Infection Control for Promotores
USA Center for Rural Public Health Preparedness at
Texas A&M Health Science Center
School of Rural Public Health
Welcome!
Germs can spread rapidly in a community, so staying informed
and active to protect yourself and the community from infectious
diseases is essential. Increased awareness will minimize the risk
of infection, prevent disease transmission, and preserve a healthy
and safe environment.
The USA Center for Rural Public Health Preparedness at Texas
A&M Health Science Center School of Rural Public Health
designed this train-the-trainer activity for promotores. It provides
information , ideas, and learning activities for the promotores on
how to prevent the spread of infection and keep their communities
healthy.
OBJECTIVES
Explain how infectious diseases are spread
Provide basic information about common infectious
diseases.
Describe basic methods to prevent the spread of
disease
What is an Infectious Disease?
Infection
– An infection occurs when microorganisms, or germs,
enter and multiply in the body.
Infectious Disease
– An infectious disease occurs when the infection
damages the body and produces signs and symptoms
indicating the body is unhealthy.
Infectious Agent
– Infectious agents are microorganisms such as bacteria,
fungi, viruses, protozoa, and parasites that can cause
infectious disease.
www.mayoclinic.com/health/infectious-disease/ID0004
Examples of Infectious Diseases
Common Cold
Influenza
Meningitis
Chickenpox
Staph / Methicillin-resistant Staphylococcus aureus (MRSA)
Tuberculosis
Severe Acute Respiratory Syndrome (SARS)
Head lice
Rabies
Salmonellosis
Chlamydia
Human Immunodeficiency Virus (HIV)
Hepatitis A, B, and C
www.go.mb.ca/health/publichealth/cdc/fs/infcontshelter.pdf
How Are Infectious Diseases Spread?
Understanding how infectious diseases are spread
is important for minimizing the risk of infection and
preventing disease transmission.
Three ways in which infectious diseases
can be transmitted:
Direct transmission
Indirect transmission
Airborne transmission
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Direct Transmission
Direct transmission occurs when an
infectious agent is transferred directly into
the body such as through the eyes, nose,
mouth, or through a break in the skin such
as a cut on the finger.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Direct Transmission
Infectious agents are spread directly in the following ways:
Person-to-person
– through physical contact including touching, biting, hugging, or kissing
– Example: MRSA, Hepatitis
Animal-to-person
– through physical contact, bites, and scratches
– Example: Ringworm, Rabies
Infectious droplets
– during coughing, sneezing, talking, singing, and spitting
(spread is limited to approximately three feet)
– Example: Cold, Influenza
Direct Transmission
Person-to-person- Hepatitis:
What is hepatitis?
How do we become infected?
What are the symptoms?
Hepatitis
Hepatitis is a viral disease causing inflammation
of the liver.
Exposure to infected blood (dirty needles) or
unprotected sexual intercourse.
Symptoms: Nausea, vomiting , fever, jaundice
Direct Transmission
Animal to person : Rabies
What is rabies?
How do we become infected?
What are the symptoms?
Rabies
Rabies is a viral infection producing an acute
illness affecting the central nervous system.
Transmission: Dogs infected by wildlife ( skunks,
squirrels, raccoons or rats)
Symptoms: Seizures, paralysis, death
Direct Transmission
Infectious droplets: Cold
What is a cold?
How do we become infected with a cold?
What are the symptoms?
Cold
A cold is a common upper respiratory infection.
Transmission: a virus is transmitted through the
droplets by coughing
Symptoms: cough, runny nose, and sometimes
sore throat
Indirect Transmission
Infectious diseases are spread indirectly through vehicles and vectors.
Vehicle-borne transmission:
– Some infectious agents can linger on inanimate objects, such as desks, chairs,
computer keyboards, doorknobs, faucets, toys, eating utensils, or clothing.
– Example: Touching a pencil used by a person infected with the flu and then
touching the eyes, nose, or mouth before performing hand hygiene.
– Other vehicles include food, water, and biological products such as blood and
body fluids.
– Example: Eating peanut butter contaminated with Salmonella, or pepperoni
contaminated with E. coli.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Indirect Transmission
Infectious diseases are spread indirectly through vehicles and vectors.
Vehicle-borne transmission: Salmonellosis
What is Salmonellosis?
How do we become infected with Salmonella?
What are the symptoms?
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Salmonellosis
Salmonellosis is an intestinal infection caused by
bacteria.
Transmission: contaminated food or drinking water
Symptoms: Diarrhea, abdominal cramps & fever
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Indirect Transmission
Infectious diseases are spread indirectly through vehicles and vectors.
Vector-borne transmission
– Common vectors: insects, such as mosquitoes, ticks,
and lice.
– Example: Becoming infected with West Nile Virus
as a result of being bitten by an infected mosquito,.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Indirect Transmission
Infectious diseases are also spread indirectly through vectors.
