Standard precautions are a set of infection control practices used to prevent transmission of diseases that can be

acquired by contact with blood, body fluids, non-intact skin (including rashes), and mucous membranes. These measures
are to be used when providing care to all individuals, whether or not they appear infectious or symptomatic.

Routes[edit]
Airborne[edit]
Further information: Airborne disease
"Airborne transmission refers to infectious agents that are spread via droplet nuclei (residue from evaporated droplets)
containing infective microorganisms. These organisms can survive outside the body and remain suspended in the air for
long periods of time. They infect others via the upper and lower respiratory tracts." [7] Diseases that are commonly spread
by coughing or sneezing include bacterial meningitis, chickenpox, common cold, influenza, mumps, strep
throat, tuberculosis, measles, rubella, whooping cough, SARS and leprosy.[citation needed]
Droplet[edit]
"Droplet transmission occurs when respiratory droplets generated via coughing, sneezing or talking contact susceptible
mucosal surfaces, such as the eyes, nose or mouth. Transmission may also occur indirectly via contact with contaminated
formites with hands and then mucosal surfaces. Respiratory droplets are large and are not able to remain suspended in
the air thus they are usually dispersed over short distances."[8]
The pathogen-containing particles, also called Flügge droplets (after Carl Flügge), are 0,1–2 mm in diameter, and are
reduced by evaporation to droplet nuclei– small (smaller than 100 μ in diameter), dry particles that can remain airborne for
long periods.[9]
Organisms spread by droplet transmission include respiratory viruses
(e.g., influenza, parainfluenza virus, adenovirus, respiratory syncytial virus, human metapneumovirus), Bordetella
pertussis, pneumococci, diphtheria, and rubella.[10]
Fecal–oral[edit]
Main article: Fecal–oral route
Direct contact is rare in this route for humans in developed countries, but relatively common for humans in developing
countries, especially those living in urban slums without access to adequate sanitation. More common in developed
countries are the indirect routes; foodstuffs or water become contaminated (by people not washing their hands before
preparing food, or untreated sewage being released into a drinking water supply) and the people who eat and drink them
become infected. In some developing countries, many people are not connected to sewer systems, and where they are,
most sewage is discharged into the environment without treatment. However, a bigger problem in some developing
countries is open defecation which leads to disease transmission via the fecal-oral route, especially for children. Even in
developed countries there are periodic system failures resulting in a sanitary sewer overflow. This is the typical mode of
transmission for the infectious agents of (at least): cholera, hepatitis A, polio, Rotavirus, Salmonella,
and parasites (e.g. Ascaris lumbricoides).
Sexual[edit]
Main article: Sexually transmitted disease
This refers to any disease that can be caught during sexual activity with another person, including vaginal or anal sex or
(less commonly) through oral sex (see below). Transmission is either directly between surfaces in contact during
intercourse (the usual route for bacterial infections and those infections causing sores) or from secretions (semen or the
fluid secreted by the excited female) which carry infectious agents that get into the partner's blood stream through tiny
tears in the penis, vagina or rectum (this is a more usual route for viruses). In this second case, anal sex is considerably
more hazardous since the penis opens more tears in the rectum than the vagina, as the vagina is more elastic and more
accommodating.[citation needed]
Some diseases transmissible by the sexual route include HIV/AIDS, chlamydia, genital warts, gonorrhea, hepatitis
B, syphilis, herpes, and trichomoniasis.
Oral sexual[edit]
Sexually transmitted diseases such as HIV and hepatitis B are thought to not normally be transmitted through mouth-to-
mouth contact, although it is possible to transmit some STDs between the genitals and the mouth, during oral sex. In the
case of HIV this possibility has been established. It is also responsible for the increased incidence of herpes simplex
virus 1 (which is usually responsible for oral infections) in genital infections and the increased incidence of the type 2 virus
(more common genitally) in oral infections.[citation needed]
Oral[edit]
Diseases that are transmitted primarily by oral means may be caught through direct oral contact such as kissing, or by
indirect contact such as by sharing a drinking glass or a cigarette. Diseases that are known to be transmissible by kissing
or by other direct or indirect oral contact include all of the diseases transmissible by droplet contact and (at least) all forms
of herpes viruses, namely Cytomegalovirus infections herpes simplex virus (especially HSV-1) and infectious
mononucleosis.[citation needed]
Direct contact[edit]
Further information: Contagious disease
Diseases that can be transmitted by direct contact are called contagious (contagious is not the same as infectious;
although all contagious diseases are infectious, not all infectious diseases are contagious). These diseases can also be
transmitted by sharing a towel (where the towel is rubbed vigorously on both bodies) or items of clothing in close contact
with the body (socks, for example) if they are not washed thoroughly between uses. For this reason, contagious diseases
often break out in schools, where towels are shared and personal items of clothing accidentally swapped in the changing
rooms.
Some diseases that are transmissible by direct contact include athlete's foot, impetigo, syphilis (on rare occasions, if an
uninfected person touches a chancre), warts, and conjunctivitis.[citation needed]
Vertical[edit]
Main article: Vertically transmitted disease
This is from mother to child (more rarely father to child), often in utero, during childbirth (also referred to as perinatal
infection) or during postnatal physical contact between parents and offspring. In mammals, including humans, it occurs
also via breast milk. Infectious diseases that can be transmitted in this way include: HIV, hepatitis B and syphilis. Many
mutualistic organisms are transmitted vertically.[11]
Iatrogenic[edit]
Transmission due to medical procedures, such as touching a wound, an injection or transplantation of infected material.
Some diseases that can be transmitted iatrogenically include: Creutzfeldt–Jakob disease by injection of contaminated
human growth hormone, MRSA and many more.[citation needed]
Vector-borne[edit]
Further information: Vector (epidemiology)
A vector is an organism that does not cause disease itself but that transmits infection by conveying pathogens from
one host to another.[12]
The route of transmission is important to epidemiologists because patterns of contact vary between different populations
and different groups of populations depending on socio-economic, cultural and other features. For example, low personal
and food hygiene due to the lack of a clean water supply may result in increased transmission of diseases by the fecal-
oral route, such as cholera. Differences in incidence of such diseases between different groups can also throw light on the
routes of transmission of the disease. For example, if it is noted that polio is more common in cities in underdeveloped
countries, without a clean water supply, than in cities with a good plumbing system, we might advance the theory that
polio is spread by the fecal-oral route. It can be minimised to a certain extent if we all consider being sure of what we do.
Vectors may be mechanical or biological. A mechanical vector picks up an infectious agent on the outside of its body and
transmits it in a passive manner. An example of a mechanical vector is a housefly, which lands on cow dung,
contaminating its appendages with bacteria from the feces, and then lands on food prior to consumption. The pathogen
never enters the body of the fly. In contrast, biological vectors harbor pathogens within their bodies and deliver pathogens
to new hosts in an active manner, usually a bite. Biological vectors are often responsible for serious blood-borne
diseases, such as malaria, viral encephalitis, Chagas disease, Lyme disease and African sleeping sickness. Biological
vectors are usually, though not exclusively, arthropods, such as mosquitoes, ticks, fleas and lice. Vectors are often
required in the life cycle of a pathogen. A common strategy used to control vector borne infectious diseases is to interrupt
the life cycle of a pathogen by killing the vector.[citation needed]

