Isolation precautions lookup

• AbscessDraining, major

  ContactStandard

  DurationDuration of illness

  Until drainage stops or can be contained by dressing.

• AbscessDraining, minor or limited

  Standard

  Duration—

  If dressing covers and contains drainage.

• Acquired human immunodeficiency syndrome (HIV)

  Standard

  Duration—

  Postexposure chemoprophylaxis for some blood exposures.

• Actinomycosis

  Standard

  Duration—

  Not transmitted from person to person.

• Adenovirus infection

  See Gastroenteritis, Conjunctivitis, Pneumonia

• Amebiasis

  Standard

  Duration—

  Person-to-person transmission is rare. Transmission in settings for the mentally challenged and in a family group has been reported. Use care when handling diapered infants and mentally challenged persons.

• Andes virus

  See comments

  DurationDuration of precautions should be determined on a case-by-case basis, in conjunction with local, state, and federal health authorities. Factors that should be considered include, but are not limited to, presence of symptoms, date symptoms resolved, other conditions that would require specific precautions (e.g. tuberculosis, Clostridium difficile) and available laboratory information.

  Patient Placement: AIIR PPE: Gown, gloves, eye protection, N95® respirator or higher

• Anthrax

  Standard

  Duration—

  Infected patients do not generally pose a transmission risk.

• AnthraxCutaneous

  Standard

  Duration—

  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.Read more

• AnthraxPulmonary

  Standard

  Duration—

  Not transmitted from person to person.

• AnthraxEnvironmental: aerosolizable spore-containing powder or other substance

  See comments

  DurationUntil environment completely decontaminated

  Until decontamination of environment complete. 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.) Postexposure prophylaxis following environmental exposure: 60 days of antimicrobials (either doxycycline, ciprofloxacin, or levofloxacin) and postexposure vaccine under IND.Read more

• Antibiotic-associated colitis

  See Clostridium difficile

• Arthropod-borne

  Standard

  Duration—

  Install screens in windows and doors in endemic areas. Use DEET-containing mosquito repellants and clothing to cover extremities.

• Ascariasis

  Standard

  Duration—

  Not transmitted from person to person.

• Aspergillosis

  Standard

  Duration—

  Contact Precautions and Airborne if massive soft tissue infection with copious drainage and repeated irrigations required.

• Avian influenza

  See influenza, avian below

• Babesiosis

  Standard

  Duration—

  Not transmitted from person to person, except rarely by transfusion.

• Blastomycosis, North American, cutaneous or pulmonary

  Standard

  Duration—

  Not transmitted from person to person.

• Botulism

  Standard

  Duration—

  Not transmitted from person to person.

• Bronchiolitis

  ContactStandard

  RSV guide

  DurationDuration of illness

  Use mask according to Standard Precautions.

• Brucellosis (undulant, Malta, Mediterranean fever)

  Standardsee comments

  Duration—

  Person-to-person transmission in healthcare settings is rare. However there have been reports of transmission to healthcare workers (HCWs) who were wearing a surgical mask and/or eye protection and performing orthopedic or obstetric surgeries; no transmission to HCWs who were outside the room during the procedures was reported. Transmission to several HCWs who had contact with body fluids has also been reported including to, a HCW who swallowed amniotic fluid during a delivery; a HCW who wore only gloves during a joint aspiration; and to HCWs who wore only gloves while performing several endotracheal intubations of a newborn with brucellosis. The exact mode of transmission could not be identified in some of these events but could have occurred through short-range exposure to aerosolized particles from infected body fluids or tissues. Therefore, an N95 respirator (or higher), instead of a facemask, in addition to eye protection and other PPE recommended as part of Standard Precautions, is recommended for HCWs performing procedures that could generate splashes or aerosolize infectious fluids or tissues. Provide antimicrobial prophylaxis following laboratory exposure.Read more

• Campylobacter gastroenteritis

  See Gastroenteritis

• Candidiasis, all forms including mucocutaneous

  Standard

  Duration—

• Cat-scratch fever (benign inoculation lymphoreticulosis)

  Standard

  Duration—

  Not transmitted from person to person.

• Cellulitis

  Standard

  Duration—

• Chancroid (soft chancre) (H. ducreyi)

  Standard

  Duration—

  Transmitted sexually from person to person.

• Chickenpox

  See Varicella

  Chickenpox guide

• Chlamydia trachomatisConjunctivitis

  Standard

  Duration—

• Chlamydia trachomatisGenital (lymphogranuloma venereum)

  Standard

  Duration—

• Chlamydia trachomatisPneumonia (infants ≤3 mos. of age)

  Standard

  Duration—

• Chlamydia pneumoniae

  Standard

  Duration—

  Outbreaks in institutionalized populations reported, rarely.

• Cholera

  See Gastroenteritis

• Closed-cavity infectionOpen drain in place; limited or minor drainage

  Standard

  Duration—

  Contact Precautions if there is copious uncontained drainage.

• Closed-cavity infectionNo drain or closed drainage system in place

  Standard

  Duration—

• Clostridium botulinum

  Standard

  Duration—

  Not transmitted from person to person.

