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Infection control and prevention - transmission-based precautions

Infection control principles and practices for local public health agencies

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Transmission-based precautions

Transmission-based precautions are used in addition to standard precautions when use of standard precautions alone does not fully prevent communicable disease transmission. There are three types of transmission-based precautions--contact, droplet, and airborne - the type used depends on the mode of transmission of a specific disease. Some diseases require more than one type of transmission-based precaution (e.g. SARS, which requires airborne and contact precautions as well as eye protection with all client contact).

  • Contact Precautions
    • Use the following measure in addition to standard precautions when in contact with individuals known or suspected of having diseases spread by direct or indirect contact (examples include norovirus, rotavirus, draining abscesses, head lice).
    • Wear gloves and gown when in contact with the individual, surfaces, or objects within his/her environment.
    • All re-usable items taken into an exam room or home should be cleaned and disinfected before removed. Disposable items should be discarded at point of use.
  • Droplet Precautions
    • In addition to standard precautions, wear a surgical mask when within 3 feet (6 feet for smallpox) of persons known or suspected of having diseases spread by droplets (examples include influenza, pertussis, meningococcal disease).
  • Airborne Precautions
    • Use the following measures in addition to standard precautions when in contact with individuals known or suspected to have diseases spread by fine particles dispersed by air currents (examples include tuberculosis, measles, and SARS).
    • Put on a NIOSH-certified fit-tested N-95 respirator just before entry to an area of shared air space and wear at all times while in the area of shared air space. Remove and discard respirator just after exiting area. The respirator may be discarded into the regular trash unless contact precautions must also be followed. In this case, place the respirator in a plastic zip-lock bag, seal and then discard into the trash. A powered air-purifying respirator (PAPR) may also be used (see PPE section).
    • If available, portable high efficiency particulate air (HEPA) filtration units may be operated in the area where the infected individual is located to filter out infectious particles. (Use of such a unit does NOT eliminate the need for employees to wear respiratory protection).
  • Eye Protection
    • If eye protection is indicated, wear goggles or a face shield during ALL contact with the individual, not just when splashes or sprays are anticipated, as with standard precautions.

Additional resources

Isolation Precautions CDC Guidelines (Exit DHS)

Contacts

Gwen Borlaug, Infection Control Epidemiologist
Wisconsin Division of Public Health 
Bureau of Communicable Diseases and Emergency Response
(Phone 608-267-7711)  (Fax 608-261-4976)

Last Revised: August 05, 2014