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Air
changes:
Ratio of the volume of air flowing through a space in a certain
period of time (air flow rate) to the volume of that space (room
volume);usually expressed as the
number of room air changes per hour (ACH).
Airborne infection isolation room (AIIR): Single- occupancy
patient-care room in which environmental factors are controlled to minimize
transmission of infectious agents spread from person to person by droplet
nuclei associated with coughing or aerosolization of contaminated fluids;AIIRs
typically have specific requirements for controlled ventilation, air
pressure, and air filtration.
Airborne infection isolation precautions: Measures
to reduce the risk of airborne transmission of infectious agents; an
AIIR with negative pressure relative to the surrounding area is required
for full implementation.
Airborne
transmission:
Occurs by dissemination of either airborne droplet nuclei (small-particle
residue [5 µm or
smaller] of evaporated droplets containing microorganisms that remain
suspended in the air for long periods of time) or dust particles containing
the infectious agent. Microorganisms carried in this manner can be dispersed
widely by air currents and may become inhaled by a susceptible host in
the same room or over a longer distance from the source patient, depending
on environmental factors.
Bronchoscopy: Procedure for visually examining the
respiratory tract and/or obtaining specimens for diagnostic purposes;
requires inserting an instrument (bronchoscope) through a patient's mouth
or nose into the trachea.
Close
contact: A person who has cared for or lived
with a person with SARS or had a high likelihood of direct contact with
respiratory secretions and/or body fluids of a person with SARS either
during the period the person was clinically ill or within 10 days of
resolution of symptoms. Examples of close contact include kissing or
embracing, sharing eating or drinking utensils, talking within 3 feet,
physical examination, and any other direct physical contact between persons.
Close contact does not include activities such as walking by a person
or briefly sitting across a waiting room or office.
Community containment: Measures to separate infected
or exposed persons by use of isolation, quarantine, or other restrictions
on movement and activities ;isolation and quarantine
are common practices in public health, and both aim to control exposure
to infected or potentially infected persons; both may be used voluntarily
or compelled by public health authorities.
Community transmission: In the context of SARS, transmission
of SARS-CoV outside of well-defined settings (i.e., hospitals; households
of SARS patients).
Contact: A person who has been exposed to someone with a communicable disease
during the infectious period. (See "close contact.")
Contact
precautions: Work practices to reduce the
risk of transmitting infectious agents by direct or indirect contact
with an infectious person.
Contact
tracing: Identification and location of persons
who may have been exposed to a person with SARS-CoV infection ;may
result in regular monitoring for evidence of illness and strict or modified
quarantine.
Coronavirus: One of a group of viruses that have a
halo or crown-like (corona) appearance when viewed under a microscope.
These viruses are a common cause of mild to moderate upper-respiratory
illness in humans and are associated with respiratory, gastrointestinal,
liver and neurologic disease in animals.
Droplet precautions:
Measures to reduce the risk of droplet transmission of infectious agents.
Droplet transmission: Occurs when droplets containing
infectious agents are propelled a short distance through the air (e.g.,
by coughing, sneezing, or talking) and deposited in the eyes, nose or
mouth of a susceptible person.
Exposure: Condition of being subjected to something
(e.g., an infectious agent) that could have a harmful effect.
Fit
test: The use of a protocol to qualitatively or quantitatively evaluate the fit
of a respirator on an individual to assess the adequacy of fit of that
respirator brand/model on that individual. Hand hygiene: A general term that applies to any one
of the following: 1) handwashing with plan (non-antimicrobial) soap and
water, 2) antiseptic handwash (soap containing antiseptic agents and
water), 3) antiseptic hand rub (waterless antiseptic product, most often
alcohol-based, rubbed on surfaces of hands), or 4) surgical hand antisepsis.
Healthcare worker:
Any employee in a healthcare facility who has close contact with patients,
patient-care areas, or patient-care items; also referred to as "healthcare
personnel."
High-efficiency particulate air (HEPA) filter:
Type of air filter that removes >99.97% of particles 0.3 um or larger
at a specified flow rate of air.
Incident
command system: Predetermined organizational structure for potential
mass casualty events that address planning, operations, logistics,
finance, and administration. Incubation
period: Time interval between infection
(i.e., introduction of the infectious
agent into the susceptible host) and the onset of the first symptom of illness
known to be caused by the infectious agent.
Infection control:
Measures practiced by healthcare personnel in healthcare facilities
to decrease transmission and acquisition of infectious agents (e.g.,
proper hand hygiene, scrupulous work practices, use of personal protective
equipment (PPE) [masks or respirators, gloves, gowns, and eye protection];
infection control measures are based on how an infectious agent is
transmitted and include standard, contact, droplet, and airborne precautions.
Isolation:
Separation of an ill person who has a communicable disease (e.g., SARSpatient)
from those who are healthy. Isolation prevents transmission of infection
to others
and also allows for the focused delivery of specialized health care
to ill persons.
Monitoring:
Watching, keeping track of, or checking for a specific purpose. In
the context
of SARS, monitoring refers to assessment (by phone or in person) of
a person
who has a known or possible exposure to SARS-CoV to detect the development
of symptoms and ensure prompt implementation of precautions if necessary.