• Clostridium difficile

  ContactStandard

  DurationDuration of illness

• Clostridium perfringensFood poisoning

  Standard

  Duration—

  Not transmitted from person to person.

• Clostridium perfringensGas gangrene

  Standard

  Duration—

  Transmission from person to person rare; 1 outbreak in a surgical setting reported. Use Contact Precautions if wound drainage is extensive.

• Coccidioidomycosis (valley fever)Draining lesions

  Standard

  Duration—

  Not transmitted from person to person except under extraordinary circumstances, because the infectious arthroconidial form of Coccidioides immitis is not produced in humans.

• Coccidioidomycosis (valley fever)Pneumonia

  Standard

  Duration—

  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.Read more

• Colorado tick fever

  Standard

  Duration—

  Not transmitted from person to person.

• Congenital rubella

  ContactStandard

  DurationUntil 1 yr of age

  Standard Precautions if nasopharyngeal and urine cultures repeatedly negative after 3 mos. of age.

• ConjunctivitisAcute bacterial

  Standard

  Duration—

• ConjunctivitisAcute bacterial — Chlamydia

  Standard

  Duration—

• ConjunctivitisAcute bacterial — Gonococcal

  Standard

  Duration—

• ConjunctivitisAcute viral (acute hemorrhagic)

  ContactStandard

  DurationDuration of illness

  Adenovirus most common; enterovirus 70, Coxsackie virus A24 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.Read more

• Corona virus associated with SARS (SARS-CoV)

  See Severe Acute Respiratory Syndrome

• Coxsackie virus disease

  See enteroviral infection

• Creutzfeldt-Jakob disease (CJD, vCJD)

  Standard

  Duration—

  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.

• Croup

  See Respiratory Infections in infants and young children

• Crimean-Congo Fever

  See Viral Hemorrhagic Fever

• Cryptococcosis

  Standard

  Duration—

  Not transmitted from person to person, except rarely via tissue and corneal transplant.

• Cryptosporidiosis

  See Gastroenteritis

• Cysticercosis

  Standard

  Duration—

  Not transmitted from person to person.

• Cytomegalovirus infection, including in neonates and immunosuppressed patients

  Standard

  Duration—

  No additional precautions for pregnant HCWs.

• Decubitus ulcer

  See Pressure Ulcer

• Dengue fever

  Standard

  Duration—

  Not transmitted from person to person.

• Diarrhea, acute-infective etiology suspected

  See Gastroenteritis

• DiphtheriaCutaneous

  ContactStandard

  DurationUntil off antimicrobial treatment and culture-negative

  Until 2 cultures taken 24 hours apart negative.

• DiphtheriaPharyngeal

  DropletStandard

  DurationUntil off antimicrobial treatment and culture-negative

  Until 2 cultures taken 24 hours apart negative.

• Ebola virus

  See Viral Hemorrhagic Fevers

• Echinococcosis (hydatidosis)

  Standard

  Duration—

  Not transmitted from person to person.

• Echovirus

  See Enteroviral Infection

• Encephalitis or encephalomyelitis

  See specific etiologic agents

• Endometritis (endomyometritis)

  Standard

  Duration—

• Enterobiasis (pinworm disease, oxyuriasis)

  Standard

  Duration—

• Enterococcus species

  See Multidrug-Resistant Organisms if epidemiologically significant or vancomycin-resistant

  VRE guide

• Enterocolitis, C. difficile

  See Gastroenteritis, C. difficile

• Enteroviral infections (i.e., Group A and B Coxsackie viruses and Echo viruses) (excludes polio virus)

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent children for duration of illness and to control institutional outbreaks.

• Epiglottitis, due to Haemophilus influenzae type b

  DropletStandard

  DurationUntil 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

  Duration—

• Erythema infectiosum

  See Parvovirus B19

• Escherichia coli gastroenteritis

  See Gastroenteritis

• Food poisoningBotulism

  Standard

  Duration—

  Not transmitted from person to person.

• Food poisoningC. perfringens or welchii

  Standard

  Duration—

  Not transmitted from person to person.

• Food poisoningStaphylococcal

  Standard

  Duration—

  Not transmitted from person to person.

• Furunculosis, staphylococcal

  Standard

  Duration—

  Contact if drainage not controlled. Follow institutional policies if MRSA.

• Furunculosis, staphylococcalInfants and young children

  ContactStandard

  DurationDuration of illness (with wound lesions, until wounds stop draining)

• Gangrene (gas gangrene)

  Standard

  Duration—

  Not transmitted from person to person.

• Gastroenteritis

  Standard

  Duration—

  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.

