Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to page options Skip directly to site content

Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)

Type and Duration of Precautions Recommended for Selected Infections and Conditions1

Appendix A Updates [September 2018]

Changes: Updates and clarifications made to the table in Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions.

A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   Y   Z

A

Diseases beginning with the letter A, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Abscess
Draining, major
Contact + Standard
Duration of illness
Until drainage stops or can be contained by dressing.
Abscess
Draining, minor or limited
Standard
n/a
If dressing covers and contains drainage.
Acquired human immunodeficiency syndrome (HIV)
Standard
n/a
Postexposure chemoprophylaxis for some blood exposures [866].
Actinomycosis
Standard
n/a
Not transmitted from person to person.
Adenovirus infection (see agent-specific guidance under Gastroenteritis, Conjunctivitis, Pneumonia)
n/a n/a n/a
Amebiasis
Standard
n/a
Person-to-person transmission is rare. Transmission in settings for the mentally challenged and in a family group has been reported [1045]. Use care when handling diapered infants and mentally challenged persons [1046].
Anthrax
Standard
n/a
Infected patients do not generally pose a transmission risk.
Anthrax
Cutaneous
Standard
n/a
Transmission through non-intact skin contact with draining lesions possible, therefore use Contact Precautions if large amount of uncontained drainage. Handwashing with soap and water preferable to use of waterless alcohol-based antiseptics since alcohol does not have sporicidal activity [983].
Anthrax
Pulmonary
Standard
n/a
Not transmitted from person to person.
Anthrax
Environmental: aerosolizable spore-containing powder or other substance
n/a
Until environment completely decontaminated
Until decontamination of environment complete [203]. Wear respirator (N95 mask or PAPRs), protective clothing; decontaminate persons with powder on them (Notice to Readers: Occupational Health Guidelines for Remediation Workers at Bacillus anthracis-Contaminated Sites — United States, 2001–2002 accessed September 2018).
Hand hygiene: Handwashing for 30-60 seconds with soap and water or 2% chlorhexidine gluconate after spore contact (alcohol handrubs inactive against spores [983].)
Postexposure prophylaxis following environmental exposure: 60 days of antimicrobials (either doxycycline, ciprofloxacin, or levofloxacin) and postexposure vaccine under IND.
Antibiotic-associated colitis (see Clostridium difficile)
n/a n/a n/a
Arthropod-borne
  • viral encephalitides (eastern, western, Venezuelan equine encephalomyelitis; St Louis, California encephalitis; West Nile Virus) and
  • viral fevers (dengue, yellow fever, Colorado tick fever)
Standard
n/a
Not transmitted from person to person except rarely by transfusion, and for West Nile virus by organ transplant, breastmilk or transplacentally [530, 1047]. Install screens in windows and doors in endemic areas.
Use DEET-containing mosquito repellants and clothing to cover extremities.
Ascariasis
Standard
n/a
Not transmitted from person to person.
Aspergillosis
Standard
n/a
Contact Precautions and Airborne if massive soft tissue infection with copious drainage and repeated irrigations required [154].
Avian influenza (see influenza, avian below)
n/a n/a n/a

 Top of Page

B

Diseases beginning with the letter B, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Babesiosis
Standard
n/a
Not transmitted from person to person, except rarely by transfusion.
Blastomycosis, North American, cutaneous or pulmonary
Standard
n/a
Not transmitted from person to person.
Botulism
Standard
n/a
Not transmitted from person to person.
Contact + Standard
Duration of illness
Use mask according to Standard Precautions.
Brucellosis (undulant, Malta, Mediterranean fever)
Standard
n/a
Not transmitted from person to person, except rarely via banked spermatozoa and sexual contact [1048, 1049]. Provide antimicrobial prophylaxis following laboratory exposure [1050].

