Practical Nursing Clinical
Infection Prevention and Control (IPAC)
Overview: Norwalk virus causes acute gastrointestinal illness sporadically or in outbreaks.
Mode of transmission: direct and indirect contact. Can be aerosolized from emesis.
Incubation period and period of infectivity: Symptoms usually develop 12 to 48 hours after being exposed, and recovery typically occurs within 1 to 3 days. Can be transmitted from infection to 3 days after illness.
Treatment: no specific treatment, supportive management only.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. Alcohol-based sanitizers are not effective against the Norwalk virus. Vaccine under development.
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Vancomycin-Resistant Enterococcus (VRE)
Overview: type of bacteria present in the gastrointestinal tract and the female genital tract that develop resistance to many antibiotics, especially vancomycin.
Mode of transmission – direct and indirect contact.
Incubation period and period of infectivity: The incubation period is variable and indefinite. Occurs commonly around 4 – 10 days after exposure. Enterococcus can live on hands for as long as 60 minutes after contact and as long as four months on inanimate surfaces. Can be transmitted until the person is cured.
Treatment: Most VRE infections can be treated with antibiotics other than vancomycin. Doxycycline, chloramphenicol, and rifampin in various combinations have been used to treat VRE infections, but the newer antibiotic choices are also now available. No vaccine.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. No current vaccine.
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Extended Spectrum Beta-Lactamase (ESBL)
Overview: ESBL is an enzyme found in some strains of bacteria that make them resistant to antibiotics. These bacteria include Escherichia coli (E. coli) and Klebsiella pneumoniae. ESBL infections are serious and can be life-threatening.
Mode of transmission – direct and indirect contact.
Incubation period and period of infectivity: The incubation period is variable. It occurs commonly around 4–10 days. A person can spread ESBL as long as they are colonized.
Treatment: antibiotics the bacteria is not resistant to such as Carbapenems. Supportive treatment for the infection.
Preventative measures and vaccinations: prevention involves proper hand washing and disinfection of contaminated surfaces. No current vaccine.
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Measles
Overview: Measles is an acute viral respiratory illness. It is characterized by a prodrome of fever (as high as 105°F) and malaise, cough, coryza, and conjunctivitis -the three “C”s -, a pathognomonic enanthema (Koplik spots) followed by a maculopapular rash.
Mode of transmission: Airbourne.
Incubation period and period of infectivity: Incubation is 7-21 days from the onset of the fever. It is contagious from 4 days before, until 4 days after, the rash appears.
Treatment: No specific treatment, supportive treatment only.
Preventative measures and vaccinations: MMR vaccine.
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