• GastroenteritisAdenovirus

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisCampylobacter species

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisCholera (Vibrio cholerae)

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisC. difficile

  ContactStandard

  C. diff guide

  DurationDuration of illness

  Discontinue antibiotics if appropriate. Do not share electronic thermometers; ensure consistent environmental cleaning and disinfection. Hypochlorite solutions may be required for cleaning if transmission continues. Handwashing with soap and water preferred because of the absence of sporicidal activity of alcohol in waterless antiseptic handrubs.Read more

• GastroenteritisCryptosporidium species

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisE. coli — Enteropathogenic O157:H7 and other Shiga toxin-producing strains

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisE. coli — Other species

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisGiardia lamblia

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisNoroviruses

  ContactStandard

  Norovirus guide

  Duration—

  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; ensure consistent environmental cleaning and disinfection with focus on restrooms even when apparently unsoiled. Hypochlorite solutions may be required when there is continued transmission. Alcohol is less active, but there is no evidence that alcohol antiseptic handrubs are not effective for hand decontamination. Cohorting of affected patients to separate airspaces and toilet facilities may help interrupt transmission during outbreaks. Gastroenteritis, Noroviruses Precaution Update [April 2019] Update: The Type of Precaution was updated from “Standard” to “Contact + Standard” to align with Guideline for the Prevention and Control of Norovirus Gastroenteritis Outbreaks in Healthcare Settings (2011).Read more

• GastroenteritisRotavirus

  ContactStandard

  DurationDuration 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.

• GastroenteritisSalmonella species (including S. typhi)

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisShigella species (Bacillary dysentery)

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisVibrio parahaemolyticus

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisViral (if not covered elsewhere)

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.

• GastroenteritisYersinia enterocolitica

  Standard

  Duration—

  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

• Giardiasis

  See Gastroenteritis

• Gonococcal ophthalmia neonatorum (gonorrheal ophthalmia, acute conjunctivitis of newborn)

  Standard

  Duration—

• Gonorrhea

  Standard

  Duration—

• Granuloma inguinale (Donovanosis, granuloma venereum)

  Standard

  Duration—

• Guillain-Barré syndrome

  Standard

  Duration—

  Not an infectious condition.

• Haemophilus influenzae

  See disease-specific recommendations

• Hand, foot, and mouth disease

  See Enteroviral Infection

• Hansen’s Disease

  See Leprosy

• Hantavirus pulmonary syndrome

  Standard

  Duration—

  Not transmitted from person to person.

• Helicobacter pylori

  Standard

  Duration—

• Hepatitis, viralType A

  Standard

  Hepatitis A guide

  Duration—

  Provide hepatitis A vaccine postexposure as recommended.

• Hepatitis, viralType A-Diapered or incontinent patients

  ContactStandard

  Hepatitis A guide

  Duration—

  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.

• Hepatitis, viralType B-HBsAg positive; acute or chronic

  Standard

  Duration—

  See specific recommendations for care of patients in hemodialysis centers.

• Hepatitis, viralType C and other unspecified non-A, non-B

  Standard

  Duration—

  See specific recommendations for care of patients in hemodialysis centers.

• Hepatitis, viralType D (seen only with hepatitis B)

  Standard

  Duration—

• Hepatitis, viralType E

  Standard

  Hepatitis A guide

  Duration—

  Use Contact Precautions for diapered or incontinent individuals for the duration of illness.

• Hepatitis, viralType G

  Standard

  Duration—

• Herpangina

  See Enteroviral Infection

• Hookworm

  Standard

  Duration—

• Herpes simplex (Herpesvirus hominis)Encephalitis

  Standard

  Duration—

• Herpes simplex (Herpesvirus hominis)Mucocutaneous, disseminated or primary, severe

  ContactStandard

  DurationUntil lesions dry and crusted

• Herpes simplex (Herpesvirus hominis)Mucocutaneous, recurrent (skin, oral, genital)

  Standard

  Duration—

• Herpes simplex (Herpesvirus hominis)Neonatal

  ContactStandard

  DurationUntil 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.Read more

• Herpes zoster (varicella-zoster) (shingles)Disseminated disease in any patient — Localized disease in immunocompromised patient until disseminated infection ruled out

  AirborneContactStandard

  Shingles guide

  DurationDuration 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.Read more

• Herpes zoster (varicella-zoster) (shingles)Localized in patient with intact immune system with lesions that can be contained/covered

  Standard

  Shingles guide

  DurationUntil lesions dry and crusted

  Susceptible HCWs should not provide direct patient care when other immune caregivers are available.

• Histoplasmosis

  Standard

  Duration—

  Not transmitted from person to person.

• Human immunodeficiency virus (HIV)

  Standard

  Duration—

  Postexposure chemoprophylaxis for some blood exposures.

• Human metapneumovirus

  ContactStandard

  DurationDuration of illness

  HAI reported, but route of transmission not established. 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.Read more

• Impetigo

  ContactStandard

  DurationUntil 24 hours after initiation of effective therapy

• Infectious mononucleosis

  Standard

  Duration—

• InfluenzaHuman (seasonal influenza)

  See comments

  Influenza guide

  Duration—

  See Prevention Strategies for Seasonal Influenza in Healthcare Settings for current seasonal influenza guidance.