 Top of Page

C

Diseases beginning with the letter C, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Campylobacter gastroenteritis (see Gastroenteritis)
n/a n/a n/a
Candidiasis, all forms including mucocutaneous
Standard
n/a n/a
Cat-scratch fever (benign inoculation lymphoreticulosis)
Standard
n/a
Not transmitted from person to person.
Cellulitis
Standard
n/a n/a
Chancroid (soft chancre) (H. ducreyi)
Standard
n/a
Transmitted sexually from person to person.
Chickenpox (see Varicella)
n/a n/a n/a
Chlamydia trachomatis
Conjunctivitis
Standard
n/a n/a
Chlamydia trachomatis
Genital (lymphogranuloma venereum)
Standard
n/a n/a
Chlamydia trachomatis
Pneumonia (infants ≤3 mos. of age)
Standard
n/a n/a
Chlamydia pneumoniae
Standard
n/a
Outbreaks in institutionalized populations reported, rarely [1051, 1052].
Cholera (see Gastroenteritis)
n/a n/a n/a
Closed-cavity infection
Open drain in place; limited or minor drainage
Standard
n/a
Contact Precautions if there is copious uncontained drainage.
Closed-cavity infection
No drain or closed drainage system in place
Standard
n/a n/a
Clostridium botulinum
Standard
n/a
Not transmitted from person to person.
Clostridium difficile (see Gastroenteritis, C. difficile)
Contact + Standard
Duration of illness
n/a
Clostridium perfringens
Food poisoning
Standard
n/a
Not transmitted from person to person.
Clostridium perfringens
Gas gangrene
Standard
n/a
Transmission from person to person rare; 1 outbreak in a surgical setting reported [1053]. Use Contact Precautions if wound drainage is extensive.
Coccidioidomycosis (valley fever)
Draining lesions
Standard
n/a
Not transmitted from person to person except under extraordinary circumstances, because the infectious arthroconidial form of Coccidioides immitis is not produced in humans [1054].
Coccidioidomycosis (valley fever)
Pneumonia
Standard
n/a
Not transmitted from person to person except under extraordinary circumstances, (e.g., inhalation of aerosolized tissue phase endospores during necropsy, transplantation of infected lung) because the infectious arthroconidial form of Coccidioides immitis is not produced in humans [1054, 1055].
Colorado tick fever
Standard
n/a
Not transmitted from person to person.
Congenital rubella
Contact + Standard
Until 1 yr of age
Standard Precautions if nasopharyngeal and urine cultures repeatedly negative after 3 mos. of age.
Conjunctivitis
Acute bacterial
Standard
n/a n/a
Conjunctivitis
Acute bacterial
Chlamydia
Standard
n/a n/a
Conjunctivitis
Acute bacterial
Gonococcal
Standard
n/a n/a
Conjunctivitis
Acute viral (acute hemorrhagic)
Contact + Standard
Duration of illness
Adenovirus most common; enterovirus 70 [1056], Coxsackie virus A24 [1057] also associated with community outbreaks. Highly contagious; outbreaks in eye clinics, pediatric and neonatal settings, institutional settings reported. Eye clinics should follow Standard Precautions when handling patients with conjunctivitis. Routine use of infection control measures in the handling of instruments and equipment will prevent the occurrence of outbreaks in this and other settings. [460, 461, 814, 1058-1060].
Corona virus associated with SARS (SARS-CoV) (see Severe Acute Respiratory Syndrome)
n/a n/a n/a
Coxsackie virus disease (see enteroviral infection)
n/a n/a n/a
Creutzfeldt-Jakob disease (CJD, vCJD)
Standard
n/a
Use disposable instruments or special sterilization/disinfection for surfaces, objects contaminated with neural tissue if CJD or vCJD suspected and has not been R/O; No special burial procedures. [1061]
n/a n/a n/a
Crimean-Congo Fever (see Viral Hemorrhagic Fever)
Standard
n/a n/a
Cryptococcosis
Standard
n/a
Not transmitted from person to person, except rarely via tissue and corneal transplant. [1062, 1063]
Cryptosporidiosis (see Gastroenteritis)
n/a n/a n/a
Cysticercosis
Standard
n/a
Not transmitted from person to person.
Cytomegalovirus infection, including in neonates and immunosuppressed patients
Standard
n/a
No additional precautions for pregnant HCWs.

 Top of Page

D

Diseases beginning with the letter D, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Decubitus ulcer (see Pressure Ulcer)
n/a n/a n/a
Dengue fever
Standard
n/a
Not transmitted from person to person.
Diarrhea, acute-infective etiology suspected (see Gastroenteritis)
n/a n/a n/a
Diphtheria
Cutaneous
Contact + Standard
Until off antimicrobial treatment and culture-negative
Until 2 cultures taken 24 hours apart negative.
Diphtheria
Pharyngeal
Droplet + Standard
Until off antimicrobial treatment and culture-negative
Until 2 cultures taken 24 hours apart negative.

 Top of Page

E

Diseases beginning with the letter E, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Ebola virus (see Viral Hemorrhagic Fevers)
n/a n/a
Ebola Virus Disease for Healthcare Workers [2014]
Update or clarification r16Update: Recommendations for healthcare workers can be found at Ebola For Clinicians.

(accessed September 2018).

Echinococcosis (hydatidosis)
Standard
n/a
Not transmitted from person to person.
Echovirus (see Enteroviral Infection)
n/a n/a n/a
Encephalitis or encephalomyelitis (see specific etiologic agents)
n/a n/a n/a
Endometritis (endomyometritis)
Standard
n/a n/a
Enterobiasis (pinworm disease, oxyuriasis)
Standard
n/a n/a
Enterococcus species (see Multidrug-Resistant Organisms if epidemiologically significant or vancomycin-resistant)
n/a n/a n/a
Enterocolitis, C. difficile (see Gastroenteritis, C. difficile)
n/a n/a n/a
Enteroviral infections (i.e., Group A and B Coxsackie viruses and Echo viruses) (excludes polio virus)
Standard
n/a
Use Contact Precautions for diapered or incontinent children for duration of illness and to control institutional outbreaks.
Epiglottitis, due to Haemophilus influenzae type b
Droplet + Standard
Until 24 hours after initiation of effective therapy
See specific disease agents for epiglottitis due to other etiologies.
Epstein-Barr virus infection, including infectious mononucleosis
Standard
n/a n/a
Erythema infectiosum (also see Parvovirus B19)
n/a n/a n/a
Escherichia coli gastroenteritis (see Gastroenteritis)
n/a n/a n/a

 Top of Page

F

Diseases beginning with the letter F, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Food poisoning
Botulism
Standard
n/a
Not transmitted from person to person.
Food poisoning
C. perfringens or welchii
Standard
n/a
Not transmitted from person to person.
Food poisoning
Staphylococcal
Standard
n/a
Not transmitted from person to person.
Furunculosis, staphylococcal
Standard
n/a
Contact if drainage not controlled. Follow institutional policies if MRSA.
Furunculosis, staphylococcal
Infants and young children
Contact + Standard
Duration of illness (with wound lesions, until wounds stop draining)
n/a

 Top of Page

G

Diseases beginning with the letter G, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Gangrene (gas gangrene)
Standard
n/a
Not transmitted from person to person.
Gastroenteritis
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks for gastroenteritis caused by all of the agents below.
Gastroenteritis
Adenovirus
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Campylobacter species
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Cholera (Vibrio cholerae)
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
C. difficile
Contact + Standard
Duration of illness
Discontinue antibiotics if appropriate. Do not share electronic thermometers; [853, 854] ensure consistent environmental cleaning and disinfection. Hypochlorite solutions may be required for cleaning if transmission continues [847]. Handwashing with soap and water preferred because of the absence of sporicidal activity of alcohol in waterless antiseptic handrubs [983].
Gastroenteritis
Cryptosporidium species
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
E. coli
Enteropathogenic O157:H7 and other Shiga toxin-producing strains
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
E. coli
Other species
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Giardia lamblia
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Noroviruses
Standard
n/a

Use Contact Precautions for a minimum of 48 hours after the resolution of symptoms or to control institutional outbreaks.

