ࡱ> [@ 8'bjbj44 (ViVihhh8hd`iLjjjjjkkkttttTu$$RH0lkk0l0lHjj]NmNmNm0lFjjtNm0ltNmNmJnJnjj PM 'hvl:JnboLs0Jnl|JnJnkkNmk kYkkkHHD4`6d2,m"`6 WORK RESTRICTIONS FOR HOSPITAL WORKERS EXPOSED TO OR INFECTED WITH SELECTED INFECTIOUS DISEASES DISEASE OR SYMPTOMRELIEVE FROM DIRECT PATIENT CONTACTPARTIAL WORK RESTRICTIONDURATIONCastsPossiblyRequired to meet all infection control and safety in the workplace guidelinesUntil cast is removedConjunctivitis, infectious (pink eye)YesNoMust be on antibiotic a full 24 hours before RTWCytomegalovirus infectionsNoDiarrhea Acute stage (with other SX) Convalescent stage, Salmonella spp. Yes PossiblyRestrict from patient contact, contact with pts environment, or food handling Restricted from care of high-risk patients.Until SX resolve Until SX resolve; consult with DSHS regarding negative stool culturesDiphtheria Active Asymptomatic carriers Post-exposure (HCWs with no Td booster dose in the previous 5 years) Exclude from Duty Exclude from Duty Exclude from DutyUntil antimicrobial therapy is completed AND 2 nasopharyngeal cultures obtained ( 24 hours apart. Same as active diphtheria Same as active diphtheriaEntero-viral (intestinal) infectionsPossiblyPersonnel should not care for infants, newborns, high-risk patients and their environmentsUntil symptoms resolveFever over 100.5 degreesExclude from DutyUntil temperature returns to normalHepatitis, viral Hepatitis ARestrict from patient contact, patient environments and food handling.Until 7 days after onset of jaundice DISEASE OR SYMPTOMRELIEVE FROM DIRECT PATIENT CONTACTPARTIAL WORK RESTRICTIONDURATIONHepatitis B HCW with acute or chronic Antigenemia: -HCWs who do not perform exposure-prone invasive procedures -HCWs who perform exposure- prone invasive procedures  No Possibly Observe Standard Precautions. No restriction unless epidemiologically liked to transmission of infection. Do not perform exposure-prone invasive procedures until cleared by an expert review panel that reviews and recommends the procedures the worker can perform. Until HB e AG is negativeHepatitis C (or other non-A, non-B hepatitis)NoObserve Standard and Barrier Precautions for procedures that involve trauma to tissues or contact with mucous membranes or non-intact skin.Period of infectivity has not been determined.Herpes Simplex Genital Hands (herpetic whitlow) Orofacial No Yes Possibly Restrict from patient contact and contact with patients environment Personnel should not care for high-risk patients. Must cover lesions on Duty Until lesions heal Until lesions healHuman Immunodeficiency VirusPossiblyDo not perform exposure-prone invasive procedures until evaluated by an expert review panel to review and recommend the procedures the worker can perform.Measles Active Post-exposure (susceptible HCWs)Yes YesUntil 7 days after the rash appears From the 5th day after 1st exposure through the 21st day after last exposure and/or 7 days after the rash appears.Meningococcal Infections Exclude from Duty Until treated and cleared by medical provider DISEASE OR SYMPTOMRELIEVE FROM DIRECT PATIENT CONTACTPARTIAL WORK RESTRICTIONDURATIONMumps Active Post-exposure (susceptible HCWs) Yes YesUntil 9 days after onset of parotitis From the 12th day after 1st exposure through the 26th day after last exposure or until 9 days after onset of parotitisParvovirus (Fifth disease)PossiblyRestrict from caring for high-risk patients, children and pregnant women.Until resolution of SXPediculosis (Lice)Exclude from DutyUntil treated and observed to be free of adult and immature licePertussis (Whooping Cough) Active Post-exposure (asymptomatic) Post-exposure (SX HCWs)  Exclude from Duty No Exclude from Duty Antimicrobial prophylactic therapy recommended21 days from the onset of rhinitis or acute cough or until 5 days after the start of effective antimicrobial therapy Ex: Z Pack (500 mg/250 mg) X 5 days or Clarithromycin 500 mg po bid x 7 days or Erythromycin 500 mg po qid x 14 days Until 5 days after the start of effective antimicrobial therapy Poison Ivy/Oak/SumacPossiblyEmployee must scrub body to remove all residue. Must keep weeping dermatitis covered. Surgical HCWs cannot scrub.If dermatitis becomes infected, full work restrictions must be enforced. Surgical personnel cannot scrub until healedRingworm Scalp Skin Exclude from Duty No Cover skin lesions while on Duty Until treated and cleared by medical providerRubella Active Post-exposure (susceptible HCWs)  Exclude from Duty Exclude from Duty Until 5 days after the rash appears From the 7th day after the 1st exposure through the 21st day after the 1st exposure and/or 5 days after the rash appearsScabies Exclude from DutyUntil treated and cleared by medical providerDISEASE OR SYMPTOMRELIEVE FROM DIRECT PATIENT CONTACTPARTIAL WORK RESTRICTIONDURATIONStaphylococcus aureus infection Active, draining skin lesions or MRSA Carrier stateExclude from duty as long as lesions are open and/or draining Possibly. Restrict from pt care, pts environment or food handling. Cover lesions while on duty. Strict Contact Precautions practiced when in contact with dressing or drainage. No restriction, unless HCW is linked to transmission of the organism24 hrs after effective antibiotic treatment and cleared by a medical provider, preferably an I.D. practitioner Refer to an Infectious Disease practitionerStreptococcal Infection Group AExclude from DutyAirborne Precautions practiced.24 hrs after effective antibiotic treatment and cleared by a medical providerTuberculosis Active disease PPD Converter  Exclude from Duty No  No restrictions Until receiving adequate therapy, if three consecutive day sputum smears are negative for AFB, and cough is resolved Upper respiratory infectionsPossiblyDuring particular seasons (winter when influenza and/or RSV are prevalent), consider excluding personnel with acute febrile upper respiratory infections (including influenza) from care of high-risk patients.Until acute symptoms resolveVaricella (chickenpox) Active Post-exposure (susceptible HCWs)Exclude from Duty Exclude from Duty Exposed susceptible individuals working in low risk or non-patient care areas may work from the 10th to the 21st day wearing a mask and eating alone (not in cafeteria)Until all lesions dry and crusty From the 10th day after the 1st exposure through the 21st day after the last exposure (28th day if VZIG administered). If varicella occurs, until all lesions dry and crustyZoster (shingles) Active (localized in normal person) Post-exposure (susceptible to Chickenpox) Possibly Exclude from Duty Cover lesions; restrict from care of high-risk patients. 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