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MMWR from Center for Disease Control

TABLE 1: Suggested restrictions for patients  infected with or exposed to major infectious diseases in health-care settings, in the absence of state and local regulations.

 

Disease/problem

Appointment restrictions

Duration

Conjunctivitis

Restrict from treatment

Until discharge ceases

Cytomegalovirus infection

No restriction

 

Diarrheal disease

    Acute stage (diarrhea with other

    symptoms) 

 

    Convalescent stage, Salmonella

    Species   

Restrict from treatment

 

 

 

Restrict from treatment

Until symptoms resolve

 

 

Until symptoms resolve; consult with local and state health authorities regarding need for negative stool cultures

Enteroviral infection

Restrict from treatment

Until symptoms resolve

Hepatitis A

Restrict from treatment

Until 7 days after onset of jaundice

Hepatitis B

   Patients with acute or chronic

   hepatitis B surface

No restrictions†; refer to state regulations. Standard precautions should always be followed.

 

Hepatitis C

No restrictions

 

Herpes simplex

   Genital

 

   Hands (herpetic whitlow)

 

 

   Orofacial

 

No restriction

 

Restrict from treatment

 

Evaluate need to restrict

 

 

 

Until lesions heal

Measles

   Active

 

 

Exclude from treatment

 

 

Until 7 days after the rash appears

Meningococcal infection

Exclude from treatment

Until 24 hours after start of effective therapy

Mumps

   Active  

 

Exclude from treatment

 

 

Until 9 days after onset of parotitis

Pediculosis 

Restrict from treatment

Until treated and observed to be free of adult and immature lice

Pertussis 

   Active

 

 

 

 

 

   Postexposure (asymptomatic)

 

 

   Postexposure (symptomatic)

  

 

Exclude from treatment

 

 

 

 

 

No restriction, prophylaxis recommended

 

 

Exclude from treatment

 

From beginning of catarrhal stage through third week after onset of paroxysms, or until 5 days after start of effective antibiotic therapy

 

 

 

 

Until 5 days after start of effective antibiotic therapy

 

 


 

Disease/problem

Work restriction

Duration

Rubella

   Active

 

Exclude from treatment

 

Until 5 days after rash appears

Staphylococcus aureus infection

   Active, draining skin lesions

 

 

  Carrier state

 

Restrict from treatment

 

 

No restriction unless patient is epidemiologically linked to transmission of the organism

 

 

Until lesions have resolved

Streptococcal infection, group A

Restrict from treatment

Until 24 hours after adequate treatment started

Tuberculosis

   Active disease

 

   PPD converter

 

Exclude from treatment

 

 

No treatment until patient has been treated for a minimum of 90 days with prophylactic medication.

 

Until proved noninfectious

through treatment.

 

Patient will need to submit documentation of completed treatment.

Varicella (chicken pox)

   Active

 

Exclude from treatment

 

 

Until all lesions dry and crust

 

Zoster (shingles)

   Localized, in healthy person

 

   Generalized or localized in

   immunosuppressed person

 

Viral respiratory infection, acute

   Febrile

 

Restrict from treatment

 

Restrict from treatment

 

 

Consider excluding from treatment at high risk ¶

 

Until all lesions dry and crust

 

 

Until all lesions dry and crust

 

Until acute symptoms resolve

 

Source: Adapted from Bolyard EA, Hospital Infection Control Practices Advisory Committee. Guidelines for infection control in health care personnel, 1998. Am J Infect. Control 1998; 26:289-354.

*Modified from recommendations of the Advisory Committee on Immunization Practices (ACIP.

1Unless epidemiologically linked to transmission of infection.

§Those susceptible to varicella and who are at increased risk of complications of varicella (e.g., neonates and  

   immunocompromised persons of any age).             

¶Patients at high risk as defined by ACIP for complications of influenza.