• InfluenzaAvian (e.g., H5N1, H7, H9 strains)

  See comments

  Duration—

  See 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 for current avian influenza guidance.Read more

• InfluenzaPandemic Influenza (also a human influenza virus)

  DropletStandard

  Influenza guide

  Duration—

  See 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 for current pandemic influenza guidance.Read more

• Kawasaki syndrome

  Standard

  Duration—

  Not an infectious condition.

• Lassa fever

  See Viral Hemorrhagic Fevers

• Legionnaires’ disease

  Standard

  Duration—

  Not transmitted from person to person.

• Leprosy

  Standard

  Duration—

• Leptospirosis

  Standard

  Duration—

  Not transmitted from person to person.

• LiceHead (pediculosis)

  ContactStandard

  Scabies guide

  DurationUntil 24 hours after initiation of effective therapy

  See CDC’s Parasites – Lice

• LiceBody

  Standard

  Scabies guide

  Duration—

  Transmitted person-to-person through infested clothing. Wear gown and gloves when removing clothing; bag and wash clothes according to CDC guidance Parasites – Lice.

• LicePubic

  Standard

  Scabies guide

  Duration—

  Transmitted person-to-person through sexual contact. See CDC’s Parasites – Lice.

• Listeriosis (listeria monocytogenes)

  Standard

  Duration—

  Person-to-person transmission rare; cross-transmission in neonatal settings reported.

• Lyme disease

  Standard

  Duration—

  Not transmitted from person to person.

• Lymphocytic choriomeningitis

  Standard

  Duration—

  Not transmitted from person to person.

• Lymphogranuloma venereum

  Standard

  Duration—

• Malaria

  Standard

  Duration—

  Not transmitted from person to person, except through transfusion rarely and through a failure to follow Standard Precautions during patient care. Install screens in windows and doors in endemic areas. Use DEET- containing mosquito repellants and clothing to cover extremities.Read more

• Marburg virus disease

  See Viral Hemorrhagic Fevers

• Measles (rubeola)

  AirborneStandard

  Measles guide

  Duration4 days after onset of rash; duration of illness in immune compromised

  Interim Measles Infection Control [July 2019] See Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings Susceptible healthcare personnel (HCP) should not enter room if immune care providers are available; regardless of presumptive evidence of immunity, HCP should use respiratory protection that is at least as protective as a fit-tested, NIOSH-certified N95 respirator upon entry into the patient’s room or care area. For exposed susceptibles, postexposure vaccine within 72 hours or immune globulin within 6 days when available. Place exposed susceptible patients on Airborne Precautions and exclude susceptible healthcare personnel.Read more

• Melioidosis, all forms

  Standard

  Duration—

  Not transmitted from person to person.

• MeningitisAseptic (nonbacterial or viral; also see Enteroviral infections)

  Standard

  Meningococcal disease guide

  Duration—

  Contact for infants and young children.

• MeningitisBacterial, gram-negative enteric, in neonates

  Standard

  Duration—

• MeningitisFungal

  Standard

  Duration—

• MeningitisHaemophilus Influenzae, type b known or suspected

  DropletStandard

  Meningococcal disease guide

  DurationUntil 24 hours after initiation of effective therapy

• MeningitisListeria monocytogenes (See Listeriosis)

  Standard

  Duration—

• MeningitisNeisseria meningitidis (meningococcal) known or suspected

  DropletStandard

  Meningococcal disease guide

  DurationUntil 24 hours after initiation of effective therapy

  See Meningococcal Disease below.

• MeningitisStreptococcus pneumoniae

  Standard

  Meningococcal disease guide

  Duration—

• MeningitisM. tuberculosis

  Standard

  Duration—

  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).Read more

• MeningitisOther diagnosed bacterial

  Standard

  Duration—

• Meningococcal disease: sepsis, pneumonia, Meningitis

  DropletStandard

  Meningococcal disease guide

  DurationUntil 24 hours after initiation of effective therapy

  Postexposure chemoprophylaxis for household contacts, HCWs exposed to respiratory secretions; postexposure vaccine only to control outbreaks.

• Molluscum contagiosum

  Standard

  Duration—

• Monkeypox

  See comments

  Duration—

  See CDC’s Monkeypox website for information on infection prevention and control.

• Mucormycosis

  Standard

  Duration—

• Multidrug-resistant organisms (MDROs), infection or colonization (e.g., MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)

  ContactStandard

  MRSA guide

  Duration—

  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. Contact state health department for guidance regarding new or emerging MDRO.Read more

• Mumps (infectious parotitis)

  DropletStandard

  Mumps guide

  DurationUntil 5 days after the onset of swelling

  Mumps [October 2017] Update: 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. 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.)Read more

• Mycobacteria, nontuberculosis (atypical)

  Standard

  Duration—

  Not transmitted person-to-person.

• Mycobacteria, nontuberculosis (atypical)Pulmonary

  Standard

  Duration—

• Mycobacteria, nontuberculosis (atypical)Wound

  Standard

  Duration—

• Mycoplasma pneumonia

  DropletStandard

  DurationDuration of Illness

• Necrotizing enterocolitis

  Standard

  Duration—

  Contact Precautions when cases clustered temporally.

