Transcript Infection Control - women's and children's hospital adelaide

Paediatric Infection Control
Jodie Burr
Infection Control Coordinator
Women’s and Children’s Hospital
IC Issues specific to
children
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Communicable diseases affect a
higher % of children than adults
 Developmental
immunity (increased
susceptibility) - acquire – spread
IC Issues specific to
children
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Child care staff are at a greater
risk for exposure to communicable
diseases - immune status
 Type
and amount of physical contact (eg
feeding, diapering)
IC Issues specific to
children
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May lack the mental / physical
ability to adhere to IC principles
 lack
of hygiene
 unable to understand / comply with IC
principles
IC Issues specific to
children
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More likely to have contact with
contaminated environmental
surfaces and objects
IC Issues specific to
children
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Parents and siblings
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have the same infectious agent
 education about transmission and IC
principles
Spread of Infection
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Sources of infections
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The host’s own (endogenous) flora
The hand’s of child care workers
Inanimate objects (fomites)
After being exposed to an
infectious agent:
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Some people already have immunity and
therefore don’t develop an infection
Some people become asymptomatic carriers
Other people develop clinical disease (ie
infection)
Spread of Infection
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The Susceptible Host
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Varies with age
Underlying medical conditions
Nutritional status
Drug therapy
Trauma
Surgical procedures
Invasive or indwelling devices
Therapeutic and diagnostic procedures
Spread of Infection
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3 main routes of transmission
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Contact
 Direct / Indirect
 Most frequent means of transmission
Droplet
 Generated during coughing, sneezing,
talking
Airborne
 Generated by coughing, sneezing, OR by,
OR by air currents
Standard Precautions
Apply
to:
Blood
Non-intact
skin
Mucus membranes
All body fluids (including sweat)
Regardless
of whether there is
visible blood or body fluids
Standard Precautions
Hand Washing
The single most effective
method in the prevention
of disease transmission is
to wash your hands well
Hand Washing
How to wash your hands
Use soap and running water
 Rub hands together (count to 10)
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Wash all over, including:
 Backs
of hands
 Wrists
 Fingers, nails and thumbs
Rinse hands well (count to 10)
 Dry hands thoroughly
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Areas most frequently
missed
When to wash hands
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When you arrive at the centre
Before handling food
Before eating
After changing nappies
\after going to the toilet
After cleaning up, coming onto contact
with faeces or vomit or other body
fluids
After wiping noses (either your own or
a childs)
Specific childcare issues
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Nappy change area:
Have a specific area for nappy
changing
 Clean nappy change area after each
nappy change
 Wear gloves
 Wash hands afterwards
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Linen
Use hot water and detergent
 Wear gloves if linen soiled
 Ensure clean linen is stored away from
soiled linen
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Specific childcare issues
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Toys
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Sandpits
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All shared toys should be able to be washed
Keep well maintained and clean
Ensure good drainage, rake often , cover
Dispose of any soiling (blood, faeces, etc)
Blood / body fluid spills
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Wear gloves
Detergent & water +/- bleach
Dispose of soiled articles or place in
waterproof bag for parents to take home
Food
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Ensure that tables and area are
clean
Wash your own and the children’s
hands
Do not share food, plates, eating
utensils
Serve food rather than use a
communal dish
Use a separate spoon for each baby
fed
Handling food
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Wash hands
Keep raw food separate from cooked
foods
Use different utensils for raw and
cooked foods
Keep food hot or cold (do not keep food
warm for a period of time)
Reheat food and bottles only once
Throw out left overs
Infectious diseases
Be aware of symptoms suggesting
infection
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Severe, persistent, prolonged coughing
Conjunctivitis
Unusual spots or rashes
Crusty or discharging skin lesions
Frequent scratching
Unusually coloured / smelly faeces or urine
Sore throat / difficulty in swallowing
Vomiting. Headache, stiff neck
Loss of appetite
Diarrhoea
Infectious diseases
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Have a written policy regarding
what to do if a child is unwell, may
include:
Notify director and parents
 Separate ill child
 Take the child’s temperature
 Encourage parents to inform staff if
a family member is ill
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Infectious diseases and
staff
Most infectious diseases can be
prevented by good hand washing
 Ensure immunization status is up
to date
 Pregnant staff should be aware
that some diseases may have an
impact on their pregnancy
 Infected child care workers may
be excluded from working
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Meningococcal Disease
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Bacterial infection caused by Neisseria
meningitidis
Transmitted by contact or droplet
Non infectious after 24 hours of
appropriate antibiotic therapy
Significant contacts traced and may be
given prophylaxis
Meningococcal Disease
Measles
Complications more common and
severe in chronically ill and very
young children
 Transmitted by droplet and
contact with respiratory
secretions
 Infectious for 4 days before and
after rash
 Vaccination available
 Notifiable disease
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Measles
Rubella
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In early pregnancy risk of teratogenic
damage to fetus
Infectious for 7 days before and 7 - 15
days after onset of rash
Infants with congenital rubella may shed
virus for several months or years
Transmitted by droplet route
Vaccination available
Notifiable disease
Rubella
Varicella Zoster Virus
Chicken Pox
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Highly contagious
Most cases in children, over 90% of
adult population is immune
Transmitted by droplet and contact
Infectious 2 days prior and 4 - 6 days
after rash
Now a notifiable disease
Vaccination now available
Varicella or Chicken-pox
Parvovirus B19
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Usually a mild rash disease
Also called Fifth Disease or “Slapped
- Cheek”
Infectious prior to the rash
Transmitted by droplet route
Parvovirus B19
Hand, foot and mouth
disease
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Incubation period:
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Infectious period
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Whilst fluid in blisters
Transmission:
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3 – 5 days
Contact with blister fluid / faeces
Control:
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Exclude until blisters have dried
Good hand washing
Hand, foot and mouth
disease