Definition of Health-Care Workers (DHCWs)Health-care workers are defined as persons, including students and trainees, whose activities involve contact with patients or with blood or other body fluids from patients in a health-care setting.
Standard precautions in prevention of cross infection,policies in placed
GENERAL POLICY STATEMENT
PREVENTION OF JAPANESE ENCEPHALITIS
PREVENTION OF TUBERCULOSIS
PREVENTION OF HIV
PREVENTION OF SARS
PREVENTION OF H1N1
invasion, adhesion, and multiplication of a
microorganism in the host.
of a host can occur exogenously (from
outside) or endogenously (from inside)
the transmission of infectious agents between
patients and staff within a clinical environment
either directly or indirectly via instruments,
appliances and surfaces
There is always the potential for contamination and
transmission in dentistry.
Saliva is a potentially infectious fluid and has
transmitted Hepatitis B, Herpes and many other infections.
The most serious infections in dentistry are transmitted by
blood to blood contact through accidental sharps injuries.
Dentistry always has the potential to transmit
infection and hence
must always be observed.
Direct contact eg. blood or body fluids
Indirect contact eg. with a contaminated instrument or
Contact of mucosa of the eyes, nose, or mouth with
droplets or spatter
Inhalation of airborne microorganisms
Chain of Infection
Infection control is the concept of standard precautions to
reduce the risk of bloodborne pathogen transmission
The primary principle - medical history and examination
cannot reliably identify all patients infected with bloodborne pathogens.
All patients, therefore, must be regarded as potentially
Based on the concept that all blood and body fluids,
secretions and excretions should be treated as infectious
when it comes into contact with non intact skin/mucous
membranes: universal precautions concept expanded by
Apply to all patients
Hand Hygiene and Skin Care
Safe Handling of Sharps
(including Sharps Injury Management)
All blood and body fluids are potentially
infectious and precautions are necessary to
prevent exposure to them.
Everyone involved in providing care in dental
practice should know and apply the standard
principles of hand decontamination
JE virus is transmitted by the bite of an infected mosquito,
mainly Culex tritaeniorhynchus and C. vishnui complex,
night-time biters that breed in stagnant water such as rice
Humans can also become infected coincidentally through
proximity to JE virus-infected animals and birds.
JE virus, rarely, may also be transmitted person-toperson through blood transfusion, organ
,transplantation, intrauterine transmission and possibly
(Alberta Health and Wellness Public Health Disease
Under Surveillance Management Guidelines
Japanese Encephalitis,March 2011 )
Single Case/Household Cluster
Determine history of recent living in, immigration from or travel to
Asia and northern Australia including:
duration of exposure, and
occupational and recreational activities (while travelling).
Determine history of mosquito bites.
Determine immunization history (i.e., recent receipt of JE vaccine).
Destroyed by heating for 30 minutes above 56
℃;Termal Inactivation Point(TIP) is 40℃.
Inactivated in acid environment of pH 1-3(stable in
alkaline environment ofpH7-9)
Inactivated by organic and lipid solvents,common
70%thanol,glutaraldehyde 3-8%,formaldegyde 1%,sodium
Sensitive to uv light ad gamma radiation.
PREVENTION AND CONTROL
Housing animals in-doors in screened stabling can provide protection
Especially during active JE outbreaks and during peak vector activity
(usually dawn to dusk)
Insecticides, repellents and fans also provide protection
Vector control reduces transmission
Immunisation of swine as they are JE virus amplifier
If practical, swine should not be raised near horses
Vaccine is available for both horses and swine; also for
Two types of vaccine:
modified live (produced in hamster or swine kidney tissue
culture or hamster lung (HmLu) cell line) or
inactivated (prepared in mouse brain, chick embryo
or cell lines, e.g. Vero cells)
(Chapter 2.1.7 Japanese encephalitis in the latest
edition of the OIE Manual of Diagnostic Tests and
Vaccines for Terrestrial Animals)
There are two forms of Tuberculosis..
TB Disease (also called Active TB)
It’s important to recognize the difference!
People with a positive TB skin test have been
exposed to the TB germ.
Have a TB Infection
Do not look or feel sick
Cannot infect others
May or may not develop TB Disease (Active TB)
May take medication to prevent TB Disease from
May have these symptoms…
A cough for more than two weeks
Coughing up blood
Loss of appetite
Most important to remember:
A person with
TB Disease (Active TB)
can infect others!
Ask history of TB disease and symptoms suggestive
Promptly referred to a physician
Positive history and symptoms of active TB
Evaluation for possible infectiousness
Elective dental treatment should be postponed
until a physician confirms, using recognized diagnostic
evaluations, that the patient does not have active
In urgent dental care TB isolation practices
Treatment limited to relieve the patient's immediate pain.
DHCWs with persistent cough and other symptoms
suggestive of active TB
evaluated promptly for TB
should not return to work until a diagnosis of TB has been
excluded or on therapy and determination has been made
that the worker is not infectious.
Blood, saliva, and gingival fluid from all dental
patients should be considered infective.
All dental workers should wear surgical masks
and protective eyewear or chin-length plastic face
shields during dental procedures
Minimize generation of droplets and spatter
Rubber dams, high-speed evacuation and proper patient
Handpieces, ultrasonic scalers should be
sterilized after use with each patient.
Blood and saliva should be thoroughly and carefully
cleaned from material that has been used in the
Contaminated materials, impressions, and intra-oral
should be cleaned and disinfected
Dental equipment and surfaces that are difficult to
disinfect (e.g., light handles or X-ray-unit heads)
should be wrapped with impervious-backed paper,
aluminum foil, or clear plastic wrap
1. Transmission of H1N1 influenza:
droplet exposure of mucosal surfaces
indirect contact –by hands and respiratory
secretions from infectious patient/contaminated
inhalation of small particle aerosols
Elimination of potential exposures
e.g. deferral of ill patients
reduce or eliminate exposure at the source without placing
primary responsibility of implementation on individual
sick-leave policies and vaccination
Personal protective equipment (PPE)
exposures that cannot otherwise be eliminated or controlled.
Should avoid treatment of individuals who have
symptoms consistent with SARS
when these symptoms have started within 10 days of
departing from a SARS affected area.
Dentists should ensure that the symptomatic
individuals consult their GP for medical assessment.
Dentists should avoid treating probable or confirmed
cases of SARS and contacts of SARS cases while
They are symptomatic
During the period following symptoms when the case is
advised to limit their contact with others
ADA Guidelines for infection control 2nd Edition, 2012
Infection Control, Standard Precautions & Tuberculosis.
Washington County Health Sysytem (Effective Date: May 1,