• Nipah virus

  See comments

  DurationDuration of precautions should be determined on a case-by-case basis, in conjunction with local, state, and federal health authorities. Factors that should be considered include, but are not limited to, presence of symptoms, date symptoms resolved, other conditions that would require specific precautions (e.g. tuberculosis, Clostridium difficile) and available laboratory information.

  Patient Placement: AIIR PPE: If suspect Nipah case and clinically stable: gown, gloves, eye protection, N95® respirator or higher If suspect Nipah and clinically unstable (e.g. hemodynamic instability, vomiting) OR confirmed Nipah case regardless of clinical stability: use PPE according to guidance for confirmed patients and clinically unstable patients suspected to have VHFRead more

• Nocardiosis, draining lesions, or other presentations

  Standard

  Duration—

  Not transmitted person-to-person.

• Norovirus

  See Gastroenteritis

• Norwalk agent Gastroenteritis

  See Gastroenteritis

• Orf

  Standard

  Duration—

• Parainfluenza virus infection, respiratory in infants and young children

  ContactStandard

  DurationDuration of illness

  Viral shedding may be prolonged in immunosuppressed patients. Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.

• Parvovirus B19 (Erythema infectiosum)

  DropletStandard

  Duration—

  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.Read more

• Pediculosis (lice)

  ContactStandard

  DurationUntil 24 hours after initiation of effective therapy after treatment

• Pertussis (whooping cough)

  DropletStandard

  Pertussis guide

  DurationUntil 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. Recommendations for Tdap vaccine in adults under development. Tdap Vaccine Recommendations Update: Current recommendations can be found at Tdap / Td ACIP Vaccine Recommendations.Read more

• Pinworm infection (Enterobiasis)

  Standard

  Duration—

• Plague (Yersinia pestis)Bubonic

  Standard

  Duration—

• Plague (Yersinia pestis)Pneumonic

  DropletStandard

  DurationUntil 48 hours after initiation of effective antibiotic therapy

  Antimicrobial prophylaxis for exposed HCW.

• PneumoniaAdenovirus

  DropletContactStandard

  DurationDuration of illness

  Outbreaks in pediatric and institutional settings reported. In immunocompromised hosts, extend duration of Droplet and Contact Precautions due to prolonged shedding of virus.

• PneumoniaBacterial not listed elsewhere (including gram-negative bacterial)

  Standard

  Duration—

• PneumoniaB. cepacia in patients with CF, including respiratory tract colonization

  ContactStandard

  DurationUnknown

  Avoid exposure to other persons with CF; private room preferred. Criteria for D/C precautions not established. See CF Foundation guideline.

• PneumoniaB. cepacia in patients without CF (see Multidrug-Resistant Organisms)

  See Multidrug-Resistant Organisms

• PneumoniaChlamydia

  Standard

  Duration—

• PneumoniaFungal

  Standard

  Duration—

• PneumoniaHaemophilus influenzae, type b — Adults

  Standard

  Duration—

• PneumoniaHaemophilus influenzae, type b — Infants and children

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

• PneumoniaLegionella spp.

  Standard

  Duration—

• PneumoniaMeningococcal

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

  See Meningococcal Disease above.

• PneumoniaMultidrug-resistant bacterial (see Multidrug-Resistant Organisms)

  See Multidrug-Resistant Organisms

• PneumoniaMycoplasma (primary atypical Pneumonia)

  DropletStandard

  DurationDuration of illness

• PneumoniaPneumococcal pneumonia

  Standard

  Duration—

  Use Droplet Precautions if evidence of transmission within a patient care unit or facility.

• PneumoniaPneumocystis jiroveci (Pneumocystis carinii)

  Standard

  Duration—

  Avoid placement in the same room with an immunocompromised patient.

• PneumoniaStaphylococcus aureus

  Standard

  Duration—

  For MRSA, see MDROs.

• PneumoniaStreptococcus, group A — Adults

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

  See Streptococcal Disease (group A Streptococcus) below Contact Precautions if skin lesions present.

• PneumoniaStreptococcus, group A — Infants and young children

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

  Contact Precautions if skin lesions present.

• PneumoniaVaricella-Zoster (See Varicella-Zoster)

  See Varicella-Zoster

• PneumoniaViral — Adults

  Standard

  Duration—

• PneumoniaViral — Infants and young children (see Respiratory Infectious Disease, acute, or specific viral agent)

  See Respiratory Infectious Disease, acute, or specific viral agent

• Poliomyelitis

  ContactStandard

  DurationDuration of illness

• Pressure ulcer (decubitus ulcer, pressure sore) infectedMajor

  ContactStandard

  DurationDuration of illness

  Until drainage stops or can be contained by dressing.

• Pressure ulcer (decubitus ulcer, pressure sore) infectedMinor or limited

  Standard

  Duration—

  If dressing covers and contains drainage.

• Prion disease

  See Creutzfeld-Jacob Disease

• Psittacosis (ornithosis) (Chlamydia psittaci)

  Standard

  Duration—

  Not transmitted from person to person.