Persons who clean areas heavily contaminated with feces or vomitus may benefit from wearing masks since virus can be aerosolized from these body substances [142, 147 148]; ensure consistent environmental cleaning and disinfection with focus on restrooms even when apparently unsoiled [273, 1064]. Hypochlorite solutions may be required when there is continued transmission [290-292]. Alcohol is less active, but there is no evidence that alcohol antiseptic handrubs are not effective for hand decontamination [294].

Cohorting of affected patients to separate airspaces and toilet facilities may help interrupt transmission during outbreaks.

Gastroenteritis
Rotavirus
Contact + Standard
Duration of illness
Ensure consistent environmental cleaning and disinfection and frequent removal of soiled diapers. Prolonged shedding may occur in both immunocompetent and immunocompromised children and the elderly [932, 933].
Gastroenteritis
Salmonella species (including S. typhi)
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Shigella species (Bacillary dysentery)
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Vibrio parahaemolyticus
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Viral (if not covered elsewhere)
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Gastroenteritis
Yersinia enterocolitica
Standard
n/a
Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
German measles (see Rubella; see Congenital Rubella)
n/a n/a n/a
Giardiasis (see Gastroenteritis)
n/a n/a n/a
Gonococcal ophthalmia neonatorum (gonorrheal ophthalmia, acute conjunctivitis of newborn)
Standard
n/a n/a
Gonorrhea
Standard
n/a n/a
Granuloma inguinale (Donovanosis, granuloma venereum)
Standard
n/a n/a
Guillain-Barré syndrome
Standard
n/a
Not an infectious condition.

 Top of Page

H

Diseases beginning with the letter H, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Haemophilus influenzae (see disease-specific recommendations)
n/a n/a n/a
Hand, foot, and mouth disease (see Enteroviral Infection)
n/a n/a n/a
Hansen’s Disease (see Leprosy)
n/a n/a n/a
Hantavirus pulmonary syndrome
Standard
n/a
Not transmitted from person to person.
Helicobacter pylori
Standard
n/a n/a
Hepatitis, viral
Type A
Standard
n/a
Provide hepatitis A vaccine postexposure as recommended. [1065]
Hepatitis, viral
Type A-Diapered or incontinent patients
Contact + Standard
n/a
Maintain Contact Precautions in infants and children <3 years of age for duration of hospitalization; for children 3-14 yrs. of age for 2 weeks after onset of symptoms; >14 yrs. of age for 1 week after onset of symptoms [833, 1066, 1067].
Hepatitis, viral
Type B-HBsAg positive; acute or chronic
Standard
n/a
See specific recommendations for care of patients in hemodialysis centers. [778]
Hepatitis, viral
Type C and other unspecified non-A, non-B
Standard
n/a
See specific recommendations for care of patients in hemodialysis centers. [778]
Hepatitis, viral
Type D (seen only with hepatitis B)
Standard
n/a n/a
Hepatitis, viral
Type E
Standard
n/a
Use Contact Precautions for diapered or incontinent individuals for the duration of illness. [1068]
Hepatitis, viral
Type G
Standard
n/a n/a
Herpangina (see Enteroviral Infection)
n/a n/a n/a
Hookworm
Standard
n/a n/a
Herpes simplex (Herpesvirus hominis)
Encephalitis
Standard
n/a n/a
Herpes simplex (Herpesvirus hominis)
Mucocutaneous, disseminated or primary, severe
Contact + Standard
Until lesions dry and crusted
n/a
Herpes simplex (Herpesvirus hominis)
Mucocutaneous, recurrent (skin, oral, genital)
Standard
n/a n/a
Herpes simplex (Herpesvirus hominis)
Neonatal
Contact + Standard
Until lesions dry and crusted
Also, for asymptomatic, exposed infants delivered vaginally or by C-section and if mother has active infection and membranes have been ruptured for more than 4 to 6 hours until infant surface cultures obtained at 24-36 hours of age negative after 48 hours incubation. [1069, 1070]
Herpes zoster (varicella-zoster) (shingles)
Disseminated disease in any patient
Localized disease in immunocompromised patient until disseminated infection ruled out
Airborne + Contact + Standard
Duration of illness
Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for protection of immune HCWs; no recommendation for type of protection (i.e. surgical mask or respirator) for susceptible HCWs.
Herpes zoster (varicella-zoster) (shingles)
Localized in patient with intact immune system with lesions that can be contained/covered
Standard
Until lesions dry and crusted
Susceptible HCWs should not provide direct patient care when other immune caregivers are available.
Histoplasmosis
Standard
n/a
Not transmitted from person to person.
Human immunodeficiency virus (HIV)
Standard
n/a
Postexposure chemoprophylaxis for some blood exposures [866].
Human metapneumovirus
Contact + Standard
Duration of illness
HAI reported [1071], but route of transmission not established [823]. Assumed to be Contact transmission as for RSV since the viruses are closely related and have similar clinical manifestations and epidemiology. Wear masks according to Standard Precautions.

