The following provide simple and effective precautions against transmission of disease for all persons, including pregnant women, potentially exposed to the blood or body fluids of any student. No distinction is made between body fluids from students with a known disease or those from students without symptoms or with an undiagnosed disease.
The body fluids of all persons should be considered to contain potentially infectious agents (germs). The term "body fluids" includes: blood, semen, drainage from scrapes and cuts, feces, urine, vomitus, respiratory secretions (e.g., nasal discharge) and saliva. Contact with body fluids presents a risk of infection with a variety of germs. In general, however, the risk is very low and dependent on a variety of factors including the type of fluid with which contact is made and the type of contact made with it.
Table 1 (below) provides examples of particular germs that may occur in body fluids of children and the respective transmission concerns. It must be emphasized that with the exception of blood, which is normally sterile, the body fluids with which one may come in contact usually contain many organisms, some of which may cause disease. Furthermore, many germs may be carried by individuals who have no symptoms of illness. These individuals may be at various stages of infection: incubating disease, mildly infected without symptoms, or chronic carriers of certain infectious agents including the AIDS and hepatitis viruses. In fact, transmission of communicable diseases is more likely to occur from contact with infected body fluids of unrecognized carriers than from contact with fluids from recognized individuals because simple precautions are not always carried out.
*Possible transmission of AIDS and Hepatitis B is of little concern from these sources. There is no evidence at this time to suggest that the AIDS virus is present in these fluids.
What should be done to avoid contact with body fluids?
When possible, direct skin contact with body fluids should be avoided. Disposable gloves should be available in at least the office of the custodian, nurse or principal. Gloves are recommended when direct hand contact with body fluids is anticipated (e.g., treating bloody noses, handling clothes soiled by incontinence, cleaning small spills by hand). If extensive contact is made with body fluids, hands should be washed afterwards. Gloves used for this purpose should be put in a plastic bag or lined trash can, secured and disposed of daily.
What should be done if direct skin contact occurs?
In many instances, unanticipated skin contact with body fluids may occur in situations where gloves may not be immediately available (e.g., when wiping a runny nose, applying pressure to a bleeding injury outside the classroom, helping a child in the bathroom). In these instances, hands and other affected skin areas of all exposed persons should be routinely washed with soap and water after direct contact has ceased.
Clothing and other non-disposable items (e.g., towels used to wipe up body fluid) that are soaked through with body fluids should be rinsed and placed in plastic bags. If presoaking is required to remove stains (e.g., blood, feces), use gloves to rinse or soak the item in cold water prior to bagging. Clothing should be sent home for washing with appropriate directions to parents/teachers (see page 5 of 5).
Contaminated disposable items (e.g., tissues, paper towels, diapers) should be handled as with disposable gloves.
How should spilled body fluids be removed from the environment?
Most schools have standards procedures already in place for removing body fluids (e.g., vomitus). Disposable gloves should be worn when using these agents. The dry material is applied to the area, left for a few minutes to absorb the fluid, and then vacuumed or swept up. The vacuum bag or sweepings should be disposed of in a plastic bag. Broom and dustpan should be rinsed in a disinfectant. No special handling is required for vacuuming equipment.
Hand Washing Procedures
Proper hand washing requires the use of soap and water and vigorous washing under a stream of running water for approximately 10 seconds. Soap suspends easily removable soil and microorganisms allowing them to be washed off. Running water is necessary to carry away dirt and debris. Rinse under running water. Use paper towels to thoroughly dry hands.
Disinfectants
An intermediate level disinfectant should be used to clean surfaces contaminated with body fluids. Such disinfectant will kill vegetative bacteria, fungi, tubercle bacillus and viruses. The disinfectant should be registered by the Environmental Protection Agency (EPA) for use as a disinfectant in medical facilities and hospitals.
Various classes of disinfectant are listed below. Hypochlorite solution (bleach) is preferred for objects that may be put in the mouth.
|
Table 1 Transmission Concerns in the School Setting Body Fluid Source of Infectious Agents |
||
| Body fluid-source | Organism of Concern | Transmission Concern |
| Blood - Cuts/abrasions - Nosebleeds - Menses - Contaminated needles | Hepatitis B virus AIDS virus Cytomegalovirus | Blood stream inoculation through Cuts and abrasions on hands |
| Feeces* incontinence | Salmonella bacteria Shigella bacteria Rotavirus Hepatitis A virus | Oral inoculation from Contaminated hands |
| Urine* Incontinence | Cytomegalovirus | Bloodstream and oral (?) Inoculation from contaminated hands |
| Respiratory secretions Saliva Nasal discharge | Mononucleosis virus Common cold virus Influenza virus AIDS virus Hepatitis B virus | Oral inoculation from Contaminated hands |
| Semen | Hepatitis B virus AIDS virus Gonorrhea | Sexual contact (intercourse) |
- Ethyl or isopropyl alcohol (70%)
- Phenolic germicidal detergent in a 1% aqueous solution (e.g., Lysol*)
- Sodium Hypochlorite with at least 100 ppm available chlorine (1/2 cup household bleach in one gallon water; needs to be freshly prepared each time it is used).
- Quaternary ammonium germicidal detergent in 2% aqueous solution (e.g., Tri-quat*, Mytar* or Sage*).
- Idophor germicidal detergent with 500 ppm available iodine (e.g., Wescodyne*).