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INFECTION CONTROL CDC Q AND A
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InbgthebgtextbgthebgacronymbgDHCPbgisbgusedbg-bgwhatbgdoesbgitbgreference?bg-bganswer--
refersbgtobgallbgpaidbgandbgunpaidbgpersonnelbginbgthebgdentalbghealth-
carebgsettingbgwhobgmightbgbebgoccupationallybgexposedbgtobginfectiousbgmaterials
iebgdentist,bgdentalbghygienest,bgdentalbgassistant,bgfrontbgdesk
HowbgarebgpathogenicbgmicroorganismsbglikebgHBVbgtransmittedbginbgthebgdentalbgsetting?bg-bganswer--
1)bgdirectbgcontactbgwithbgblood,bgoralbgfluids,bgorbgotherbgpatientbgmaterials;bg2)bgindirectbgcontactbgwithbgcontaminatedbg
jectsbg(e.g.,bginstruments,bgequipment,bgorbgenvironmentalbgsurfaces);bg3)bgcontactbgofbgconjunctival,bgnasal,bgorbgoralbg
ucosabgwith
dropletsbg(e.g.,bgspatter)bgcontainingbgmicroorganismsbggeneratedbgfrombganbginfectedbgpersonbgandbgpropelledbgabgsh
bgdistancebg(e.g.,bgbybgcoughing,bgsneezing,bgorbgtalking);bgandbg4)bginhalationbgofbgair-
bgbornebgmicroorganismsbgthatbgcanbgremainbgsuspendedbginbgthebgairbgforbglongbgperiods
Whatbgisbgthebgdifferencebgbetweenbguniversalbgprecautionsbgandbgstandardbgprecautionsbginbgthebgclinicalbgdentalbgpra
ce?bg-bganswer--
Standardbgprecautionsbgapplybgtobgcontactbgwithbg1)bgblood;bg2)bgallbgbodybgfluids,bgsecretions,bgandbgexcretionsbg(excep
sweat),bgregard-
bglessbgofbgwhetherbgtheybgcontainbgblood;bg3)bgnonintactbgskin;bgandbg4)bgmucousbgmembranes.bgSalivabghasbgalwaysbgb
enbgconsideredbgabgpotentiallybginfectiousbgmaterialbginbgdentalbginfectionbgcontrol;bgthus,bgnobgoperationalbgdifferencebg
istsbginbgclinicalbgdentalbgpracticebgbetweenbguniversalbgprecautionsbgandbgstandardbgprecautions.
InbgthebgtextbgthebgacronymbgOPIMbgisbgusedbg-bgwhatbgdoesbgitbgreference?bg-bganswer--
Otherbgpotentiallybginfectiousbgmaterials.bgOSHAbgtermbgthatbgrefersbgtobg1)bgbodybgfluidsbgincludingbgsemen,bgvaginalbgs
cretions,bgcerebrospinalbgfluid,bgsynovialbgfluid,bgpleuralbgfluid,bgpericardialbgfluid,bgperitonealbgfluid,bgamnioticbgfluid,bgsa
vabginbgdentalbgprocedures;bganybgbodybgfluidbgvisiblybgcontaminatedbgwithbgblood;bgandbgallbgbodybgfluidsbginbgsituations
wherebgdifferentiatingbgbetweenbgbodybgfluidsbgisbgdifficultbgorbgimpossible;bg2)bganybgunfixedbgtissuebgorbgorganbg(otherb
anbgintactbgskin)bgfrombgabghumanbg(livingbgorbgdead);bgandbg3)bgHIV-
containingbgcellbgorbgtissuebgcultures,bgorganbgcultures;bgHIV-bgorbgHBV-
containingbgculturebgmediumbgorbgotherbgsolutions;bgandbgblood,bgorgans,bgorbgotherbgtissuesbgfrombgexperimen-
bgtalbganimalsbginfectedbgwithbgHIVbgorbgHBV.
CanbganbgindividualbgthatbgisbgabgcarrierbgofbgHepatitisbgBbgworkbgasbgabgdentalbgreceptionist?bgWhybgorbgwhybgnot?bg-
bganswer--Yes,bgasbgthatbgpositionbgdoesbgnotbgperformbgexposure-pronebgprocedures.
CanbganbgindividualbgwithbgHepatitisbgCbgworkbgasbgabgdentalbghygienist?Whybgorbgwhybgnot?bg-bganswer--
Nobgrestrictionsbgonbgprofessionalbgactivity.HCV-positivebghealth-
carebgpersonnelbgshouldbgfollowbgasepticbgtechniquebgandbgstandardbgprecautions.
Givenbgthebgscenariobgthatbgyoubghavebgchickenbgpox,bgwhenbgcanbgyoubgreturnbgtobgworkbgasbgabgdentalbghygienist?bg-
bganswer--Frombgtenthbgdaybgafterbgfirstbgexposurebgthroughbgtwenty-firstbgdaybg(twenty-eighthbgdaybgifbgvaricella-
zosterbgimmunebgglobulinbg[VZIG]bgadministered)bgafterbglastbgexposure.