 Top of Page

I

Diseases beginning with the letter I, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Impetigo
Contact + Standard
Until 24 hours after initiation of effective therapy
n/a
Infectious mononucleosis
Standard
n/a n/a
Influenza
Human (seasonal influenza)
n/a n/a
See Prevention Strategies for Seasonal Influenza in Healthcare Settings (accessed September 2018). [Current version of this document may differ from original.] for current seasonal influenza guidance.
Influenza
Avian (e.g., H5N1, H7, H9 strains)
n/a n/a
See [This link is no longer active: www.cdc.gov/flu/avian/professional/infect-control.htm. Similar information may be found at Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease (accessed September 2018).] for current avian influenza guidance.
Influenza
Pandemic Influenza (also a human influenza virus)
Droplet + Standard
n/a
See [This link is no longer active: http://www.pandemicflu.gov. Similar information may be found at Interim Guidance for Infection Control Within Healthcare Settings When Caring for Confirmed Cases, Probable Cases, and Cases Under Investigation for Infection with Novel Influenza A Viruses Associated with Severe Disease (accessed September 2018).] for current pandemic influenza guidance.

 Top of Page

K

Diseases beginning with the letter K, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Kawasaki syndrome
Standard
n/a
Not an infectious condition.

 Top of Page

L

Diseases beginning with the letter L, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Lassa fever (see Viral Hemorrhagic Fevers)
n/a n/a n/a
Legionnaires’ disease
Standard
n/a
Not transmitted from person to person.
Leprosy
Standard
n/a n/a
Leptospirosis
Standard
n/a
Not transmitted from person to person.
Lice
Head (pediculosis)
Contact + Standard
Until 24 hours after initiation of effective therapy
See [This link is no longer active: https://www.cdc.gov/ncidod/dpd/parasites/lice/default.htm. Similar information may be found at CDC’s Parasites – Lice (accessed September 2018).]
Lice
Body
Standard
n/a
Transmitted person-to-person through infested clothing. Wear gown and gloves when removing clothing; bag and wash clothes according to CDC guidance Parasites – Lice (accessed September 2018).
Lice
Pubic
Standard
n/a
Transmitted person-to-person through sexual contact. See CDC’s Parasites – Lice (accessed September 2018).
Listeriosis (listeria monocytogenes)
Standard
n/a
Person-to-person transmission rare; cross-transmission in neonatal settings reported. [1072-1075]
Lyme disease
Standard
n/a
Not transmitted from person to person.
Lymphocytic choriomeningitis
Standard
n/a
Not transmitted from person to person.
Lymphogranuloma venereum
Standard
n/a n/a

 Top of Page

M

Diseases beginning with the letter M, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Malaria
Standard
n/a
Not transmitted from person to person, except through transfusion rarely and through a failure to follow Standard Precautions during patient care. [1076-1079] Install screens in windows and doors in endemic areas. Use DEET- containing mosquito repellants and clothing to cover extremities.
Marburg virus disease (see Viral Hemorrhagic Fevers)
n/a n/a n/a
Measles (rubeola)
Airborne + Standard
4 days after onset of rash; duration of illness in immune compromised

Measles [November 2011]

Update or clarification r2Update: Recommendations for healthcare workers can be found at Immunization of Healthcare Personnel: Recommendations of the Advisory Committee on Immunization Practices (ACIP) [PDF – 705 KB].

 

Susceptible HCWs should not enter room if immune care providers are available; no recommendation for face protection for immune HCW; no recommendation for type of face protection for susceptible HCWs, i.e., mask or respirator [1027, 1028]. For exposed susceptibles, postexposure vaccine within 72 hours or immune globulin within 6 days when available [17, 1032, 1034]. Place exposed susceptible patients on Airborne Precautions and exclude susceptible healthcare personnel.

Melioidosis, all forms
Standard
n/a
Not transmitted from person to person.
Meningitis
Aseptic (nonbacterial or viral; also see Enteroviral infections)
Standard
n/a
Contact for infants and young children.
Meningitis
Bacterial, gram-negative enteric, in neonates
Standard
n/a n/a
Meningitis
Fungal
Standard
n/a n/a
Meningitis
Haemophilus Influenzae, type b known or suspected
Droplet + Standard
Until 24 hours after initiation of effective therapy
n/a
Meningitis
Listeria monocytogenes (See Listeriosis)
Standard
n/a n/a
Meningitis
Neisseria meningitidis (meningococcal) known or suspected
Droplet + Standard
Until 24 hours after initiation of effective therapy
Meningitis
Streptococcus pneumoniae
Standard
n/a n/a
Meningitis
M. tuberculosis
Standard
n/a
Concurrent, active pulmonary disease or draining cutaneous lesions may necessitate addition of Contact and/or Airborne. For children, Airborne Precautions until active tuberculosis ruled out in visiting family members (see Tuberculosis below). [42]
Meningitis
Other diagnosed bacterial
Standard
n/a n/a
Meningococcal disease: sepsis, pneumonia, Meningitis
Droplet + Standard
Until 24 hours after initiation of effective therapy
Postexposure chemoprophylaxis for household contacts, HCWs exposed to respiratory secretions; postexposure vaccine only to control outbreaks. [15, 17]
Molluscum contagiosum
Standard
n/a n/a
Monkeypox
Airborne + Contact + Standard
Airborne – Until monkeypox confirmed and smallpox excluded
Contact – Until lesions crusted
See CDC’s Monkeypox website (accessed September 2018). [Current version of this document may differ from original.] for most current recommendations. Transmission in hospital settings unlikely [269]. Pre- and postexposure smallpox vaccine recommended for exposed HCWs.
Mucormycosis
Standard
n/a n/a
Multidrug-resistant organisms (MDROs), infection or colonization (e.g., MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)
Contact + Standard
n/a
MDROs judged by the infection control program, based on local, state, regional, or national recommendations, to be of clinical and epidemiologic significance. Contact Precautions recommended in settings with evidence of ongoing transmission, acute care settings with increased risk for transmission or wounds that cannot be contained by dressings. See recommendations for management options in Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006 [870]. Contact state health department for guidance regarding new or emerging MDRO.
Mumps (infectious parotitis)
Droplet + Standard
Until 5 days after the onset of swelling
Mumps [October 2017]
Update on mumps recommendationUpdate: The Healthcare Infection Control Practices Advisory Committee (HICPAC) voted to change the recommendation of isolation for persons with mumps from 9 days to 5 days based on this 2008 MMWR reportUpdated Recommendations for Isolation of Persons with Mumps (accessed September 2018).
After onset of swelling; susceptible HCWs should not provide care if immune caregivers are available.
The below note has been superseded by the above recommendation update
Note: (Recent assessment of outbreaks in healthy 18-24 year olds has indicated that salivary viral shedding occurred early in the course of illness and that 5 days of isolation after onset of parotitis may be appropriate in community settings; however the implications for healthcare personnel and high-risk patient populations remain to be clarified.)
Mycobacteria, nontuberculosis (atypical)
n/a n/a
Not transmitted person-to-person.
Mycobacteria, nontuberculosis (atypical)
Pulmonary
Standard
n/a n/
Mycobacteria, nontuberculosis (atypical)
Wound
Standard
n/a n/a
Mycoplasma pneumonia
Droplet + Standard
Duration of Illness
n/a

