precautions specifically necessary were used to interrupt transmission of that one disease.
In 1996 the CDC developed a new system of Standard Precautions synthesizing the features of universal precautions (described in Chapter 4) and body substance isolation. Standard precautions are used in the care of all patients and apply to blood; all body fluids, secretions, and excretions except sweat, regardless of whether they contain visible blood; nonintact skin; and mucous membranes.
In addition, transmission-based precautions are used for patients known (or suspected) to be infected with pathogens spread by airborne or droplet transmission or by contact with dry skin or fomites. Box 64-1 lists infection control measures for standard precautions. Table 64-2 lists the infectious agents or syndromes along with the respective infection control measures for each transmission-based precaution. Many infection control practitioners find these guidelines a lot less cumbersome to implement than the old category- and disease-specific measures. Hospitals, however, may modify these guidelines to fit their individual situations as long as their number of nosocomial infections remains low.
Some of the potential agents of bioterrorism can be transmitted person-to-person (smallpox, pneumonic plague, and viral hemorrhagic fevers) and some cannot (anthrax). The ones that can be easily transmitted have specific transmission-based precautions, that is, airborne precautions for smallpox, droplet precautions for patients with pneumonic plague, and contact precautions for individuals with one of the viral hemorrhagic fevers (Ebola, Marburg).
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