If a patient has measles, which of the following is a required additional precaution?
Vaccination is the best way to prevent measles. Vaccination provides long-lasting protection against measles. Show
Measles vaccine is available combined with mumps and rubella vaccines as MMR, or MMR combined with varicella vaccine as MMRV. The MMR vaccine is a live-attenuated (weakened) vaccine that produces a mild, non-infectious response. CDC’s Advisory Committee on Immunization Practices (ACIP) recommends that MMR be used when any of the individual components is indicated. Single-antigen measles vaccine is not available in the United States. Vaccine recommendationsInfants: If traveling internationally, infants 6 through 11 months old should receive 1 dose of MMR vaccine before departure.
Children: Children should receive 2 doses of MMR vaccine–the first dose at 12 through 15 months of age and the second dose 4 through 6 years of age.
Students/travelers/health care personnel: Unless they have evidence of measles immunity, college and other students, health care personnel, and international travelers need 2 doses that have been given on or after age 1 and at least 28 days apart. Adults: All other adults born in or after 1957 should have documentation of at least 1 dose of MMR or other evidence of measles immunity. Persons receiving postexposure prophylaxis IG: Refer to VDH’s Postexposure Prophylaxis (PEP) Guidance for Measles Exposures for details about postexposure prophylaxis. MMR vaccine should be administered no earlier than 6 months after IGIM administration or 8 months after IGIV administration. Once the time interval has passed, follow age-appropriate dosing recommendations Contraindications and precautions to MMR vaccinationPatients who are severely immunocompromised for any reason should not be given MMR vaccine. However, HIV-infected individuals may receive MMR vaccination if they are not severely immunosuppressed. HIV-infected children may receive MMR vaccine if CD4+ T-lymphocyte count is >15 percent; HIV-infected adults may receive MMR vaccine if they are not severely immunocompromised (i.e., CD4 count is 200 cells/µL or greater). Persons known to be pregnant should not receive the measles vaccine. Pregnancy should be avoided for 4 weeks following MMR vaccine. Persons receiving large daily doses of corticosteroids (>2 mg/kg per day or >20 mg per day of prednisone) for 14 days or more should not receive MMR vaccine because it can lead to complications. Avoid MMR vaccination for at least one month after stopping high dose steroid therapy. Administration of blood products and immune globulin require waiting a certain period before administering measles vaccine. Refer to the most current Vaccine Information Statement for measles. Additional Vaccine Information
Effectiveness of MMR vaccineMMR vaccine is about 93% effective at preventing measles after 1 dose and about 97% effective after 2 doses.
Chapter 1. Infection Control Certain pathogens and communicable diseases are easily transmitted and require additional precautions to interrupt the spread of suspected or identified agents to health care providers, other patients, and visitors (PIDAC, 2012). Additional precautions are used in addition to routine precautions and are defined by how a microorganism is transmitted (Perry et al., 2014). Types of Additional PrecautionsThere are three categories of additional precautions: contact precautions, droplet precautions, and airborne precautions. Contact precautions are are the most common type of additional precautions. They are used in addition to routine practice for patients who are known or suspected to be infected with microorganisms that can be transferred by direct (touching) or indirect (shared equipment) contact. Types of organisms in this category are antibiotic-resistant organisms (AROs) such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), extended spectrum beta-lactamase (ESBL), Clostridium difficile (CDI), carbapenemase-producing organisms (CPO), diarrhea, and scabies. AROs are also known as multi-drug-resistant organisms (MDROs). Droplet precautions are used in addition to routine practices for patients who are known or suspected to be infected with microorganisms that are spread through the air by large droplets. Types of organisms and unconfirmed conditions in this category include mumps, influenza, vomiting of unknown cause, norovirus, and unconfirmed cough. Airborne precautions are used in addition to routine practices for patients who are known to have or are suspected of having an illness that is transmitted by small droplet nuclei that may stay suspended in the air and be inhaled by others. These particles can remain infectious for a long period of time when spread through the air. Types of organisms in this category include tuberculosis (TB), measles, chicken pox (varicella), disseminated zoster, and severe acute respiratory syndrome (SARS). Special considerations:
Tables 1.1, 1.2, and 1.3. summarize the three categories of additional precautions. Table 1.1 Contact Precaution Guidelines
Personal Protective Equipment (PPE)Additional precautions require the use of personal protective equipment (PPE), which is equipment or clothing worn by staff to prevent the transmission of infection from patient to staff or to family member (PIDAC, 2012). All PPE must be applied and removed in a specific order to ensure the skin, nose, mouth, and eyes are covered to prevent transmission of infection to health care providers. Depending on the type of additional precaution or risk assessment, a gown, goggles, face shield, and mask (surgical or N95) may be used during patient care. Refer to Checklist 6 for steps to take when donning (putting on) PPE. Checklist 6: Donning PPE
See Checklist 7 for steps on how to doff or remove PPE. Checklist 7: Doffing PPE
Video 1.1Blood or Body Fluid (BBF) ExposureA blood and body fluid (BBF) exposure is defined as an exposure to potentially infectious body fluids or blood through the following methods: a puncture wound by a sharp object or needle (percutaneous exposure), from a body fluid/blood splash onto your mucous membranes (permucosal exposure) or exposure through eczema, an open wound/skin or scratch (non-intact skin exposure) (BCCDC, 2015). Post-exposure management is only required when (1) percutaneous, permucosal, or non-intact skin is exposed to a BBF; (2) the exposure is to blood or potentially infectious body tissue or fluid; (3) the source is considered potentially infectious (e.g., patient is part of a high-risk group, exposure occurred in a high-risk setting, or patient has a positive test); and (4) the exposed person is considered susceptible to HIV, hepatitis B, or hepatitis C. Checklist 8 explains what to do if exposed. Checklist 8: BBF Exposure
Does measles require droplet precautions?Diseases requiring airborne precautions include, but are not limited to: Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis. Airborne precautions apply to patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei.
Which type of precautions would be used for a patient suspected to be infected with measles?Use Airborne Precautions for patients known or suspected to be infected with pathogens transmitted by the airborne route (e.g., tuberculosis, measles, chickenpox, disseminated herpes zoster).
What are the 4 types of precautions?Infection Control and Prevention - Transmission-based precautions. Contact Precautions. ... . Droplet Precautions. ... . Airborne Precautions. ... . Eye Protection.. Which of the following would require contact precautions?Illnesses requiring contact precautions may include, but are not limited to: presence of stool incontinence (may include patients with norovirus, rotavirus, or Clostridium difficile), draining wounds, uncontrolled secretions, pressure ulcers, presence of generalized rash, or presence of ostomy tubes and/or bags ...
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