Passive
monitoring: relies on self-assessment
by the affected person, who is asked to contact health authorities
if symptoms develop.
Active
monitoring: involves
direct assessment of each affected person at least once a day by
healthcare or public health staff or designee.
N-95
respirator: Respirator whose filtering efficiency has been determined
to be at least 95% for the most penetrating sized particle (~0.3 um);
an N-95 respirator may either be a disposable filtering facepiece respirator
(the entire face piece serves as the filter) or an elastomeric facepiece
respirator equipped with an appropriate particulate filter cartridge.
Negative
pressure: Pressure less than that of the ambient atmosphere. Nosocomial: Acquired in a healthcare setting or as
a result of medical care.
PCR (polymerase chain reaction): Laboratory method
for detecting the genetic material of an infectious disease agent in
specimens.
Personal
protective equipment (PPE): Specialized clothing and equipment
designed to create a barrier against health and safety hazards; examples
include goggles, face shields, gloves, and respirators.
Powered air-purifying respirator (PAPR): Respirator
equipped with a face piece, hood, or helmet, breathing tube, air-purifying
filter, cartridge and/or canister, and fan; air is pulled through the
air-purifying element and pushed through the breathing tube and into
the face piece, hood, or helmet.
Quarantine: Separation
or restriction of activities of well persons who are not ill but who
are believed to have been exposed to a communicable disease and are
therefore at
high risk of becoming infected. In the context of SARS, quarantine
refers to a combined approach to managing contacts, which consists
of active monitoring plus activity restrictions.
Respirator:
A personal protective device that is worn over the nose and mouth to reduce
the risk of inhaling hazardous airborne particles, gases, or vapors.
Respiratory
hygiene/cough etiquette: A group of infection
control measures used
to contain infection at its source by covering the mouth and nose during coughing
and sneezing, using tissues to contain respiratory secretions with prompt disposal
in a no-touch receptacle, and maintaining spatial separation when coughing. These
measures are targeted to patients and the persons accompanying them beginning
at the point of initial encounter with a healthcare setting.
Respiratory
symptoms: When screening patients for potential SARS-CoV disease, "respiratory symptoms" generally refers to symptoms of infection of the lower respiratory tract (e.g., cough, shortness of breath, difficulty breathing). However, when screening patients who have a high risk of exposure to SARS-CoV (e.g., persons previously identified through contact tracing or self-identified as close contacts of a laboratory-confirmed case of SARS-CoV disease; persons who are epidemiologically linked to a laboratory-confirmed case of SARS-CoV disease), respiratory symptoms used to screen patients should be expanded to include upper respiratory symptoms such as sore throat and rhinorrhea (in addition to other early non-respiratory symptoms of SARS-CoV disease such as subjective fever, chills, rigors, myalgia, headache, and diarrhea).
SARS: Severe
acute respiratory syndrome; a clinical syndrome characterized by fever,
lower respiratory symptoms, and radiographic evidence of pneumonia.
SARS-CoV: SARS-associated coronavirus; a newly described coronavirus
that is genetically and antigenically distinct from other human coronaviruses. SARS isolation precautions: The
combined use of Standard, Contact, and Droplet Precautions plus Airborne
Infection Isolation for the care of SARS patients. This combination
of isolation precautions is recommended until the dynamics of SARS-CoV
transmission are more fully defined.
Seroconversion: Four-fold
or greater increase in antibody titer between acute- and convalescent-phase
serum specimens tested in parallel, or negative antibody test on acute-phase
serum with positive test on convalescent-phase serum tested in parallel.
Serologic assay: A laboratory method for detecting
the presence and/or level of antibodies to an infectious agent in serum
from a person. Antibodies are substances made by the body's immune system
to fight a specific infection.
Snow-day measure: One type of community containment
measure designed to prevent transmission of a communicable disease by
limiting social interactions and preventing inadvertent exposures. Community
members are asked to stay home as they would during a major snowstorm.
Schools are closed, work sites are closed or restricted, large public
gatherings are cancelled, and public transportation is halted or scaled
back.
Standard
Precautions: Work practices required for the basic level of
infection control; they center on proper hand hygiene and also include
use of protective barriers and appropriate handling of clinical waste.
Surge
capacity: Ability to obtain additional resources when needed
during an emergency.
Transmission: Any
mechanism through which an infectious agent, such as a virus, is
spread from a reservoir or source to a human.
Travel advisory: One type of notification of an outbreak
of disease occurring in a geographic area. A travel advisory provides
information about the disease outbreak and informs travelers how to reduce
their risk of acquiring the infection. An advisory recommends against
nonessential travel to the area.
Travel alert: One type of notification of an outbreak
of disease occurring in a geographic area. A travel alert provides information
about the disease outbreak and informs travelers how to reduce their
risk of acquiring the infection. An alert does not include a recommendation
against nonessential travel to the area.
Triage: The
process for sorting or "ranking" ill or injured people
into groups based on their need for or benefit from immediate medical
treatment.
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