Airborne transmission occurs when infectious agents are carried by dust or droplet nuclei suspended in air. Airborne
dust includes material that has settled on surfaces and become resuspended by air currents as well as infectious particles
blown from the soil by the wind. Droplet nuclei are dried residue of less than 5 microns in size. In contrast to droplets that
fall to the ground within a few feet, droplet nuclei may remain suspended in the air for long periods of time and may be
blown over great distances. Measles, for example, has occurred in children who came into a physician's office after a child
with measles had left, because the measles virus remained suspended in the air.(46)
 Vehicles that may indirectly transmit an infectious agent include food, water, biologic products (blood), and fomites
(inanimate objects such as handkerchiefs, bedding, or surgical scalpels). A vehicle may passively carry a pathogen — as
food or water may carry hepatitis A virus. Alternatively, the vehicle may provide an environment in which the agent grows,
multiplies, or produces toxin — as improperly canned foods provide an environment that supports production of botulinum
toxin by Clostridium botulinum.

Vectors such as mosquitoes, fleas, and ticks may carry an infectious agent through purely mechanical means or may
support growth or changes in the agent. Examples of mechanical transmission are flies carrying Shigella on their
appendages and fleas carrying Yersinia pestis, the causative agent of plague, in their gut. In contrast, in biologic
transmission, the causative agent of malaria or guinea worm disease undergoes maturation in an intermediate host before
it can be transmitted to humans (Figure 1.20).

1. Block off the area until cleanup and disinfection is complete. No visitors or unprotected staff
members should be able to access the area.
2. Put on disposable gloves.
3. Wipe up the spill as much as possible with paper towel or other absorbent material.
4. Gently pour bleach solution – 1 part bleach to 9 parts water – onto all contaminated areas.
5. Let bleach solution remain on contaminated area for 20 minutes and then wipe up remaining
bleach solution.
6. All non-disposable cleaning materials such as mops, brushes and rags need to be disinfected by
saturating with a bleach solution and then allowed to air dry.
7. Remove gloves and place in a garbage bag with all other soiled cleaning materials.
8. Double bag and securely tie up garbage bags and discard.
9. Thoroughly wash hands with soap and water.

The coagulase test identifies whether an organism produces the exoenzyme coagulase, which causes the fibrin of
blood plasma to clot. Organisms that produce catalase can form protective barriers of fibrin around themselves,
making themselves highly resistant to phagocytosis, other immune responses, and some other antimicrobial agents.
The coagulase slide test is used to identify the presence of bound coagulase or clumping factor, which is attached to
the cell walls of the bacteria. Bound coagulase reacts with the fibrinogen in plasma, causing the fibrinogen to
precipitate. This causes the cells to agglutinate, or clump together, which creates the “lumpy” look of a positive
coagulase slide test. You may need to place the slide over a light box to observe the clumping of cells in the
plasma.
The coagulase tube test has been set up as a demo for you to observe in class. This version of the coagulase test is
used to identify the presence of either bound coagulase or free coagulase, which is an extracellular enzyme. Free
coagulase reacts with a component of plasma called coagulase-reacting factor. The result is to cause the plasma to
coagulate. In the demo, the coagulase plasma has been inoculated with Staphylococcus
aureus and Staphylococcus epidermidis and allowed to incubate at 37˚C for 24 hours. Staphylococcus
aureus produces free coagulase; Staphylococcus epidermidis does not.
The coagulase test is useful for differentiating potentially pathogenic Staphylococci such as Staphylococcus
aureus from other Gram positive, catalase-positive cocci.
 Autoimmune Neutropenia of Infancy.
 Chediak-Higashi Syndrome.
 Chronic Granulomatous Disease (CGD)
 Cyclic Neutropenia.
 Drug-Induced Neutropenia.
 Ethnic Neutropenia.
 Glycogen Storage Disease Type 1B.
 Idiopathic Neutropenia.