Howbglongbgisbgyourbgdentist-employerbgrequiredbgtobgkeepbgyourbgconfidentialbgmedicallybgrelatedbginformation?bg-
bganswer--atbgleastbgthebgdurationbgofbgemploymentbgplusbg30bgyears
1bg/
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WhatbgbodybgfluidbgcontainsbgthebggreatestbgproportionbgofbgHBVbginfectiousbgparticlebgtitersbgandbgisbgthebgmostbgcritical
ehiclebgofbgtransmissionbginbgthebghealth-carebgsetting?bg-bganswer--bloodandbgblood-contaminatedbgsaliva
HowbglongbgcanbgHBVbgsurvivebginbgdriedbgbloodbgatbgroombgtemperaturebgonbganbgenvironmentalbgsurface?bg-bganswer-
lessbgthanbgorbgequalbgtobg1bgweek
GivenbgthebgscenariobgthatbgyoubgreceivedbgthebgprimarybgvaccinebgseriesbgforbgHBV,bgwhatbgshouldbgyoubgdobgifbgyoubgdi
notbgdevelopbganbgadequatebgantibodybgresponse?bg-bganswer--completebgabgsecondbg3-
dosebgvaccinebgseriesbgorbgbebgevaluatedbgtobgdeterminebgifbgtheybgarebgHBsAg-
positive.bgIfbgnobgantibodybgresponsebgoccursbgafterbgthebgsecondbgseries,bgtestingbgforbgHBsAgbgshouldbgbebgperformed
GivenbgthebgscenariobgthatbgyoubgreceivedbgthebgprimarybgvaccinebgseriesbgforbgHBV,bgwhatbgshouldbgyoubgdobgifbgyoubgar
abgnonresponderbgtobgthebgvaccination?bg-bganswer--NonrespondersbgtobgvaccinationbgwhobgarebgHBsAg-
negativebgshouldbgbebgconsideredbgsusceptiblebgtobgHBVbginfectionbgandbgshouldbgbebgcounseledbgregard-
bgingbgprecautionsbgtobgpreventbgHBVbginfectionbgandbgthebgneedbgtobgobtainbgHBIGbgprophylaxisbgforbganybgknownbgorbgp
bablebgparenteralbgexposurebgtobgHBsAg-positivebgblood.
GivenbgthebgscenariobgthatbgyoubgreceivedbgthebgprimarybgvaccinebgseriesbgforbgHBVbgandbgyoubgrespondedbgaccordingl
withbgantibodies,bghowbgoftenbgshouldbgyoubgreceivebgabgboosterbgdoesbgofbgthebgvaccine?bg-bganswer--Vaccine-
inducedbgantibodiesbgdeclinebggraduallybgoverbgtime,bgandbg60%bgofbgpersonsbgwhobginitiallybgrespondbgtobgvaccinationb
illbglosebgdetectablebgantibodiesbgoverbg12bgyears.bgEvenbgso,bgimmunitybgcontinuesbgtobgpreventbgclinicalbgdiseasebgorbg
tectablebgviralbginfection.bgBoosterbgdosesbgofbgvaccinebgandbgperiodicbgserologicbgtestingbgtobgmonitorbgantibodybgconc
trationsbgafterbgcompletionbgofbgthebgvaccinebgseriesbgarebgnotbgnecessarybgforbgvaccinebgresponders
Whatbgisbgthebgcausebgofbgoccupationalbgexposuresbgtobgbloodbginbgdentistrybgthatbgposesbgthebggreatestbgriskbgofbgdiseas
gtransmission?bg-bganswer--Exposuresbgoccurbgthroughbgpercutaneousbginjurybg(e.g.,bgabgneedle-
stickbgorbgcutbgwithbgabgsharpbgobject),bgasbgwellbgasbgthroughbgcontactbgbetweenbgpotentiallybginfectiousbgblood,bgtissues
orbgotherbgbodybgfluidsbgandbgmucousbgmembranesbgofbgthebgeye,bgnose,bgmouth,bgorbgnon-
intactbgskinbg(e.g.,bgexposedbgskinbgthatbgisbgchapped,bgabraded,bgorbgshowsbgsignsbgofbgdermatitis)
Dr.bgPearcebgjustbgprovidedbgabglocalbganesthesiabginjectionbgandbgturnedbgoverbgthebgusedbgsyringebgtobgyou,bghowbgare
oubggoingbgtobgrecapbgthebgcontaminatedbgneedle?bg-bganswer--
thebgpractitionerbgshouldbgrecapbgthebgneedlebgbetweenbginjectionsbgbybgusingbgabgone-
handedbgtechniquebgorbgusebgabgdevicebgwithbgabgneedle-
resheathingbgmechanism.bgPassingbgabgsyringebgwithbganbgunsheathedbgneedlebgshouldbgbebgavoidedbgbecausebgofbgth
potentialbgforbginjury.
Whatbgisbgthebgsinglebgmostbgcriticalbgmeasurebgforbgreducingbgthebgriskbgofbgtransmittingbgdisease?bg-bganswer--
Handbghygienebg(e.g.,bghandwashing,bghandbgantisepsis,bgorbgsurgi-
bgcalbghandbgantisepsis)bgsubstantiallybgreducesbgpotentialbgpathogensbgonbgthebghandsbgandbgisbgconsideredbgthebgsing
gmostbgcriticalbgmea-bgsurebgforbgreducingbgthebgriskbgofbgtransmitting
Ifbgyourbghandsbgarebgvisiblybgsoiled,bgisbgitbgacceptablebgtobgusebganbgalcohol-basedbghandbgrub?bg-bganswer--No
Whybgshouldbghandbgantisepticbgproductsbghavebgabgpersistentbgeffect?bg-bganswer--
Persistencebgisbgcriticalbgbecausebgmicroorganismsbgcanbgcolonizebgonbghandsbginbgthebgmoistbgenvironmentbgunderne
hbggloves
Isbgourbgliquidbgsoapbgdispensingbgsystembgthebgideal?bgWhybgorbgwhybgnot?bg-bganswer--
Yes,bgbecausebgpathogenicbgorganismsbghavebgbeenbgfoundbgonbgorbgaroundbgbarbgsoapbgduringbgandbgafterbguse
2bg/
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