Isolation
DEFINITION:
- The separation of a person with infectious disease from contact with other human beings for the period of communicability
TRANSMISSION BASED PRECAUTION:
Airborne Precautions:
- Causative agents of diseases under airborne precaution are less than 5 μm, thus can be carried away by air currents
- Diseases:
- Measles
- Tuberculosis (Pulmonary/Laryngeal)
- Varicella
- Patients placement:
- Single room with negative air pressure
- 6-12 air exchanges per hour
- Room door closed
- Protection of HCW: N95 respirator will be used as PPE
- Discontinuation of isolation:
- TB:After 2 weeks from starting effective treatment, 3 sputum samples (with 8 hours in between & at least one morning sample) should be negative to discontinue the isolation.
- MERS CoV:For positive cases we can discontinue isolation 48hrs after S/S disappearance with at least one negative lab result
Droplet Precaution:
- Causative agents of diseases under droplet precaution are greater than 5 μm.
- They can travel up to 3 feet (1 meter) before falling to the ground
- Diseases:
- Haemophilus influenzae type B disease, including meningitis, pneumonia, epiglottis and sepsis
- Streptococcal (group A) pharyngitis, scarlet fever in infants and young children
- Influenza, Mumps
- Patient placement:
- Private room
- Cohort nursing
- Maintain special separation of at least 3 feet (1 meter) in between
Contact Precaution:
- Use In addition to standard precaution, for patients known or suspected to have serious illness transmitted through contact.
- Types:
- Direct Contact Transmission
- In-Direct Contact Transmission
- Diseases:
- Multi-drug resistant microorganisms (MDRO’s), VRE, MRSA, ESBL, B.cepacia
- RSV infection in infants, young childrena nd immunocompromised patients
- Clostridium defficile enterocolitis
- Patient placement :
- Private room
- Cohort nursing
Periods of isolation recommended
| Disease | Duration of isolation |
| Chickenpox | Until all lesions cursted; usually about 6 days after onset of rash |
| Measles | From the onset of catarrhal stage through 3rd day of rash |
| German measles | None , except that women in the first trimester or sexually active, non-immune women in childbearing years not using contraceptive measures should not be exposed. |
| Cholera, diphtheria | 3 days after tetracyclines started, until 48 hours of antibiotics (or negative cultures after treatment) |
| Shigellosis | Until 3 consecutive negative stool cultures. |
| Salmonellosis | 3 |
| Hepatitis A | 3 weeks |
| Influenza | 3 days after onset |
| Polio | 2 weeks adult, 6 weeks paediatric. |
| Tuberculosis | Until 3 weeks of effective chemotherapy (sputum +) |
| Herpes zoster | 6 days after onset of rash |
| Mumps | Until swelling subsides |
| Pertussis | 4 weeks or until paroxysms cease Meningococcal |
| meningitis | Until the first 6 hours of effective |
| Streptococcal | antibiotic therapy are completed Pharyngitis |
- Isolation has failed in the control of disease such as leprosy, TB & STD. In the control of these diseases, the concept of physical isolation has been replaced by chemical isolation, i.e., rapid treatment of cases in their own-homes and rendering them non-infectious as quickly as possible.
Exam Important
- Isolation period should be Period of communicability
- Isolation is strictly recommended for Pneumonic plague
- Isolation is useful for Hepatitis A,Mumps. Plague,Cholera, Chicken pox, Diphtheria & Typhoid
- Isolation period of Hepatitis A is 3 weeks
- After the appearance of rash, prophylactic isolation of measles case is necessary for a minimum of 5 days
- Chicken pox: 6 days after the onset of rash
- Measles: 3 days after the onset of rash
- Herpes zoster: 6 days after the onset of rash
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