 Top of Page

N

Diseases beginning with the letter N, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Necrotizing enterocolitis
Standard
n/a
Contact Precautions when cases clustered temporally [1080-1083].
Nocardiosis, draining lesions, or other presentations
Standard
n/a
Not transmitted person-to-person.
Norovirus (see Gastroenteritis)
n/a n/a n/a
Norwalk agent Gastroenteritis (see Gastroenteritis)
n/a n/a n/a

 Top of Page

O

Diseases beginning with the letter O, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Orf
Standard
n/a n/a

 Top of Page

P

Diseases beginning with the letter P, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Parainfluenza virus infection, respiratory in infants and young children
Contact + Standard
Duration of illness
Viral shedding may be prolonged in immunosuppressed patients [1009, 1010]. Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.
Parvovirus B19 (Erythema infectiosum)
Droplet + Standard
n/a
Maintain precautions for duration of hospitalization when chronic disease occurs in an immunocompromised patient. For patients with transient aplastic crisis or red-cell crisis, maintain precautions for 7 days. Duration of precautions for immunosuppressed patients with persistently positive PCR not defined, but transmission has occurred [929].
Pediculosis (lice)
Contact + Standard
Until 24 hours after initiation of effective therapy after treatment
n/a
Pertussis (whooping cough)
Droplet + Standard
Until 5 days after initiation of effective antibiotic therapy

Single patient room preferred. Cohorting an option. Postexposure chemoprophylaxis for household contacts and HCWs with prolonged exposure to respiratory secretions [863]. Recommendations for Tdap vaccine in adults under development.

Tdap Vaccine Recommendations [2018]
Update or clarificationUpdate: Current recommendations can be found at Tdap / Td ACIP Vaccine Recommendations (accessed September 2018).

Pinworm infection (Enterobiasis)
Standard
n/a n/a
Plague (Yersinia pestis)
Bubonic
Standard
n/a n/a
Plague (Yersinia pestis)
Pneumonic
Droplet + Standard
Until 48 hours after initiation of effective antibiotic therapy
Antimicrobial prophylaxis for exposed HCW [207].
Pneumonia
Adenovirus
Droplet + Contact + Standard
Duration of illness
Outbreaks in pediatric and institutional settings reported [376, 1084-1086]. In immunocompromised hosts, extend duration of Droplet and Contact Precautions due to prolonged shedding of virus. [931]
Pneumonia
Bacterial not listed elsewhere (including gram-negative bacterial)
Standard
n/a n/a
Pneumonia
B. cepacia in patients with CF, including respiratory tract colonization
Contact + Standard
Unknown
Avoid exposure to other persons with CF; private room preferred. Criteria for D/C precautions not established. See CF Foundation guideline. [20]
Pneumonia
B. cepacia in patients without CF (see Multidrug-Resistant Organisms)
n/a n/a n/a
Pneumonia
Chlamydia
Standard
n/a n/a
Pneumonia
Fungal
Standard
n/a n/a
Pneumonia
Haemophilus influenzae, type b
Adults
Standard
n/a n/a
Pneumonia
Haemophilus influenzae, type b
Infants and children
Droplet + Standard
Until 24 hours after initiation of effective therapy
n/a
Pneumonia
Legionella spp.
Standard
n/a n/a
Pneumonia .
Meningococcal
Droplet + Standard
Until 24 hours after initiation of effective therapy
Pneumonia
Multidrug-resistant bacterial (see Multidrug-Resistant Organisms)
n/a n/a n/a
Pneumonia
Mycoplasma (primary atypical Pneumonia)
Droplet + Standard
Duration of illness
n/a
Pneumonia
Pneumococcal pneumonia
Standard
n/a
Use Droplet Precautions if evidence of transmission within a patient care unit or facility. [196-198, 1087]
Pneumonia
Pneumocystis jiroveci (Pneumocystis carinii)
Standard
n/a
Avoid placement in the same room with an immunocompromised patient.
Pneumonia
Staphylococcus aureus
Standard
n/a
For MRSA, see MDROs.
Pneumonia
Streptococcus, group A
Adults
Droplet + Standard
Until 24 hours after initiation of effective therapy
See Streptococcal Disease (group A Streptococcus) below
Contact Precautions if skin lesions present.
Pneumonia
Streptococcus, group A
Infants and young children
Droplet + Standard
Until 24 hours after initiation of effective therapy
Contact Precautions if skin lesions present.
Pneumonia
Varicella-Zoster (See Varicella-Zoster)
n/a n/a n/a
Pneumonia
Viral
Adults
Standard
n/a n/a
Pneumonia
Viral
Infants and young children (see Respiratory Infectious Disease, acute, or specific viral agent)
n/a n/a n/a
Poliomyelitis
Contact + Standard
Duration of illness
n/a
Pressure ulcer (decubitus ulcer, pressure sore) infected
Major
Contact + Standard
Duration of illness
Until drainage stops or can be contained by dressing.
Pressure ulcer (decubitus ulcer, pressure sore) infected
Minor or limited
Standard
n/a
If dressing covers and contains drainage.
Prion disease (See Creutzfeld-Jacob Disease)
n/a n/a n/a
Psittacosis (ornithosis) (Chlamydia psittaci)
Standard
n/a
Not transmitted from person to person.

