Tuesday, August 9, 2011

Prevention of Spread of Hospital acquired Respiratory Virus Infections

This depends on the early diagnosis of infection and is most conveniently achieved by direct immunofluorescence on nasopharyngeal epithelial cells. Good communication between the laboratory and infection control team and effective procedures such as source isolation, wearing protective clothes, and hand washing with proprietary soap preparations to interrupt transmission are also of major importance. Cleaning the environment with hospital cleaners and disinfectants virtually eliminates surface contamination.
Repeated hand washing may result in chapped, irritated skin. Gloves are a practical alternative, although they are uncomfortable if worn for long periods. Gloves should be changed after patients contact and before contact with another patient. The need for masks in conjunction with other infection control procedures may reduce nosocomial transmissions to high risk patients.
Eye-nose goggles have been used, but because of their limited availability, they are not recommended for routine use. Other measures, such as prohibiting symptomatic staff or relatives from working with or visiting high-risk patients and limiting visits by children under the age of 12 years during the winter months, may also reduce nosocomial transmission.
To interrupt nosocomial transmission, it is essential that all possible cases of hospital acquired infection be identified early and that the infection control team is informed so that the appropriate procedures are implemented. Jones et al. (2000) partly attributed an outbreak in BMT unit to a delay in informing the infection control team.
Control of nosocomial spread of influenza virus is based on general measures of prevention of spread of respiratory virus infections especially precautions against droplet infection. The most effective way is good infection control practices and social distancing. Precautions to prevent nosocomial spread of influenza can be maximized by the use of immunization and antiviral drug prophylaxis. In the U.K., annual influenza immunization is recommended for all patients with underlying chronic cardiac or respiratory disease, diabetes mellitus, chronic renal disease, or immunosuppression and for those over the age of 65 or living in long-stay care facilities. 
In the U.S., those over the age of 50 are offered immunization. Although not a routine immunization of health care workers, especially those working with immunocompromised, is also recommended in many hospitals. Immunization of staff and/or patients may still be of benefit even during an outbreak, as an immune response is usually detectable within about 14 days in adults .

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