and hygiene training
presented in this lesson.
REVIEW
Keeping a safe and clean environment is important in preventing the
growth and spread of infectious organisms.
The “close quarters” situation in many university settings creates a
perfect environment for the spread of infectious diseases.
An infectious disease is one that is caused by a microorganism such
as a bacterium, virus, fungus, protozoa or other parasite. Examples
include Influenza, SARS, HIV/AIDS, Chicken Pox, Meningitis, and
the common cold.
Many infectious diseases are contagious, meaning they can be
passed from human to human.
REVIEW CONTINUED
Influenza is a highly contagious disease that is spread through
droplets of saliva transmitted through coughs, sneezes, close
contact, and contaminated surfaces. Influenza exists in various
forms.
Seasonal Flu - mild to severe respiratory illness transmitted
human to human each year. The best protection against
seasonal flu is vaccination.
Avian Flu - caused by the avian Influenza (bird flu) virus that
occurs naturally among birds worldwide.
Pandemic Flu - global outbreaks of a newly emerged strain of
Influenza.
An epidemic is a serious outbreak in a single community,
population, or region. A pandemic is an epidemic that exists
worldwide, affecting people across many countries.
REVIEW CONTINUED
Infectious agents can be taken into the body through four routes of
exposure: ingestion, inhalation, contact, or injection.
There are three types of transmission: direct transmission, indirect
transmission, and airborne transmission.
Direct transmission is the spread of Infectious agents directly from
person to person, animal to person, or through droplet transmission.
Infectious agents can be spread through indirect transmission via
vector borne transmission (i.e. mosquito bite) or vehicle borne
transmission (i.e. contaminated object).
Airborne transmission is the spread of infectious agents through tiny
aerosol particles that are smaller than droplet particles and can
remain suspended in the air for long periods of time.
REVIEW CONTINUED
Clean hands are the most important step in staying free of infectious
disease.
Proper hand hygiene includes washing hands for 15 to 20 seconds
under warm running water and scrubbing in between and around
fingers, finger tips and nails, palms, backs of hands, and wrists.
Waterless alcohol-based products are effective when soap and
water are not available and hands are not visibly dirty. Hand
sanitizers work well while on the job and should be rubbed entirely
in to cover hands, fingers, and wrists in the same manner as when
washing hands.
REVIEW CONTINUED
Highly frequented areas should be routinely disinfected to reduce
lingering microbes. Employees and students should maintain good
hygiene, practice proper cough and sneeze etiquette, wash hands
frequently, and take measures to recover when ill.
Hand hygiene should be performed before eating or handling food,
after using the bathroom, after coughing, sneezing, or blowing your
nose; after handling wastes, garbage, or raw foods; and any other
time hands appear dirty or reasonably in need of cleaning.
To disinfect is to remove or destroy microorganisms such as
bacteria, fungi, viruses, protozoa, and parasites that can cause
infectious diseases.
Chemicals should always be used as described by the
manufacturer. Mixing different chemicals is ineffective and can be
very dangerous.
POST TEST
1. All of the following are examples of infectious diseases except for:
a)
b)
c)
d)
e)
Tuberculosis
HIV/AIDS
Cancer
Meningitis
Influenza
2. When is it a good idea to wash your hands?
a)
b)
c)
d)
e)
After using the bathroom
After touching your eyes or mouth
When you are sick
Before touching food
All of the above
POST TEST CONTINUED
3. True or False?
To accomplish a safer level of disinfection you should combine two
powerful cleaners such as bleach and ammonia.
4. True or False?
There has been no instance of a pandemic flu within the past two
centuries.
POST TEST CONTINUED
5. Which of the following choices is true about alcohol-based hand sanitizers
a) They are an ineffective way to reduce the spread of infection at the university.
b) They should be rubbed into hands, covering all surfaces until dry.
c) They are a better method of hand disinfection than soap and warm water.
d) They work well in removing visible dirt from hands.
e) They should be washed off with water at the sink.
POST TEST CONTINUED
6. Which area is usually cleaned most efficiently in typical routine
handwashing by adults?
a) Finger tips
b) Under finger nails
c) Back of hands
d) Between fingers
e) Palms
POST TEST CONTINUED
7) Match the following with the appropriate description:
1. INGESTION
a) Agent on inanimate object is introduced to the body by
the object
2. INHALATION
b) A pathogen is contacted, invades, and infects an open
wound
3. INDIRECT CONTACT c) Introduction of an infectious agent by way of a syringe
or some other means of skin puncture
4. INJECTION
d) Breathing in the infectious agent
5. DIRECT CONTACT
e) Consumption of an infectious agent by mouth
ANSWER KEY
1)
2)
3)
4)
5)
6)
C
E
F
F
B
E
7)
1)
2)
3)
4)
5)
E
D
A
C
B