Page updated 30 April 2007
VHF - Infection Control Guidance
Communication
SpR microbiology will inform consultants and Infection Control Nurse as soon as practicable. The infection control nurse/doctor will provide infection control support and advice to staff in all areas where the patient the patient has visited.
Protective Clothing
Moderate Risk VHF:
When handling the patient or collecting specimens or disposing of waste, WEAR
- Theatre clothes
- Plastic apron
- Gloves
- Dust-Mist mask (eg Technol), properly fitting
- Visor (for procedures such as collecting blood or doing suction)
High Risk VHF (bleeding), in addition:
When handling the patient or collecting specimens or disposing of waste, WEAR
- Paper theatre gown over the plastic apron
- Theatre hat
- Theatre clothes will be changed before leaving the isolation area and discarded in a suitable waste bin kept in the anteroom (for incineration)
- A chain of evidence form will be used to check that all waste is incinerated
- Protective clothing will be available in A/E
Spillage / Contamination
Environmental surfaces or inanimate objects contaminated with blood, other body fluids, secretions or excretions should be disinfected using dichloroisocyanurate granules (for spillages) or fresh 10,000ppm free chlorine solution.
Waste
Linen should be double-bagged in yellow bags clearly labelled at the site of use and transported directly in a dedicated sealed clinical waste bin by suitably clothed and informed personnel for incineration.1 A tracking form (chain of evidence) will be completed and returned to the ward.
There is no evidence for transmission of haemorrhagic fever viruses to humans or animals through exposure to contaminated sewage3. The risk of such transmission would be expected to be extremely low owing to dilution and sewage treatment procedures in use in the United Kingdom. As an added precaution, however, measures should be taken to eliminate or reduce the infectivity of bulk blood, suctioned fluids, secretions, and excretions before disposal. These fluids will be treated with dichloroisocyanurate for 5 minutes or more (e.g. in a bedpan or commode) before flushing or disposal in a drain connected to a sanitary sewer. Full protective clothing will be worn to reduce exposure to splashes. Care should be taken to avoid splashing when disposing of these materials.3
Potentially infectious solid medical waste (e.g., contaminated needles, syringes, and tubing) will be placed in appropriate safe containers, then placed in sealable bins for incineration.2 All items such as cutlery, crockery, books etc, which have been in the patient's room will be destroyed by incineration. Send them in yellow bags as above.
All waste and clothing to be discarded in a sealable waste bin or "Sharps Container" kept in the patient's room or annexe. All waste bins to be sealed with Hazard tape and marked "For Incineration". Special arrangement are be made to ensure these are taken to the incinerator safely. Used clinical samples of any sort to be autoclaved in Microbiology and incinerated.
Last Offices
If the patient dies, handling of the body should be minimal. The corpse should be placed in a sealed body bag, not embalmed, and cremated or buried promptly in a sealed casket according to Department of Health Guidelines.
References
UK Department of Health Advisory Committee on Dangerous Pathogens. Guidance on the Management and Control of Viral Heamorrhagic Fevers. (the full report can be accessed at http://www.hpa.org.uk/infections/topics_az/VHF/ACDP_VHF_guidance.pdf)
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