• Q fever

  Standard

  Duration—

• Rabies

  Standard

  Duration—

  Person to person transmission rare; transmission via corneal, tissue and organ transplants has been reported. If patient has bitten another individual or saliva has contaminated an open wound or mucous membrane, wash exposed area thoroughly and administer postexposure prophylaxis.Read more

• Rat-bite fever (Streptobacillus moniliformis disease, Spirillum minus disease)

  Standard

  Duration—

  Not transmitted from person to person.

• Relapsing fever

  Standard

  Duration—

  Not transmitted from person to person.

• Resistant bacterial infection or colonization

  See Multidrug-Resistant Organisms

• Respiratory infectious disease, acute (if not covered elsewhere)Adults

  Standardsee comments

  Duration—

  Interim recommendations for SARS-CoV-2, which are being reviewed for potential updates: Place patients in a single-person room. Aerosol-generating procedures should take place in an AIIR, if possible. HCP should wear a gown, gloves, eye protection, N95 respirator or higher. Recommended duration of Transmission-Based Precautions: Patients with mild to moderate illness who are not moderately to severely immunocompromised: At least 10 days have passed since symptoms first appeared and At least 24 hours have passed since last fever without the use of fever-reducing medications and Symptoms (e.g., cough, shortness of breath) have improved Patients who were asymptomatic throughout their infection and are not moderately to severely immunocompromised: At least 10 days have passed since the date of their first positive viral test. Patients with severe to critical illness and who are not moderately to severely immunocompromised: At least 10 days and up to 20 days have passed since symptoms first appeared and At least 24 hours have passed since last fever without the use of fever-reducing medications and Symptoms (e.g., cough, shortness of breath) have improved The test-based strategy as described for moderately to severely immunocompromised patients below can be used to inform the duration of isolation. The exact criteria that determine which patients will shed replication-competent virus for longer periods are not known. Disease severity factors and the presence of immunocompromising conditions should be considered when determining the appropriate duration for specific patients. For a summary of the literature, refer to Preventing Spread of Respiratory Viruses When You're Sick Patients who are moderately to severely immunocompromised may produce replication-competent virus beyond 20 days after symptom onset or, for those who were asymptomatic throughout their infection, the date of their first positive viral test. Use of a test-based strategy and (if available) consultation with an infectious disease specialist is recommended to determine when Transmission-Based Precautions could be discontinued for these patients. The criteria for the test-based strategy are: Patients who are symptomatic: Resolution of fever without the use of fever-reducing medications and Symptoms (e.g., cough, shortness of breath) have improved, and Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAAT Patients who are not symptomatic: Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAATRead more

• Respiratory infectious disease, acute (if not covered elsewhere)Infants and young children

  ContactStandard

  DurationDuration of illness

  Also see syndromes or conditions listed in Table 2. For SARS-CoV-2, see comments in Respiratory infectious disease, acute (if not covered elsewhere) Adults.

• Respiratory syncytial virus infection, in infants, young children and immunocompromised adults

  ContactStandard

  RSV guide

  DurationDuration of illness

  Wear mask according to Standard Precautions. In immunocompromised patients, extend the duration of Contact Precautions due to prolonged shedding. Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.Read more

• Reye’s syndrome

  Standard

  Duration—

  Not an infectious condition.

• Rheumatic fever

  Standard

  Duration—

  Not an infectious condition.

• Rhinovirus

  DropletStandard

  DurationDuration of illness

  Droplet most important route of transmission. Outbreaks have occurred in NICUs and LTCFs. Add Contact Precautions if copious moist secretions and close contact likely to occur (e.g., young infants).

• Rickettsial fevers, tickborne (Rocky Mountain spotted fever, tickborne Typhus fever)

  Standard

  Duration—

  Not transmitted from person to person except through transfusion, rarely.

• Rickettsialpox (vesicular rickettsiosis)

  Standard

  Duration—

  Not transmitted from person to person.

• Ringworm (dermatophytosis, dermatomycosis, tinea)

  Standard

  Duration—

  Rarely, outbreaks have occurred in healthcare settings, (e.g., NICU, rehabilitation hospital. Use Contact Precautions for outbreak.

• Rocky Mountain spotted fever

  Standard

  Duration—

  Not transmitted from person to person except through transfusion, rarely.

• Roseola infantum (exanthem subitum; caused by HHV-6)

  Standard

  Duration—

• Rotavirus infection

  See Gastroenteritis

• Rubella (German measles)

  DropletStandard

  DurationUntil 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. Administer vaccine within 3 days of exposure to susceptible men and non-pregnant susceptible women. 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.Read more

• Rubeola

  See Measles

• Salmonellosis

  See Gastroenteritis

• Scabies

  ContactStandard

  Scabies guide

  DurationUntil 24 hours after initiation of effective therapy

• Scalded skin syndrome, staphylococcal

  ContactStandard

  DurationDuration of illness

  See Staphylococcal Disease, scalded skin syndrome below.

