Middle East respiratory syndrome coronavirus infection contact and airborne precautions
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Directions to Hospitals Treating Middle East respiratory syndrome coronavirus infection |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Implementation of infection prevention and control measures is critical to prevent the possible spread of MERS-CoV in hospitals and communities. Hospitalized patients should be admitted to airborne infection isolation rooms. All healthcare personall should also wear personal protective equipment, including gloves, gowns, and eye and respiratory protection, when exposed to patients with MERS-CoV. Patients evaluated for MERS-CoV infection who do not require hospitalization may be treated and isolated at home to prevent the nosocomial spread of infection. Isolation at home is defined as the separation or restriction of activities of an ill person with a contagious disease from those who are well.[1]
Standard, Contact and Airborne Precautions for Hospitalized Patients
Patient Placement in Airborne Infection Isolation Room (AIIR)
- If an AIIR is not available, the patient should be transferred as soon as feasible to a facility where an AIIR is available. Pending transfer, placement of a facemask on the patient and isolation in a single-patient closed-door room are recommended. The patient should not be placed in any room where exhaust is recirculated without high-efficiency particulate air (HEPA) filtration.
- Once in an AIIR, the patient’s facemask may be removed
- When outside of the AIIR, patients should wear a facemask to contain secretions
- Limit transport and movement of the patient outside of the AIIR to medically-essential purposes
- Implement staffing policies to minimize the number of personnel that must enter the room
Personal Protective Equipment (PPE) for Healthcare Personnel (HCP)
- PPE include:
- Gloves
- Gowns
- Eye protection (goggles or face shield)
- Respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator.
- If a respirator is unavailable, a facemask should be worn. In this situation respirators should be made available as quickly as possible.
- Recommended PPE should be worn by HCP upon entry into patient rooms or care areas.
- Upon exit from the patient room or care area, PPE should be removed and either
- Discarded
- Cleaned and disinfected according to the manufacturer’s reprocessing instructions, for re-useable PPE
Environmental Infection Control
Follow standard procedures, accordingly to hospital policy and manufacturers’ instructions, for cleaning and/or disinfection of:
- Environmental surfaces and equipment
- Textiles and laundry
- Food utensils and dishware
Standard, Contact, and Airborne Precautions for Patients at Home
This guidance is for local and state health departments, infection prevention and control professionals, healthcare providers, and healthcare workers who are coordinating the home care and isolation of ill people, who are being evaluated for Middle East Respiratory Syndrome (MERS-CoV) infection. The guidance is based on what is currently known about viral respiratory diseases and MERS-CoV. CDC will update this guidance as needed.[1]
Ill people who are being evaluated for MERS-CoV infection and do not require hospitalization for medical reasons may be cared for and isolated in their home. Isolation is defined as the separation or restriction of activities of an ill person with a contagious disease from those who are well.
Before the ill person is isolated at home, the healthcare professional should:
- Assess whether the home is suitable and appropriate for isolating the ill person. You can conduct this assessment by phone or direct observation.
- The home should have a functioning bathroom that only the ill person and household members use. If there are multiple bathrooms, one should be designated solely for the ill person.
- The ill person should have his or her own bed and preferably a private room for sleeping.
- Basic amenities, such as heat, electricity, potable and hot water, sewer, and telephone access, should be available.
- If the home is in a multiple-family dwelling, such as an apartment building, the area in which the ill person will stay should use a separate air-ventilation system, if one is present.
- There should be a primary caregiver who can follow the healthcare provider’s instructions for medications and care. The caregiver should help the ill person with basic needs in the home and help with obtaining groceries, prescriptions, and other personal needs.