 Top of Page

Q

Diseases beginning with the letter Q, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Q fever
Standard
n/a n/a

 Top of Page

R

Diseases beginning with the letter R, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Rabies
Standard
n/a
Person to person transmission rare; transmission via corneal, tissue and organ transplants has been reported [539, 1088]. If patient has bitten another individual or saliva has contaminated an open wound or mucous membrane, wash exposed area thoroughly and administer postexposure prophylaxis. [1089]
Rat-bite fever (Streptobacillus moniliformis disease, Spirillum minus disease)
Standard
n/a
Not transmitted from person to person.
Relapsing fever
Standard
n/a
Not transmitted from person to person.
Resistant bacterial infection or colonization (see Multidrug-Resistant Organisms)
n/a n/a n/a
Respiratory infectious disease, acute (if not covered elsewhere)
Adults
Standard
n/a n/a
Respiratory infectious disease, acute (if not covered elsewhere)
Infants and young children
Contact + Standard
Duration of illness
Also see syndromes or conditions listed in Table 2.
Respiratory syncytial virus infection, in infants, young children and immunocompromised adults
Contact + Standard
Duration of illness
Wear mask according to Standard Precautions [24] CB [116, 117]. In immunocompromised patients, extend the duration of Contact Precautions due to prolonged shedding [928]. Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.
Reye’s syndrome
Standard
n/a
Not an infectious condition.
Rheumatic fever
Standard
n/a
Not an infectious condition.
Rhinovirus
Droplet + Standard
Duration of illness
Droplet most important route of transmission [104 1090]. Outbreaks have occurred in NICUs and LTCFs [413, 1091, 1092]. Add Contact Precautions if copious moist secretions and close contact likely to occur (e.g., young infants) [111, 833].
Rickettsial fevers, tickborne (Rocky Mountain spotted fever, tickborne Typhus fever)
Standard
n/a
Not transmitted from person to person except through transfusion, rarely.
Rickettsialpox (vesicular rickettsiosis)
Standard
n/a
Not transmitted from person to person.
Ringworm (dermatophytosis, dermatomycosis, tinea)
Standard
n/a
Rarely, outbreaks have occurred in healthcare settings, (e.g., NICU [1093], rehabilitation hospital [1094]. Use Contact Precautions for outbreak.
Rocky Mountain spotted fever
Standard
n/a
Not transmitted from person to person except through transfusion, rarely.
Roseola infantum (exanthem subitum; caused by HHV-6)
Standard
n/a n/a
Rotavirus infection (see Gastroenteritis)
n/a n/a n/a
Rubella (German measles) (also see Congenital Rubella)
Droplet + Standard
Until 7 days after onset of rash

Susceptible HCWs should not enter room if immune caregivers are available. No recommendation for wearing face protection (e.g., a surgical mask) if immune. Pregnant women who are not immune should not care for these patients [17, 33]. Administer vaccine within 3 days of exposure to non-pregnant susceptible individuals.

Place exposed susceptible patients on Droplet Precautions; exclude susceptible healthcare personnel from duty from day 5 after first exposure to day 21 after last exposure, regardless of postexposure vaccine.

Rubeola (see Measles)
n/a n/a n/a

 Top of Page

S

Diseases beginning with the letter S, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Salmonellosis (see Gastroenteritis)
n/a n/a n/a
Scabies
Contact + Standard
Until 24
n/a
Scalded skin syndrome, staphylococcal
Contact + Standard
Duration of illness
Schistosomiasis (bilharziasis)
Standard
n/a n/a
Severe acute respiratory syndrome (SARS)
Airborne + Droplet + Contact + Standard
Duration of illness plus 10 days after resolution of fever, provided respiratory symptoms are absent or improving

Airborne preferred; Droplet if AIIR unavailable. N95 or higher respiratory protection; surgical mask if N95 unavailable; eye protection (goggles, face shield); aerosol-generating procedures and “supershedders” highest risk for transmission via small droplet nuclei and large droplets [93, 94, 96].

Vigilant environmental disinfection (see [This link is no longer active: www.cdc.gov/ncidod/sars. Similar information may be found at CDC Severe Acute Respiratory Syndrome (SARS) (accessed September 2018).])

