Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-12-02T19:42:00.379Z Has data issue: false hasContentIssue false
  • English
  • Français

research-article

Published online by Cambridge University Press:  02 January 2015

Get access Rights & Permissions [Opens in a new window]

Extract

In the United States, about 5 million persons work in more than 7,000 hospitals. These personnel may become infected through exposure to infected patients if proper precautions are not used, or acquire infection outside the hospital. They may then transmit the infection to susceptible patients or other hospital personnel, members of their households, or other community contacts. In this guideline, we focus on diseases that are of particular concern to hospital personnel because of the possibility of transmission. In some instances we focus our discussion on transmission of infectious disease from patient-care personnel to patients. In other instances we focus on transmission of disease from patients to patient-care personnel. Recommendations for prevention and control are limited to these areas. We frequently refer to the Guideline for Isolation Precautions in Hospitals, where suggestions can be found on precautions that personnel may use when taking care of patients to prevent the spread of infection to themselves, other personnel or patients, and visitors.

Personnel who have direct contact with patients include nursing personnel, medical house staff, clinical faculty, attending physicians, paramedical staff, and nursing and medical students. Since other hospital personnel may have exposure to patients that is comparable in quality, intensity, and duration to that of patient-care personnel, hospitals may also consider them in applying these recommendations. Risk to patients from personnel with whom patients have only brief casual contact, or risk to these personnel, is generally felt to be low.

Type
Guideline for Infection Control in Hospital Personnel
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue S4: CDC Guideline for Isolation Precautions in Hospitals , 07/08 1983 , pp. 329 - 349
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