Vector-borne transmission: West Nile Virus
What is the West Nile Virus?
How do become infected with West Nile?
What are the symptoms?
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
West Nile Virus
West Nile Virus is a viral disease infecting the brain and
nervous system resulting in meningitis or encephalitis.
Transmission: by mosquitoes feeding on infected birds
Symptoms: fever, severe headache, convulsions, coma
& death
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Airborne Transmission
Airborne transmission:
 Spread of infectious agents as aerosols that
usually enter the respiratory tract
 Tiny particles have the ability to remain
suspended in the air for long periods of time and
travel long distances.
Ex: Tuberculosis, chicken pox, and measles
An individual can become infected with TB by inhaling
infectious airborne particles while on a crowded bus.
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Airborne Transmission
Airborne transmission: Tuberculosis
What is tuberculosis (TB)?
How do we become infected with TB?
What are the symptoms?
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Tuberculosis
Tuberculosis (TB) is a lung disease caused
by bacteria.
Transmission: sputum droplets by coughing
Symptoms: fever, night sweats, weight loss,
and chronic cough
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
Promotora’s Role in Identifying
Infectious Diseases
Does the promotora have a responsibility to the
community when an infectious disease is identified?
How can we identify an infectious disease?
How can we prevent the spread of this disease?
www.cdc.gov/ncidod/dvrd/spb/mnpages/glossary.htm
PREVENTION
Hand Hygiene
Disinfection
Communication
Importance of Hand Hygiene
Hand hygiene includes:
Hand washing
Hand sanitizer
Hand washing is the single most important practice to
prevent the spread of infectious disease
www.cdc.gov/cleanhands
Hand Washing
Three necessary components of proper
hand washing include:
Soap
Clean water
Friction
www.cdc.gov/cleanhands/
Proper Hand Washing Technique
1.
2.
3.
4.
5.
6.
7.
Wet hands with clean warm water.
Apply soap and rub hands together to create a lather.
Scrub all surfaces of the hands including the palms, back of
hands, wrists, between fingers, and under fingernails.
Continue washing hands for 20 seconds, about the time it
takes to sing the “Happy Birthday” song twice.
Rinse hands well to remove all soap.
Dry hands completely with a towel or air dryer.
If available, use a towel to turn off the faucet and open the
door to avoid recontamination.
www.cdc.gov/cleanhands/
Easy to Miss Areas
Proper technique is :
Essential to sanitize hands effectively
Inadequate or insufficient hand washing
causes significant areas of the hands to be
missed: fingers, hands, and wrists
www.foodlink.org.uk/factfile_c.asp?file=2&chapter=2 /
Frequently Missed Areas
www.foodlink.org.uk/factfile_c.asp?file=2&chapter=2 /
When to Wash Hands
After blowing the nose, sneezing, or coughing
After going to the bathroom
After contact with blood or body fluids, such as saliva, nasal
secretions, urine, feces, or vomit (changing diaper)
After handling garbage or waste
When hands appear soiled
Before preparing medicine or handling contact lenses
www.cdc.gov/cleanhands/
When to Wash Hands (2)
Before preparing, serving, or handling food
Before eating lunch or snacks
When sick or after contact with others who are sick
Before and after touching a cut or wound
Before and after touching the eyes, nose, or mouth
After handling animals, animal waste, or their belongings,
such as toys or a leash
www.cdc.gov/cleanhands/
Waterless Alcohol-based
Hand Sanitizer
When to Use
–
–
–
–
–
Substitute when soap and water are not available.
Ineffective for cleaning hands that are visibly dirty.
Do not substitute when handling or preparing food.
Do not overuse; traditional hand washing is best.
Supervise children while they use hand sanitizer.
Two necessary components
– Alcohol-based hand sanitizer
– Friction
www.health.state.mn.us/handhygiene/clean.html
Waterless Alcohol-based
Hand Sanitizer Continued
Proper Technique
 Apply small amount of hand sanitizer to the palm.
 Rub hands together covering all surfaces, much
like when washing hands with soap and water.
 Rub until hand sanitizer is absorbed completely
and hands become dry.
www.health.state.mn.us/handhygiene/clean.html
Hand Washing & Absenteeism
Am J Infect Control 2002; 28: 340-6
“A study of 305 school children found
that those who washed their hands
four times a day had 24% fewer sick
days due to respiratory illness and
51% fewer sick days due to upset
stomach.”
www.cdc.gov
Hand Washing Activity Ideas
Practice washing hands properly with children. Have
them sing the “HAPPY BIRTHDAY” song twice to
demonstrate 20 seconds.
Post hand washing facts in bathroom stalls
For younger kids, place posters in restrooms
illustrating children washing hands to encourage hand
hygiene.
