Healthcare Epidemiology and Infection Prevention
Core concepts
Healthcare epidemiology rests on standard precautions for every patient plus transmission-based precautions. Contact: MRSA, VRE, C. difficile, RSV, scabies, rotavirus. Droplet: influenza, pertussis, mumps, rubella, adenovirus respiratory disease. Airborne: tuberculosis, measles, varicella, disseminated zoster. Hand hygiene is the single most effective intervention. Device bundles prevent central line-associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia. C. difficile requires contact precautions and sporicidal cleaning with soap and water handwashing.
Traps
- MRSA pneumonia needs contact precautions, not airborne.
- Varicella requires airborne plus contact precautions.
- Pertussis is droplet, not airborne.
- A patient with suspected measles should be masked and placed in airborne isolation immediately; do not send them to a waiting room.
Worked example
A child with a febrile rash and cough arrives in the emergency department during a measles outbreak: place a mask, move to a negative-pressure room, verify staff immunity, and report to public health. Use airborne precautions until measles is excluded.
Rule of thumb: standard precautions for all, then add the extra precaution based on how the organism spreads; hand hygiene remains the anchor.