1.Dienstag, JL, Stevens, CE, Bhan, AK, Szmuness, W. Hepatitis B vaccine administered to chronic carriers of hepatitis B surface antigen. Ann Intern Med 1982;96:575–9.CrossRefGoogle ScholarPubMed
2.Szmuness, W, Stevens, CE, Oleszko, WR, Goodman, A. Passive-active immunization against hepatitis B: immunogenicity studies in adult Americans. Lancet 1981;1:575–7.Google Scholar
3.Immunization Practices Advisory Committee. Recommendation on inactivated hepatitis B virus vaccine. MMWR 1982;31:317–28.Google Scholar
4.Mulley, AG, Silverstein, MD, Dienstag, JL. Indications for use of hepatitis B vaccine, based on cost effectiveness analysis. N Engl J Med 1982;307:644–52.Google Scholar
5.Immunization Practices Advisory Committee. Recommendation on rubella prevention. MMWR 1981;30:37–47.Google Scholar
6.Centers for Disease Control. Acquired immune deficiency syndrome (AIDS): precautions for clinical and laboratory staffs. MMWR 1982;31:557–80.Google Scholar
7.Maynard, JE. Viral hepatitis as an occupational hazard in the health care profession. In: Vyas, GN, Cohen, SN, Schmid, R, eds. Viral hepatitis: a contemporary assessment of epidemiology, pathogenesis and prevention. Philadelphia: Franklin Institute Press, 1978:321–31.Google Scholar
8.Seeberg, S, Bandberg, A, Hermodsson, S, et al.Hospital outbreak of hepatitis A secondary to blood exchange in a baby (letter). Lancet 1981;1:1155–6.Google Scholar
9.Coulepis, AG, Locarnini, SA, Lehmann, NI, Gust, ID. Detection of hepatitis A virus in the feces of patients with naturally acquired infections. J Infect Dis 1980;141:151–6.Google Scholar
10.Carl, M, Kantor, RJ, Webster, HM, et al.Excretion of hepatitis A virus in the stools of hospitalized patients. J Med Virol 1982;9:125–9.Google Scholar
11.Reiner, NE, Judson, FN, Bond, WW, et al.Asymptomatic rectal mucosal lesions and hepatitis B surface antigen at sites of sexual contact in homosexual men with persistent hepatitis B virus infection: evidence for de facto parenteral transmission. Ann Intern Med 1982;96:170–3.Google Scholar
12.Petersen, NJ, Bond, WW, Marshall, JH, et al.An air sampling technique for hepatitis B surface antigen. Health Lab Sci 1976;13:233–7.Google Scholar
13.Petersen, NJ, Bond, WW, Favero, MS. Air sampling for hepatitis B surface antigen in a dental operatory. JADA 1979;99:465–7.Google Scholar
14.Pattison, CP, Maynard, JE, Berquist, KR, et al.Epidemiology of hepatitis B in hospital personnel. Am J Epidemiol 1975;101:59–64.Google Scholar
15.Dienstag, JL, Ryan, DM. Occupational exposure to hepatitis B virus in hospital personnel: infection or immunization? Am J Epidemiol 1982;115:26–39.Google Scholar
16.Janzen, J, Tripatzis, I, Wagner, U, et al.Epidemiology of hepatitis B surface antigen (HBsAg) and antibody to HBsAg in hospital personnel. J Infect Dis 1978;137:261–5.Google Scholar
17.Levy, BS, Harris, JC, Smith, JL, et al.Hepatitis B in ward and clinical laboratory employees of a general hospital. Am J Epidemiol 1977;106:330–5.Google Scholar
18.Hirschowitz, BA, Dasher, CA, Whitt, FJ, Cole, GW. Hepatitis B antigen and antibody and tests of liver function—a prospective study of 310 hospital laboratory workers. Am J Clin Pathol 1980;73:63–8.CrossRefGoogle ScholarPubMed
19.Leers, WD, Kouroupis, GM. Prevalence of hepatitis B antibodies in hospital personnel. Can Med Assoc J 1975;113:844–7.Google Scholar
20.Tabor, E, Gerety, RJ, Mott, M, Wilbur, J. Prevalence of hepatitis B in a high risk setting: a serologic study of patients and staff in a pediatric oncology unit. Pediatrics 1978;61:711–5.Google Scholar
21.Favero, MS, Maynard, JE, Leger, RT, Graham, DR, Dixon, RE. Guide-lines for care of patients hospitalized with viral hepatitis. Ann Intern Med 1979;91:872–6.Google Scholar
22.Hadler, SC, Sorley, DL, Acree, KH, et al.An outbreak of hepatitis B in a dental practice. Ann Intern Med 1981;95:133–8.Google Scholar
23.Rimland, D, Parkin, WE, Miller, GB, Schrack, WD. Hepatitis B outbreak traced to an oral surgeon. N Engl J Med 1977;296:953–8.CrossRefGoogle Scholar
24.Communicable Disease Surveillance Centre and the Epidemiological Research Laboratory of the Public Health Laboratory Service, London. Acute hepatitis B associated with gynecological surgery. Lancet 1980;1:1–6.Google Scholar
25.Reingold, AL, Kane, MA, Murphy, BL, et al.Transmission of hepatitis B by an oral surgeon. J Infect Dis 1982;145:262–8.Google Scholar
26.Carl, M, Francis, DP, Blakey, DL, Maynard, JE. Interruption of hepatitis B transmission by modification of a gynecologist's surgical technique. Lancet 1982;1:731–3.Google Scholar
27.Alter, HJ, Chalmers, TC, Freeman, BM, et al.Health-care workers positive for hepatitis B surface antigen: are their contacts at risk? N Engl J Med 1975;292:454–7.Google Scholar
28.Snydman, DR, Hindman, SH, Wineland, MD, et al.Nosocomial viral hepatitis B: a cluster among staff with subsequent transmission to patients. Ann Intern Med 1976;85:573–7.Google Scholar
29.Center for Disease Control. Control measures for hepatitis B in dialysis centers. Atlanta: Department of Health, Education and Welfare, Public Health Service, Viral Hepatitis Investigations and Control Series, November 1977. (HEW publication no. [CDC] 78-8358).Google Scholar
30.Tong, MJ, Thursby, M, Rakela, J, et al.Studies on the maternal-infant transmission of the viruses which cause acute hepatitis. Gastroenterology 1981;80:999–1004.Google Scholar
31.Schweitzer, IL, Dunn, AE, Peters, RL, Spears, RL. Viral hepatitis B in neonates and infants. Am J Med 1973;55:762–71.Google Scholar
32.Craig, CP, Gribble, C, Suarez, K. Risk of hepatitis B among phlebotomists. Am J Infect Control 1981;9:11–4.Google Scholar
33.Centers for Disease Control. Hepatitis Surveillance Report No. 47. Issued December 1981:3.Google Scholar
34.Szmuness, W, Stevens, CE, Harley, EJ, et al.Hepatitis B vaccine: demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. N Engl J Med 1980;303:833–41.Google Scholar
35.Francis, DP, Hadler, SC, Thompson, SE, et al.The prevention of hepatitis B with vaccine: report of the CDC multi-center efficacy trial among homosexual men. Ann Intern Med 1982;97:362–6.Google Scholar
36.Szmuness, W, Stevens, CE, Zang, EA, et al.A controlled clinical trial of the efficacy of the hepatitis B vaccine (Heptavax-B): a final report. Hepatology 1981;1:377–85.Google Scholar
37.Centers for Disease Control. Hepatitis B virus vaccine safety: report of an inter-agency group. MMWR 1982;31:465–8.Google Scholar
38.Centers for Disease Control. The safety of hepatitis B virus vaccine. MMWR 1983;32:134–6.Google Scholar
39.McCormick, RD, Maki, DG. Epidemiology of needle-stick injuries in hospital personnel. Am J Med 1981;70:928–32.Google Scholar
