Precautions I Appendix A I Isolation Precautions I Guidelines Library IInfection Control I CDC Page 1 of 35 1'~Centers for Disease Control and Prevention 1~ CDC 24/7: Saving Lives, Protecting People™ Infection Control Type and Duration of Precautions Recommended for Selected Infections and Conditions1 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007) ··················- -·················---··························································· - Appendix A Updates [September 2018] Changes: Updates and clarifications made to the table in Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions. ABCDEFGHIJKLMNOPQRSTUVWYZ A Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Abscess Contact+ Duration of illness Until drainage stops or can be contained by Draining, major Standard dressing. Abscess Standard nla If dressing covers and contains drainage. Draining, minor or limited Acquired human Standard nla Postexposure chemoprophylaxis for some immunodeficiency syndrome blood exposures [866]. (HIV) Actinomycosis Standard nla Not transmitted from person to person. Adenovirus infection (see n/a nla nla agent-specific guidance under Gastroenteritis, Conjunctivitis, Pneumonia) Amebiasis Standard nla Person-to-person transmission is rare. Transmission in settings for the mentally challenged and in a family group has been reported [1045]. Use care when handling diapered infants and mentally challenged persons [1046]. https://www.cdc.gov/infectioncontrol/guidelines/isolation/appendix/type-duration-precautions.html 8/17/2020 Precautions I Appendix A I Isolation Precautions I Guidelines Library I Infection Control I CDC Page 2 of 35 Type of Duration of lnfection/Cond ition Precaution Precaution Precautions/Comments Anthrax Standard nla Infected patients do not generally pose a transmission risk. Anthrax Standard nla Transmission through non-intact skin contact Cutaneous with draining lesions possible, therefore use Contact Precautions if large amount of uncontained drainage. Handwashing with soap and water preferable to use of waterless alcohol-based antiseptics since alcohol does not have sporicidal activity [983]. Anthrax Standard n/a Not transmitted from person to person. Pulmonary Anthrax n/a Until environment Until decontamination of environment Environmental: completely complete [203]. Wear respirator (N95 mask or aerosolizable spore­ decontaminated PAPRs), protective clothing; decontaminate containing powder or other persons with powder on them (Notice to substance Readers: Occupational Health Guidelines for Remediation Workers at Bacillus anthracis- Contaminated Sites - United States, 2001 -2002 accessed September 2018). Hand hygiene: Handwashing for 30-60 seconds with soap and water or 2% chlorhexidine gluconate after spore contact (alcohol hand rubs inactive against spores [983].) Postexposure prophylaxis following environmental exposure: 60 days of antimicrobials (either doxycycline, ciprofloxacin, or levofloxacin) and postexposure vaccine under IND. Antibiotic-associated colitis (see n/a n/a n/a C/ostridium difficile) Arthropod-borne Standard nla Not transmitted from person to person except • viral encephalitides rarely by transfusion, and for West Nile virus (eastern, western, by organ transplant, breastmilk or Venezuelan equine transplacentally [530, 1047]. Install screens in encephalomyelitis; St windows and doors in endemic areas. Louis, California Use DEET-containing mosquito repellants and encephalitis; West Nile clothing to cover extremities. Virus) and • viral fevers (dengue, yellow fever, Colorado tick fever) https ://www.cdc.gov/infectioncontro I/guidelines/isolation/ appendix/type-duration-precauti ans.html 8/1 7/2 020 Precautions IAppendix A IIsolation Precautions IGuidelines Library IInfection Control ICDC Page 3 of 35 Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Ascariasis Standard 11/a Not transmitted from person to person. Aspergillosis Standard n/a Contact Precautions and Airborne if massive soft tissue infection with copious drainage and repeated irrigations required [154]. Avian influenza (see influenza, n/a n/a n/a avian below) B Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Babesiosis Standard n/a Not transmitted from person to person, except rarely by transfusion. Blastomycosis, North Standard n/a Not transmitted from person to person. American, cutaneous or pulmonary Botulism Standard n/a Not transmitted from person to person. Bronchiolitis (see Respiratory Contact+ Duration of Use mask according to Standard Precautions. Infections in infants and Standard illness young children) Brucellosis (undulant, Malta, Standard n/a Not