● Pathogens – agents that cause infection or disease, including microorganisms such as a bacterium, protozoan, prion, or virus. These agents cause communicable diseases that spread easily through contact with others. ● Percutaneous exposure – caused by an injury, such as a needle stick or cut with a sharp object that allows contact of mucous membrane or nonintact skin with blood, saliva, tissue, or other body fluids that are potentially infectious. Injury can also occur through exposed skin that is chapped, abraded, or broken due to dermatitis or other skin conditions. CDC guidelines: Types of infectious disease and transmission Infection transmitted between an infectious agent and a host may cause disease to develop and progress, bringing about illness or death. In some cases, the host may be temporarily or permanently colonized but show no symptoms of the infection or disease. It is possible for infection to develop from colonization and rapidly progress to disease after exposure or after an extended period of colonization. Sources of infection after death The four main sources of infection that may be present in human remains include the following: ● Blood and body fluids, including saliva and lung and gastrointestinal fluids. ● Waste products, such as feces and urine. Transmission Transmission of infectious agents within a healthcare setting requires three elements: ● A source or reservoir of infectious agents. ● A susceptible host with a portal of entry to receive the infectious agent. ● A mode of transmission for the infectious agent. Individual microorganisms normally have a specific mode of transmission and route to enter the body, but some types of infection can spread in multiple ways, such as: ● Contaminated hands, fingers, or objects placed into the mouth, nose, or eyes. ● Instruments or equipment that are inadequately cleaned between patients or before disinfection or sterilization or that have manufacturing defects that interfere with the effectiveness of reprocessing may transmit bacterial and viral pathogens. ● Clothing, uniforms, laboratory coats, or personal protective equipment (PPE) may become contaminated with potential pathogens after contact with colonized or infectious agents, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), and Clostiridium difficile (C. diff.). Soiled garments have the potential to transmit infectious agents. ● Inhalation of small droplets of microorganisms can occur without PPE. ● Blood and body fluids may splash into the eye, nose, or mouth for contact with other mucous membranes. ● Breaks in the skin may lead to direct contact with microorganisms or contaminated objects. ● Pathogens may enter through any puncture or injury to the skin such as contaminated needles or sharp objects. According to OSHA guidelines (n.d.b), the routes of infectious disease transmission for mortuary personnel include contact, droplet, and airborne. ● Contact transmission can be classified as direct or indirect contact. Direct contact transmission involves transfer of infectious agents to a susceptible individual through physical contact with an infected individual such as direct skin-to-skin contact. Indirect contact transmission occurs when infectious agents transfer to a susceptible individual when the individual makes physical contact with contaminated items and surfaces, such as doorknobs, instruments, equipment, or
● Prions – proteins that can trigger other proteins to fold abmormally (Johns Hopkins Medicine, (2022). They can cause degenerative brain diseases, including mad cow disease (bovine spongiform encephalopathy, BSE), Creutzfeldt-Jakob disease (CJD), and inherited forms of dementia such as Gerstmann-Straussler-Scheinker (GSS) disease.. ● Susceptible host – an individual without adequate immunity to withstand exposure or contact with a particular infectious agent. ● Virulence – the ability of an agent of infection to produce disease. The virulence of a microorganism is a measure of the severity of the disease it causes. Exposure to a variety of infectious disease agents may occur when handling any deceased body. The body may remain infectious, and microbes may continue to colonize after death and be dispersed through contact. If infectious disease was present at the time of death, mortuary personnel, family, and the public may be at risk for infection, and burial practices involving touching and washing the body should be avoided, depending upon the type of infection present. ● Aerosols of infectious material might be released when moving or opening the body. ● Microbes may be present on the skin and spread through direct contact. examination tables. Two examples of contact-transmissible infectious agents include MRSA and VRE. ● Droplets containing infectious agents can spread during certain postmortem preparations, including transport and embalming procedures. Transmission occurs when droplets come into direct contact with the mucosal surfaces of the eyes, nose, or mouth of a susceptible individual. The distance droplets travel depends on the velocity and means by which respiratory droplets are propelled from the source, the density of respiratory secretions, environmental factors such as temperature and humidity, and the ability of the pathogen to remain infectious over that distance. A distance of three feet around the patient is an example of “a short distance from a patient” but should not be used as the sole criterion for deciding when a mask should be donned to protect from droplet exposure. Due to the variables that affect droplet transmission, staff should wear a mask when they are within six to ten feet of the body upon entry into the room, especially when exposure to emerging or highly virulent pathogens is possible. According to Harriman and Brosseau (2011), “observations of particle dynamics have shown that a range of droplet sizes, including those with diameters of thirty μm (30 micrometers, or 30 millionths of a meter) or greater can remain suspended in the air.” ● Airborne transmission occurs through very small particles or droplet nuclei that contain infectious agents and remain suspended in the air for extended periods of time. COVID-19, for example, spreads through both droplets and particles (CDC, 2022a). The U.S. Environmental Protection Agency (EPA, 2021) calculates that the particles can linger in the air for hours. When the susceptible individual inhales the pathogen, it enters the respiratory tract and can cause infection. Airborne transmission only occurs with infectious agents that are capable of surviving and remaining infectious for relatively long periods of time in airborne particles or droplet nuclei. Airborne microorganisms may be dispersed over long distances by air currents and may be inhaled by susceptible individuals who have not had face-to-face contact with or been in the same room as the infectious individual. Preventing the spread of pathogens by airborne routes requires the use of special air handling and ventilation
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Book Code: FTX1624
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