• Schistosomiasis (bilharziasis)

  Standard

  Duration—

• Severe acute respiratory syndrome (SARS)

  AirborneDropletContactStandard

  DurationDuration 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. Vigilant environmental disinfection (see CDC Severe Acute Respiratory Syndrome (SARS))Read more

• Shigellosis

  See Gastroenteritis

• Smallpox (variola; see Vaccinia for management of vaccinated persons)

  AirborneContactStandard

  DurationDuration 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.Read more

• Sporotrichosis

  Standard

  Duration—

• Spirillum minor disease (rat-bite fever)

  Standard

  Duration—

  Not transmitted from person to person.

• Staphylococcal disease (S. aureus)Skin, wound, or burn — Major

  ContactStandard

  MRSA guide

  DurationDuration of illness

  Until drainage stops or can be contained by dressing.

• Staphylococcal disease (S. aureus)Skin, wound, or burn — Minor or limited

  Standard

  MRSA guide

  Duration—

  If dressing covers and contains drainage adequately.

• Staphylococcal disease (S. aureus)Enterocolitis

  Standard

  Duration—

  Use Contact Precautions for diapered or incontinent children for duration of illness.

• Staphylococcal disease (S. aureus)Multidrug-resistant (see Multidrug-Resistant Organisms)

  See Multidrug-Resistant Organisms

• Staphylococcal disease (S. aureus)Pneumonia

  Standard

  Duration—

• Staphylococcal disease (S. aureus)Scalded skin syndrome

  ContactStandard

  DurationDuration of illness

  Consider healthcare personnel as potential source of nursery, NICU outbreak.

• Staphylococcal disease (S. aureus)Toxic shock syndrome

  Standard

  Duration—

• Streptobacillus moniliformis disease (rat-bite fever)

  Standard

  Duration—

  Not transmitted from person to person.

• Streptococcal disease (group A Streptococcus)Skin, wound, or burn — Major

  DropletContactStandard

  DurationUntil 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

  Duration—

  If dressing covers and contains drainage.

• Streptococcal disease (group A Streptococcus)Endometritis (puerperal sepsis)

  Standard

  Duration—

• Streptococcal disease (group A Streptococcus)Pharyngitis in infants and young children

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

• Streptococcal disease (group A Streptococcus)Pneumonia

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

• Streptococcal disease (group A Streptococcus)Scarlet fever in infants and young children

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

• Streptococcal disease (group A Streptococcus)Serious invasive disease

  DropletStandard

  DurationUntil 24 hours after initiation of effective therapy

  Outbreaks of serious invasive disease have occurred secondary to transmission among patients and healthcare personnel. Contact Precautions for draining wound as above; follow recommendations for antimicrobial prophylaxis in selected conditions.Read more

• Streptococcal disease (group B Streptococcus), neonatal

  Standard

  Duration—

• Streptococcal disease (not group A or B) unless covered elsewhereMultidrug-resistant (see Multidrug-Resistant Organisms)

  See Multidrug-Resistant Organisms

• Strongyloidiasis

  Standard

  Duration—

• SyphilisLatent (tertiary) and seropositivity without lesions

  Standard

  Duration—

• SyphilisSkin and mucous membrane, including congenital, primary, Secondary

  Standard

  Duration—

• Tapeworm diseaseHymenolepis nana

  Standard

  Duration—

  Not transmitted from person to person.

• Tapeworm diseaseTaenia solium (pork)

  Standard

  Duration—

• Tapeworm diseaseOther

  Standard

  Duration—

• Tetanus

  Standard

  Duration—

  Not transmitted from person to person.

• Tinea (e.g., dermatophytosis, dermatomycosis, ringworm)

  Standard

  Duration—

  Rare episodes of person-to-person transmission.

• Toxoplasmosis

  Standard

  Duration—

  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

  Duration—

  Droplet Precautions for the first 24 hours after implementation of antibiotic therapy if Group A Streptococcus is a likely etiology.

• Trachoma, acute

  Standard

  Duration—

• Transmissible spongiform encephalopathy

  See Creutzfeld-Jacob disease, CJD, vCJD

• Trench mouth (Vincent’s angina)

  Standard

  Duration—

• Trichinosis

  Standard

  Duration—

• Trichomoniasis

  Standard

  Duration—

• Trichuriasis (whipworm disease)

  Standard

  Duration—

• Tuberculosis (M. tuberculosis)Extrapulmonary, draining lesion

  AirborneContactStandard

  TB guide

  Duration—

  Discontinue precautions only when patient is improving clinically, and drainage has ceased or there are 3 consecutive negative cultures of continued drainage. Examine for evidence of active pulmonary tuberculosis.

• Tuberculosis (M. tuberculosis)Extrapulmonary, no draining lesion, Meningitis

  Standard

  TB guide

  Duration—

  Examine for evidence of pulmonary tuberculosis. For infants and children, use Airborne until active pulmonary tuberculosis in visiting family members ruled out.

