Infectious Rash Infection Prevention and Control Measures Algorithm Issued: November 2019

Is rash crusted, Contact Is rash RASH scaly or papular and Yes maculopapular? Is Measles Yes Airborne Precautions scabies is suspected? Precautions Yes suspected? Contact site ICP OBSERVED Apular?

STAFF: Has scabies been No Perform Droplet Precautions reconsidered & ruled Routine Is rash hand No out if diagnosed as Yes Contact site ICP hygiene psoriasis or eczema? Yes Practices petechial/purpuric Is person >5 Put on AND Neisseria Yes years old? meningitidis gloves Yes No Droplet/Contact for direct suspected? Precautions Is medication/ contact Contact site ICP with lesions allergic reaction or heat rash suspected?

Is person Is fever an adult? No Droplet/Contact present? Yes Yes Precautions

Is Scarlet Fever Yes Is rash Yes Is Fifth erythematous? suspected? Cover rash if possible. No Disease Routine Practices Person with rash: Perform hand hygiene. suspected? Yes P ut on procedure mask if Measles, Neisseria meningitidis, Chickenpox or disseminated Shingles suspected. If unable to tolerate mask, consider room placement. Airborne/Contact Precautions Yes

Is Chickenpox suspected? Yes Yes No Contact Precautions Is rash Is person immune Can rash be Is rash disseminated No (on 3 or more No compromised? covered? vesicular? Is Shingles suspected? Yes Yes dermatomes)? Routine Practices

No Is Hand foot and mouth Pediatric AND disease suspected? Yes incontinent? Yes Contact Precautions

Algorithm includes initial IP&C highlights only, not treatment recommendations. Consider differential and additional diagnoses; if suspected cause/the answer “No” is not shown, use best clinical judgment.

This algorithm includes highlights of some common or consequential infectious rashes. It is not exhaustive and is intended to be used as a guideline with clinical judgment and risk benefit analysis. People who heavily contaminate the environment or are Immune compromised may require additional measures. See Microorganism, Infectious Diseases Table or Clinical Presentation and Empiric Precautions Table

Infectious Rash Algorithm Examples of Infectious Rashes Issued: November 2019

Norwegian (Crusted) Scabies rash Typical Scabies rash Localized Shingles rash Disseminated Shingles rash

(papular: small, red, raised lesions) (vesicular: small fluid filled sacs) (vesicular: small fluid filled sacs)

Neisseria meningiditidis rash Fifth Disease rash Measles rash Chicken Pox rash

(petechial/ purpuric: tiny or large, (erythematous: many red, (maculopapular: small, flat, red areas (vesicular: small fluid filled sacs) purple or red spots that do not blanch) pink and pale rings that blanch) and small, redraisedlesions) Image courtesy American Academy of Pediatrics Image courtesy Centres for Disease Control and Prevention Image courtesy Infectious Diseases Society of America

For more information see WRHA Infection Prevention and Control: Microorganism, Infectious Diseases Table

2