Infectious Diseases

Bill Edstrom, EpidemiologistSpokane 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

Germs transmitted from one person to another

through contact with blood or OPIM

What are pathogens?

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 fluid-

soaked 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•Fatigue

•Loss of appetite

•Nausea

•Anxiety

•Weight Loss

•Alcohol Intolerance

•Abdominal pain

•Loss of concentration

•Jaundice

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

Measures

• Measures you take to prevent HBV, HCV, and HIV also help prevent diseases caused by other bloodborne pathogens

Do Exposures Always Cause Infection?

• 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

• NONO • The risk of infection• after an exposure

depends• on:

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 Weight Loss

Fever Skin rashes

Swollen lymph nodes Diarrhea

Night sweats Tiredness

Inability to fight off infection

Severity Life-long

Prevention No Vaccine

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

TuberculosisTransmission Inhaling the TB pathogen after an

infected person coughs or sneezes

Signs & Symptoms 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 swine-origin 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 swine-origin 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 Anderson509-232-8155

1-866-630-4033andersr@inhs.org

Fax: 509-232-8168