Shigellosis (see Gastroenteritis)
n/a n/a n/a
Smallpox (variola; see Vaccinia for management of vaccinated persons)
Airborne + Contact + Standard
Duration of illness
Until all scabs have crusted and separated (3-4 weeks). Non-vaccinated HCWs should not provide care when immune HCWs are available; N95 or higher respiratory protection for susceptible and successfully vaccinated individuals; postexposure vaccine within 4 days of exposure protective [108, 129, 1038-1040].
Sporotrichosis
Standard
n/a n/a
Spirillum minor disease (rat-bite fever)
Standard
n/a
Not transmitted from person to person.
Staphylococcal disease (S. aureus)
Skin, wound, or burn
Major
Contact + Standard
Duration of illness
Until drainage stops or can be contained by dressing.
Staphylococcal disease (S. aureus)
Skin, wound, or burn
Minor or limited
Standard
n/a
If dressing covers and contains drainage adequately.
Staphylococcal disease (S. aureus)
Enterocolitis
Standard
n/a
Use Contact Precautions for diapered or incontinent children for duration of illness.
Staphylococcal disease (S. aureus)
Multidrug-resistant (see Multidrug-Resistant Organisms)
n/a n/a n/a
Staphylococcal disease (S. aureus)
Pneumonia
Standard
n/a n/a
Staphylococcal disease (S. aureus)
Scalded skin syndrome
Contact + Standard
Duration of illness
Consider healthcare personnel as potential source of nursery, NICU outbreak [1095].
Staphylococcal disease (S. aureus)
Toxic shock syndrome
Standard
n/a n/a
Streptobacillus moniliformis disease (rat-bite fever)
Standard
n/a
Not transmitted from person to person.
Streptococcal disease (group A Streptococcus)
Skin, wound, or burn
Major
Contact + Droplet + Standard
Until 24 hours after initiation of effective therapy
Until drainage stops or can be contained by dressing.
Streptococcal disease (group A Streptococcus)
Skin, wound, or burn
Minor or limited
Standard
n/a
If dressing covers and contains drainage.
Streptococcal disease (group A Streptococcus)
Endometritis (puerperal sepsis)
Standard
n/a n/a
Streptococcal disease (group A Streptococcus)
Pharyngitis in infants and young children
Droplet + Standard
Until 24 hours after initiation of effective therapy
n/a
Streptococcal disease (group A Streptococcus)
Pneumonia
Droplet + Standard
Until 24 hours after initiation of effective therapy
n/a
Streptococcal disease (group A Streptococcus)
Scarlet fever in infants and young children
Droplet + Standard
Until 24 hours after initiation of effective therapy
n/a
Streptococcal disease (group A Streptococcus)
Serious invasive disease
Droplet + Standard
Until 24 hours after initiation of effective therapy
<divOutbreaks of serious invasive disease have occurred secondary to transmission among patients and healthcare personnel [162, 972, 1096-1098].

Contact Precautions for draining wound as above; follow recommendations for antimicrobial prophylaxis in selected conditions [160].

Streptococcal disease (group B Streptococcus), neonatal
Standard
n/a n/a
Streptococcal disease (not group A or B) unless covered elsewhere
Multidrug-resistant (see Multidrug-Resistant Organisms)
n/a n/a n/a
Strongyloidiasis
Standard
n/a n/a
Syphilis
Latent (tertiary) and seropositivity without lesions
Standard
n/a n/a
Syphilis
Skin and mucous membrane, including congenital, primary, Secondary
Standard
n/a n/a

 Top of Page

T

Diseases beginning with the letter T, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Tapeworm disease
Hymenolepis nana
Standard
n/a
Not transmitted from person to person.
Tapeworm disease
Taenia solium (pork)
Standard
n/a n/a
Tapeworm disease
Other
Standard
n/a n/a
Tetanus
Standard
n/a
Not transmitted from person to person.
Tinea (e.g., dermatophytosis, dermatomycosis, ringworm)
Standard
n/a
Rare episodes of person-to-person transmission.
Toxoplasmosis
Standard
n/a
Transmission from person to person is rare; vertical transmission from mother to child, transmission through organs and blood transfusion rare.
Toxic shock syndrome (staphylococcal disease, streptococcal disease)
Standard
n/a
Droplet Precautions for the first 24 hours after implementation of antibiotic therapy if Group A Streptococcus is a likely etiology.
Trachoma, acute
Standard
n/a
n/a
Transmissible spongiform encephalopathy (see Creutzfeld-Jacob disease, CJD, vCJD)
n/a n/a n/a
Trench mouth (Vincent’s angina)
Standard
n/a n/a
Trichinosis
Standard
n/a n/a
Trichomoniasis
Standard
n/a n/a
Trichuriasis (whipworm disease)
Standard
n/a n/a
Tuberculosis (M. tuberculosis)
Extrapulmonary, draining lesion
Airborne + Contact + Standard
n/a
Discontinue precautions only when patient is improving clinically, and drainage has ceased or there are 3 consecutive negative cultures of continued drainage [1025, 1026]. Examine for evidence of active pulmonary tuberculosis.
Tuberculosis (M. tuberculosis)
Extrapulmonary, no draining lesion, Meningitis
Standard
n/a
Examine for evidence of pulmonary tuberculosis. For infants and children, use Airborne until active pulmonary tuberculosis in visiting family members ruled out. [42]
Tuberculosis (M. tuberculosis)
Pulmonary or laryngeal disease, confirmed
Airborne + Standard
n/a
Discontinue precautions only when patient on effective therapy is improving clinically and has 3 consecutive sputum smears negative for acid-fast bacilli collected on separate days (MMWR 2005; 54: RR-17 Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005) (accessed September 2018) [12].
Tuberculosis (M. tuberculosis)
Pulmonary or laryngeal disease, suspected
Airborne + Standard
n/a
Discontinue precautions only when the likelihood of infectious TB disease is deemed negligible, and either
  1. there is another diagnosis that explains the clinical syndrome, or
  2. the results of 3 sputum smears for AFB are negative.

Each of the 3 sputum specimens should be collected 8 -24 hours apart, and at least 1 should be an early morning specimen.

Tuberculosis (M. tuberculosis)
Skin-test positive with no evidence of current active disease
Standard
n/a n/a
Tularemia
Draining lesion
Standard
n/a
Not transmitted from person to person.
Tularemia
Pulmonary
Standard
n/a
Not transmitted from person to person.
Typhoid (Salmonella typhi) fever (see Gastroenteritis)
n/a n/a n/a
Typhus
Rickettsia prowazekii (Epidemic or Louse-borne Typhus)
Standard
n/a
Transmitted from person to person through close personal or clothing contact.
Typhus
Rickettsia typhi
Standard
n/a
Not transmitted from person to person.