DISINFECTION
DEFINITIONS
Cleaning - to remove dirt
Disinfect - to remove or destroy many of the
organisms that causes infectious diseases
DISINFECTION
SPRAY
WIPE
SPRAY
AIR DRY
CLEANING & DISINFECTING
Systemize approach
Work from top to
bottom
From back to front
PRECAUTIONS FOR
DISINFECTION
Wear protective clothing when
recommended by the
manufacturer and take care to
avoid skin contact.
Wash hands thoroughly after
use.
Use correct concentration.
RULES FOR DISINFECTION
Use at the chemical’s optimum
temperature for action.
Using very hot water can be dangerous. If
it spills or splashes, it can injure the
operator.
Contact time is important. Use according
to manufacturer’s recommendation.
Make up fresh solutions to ensure
effectiveness.
RULES FOR DISINFECTION
A disinfectant should have no substance other
than water added.
Combination of chemicals can negate the effect of
the active ingredients in products as well as
producing unhealthy fumes or causing corrosion.
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.
General Infection Prevention
Follow general infection prevention measures and maintain
personal hygiene to reduce the spread of infectious
diseases.
Encourage everyone to wash hands frequently using soap
and water for 15-20 seconds
Substitute alcohol-based hand sanitizer when clean water
and soap are unavailable.
Promote appropriate respiratory etiquette: Cover coughs and
sneezes with tissue. Throw away tissues immediately and
use hand hygiene. If a tissue is not available, sneeze or
cough into the elbow or upper sleeve.
General Infection Prevention (2)
Remain at home when ill and encourage others to do the
same.
Avoid close contact (less than 3 feet of space) with those
who are sick.
Maintain and promote good personal hygiene; bathe and
wash hands regularly.
Discourage touching the eyes, nose, and mouth.
Ensure commonly used areas such as door handles, eating
surfaces, and desks are clean and disinfected.
General Infection Prevention (3)
Keep open wounds clean and covered with a bandage until
healed.
Avoid contact with other people’s wounds and bandages.
Discourage sharing eating utensils, glassware, or personal
items such as toothbrushes, combs, razors, towels, clothing
or other items that come into contact with bare skin.
Clean shared sports equipment with antiseptic before each
use
Avoid skin-to-skin contact with anyone who has a Staph
infection.
Encourage a healthy lifestyle that includes a nutritious diet
and adequate sleep.
Additional Considerations
When handling animals, it is important to keep in mind the risks
of Zoonotic Diseases, or those that are transmissible from
animals to humans.
The following considerations are important when dealing with
animals :
– Always wash hands very thoroughly after touching animals or their
belongings
– Ensure animals have current vaccinations and receive annual veterinary
exams
– Bathe animals regularly
– Avoid contact with animal waste or food
– Only handle a new animal with permission and supervision
COMMUNICATION
Awareness is important in
the prevention of
transmission of infectious
organisms to others.
Notify others:
– if any special precautions or
instructions are necessary
– In case of emergency, call
supervisor or 911
Fun Online Resources
The following are additional informative internet links
providing more resources to teach children about infection
prevention, including online games that students can explore
in the classroom or at home.
FIGHT BAC! Animated bacteria fighting games
http://www.fooddetectives.org/
CLEAN HANDS COALITION Hand washing resources
http://cleaning101.com/files/Clean_Hands_Flyer_2.pdf
LATHER UP FOR GOOD HEALTH! Activities by SOFTSOAP
http://www.colgate.com/app/LatherUpForGoodHealth/us/HomePage.cvsp
Additional Activities & Material
Please take a moment to explore the following online resources for
helpful teaching materials about infection prevention.
HANDWASHING PROJECT IDEAS
http://www.kdheks.gov/wash_em/teach_module/wash_em_teachers_module.pdf
THE WORLD OF GERMS Hand hygiene activities for kids
http://toys.about.com/b/2007/08/13/the-world-of-germs.htm
HAND HYGIENE EXPERIMENT
http://www.bam.gov/teachers/activities/epi_4_hand_wash.pdf
“CROSSGERMS” CROSSWORD PUZZLE”
http://www.lysol.com/germ-information-center/resources/
The End
This concludes the train-the-trainer activity,
“Infection Control for Promotores.” We hope
you have enjoyed this presentation and will
utilize and share this information with your
communities to help everyone keep healthy and
prevent the spread of infection.
Contact Information
USA Center for Rural Public Health Preparedness
Texas A&M Health Science Center
School of Rural Public Health
1266 TAMU
College Station, Texas 77843-1266
Phone: (979) 845-2387
E-mail: USACenter@srph.tamhsc.edu
The CDC-funded Centers for Public Health Preparedness are a
national network of academic institutions working in collaboration
with state and local public health departments and other community
partners to provide life-long learning opportunities to the public
health workforce in order to handle the next public health crisis.