40.Seeff, LB, Wright, EC, Zimmerman, HJ, et al.Type B hepatitis after needle-stick exposure: prevention with hepatitis B immune globulin; final report of the Veterans Administration Cooperative Study. Ann Intern Med 1978;88:285–93.Google Scholar
41.Osterman, CA. Relationship of new disposal unit to risk of needle puncture injuries. Hosp Top 1975;53:12–13.Google Scholar
42.Immunization Practices Advisory Committee. Recommendation on immune globulins for protection against viral hepatitis. MMWR 1981;30:423-8, 433–5.Google Scholar
43.American Academy of Pediatrics Committee on Fetus and Newborn. Perinatal herpes simplex viral infections. Pediatrics 1980;66:147–9.Google Scholar
44.Greaves, WL, Kaiser, AB, Alford, RH, Schaffner, W. The problem of herpetic whitlow among hospital personnel. Infect Control 1980;1:381–5.CrossRefGoogle Scholar
45.Stamm, WE, Feeley, JC, Facklam, RR. Wound infections due to group A Streptococcus traced to a vaginal carrier. J Infect Dis 1978;138:287–92.CrossRefGoogle ScholarPubMed
46.Berkelman, RL, Martin, D, Graham, DR, et al.Streptococcal wound infections caused by a vaginal carrier. JAMA 1982;247:2680–2.Google Scholar
47.Centers for Disease Control. Guidelines for prevention of TB transmission in hospitals. Atlanta: U.S. Department of Health and Human Services. (HHS publication no. [CDC] 82-8371), 1982.Google Scholar
48.Craven, RB. Wenzel, RP, Atuk, NO. Minimizing tuberculosis risk to hospital personnel and students exposed to unsuspected disease. Ann Intern Med 1975;82:628–32.Google Scholar
49.American Thoracic Society, Ad Hoc Committee of the Scientific Assembly on Tuberculosis. Screening for pulmonary tuberculosis in institutions. Am Rev Respir Dis 1977;115:901–6.Google Scholar
50.American Thoracic Society, American Lung Association, and Centers for Disease Control. Preventive therapy of tuberculous infection. Am Rev Respir Dis 1974;110:371–4.Google Scholar
51.American Thoracic Society Executive Committee. The tuberculin skin test. Am Rev Respir Dis 1981;124:356–63.Google Scholar
52.Thompson, NJ, Glassroth, JL, Snider, DE, Farer, LS. The booster phenomenon in serial tuberculin testing. Am Rev Respir Dis 1979;119:587–97.Google Scholar
53.American Thoracic Society Executive Committee. Diagnostic standards and classification of tuberculosis and other mycobacterial diseases. 14th ed. Am Rev Respir Dis 1981;123:343–58.Google Scholar
54.Valenti, WM, Andrews, BA, Presley, BA, Reifler, CB. Absence of the booster phenomenon in serial tuberculin skin testing. Am Rev Respir Dis 1982;125:323–5.Google Scholar
55.Barrett-Connor, E. The periodic chest roentgenogram for the control of tuberculosis in health care personnel. Am Rev Respir Dis 1980;122:153–5.Google Scholar
56.American Thoracic Society, Ad Hoc Committee of the Scientific Assembly on Tuberculosis. Discharge of tuberculosis patients from medical surveillance. Am Rev Respir Dis 1976;113:709–10.Google Scholar
57.American Thoracic Society. Guidelines for work for patients with tuberculosis. Am Rev Respir Dis 1973;108:160–1.Google Scholar
58.Ross, AH. Modification of chickenpox in family contacts by administration of gamma globulin. N Engl J Med 1962;267:369–76.Google Scholar
59.Hayden, GF, Meyers, JD, Dixon, RE. Nosocomial varicella: II. Suggested guidelines for management. West J Med 1979;130:300–3.Google Scholar
60.Valenti, WM, Hall, CB, Douglas, RG Jret al.Nosocomial viral infections: I. Epidemiology and significance. Infect Control 1980;1:33–7.Google Scholar
61.Valenti, WM, Betts, RF, Hall, CB, et al.Nosocomial viral infections: 4 II. Guidelines for prevention and control of respiratory viruses, herpes viruses, and hepatitis viruses. Infect Control 1981;1:165–78.Google Scholar
62.Valenti, WM, Hruska, JF, Menegus, MA, Freeburn, MJ. Nosocomial viral infections: III. Guidelines for prevention and control of exanthematous viruses, gastroenteritis viruses, picornaviruses, and uncommonly seen viruses. Infect Control 1981;2:38–49.Google Scholar
63.Hall, CD, Douglass, RG JrNosocomial respiratory syncytial viral infections: should gowns and masks be used? Am J Dis Child 1981;135:512–5.Google Scholar
64.Hall, CB, Douglass, RG JrModes of transmission of respiratory syncytial virus. J Pediatr 1981;99:100–3.Google Scholar
65.Tolkoff-Rubin, NE, Rubin, RH, Keller, EE, et al.Cytomegalovirus infection in dialysis patients and personnel. Ann Intern Med 1978;89:625–8.Google Scholar
66.Duvall, CP, Casazza, AR, Grimley, PM, et al.Recovery of cytomegalovirus from adults with neoplastic disease. Ann Intern Med 1966;65:531–9.Google Scholar
67.Yeager, AS. Longitudinal, serological study of cytomegalovirus infections in nurses and in personnel without patient contact. J Clin Microbiol 1975;2:448–52.Google Scholar
68.Ahlfors, K. Ivarsson, S-A, Johnsson, T, Renmarker, K. Risk of cytomegalovirus infection in nurses and congenital infection in their offspring. Acta Paediatr Scand 1981;70:819–23.Google Scholar
69.Jordan, MC, Rousseau, WE, Noble, GR, et al.Association of cervical cytomegalovirus with venereal disease. N Engl J Med 1973;288:932–4.Google Scholar
70.Davis, LE, Steward, JA, Garvin, S. Cytomegalovirus infection: a sero-epidemiologic comparison of nuns and women from a venereal disease clinic. Am J Epidemiol 1975;102:327–30.Google Scholar
71.Stagno, S, Reynolds, DW, Huang, E-S, et al.Congenital cytomegalovirus infection: occurrence in an immune population. N Engl J Med 1977;296:1254–8.Google Scholar
72.Ahlfors, K, Ivarsson, S-A, Johnsson, T, Svanberg, L. Primary and secondary maternal cytomegalovirus infections and their relation to congenital infection. Acta Paediatr Scand 1082;71:109–13.Google Scholar
73.Cohen, MS, Steere, AC, Baltimore, R, et al.Possible nosocomial transmission of group Y Neisseria meningitidis among oncology patients. Ann Intern Med 1979;91:7–12.Google Scholar
74.Rose, HD, Lenz, IE, Sheth, NK. Meningococcal pneumonia: a source of nosocomial infection. Arch Intern Med 1981;141:575–7.Google Scholar
75.Linnemann, CC JrRamundo, N, Perlstein, PH, Minton, SD. Use of pertussis vaccine in an epidemic involving hospital staff. Lancet 1975;2:540–3.Google Scholar
76.Kurt, TL, Yeager, AS, Guenette, S, Dunlop, S. Spread of pertussis by hospital staff. JAMA 1972;221:264–7.Google Scholar
77.Gooch, JJ, Strasius, SR, Beamer, B, et al.Nosocomial outbreak of scabies. Arch Dermatol 1978;114:897–8.Google Scholar
78.Belle, EA, D'Souza, TJ, Zarzour, JY, et al.Hospital epidemic of scabies: diagnosis and control. Can J Pub Health 1979;70:133–5.Google Scholar
79.Bernstein, B, Mihan, R. Hospital epidemic of scabies. J Pediatr 1973;83:1086–7.Google Scholar
80.Haydon, JR JrCaplan, RM. Epidemic scabies. Arch Dermatol 1971;103:168–73.Google Scholar
81.Estes, SA. Diagnosis and management of scabies. Med Clin N Am 1982;66:955–63.Google Scholar