• Tuberculosis (M. tuberculosis)Pulmonary or laryngeal disease, confirmed

  AirborneStandard

  TB guide

  Duration—

  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).Read more

• Tuberculosis (M. tuberculosis)Pulmonary or laryngeal disease, suspected

  AirborneStandard

  TB guide

  Duration—

  Discontinue precautions only when the likelihood of infectious TB disease is deemed negligible, and either there is another diagnosis that explains the clinical syndrome, or 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.Read more

• Tuberculosis (M. tuberculosis)Skin-test positive with no evidence of current active disease

  Standard

  TB guide

  Duration—

• TularemiaDraining lesion

  Standard

  Duration—

  Not transmitted from person to person.

• TularemiaPulmonary

  Standard

  Duration—

  Not transmitted from person to person.

• Typhoid (Salmonella typhi) fever

  See Gastroenteritis

• TyphusRickettsia prowazekii (Epidemic or Louse-borne Typhus)

  Standard

  Duration—

  Transmitted from person to person through close personal or clothing contact.

• TyphusRickettsia typhi

  Standard

  Duration—

  Not transmitted from person to person.

• Urinary tract infection (including pyelonephritis), with or without urinary catheter

  Standard

  Duration—

• Vaccinia

  See comments

  Duration—

  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.

• VacciniaVaccination site care (including autoinoculated areas)

  Standard

  Duration—

  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.Read more

• Vaccinia (adverse events following vaccination)Eczema vaccinatum

  ContactStandard

  DurationUntil lesions dry and crusted, scabs separated

  For contact with virus-containing lesions and exudative material.

• Vaccinia (adverse events following vaccination)Fetal vaccinia

  ContactStandard

  DurationUntil lesions dry and crusted, scabs separated

  For contact with virus-containing lesions and exudative material.

• Vaccinia (adverse events following vaccination)Generalized vaccinia

  ContactStandard

  DurationUntil lesions dry and crusted, scabs separated

  For contact with virus-containing lesions and exudative material.

• Vaccinia (adverse events following vaccination)Progressive vaccinia

  ContactStandard

  DurationUntil lesions dry and crusted, scabs separated

  For contact with virus-containing lesions and exudative material.

• Vaccinia (adverse events following vaccination)Postvaccinia encephalitis

  Standard

  Duration—

• Vaccinia (adverse events following vaccination)Blepharitis or conjunctivitis

  ContactStandard

  Duration—

  Use Contact Precautions if there is copious drainage.

• Vaccinia (adverse events following vaccination)Iritis or keratitis

  Standard

  Duration—

• Vaccinia (adverse events following vaccination)Vaccinia-associated erythema multiforme (Stevens Johnson Syndrome)

  Standard

  Duration—

  Not an infectious condition.

• Vaccinia (adverse events following vaccination)Secondary bacterial infection (e.g., S. aureus, group A beta hemolytic Streptococcus)

  ContactStandard

  Duration—

  Follow organism-specific (strep, staph most frequent) recommendations and consider magnitude of drainage.

• Varicella Zoster

  AirborneContactStandard

  Chickenpox guide

  DurationUntil 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. Varicella Post-exposure Prophylaxis Update [April 2019] Update: 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 varicella zoster immune globulin as soon as possible after exposure and within 10 days. 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 varicella zoster immune globulin, regardless of postexposure vaccination.Read more

• Variola

  See Smallpox

• Vibrio parahaemolyticus

  See Gastroenteritis

• Vincent’s angina (trench mouth)

  Standard

  Duration—

• Viral hemorrhagic fevers due to Lassa, Marburg, Ebola, Crimean-Congo Hemorrhagic Fever, and South American Hemorrhagic Fever viruses (i.e., those caused by Junin, Machupo, Chapare, Guanarito and Sabia viruses)

  See comments

  DurationDuration of precautions should be determined on a case-by-case basis, in conjunction with local, state, and federal health authorities. Factors that should be considered include, but are not limited to, presence of symptoms, date symptoms resolved, other conditions that would require specific precautions (e.g. tuberculosis, Clostridium difficile) and available laboratory information.

  Guidance on Personal Protective Equipment (PPE) in U.S. Healthcare Settings for: Clinically Stable Patients Suspected to have VHF Confirmed Patients and Clinically Unstable Patients Suspected to have VHF

• Viral respiratory diseases (not covered elsewhere)Adults

  Standard

  Duration—

• Viral respiratory diseases (not covered elsewhere)Infants and young children (see Respiratory infectious disease, acute)

  See Respiratory infectious disease, acute

• Whooping cough

  See Pertussis

• Wound infectionsMajor

  ContactStandard

  DurationDuration of illness

  Until drainage stops or can be contained by dressing.

• Wound infectionsMinor or limited

  Standard

  Duration—

  If dressing covers and contains drainage.

• Yersinia enterocolitica Gastroenteritis

  See Gastroenteritis

• Zoster (varicella-zoster)

  See Herpes Zoster

• Zygomycosis (phycomycosis, mucormycosis)

  Standard

  Duration—

  Not transmitted person-to-person.

No match in CDC’s table. Try another name (for example “varicella” instead of “chickenpox”) or clear the search.