Tularemia

Isolation and Decontamination

Standard precautions for healthcare workers. Organisms are relatively easy to render harmless by mild heat (55┬░Celsius for 10 min) and standard disinfectants.

Hospital Infection Control

Isolation Precautions

Person-to-person transmission of tularemia has not been documented; therefore, Standard Precautions are considered adequate for patients with tularemia. Standard Precautions include the following practices related to direct patient care (see References: CDC/HICPAC 2007):

  • Handwashing:
    • Wash hands after touching blood, body fluids, secretions, excretions, and contaminated items, whether or not gloves are worn.
    • Wash hands immediately after gloves are removed, between patient contacts, and when otherwise indicated to avoid transfer of microorganisms to other patients or environments.
  • Gloves:
    • Wear gloves when touching blood, body fluids, secretions, excretions, and contaminated items; put on clean gloves just before touching mucous membranes and nonintact skin.
    • Change gloves between tasks and procedures on the same patient after contact with material that may contain a high concentration of microorganisms.
    • Remove gloves promptly after use, before touching noncontaminated items and environmental surfaces, and before going to another patient, and wash hands immediately to avoid transfer of microorganisms to other patients or environments.
  • Masks, eye protection, face shields:
    • Wear a mask (ie, standard surgical mask) and eye protection or a face shield to protect mucous membranes of the eyes, nose, and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
  • Gowns:
    • Wear a gown to protect skin and prevent soiling of clothing during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
    • Select a gown that is appropriate for the activity and amount of fluid likely to be encountered.
    • Remove a soiled gown as promptly as possible and wash hands.
  • Patient-care equipment:
    • Handle used equipment soiled with blood, body fluids, secretions, or excretions in a manner that prevents skin and mucous membrane exposures, contamination of clothing, and transfer of microorganisms to other patients or environments.
    • Ensure that reusable equipment is not used for the care of another patient until it has been appropriately cleaned and reprocessed; single-use items should be appropriately discarded.

Decontamination

  • Commercially available bleach or a 1:10 dilution of household bleach and water is considered adequate for cleaning contaminated surfaces. After 10 minutes, a 70% solution of alcohol can be used to further clean the area and reduce the corrosive action of the bleach (see References: Dennis 2001).
  • Following direct exposure to powder or liquid aerosols containing F tularensis, body surfaces and clothing should be washed with soap and water.
  • Water contamination can be eradicated through standard chlorination. Chlorinating natural water sources is generally not feasible, so contaminated natural water sources must be contained to prevent public and animal use (see References: Hodges 2010).
  • The risk of environmental contamination following an intentional release of F tularensis is expected to be minimal, and no special environmental decontamination procedures are recommended (see References: Dennis 2001).
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