Further Reading

1.National Institute for Occupational Safety and Health (NIOSH). Hospital occupational health services study, NIOSH I-VII. Cincinnati: U.S. Department of Health, Education and Welfare, Public Health Service, Center for Disease Control, July 1974 to April 1976. (HEW publication No. [NIOSH] 75-101, 75-137, 76-107, 76-115, 76-116, 77–140).Google Scholar
2.Haley, RW, Emori, TG. The employee health service and infection control in U.S. hospitals, 1976–1977: I. Screening procedures. JAMA 1981;246:844–7.Google Scholar
3.Haley, RW, Emori, TG. The employee health service and infection control in U.S. hospitals, 1976–1977: II. Managing employee illness. JAMA 1981;246:962–6.Google Scholar
4.Werdegar, D. Guidelines for infection control aspects of employee health. J Assoc Pract Infect Cont 1977;5(Sept):17–22.Google Scholar
5.Werdegar, D. Guidelines for infection control aspects of employee health. J Assoc Pract Infect Cont 1977;5(Dec):15–22.Google Scholar
6.Werdegar, D. Employee health. Nurs Clin N Am 1980;15:769–87.Google Scholar
7.Gardner, P, Oxman, MN, Breton, S. Hospital management of patients and personnel exposed to communicable diseases. Pediatrics 1975;56:700–9.Google Scholar
8.Klein, JO. Management of infections in hospital employees. Am J Med 1981;70:919–23.Google Scholar