transmitted from person to person, except rarely Mediterranean fever) via banked spermatozoa and sexual contact [1048, 1049]. Provide antimicrobial prophylaxis following laboratory exposure [1050]. C Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Campy!obacter n/a 11/a n/a gastroenteritis (see Gastroenteritis) Candidiasis, all forms Standard 11/a n/a including mucocutaneous https :/ /www.cdc.gov/infectioncontro I/guidelines/isolation/appendix/type-duration-precautions.html 8/ I 7/2020 Precautions I Appendix A IIsolation Precautions I Guidelines Library IInfection Control I CDC Page 4 of 35 Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Cat-scratch fever (benign Standard n/a Not transmitted from person to person. inoculation lymphoreticulosis) Cellulitis Standard n/a n/a Chancroid (soft chancre) Standard n/a Transmitted sexually from person to person. (H. ducrey~ Chickenpox (see Varicella) n/a nla n/a Chlamydia trachomatis Standard nla n/a Conjunctivitis Chlamydia trachomatis Standard n/a n/a Genital (lymphogranuloma venereum) Chlamydia trachomatis Standard n/a n/a Pneumonia (infants ~3 mos. of age) Chlamydia pneumoniae Standard n/a Outbreaks in institutionalized populations reported, rarely [1051, 1052]. Cholera (see n/a n/a nla Gastroenteritis) Closed-cavity infection Standard n/a Contact Precautions if there is copious uncontained Open drain in place; drainage. limited or minor drainage Closed-cavity infection Standard n/a nla No drain or closed drainage system in place Clostridium botulinum Standard nla Not transmitted from person to person. Clostridium difficile (see Contact+ Duration of nla Gastroenteritis, C difficile) Standard illness Clostridium perfringens Standard nla Not transmitted from person to person. Food poisoning https ://www.cdc.gov/infectioncontrol/guidelines/isolation/ appendix/type-duration-precautions.html 8/1 7/2 020 Precautions I Appendix A IIsolation Precautions I Guidelines Library IInfection Control ICDC Page 5 of 35 Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Clostridium perfringens Standard nla Transmission from person to person rare; 1 outbreak in a Gas gangrene surgical setting reported [1053]. Use Contact Precautions if wound drainage is extensive. Coccidioidomycosis (valley Standard 11/a Not transmitted from person to person except under fever) extraordinary circumstances, because the infectious Draining lesions arthroconidial form of Coccidioides immitisis not produced in humans [1054]. Coccidioidomycosis (valley Standard nla Not transmitted from person to person except under fever) extraordinary circumstances, (e.g., inhalation of Pneumonia aerosolized tissue phase endospores during necropsy, transplantation of infected lung) because the infectious arthroconidial form of Coccidioides immitisis not produced in humans [1054, 1055]. Colorado tick fever Standard nla Not transmitted from person to person. Congenital rubella Contact+ Until 1 yr of Standard Precautions if nasopharyngeal and urine Standard age cultures repeatedly negative after 3 mos. of age. Conjunctivitis Standard nla n/a Acute bacterial Conjunctivitis Standard nla nla Acute bacterial Chlamydia Conjunctivitis Standard n/a n/a Acute bacterial Gonococcal Conjunctivitis Contact+ Duration of Adenovirus most common; enterovirus 70 [1056], Acute viral (acute Standard illness Coxsackie virus A24 [1057] also associated with hemorrhagic) community outbreaks. Highly contagious; outbreaks in eye clinics, pediatric and neonatal settings, institutional settings reported. Eye clinics should follow Standard Precautions when handling patients with conjunctivitis. Routine use of infection control measures in the handling of instruments and equipment will prevent the occurrence of outbreaks in this and other settings. [460, 461,814, 1058-1060]. Corona virus associated nla n/a nta with SARS (SARS-CoV) (see Severe Acute Respiratory Syndrome) https :/ /www.cdc. gov/infectioncontrol/ guidelines/isolation/ appendix/type-duration-precautions .html 8/1 7 /2 02 0 Precautions I Appendix A I Isolation Precautions I Guidelines Library I Infection Control I CDC Page 6 of 35 Type of Duration of Infection/Condition Precaution Precaution Precautions/Comments Coxsackie virus disease n/a n/a n/a (see enteroviral infection) Creutzfeldt-Jakob disease Standard n/a Use disposable instruments or special (CJD, vCJD) sterilization/disinfection for surfaces, objects contaminated with neural tissue if CJD or vCJD suspected and has not been R/O; No special burial procedures. [1 061 l Croup (see Respiratory n/a 11/a n/a Infections in infants and young children) Crimean-Congo Fever (see Standard n/a n/a Viral