Transcript Infectious Diseases Ongoing Training and Evaluation Program

Infectious Diseases
Bill Edstrom, Epidemiologist
Spokane Regional Health District
OSHA
Bloodborne Pathogen Standard
• Designed to eliminate or
minimize employees’ exposure
to human blood and other
potentially infectious materials
(OPIM) in the workplace
Who is Covered?
• All employees who may
reasonably expect to be
exposed to blood and
OPIM that may contain
pathogens
• Anyone whose job
involves handling or
possibly being exposed to
blood or blood products,
or OPIM
What are pathogens?
Germs transmitted from one person to another
through contact with blood or OPIM
Caution!
You do NOT need to
directly contact someone
carrying a bloodborne
pathogen to be at risk for
exposure!
Risks also come from:
• Clinical specimens
• Biohazardous trash
• Blood- or body fluidsoaked laundry
• Needles or sharps
Annual Training Required:
• How diseases are transmitted and their symptoms
• Protective measures to prevent exposure
• Procedures to be followed if exposed
Exposure Control Plan
• OSHA requirement
• Must describe:
–
–
–
–
Exposure prevention
Engineering and work practice controls
Universal precautions
Personal protective equipment
Infectious Disease Transmission
•
Stages of Disease
Transmission:
1. Someone has an infection
2. The infectious pathogen
leaves the
Infected person’s body
Infectious Disease Transmission:
3. The infectious pathogen
reaches another person and
enters his or her body.
Transmission:
- Bloodborne
- Airborne
- Vector
- Direct or indirect contact
4. The second person
develops the infection.
Serious Bloodborne Pathogens
•
Hepatitis B virus (HBV)
•
Hepatitis C virus (HCV)
•
Human immunodeficiency
virus (HIV)
Hepatitis A
Hepatitis B
Hepatitis C
Transmission
Person-to-Person
through fecal-oral
Exposure to fecally
contaminated
food/water
Blood/Semen
OPIM
All Body Fluids
Contaminated needles
Unclean
tattoo/piercing tools
Sharing contaminated
items
Signs &
Symptoms
Fever
Fatigue
N/V
ABD pain
Dark Urine
Clay-colored stool
Joint pain
Loss of appetite
Jaundice
Flu-like symptoms
Loss of Appetite
Nausea
Fatigue
Muscle/joint aches
Mild fever
Stomach pain
Jaundice
MOST INFECTED
PEOPLE DO NOT
HAVE SYMPTOMS
Severity
Symptoms last < 2
months, can last up to
6 months
Major liver damage
Cirrhosis
Liver CA
Infection for decades
No Cure –
Prevention is
critical
Prevention
Vaccine
Vaccine
No Vaccine
•Fatigue
•Loss of appetite
•Nausea
•Anxiety
•Weight Loss
•Alcohol Intolerance
•Abdominal pain
•Loss of concentration
•Jaundice
Measures
• Measures you take to
prevent HBV, HCV,
and HIV also help
prevent diseases
caused by other
bloodborne
pathogens
Do Exposures Always Cause Infection?
• NO
• The risk of infection
• after an exposure
depends
• on:
• Whether pathogens are
present in the source
blood or body fluid
• The number of pathogens
present
• The type of injury or
exposure
• Your current health and
immunization status
HIV and AIDS
• Acquired immunodeficiency syndrome (AIDS) is caused by the
human immunodeficiency virus (HIV)
• There are almost one million HIV-positive people in the U.S.
HIV and AIDS
• AIDS damages cells essential for immune function
• People with AIDS are more susceptible to opportunistic
infections
• The disease is eventually fatal
HIV and AIDS
Transmission
Through an infected person’s body fluids
Signs & Symptoms
One quarter of the HIV-infected persons in the U.S.
do not know that they are infected.
Loss of appetite
Fever
Swollen lymph nodes
Night sweats
Inability to fight off infection
Severity
Life-long
Prevention
No Vaccine
Weight Loss
Skin rashes
Diarrhea
Tiredness
Prevention
OSHA Standard
• Requires employers to use strategies to reduce
occupational exposures:
• Engineering controls
• Work practice controls
• Personal protective equipment
• Universal precautions
Engineering Controls
• Needleless systems
• Eye wash stations
• Handwashing facilities
• Biohazard labels
Work Practice Controls
• Use of personal protective equipment (PPE)
• Handwashing
• Decontamination and sterilization of equipment
and areas
Personal Protective Equipment
• Gloves
• Jumpsuits, aprons
• Eye shields, goggles
• Face masks, face shields
• Caps
• Booties
OSHA Standard
Requires that your employer:
– Provide PPE at no cost
– Train you how to use equipment
– Must clean, repair, or replace it as needed
For Unexpected Exposure
•
If blood or OPIM splashes in your eyes or other mucous membranes, flush
area with running water for 20 minutes
•
Wash any exposed area well with soap, using an antibacterial soap
– Gently treat any scabs and sores
• Report the exposure to your supervisor
• Save any potentially contaminated object for testing
purposes
• Seek medical care
Employer Responsibilities
• Identify and document source of blood or OPIM
• Obtain consent and arrange to test the source blood
• Inform you of the test results
• Arrange for you to have your blood tested
• Arrange counseling and medical care for you as needed
Airborne Pathogens
Three Types of Airborne Pathogens
• Viral
• Bacterial
• Fungal
Airborne Pathogens
• Precautions for tuberculosis also lower the risk
for other airborne pathogens
– Meningitis
– Influenza
– Pneumonia
– Tuberculosis
Airborne Pathogens
• Spread by inhaling the germ
• Coughing or sneezing tiny droplets of moisture
into the air containing pathogens
• Pathogens can remain airborne for several
hours
Airborne Transmission
• Depends On:
– How contagious the
infectious person is
– Where the exposure occurs
– How long the exposure
lasts
– How healthy you are at the
time of the exposure
Tuberculosis
Transmission
Signs & Symptoms
Inhaling the TB pathogen after an
infected person coughs or sneezes
Many people with TB infection
have no symptoms!
Weight loss
Fever
Night sweats
Feeling weak
Severity
Skin test cannot distinguish between TB
infection and TB disease
Chest x-ray and phlegm sample needed to
determine diagnosis
Prevention
Engineering Controls
H1N1 (“Swine Flu”)
H1N1 and EMS
• EMS personnel should stay more than 6 feet away from
patients and bystanders with symptoms and exercise
appropriate routine respiratory droplet precautions while
assessing all patients for suspected cases of swineorigin influenza.
• Assess all patients for symptoms of acute febrile
respiratory illness (fever plus one or more of the
following: nasal congestion/ rhinorrhea, sore throat, or
cough).
H1N1 and EMS
• If no acute febrile respiratory illness, proceed
with normal EMS care.
• If symptoms of acute febrile respiratory illness,
then assess all patients for travel to a
geographic area with confirmed cases of swineorigin influenza within the last 7 days or close
contact with someone with travel to these areas.
H1N1 and EMS
• If travel exposure, don appropriate PPE for suspected
case of swine-origin influenza.
• If no travel exposure, place a standard surgical mask on
the patient (if tolerated) and use appropriate PPE for
cases of acute febrile respiratory illness without
suspicion of swine-origin influenza (as described in PPE
section).
Questions
Contact: Renee Anderson
509-232-8155
1-866-630-4033
[email protected]
Fax: 509-232-8168