Infectious Diseases in Critical Care Medicine

Table 5 Recommended Transmission-Based Isolation Precautions (Continued)

Pathogen

Recommended

isolation precautions Comments

Class B pathogens

Brucellosis (Brucella
species)

Standard Person-to-person transmission infrequent (Mesner O,
Riesenberg K, Biliar N, et al. The many faces of
human-to-human transmission of brucellosis:
congenital infection and outbreak of nosocomial
disease related to an unrecognized clinical case.
Clin Infect Dis 2007; 45:e135–e140). Antibiotic
prophylaxis after laboratory exposure.
Epsilon toxin of
C. perfringens

Standard

Food safety threats
(e.g.,Salmonellasp.,
E. coliO157:H7,
Shigella, Vibriospp.,
L. monocytogenes,
C. jejuni,
Y. enterocolitica)

Standard, contact

Glanders (Bk. mallei) Standard, contact Not transmitted person-to-person.
Melioidosis
(Bk. pseudomallei)

Standard, contact Not transmitted person-to-person.

Psittacosis (C. psittaci) Standard Not usually transmitted from person-to-person. Very
rare cases have been reported and resulted in more
severe disease.
Q fever (C. burnetii) Standard Very rare cases of human-to-human transmission
among family members living together.
Ricin toxin fromR.
communis(castor beans)

Standard

Staphylococcal
enterotoxin B

Standard

Typhus fever
(R. prowazekii)

Standard, contact Transmitted person-to-person by close personal
contact. Minimize aerosol-generating procedures.
Viral encephalitis
[alphaviruses (e.g.,
Venezuelan equine
encephalitis, eastern
equine encephalitis,
western equine
encephalitis)]

Standard Not transmitted person-to-person. Rarely transmitted

by transfusion.

Viruses (noroviruses,
hepatitis A virus)

Standard, contact Postexposure hepatitis A vaccine recommended.

Water safety threats (e.g.,
V. cholerae,C. parvum)

Standard, contact

Protozoa (C. cayatanensis,
G. lamblia, E. histolytica,
Toxoplasmaspp.,
Microsporidia)

Standard, contact

Class C pathogens

Emerging infectious
diseases, such as Nipah
virus and hantavirus,
yellow fever virus;
Tick-borne encephalitis
complex (Flaviviridae).
Other viruses within the
same group are louping ill
virus, Langat virus, and
Powassan virus

Standard, contact

(Continued )

Bioterrorism Infections in Critical Care 441