 Top of Page

U

Diseases beginning with the letter U, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Urinary tract infection (including pyelonephritis), with or without urinary catheter
Standard
n/a n/a

 Top of Page

V

Diseases beginning with the letter V, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Vaccinia
n/a n/a
Only vaccinated HCWs have contact with active vaccination sites and care for persons with adverse vaccinia events; if unvaccinated, only HCWs without contraindications to vaccine may provide care.
Vaccinia
Vaccination site care (including autoinoculated areas)
Standard
n/a
Vaccination recommended for vaccinators; for newly vaccinated HCWs: semi-permeable dressing over gauze until scab separates, with dressing change as fluid accumulates, ~3-5 days; gloves, hand hygiene for dressing change; vaccinated HCW or HCW without contraindication to vaccine for dressing changes. [205, 221, 225].
Vaccinia (adverse events following vaccination)
Eczema vaccinatum
Contact + Standard
Until lesions dry and crusted, scabs separated
For contact with virus-containing lesions and exudative material.
Vaccinia (adverse events following vaccination)
Fetal vaccinia
Contact + Standard
Until lesions dry and crusted, scabs separated
For contact with virus-containing lesions and exudative material.
Vaccinia (adverse events following vaccination)
Generalized vaccinia
Contact + Standard
Until lesions dry and crusted, scabs separated
For contact with virus-containing lesions and exudative material.
Vaccinia (adverse events following vaccination)
Progressive vaccinia
Contact + Standard
Until lesions dry and crusted, scabs separated
For contact with virus-containing lesions and exudative material.
Vaccinia (adverse events following vaccination)
Postvaccinia encephalitis
Standard
n/a n/a
Vaccinia (adverse events following vaccination)
Blepharitis or conjunctivitis
Contact + Standard
n/a
Use Contact Precautions if there is copious drainage.
Vaccinia (adverse events following vaccination)
Iritis or keratitis
Standard
n/a n/a
Vaccinia (adverse events following vaccination)
Vaccinia-associated erythema multiforme (Stevens Johnson Syndrome)
Standard
n/a
Not an infectious condition.
Vaccinia  (adverse events following vaccination)
Secondary bacterial infection (e.g., S. aureus, group A beta hemolytic Streptococcus)
Standard + Contact
n/a
Follow organism-specific (strep, staph most frequent) recommendations and consider magnitude of drainage.
Varicella Zoster
Airborne + Contact + Standard
Until lesions dry and crusted

Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for face protection of immune HCWs; no recommendation for type of protection (i.e., surgical mask or respirator) for susceptible HCWs.

In immunocompromised host with varicella pneumonia, prolong duration of precautions for duration of illness.

Postexposure prophylaxis: provide postexposure vaccine ASAP but within 120 hours; for susceptible exposed persons for whom vaccine is contraindicated (immunocompromised persons, pregnant women, newborns whose mother’s varicella onset is <5 days before delivery or within 48 hours after delivery) provide VZIG, when available, within 96 hours; if unavailable, use IVIG.

Use Airborne for exposed susceptible persons and exclude exposed susceptible healthcare workers beginning 8 days after first exposure until 21 days after last exposure or 28 if received VZIG, regardless of postexposure vaccination. [1036]

Variola (see Smallpox)
n/a n/a n/a
Vibrio parahaemolyticus (see Gastroenteritis)
n/a n/a n/a
Vincent’s angina (trench mouth)
Standard
n/a n/a
Viral hemorrhagic fevers due to Lassa, Ebola, Marburg, Crimean-Congo fever viruses
Droplet + Contact + Standard
Duration of illness

Ebola Virus Disease for Healthcare Workers [2014]
Update or clarification r16Update: Recommendations for healthcare workers can be found at Ebola For Clinicians.
(accessed September 2018).

Single-patient room preferred. Emphasize:

  1. use of sharps safety devices and safe work practices,
  2. hand hygiene;
  3. barrier protection against blood and body fluids upon entry into room (single gloves and fluid-resistant or impermeable gown, face/eye protection with masks, goggles or face shields); and
  4. appropriate waste handling.

Use N95 or higher respirators when performing aerosol-generating procedures. Largest viral load in final stages of illness when hemorrhage may occur; additional PPE, including double gloves, leg and shoe coverings may be used, especially in resource-limited settings where options for cleaning and laundry are limited. Notify public health officials immediately if Ebola is suspected [212, 314, 740, 772]. Also see Table 3C for Ebola as a bioterrorism agent.

Viral respiratory diseases (not covered elsewhere)
Adults
Standard
n/a n/a
Viral respiratory diseases (not covered elsewhere)
Infants and young children (see Respiratory infectious disease, acute)
n/a n/a n/a

 Top of Page

W

Diseases beginning with the letter W, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Whooping cough (see Pertussis)
n/a n/a n/a
Wound infections
Major
Contact + Standard
Duration of illness
Until drainage stops or can be contained by dressing.
Wound infections
Minor or limited
Standard
n/a
If dressing covers and contains drainage.

 Top of Page

Y

Diseases beginning with the letter Y, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Yersinia enterocolitica Gastroenteritis (see Gastroenteritis)
n/a n/a n/a

 Top of Page

Z

Diseases beginning with the letter Z, precaution type, duration, and comments.
Infection/Condition Type of Precaution Duration of Precaution Precautions/Comments
Zoster (varicella-zoster) (see Herpes Zoster)
n/a n/a n/a
Zygomycosis (phycomycosis, mucormycosis)
Standard
n/a
Not transmitted person-to-person.

 Top of Page

TOP