How do infections spread? For an infection to spread 4 conditions must be present. 1. A germ must be present.

Examples include: o virus o fungus o bacterium o parasite 2. The germ must have a place to live and multiply such as: o people o plants o food o soil o water 3. A susceptiple host, specifically a person who does not have immunity to the germ. 4. A way for the germ to enter the host such as: o direct contact (touch, sexual contact, kissing, etc) o indirect contact (through contaminated food, water, feces, etc.) o water droplets o particles in the air Removing any one of these four conditions breaks the chain of infection, thus preventing the infection from spreading. So to prevent infection, we must remove one of the four links in the infection. But how? How can we break the chain of infection? Preventing infection means looking at your habits, lifestyles, and surroundings and assessing for those things that may promote infection. By identifying those things in the infection chain, we can take steps to eliminate them. For instance: Practice good personal hygeine Treat all bodily fluids as potentially infectious. Use protective barriers such as gloves, masks, aprons, and condoms when exposure to infections agents is possible. Maintain a clean home and enviroment. Store and cook foods at the proper temperature. Proper disposal of wastes, garbage, and used medical supplies See your doctor regularly for protective vaccines and immunizations. Wash your hands often! Frequent and proper handwashing is key in preventing the spread of infection. Wash your hands before handling or eating food. Wash your hands after: o using the toilet o changing a diaper o coughing sneezing or blowing your nose o handling a pet o preparing or handling uncooked foods Wash your hands before and after: o cleaning cuts or abrasions o changing bandages or soiled linens Control infections throughout your home Your home can be a breeding ground for germs that can cause infection. Reduce the risk of spreading infection by: Improve your home's air quality by increasing air circulation, changing your furnace filters, and maintain good ventilation by opening windows. Be cautious with pet care o change litter boxes daily o avoid handing bird droppings o avoid handling fish tank water Use liquid hand soap instead of bar soap Change bathroom linens frequently, especially after they become wet Replace toothbrushes often and store them in a clean, dry place

 Use disposable drinking cups in the bathroom instead of reusable drinking glasses Disinfect the toilet regularly using bleach (always use rubber gloves and eye protection when handling bleach). Clean sinks and tubs with a household cleaner Mop the floor each week with a standard floor cleaner Controlling infection in the kitchen The kitchen is a prime location for the spread of germs and infection. Reduce your risk by: Store food properly o refrigerate leftovers immediately o clean your refrigerator weekly o set your refrigerator temperature at 40 degrees F or less and your freezer at 0 degrees or less o thaw foods in a microwave instaed of at room temperature Handle meats, fish and eggs properly o never eat them raw o cook them at proper temperatures o never buy cracked eggs Wash fruits and vegetables under running water Use separate cutting boards and utensils for cooked and raw foods. Clean the can opener after each use Keep work surfaces clean Wash your hands immediately after handling raw foods, especially meats and poultry Wash used dishes in hot, soapy water or a dishwasher and allow to air dry. By taking the proper precautions and following a few simple rules, you can decrease your risk of infection. Help your immune system keep you healthy. Break that chain of infection.

A model used to understand the infection process is the chain of infection , a circle of links, each representing a component in the cycle. Each link must be present and in sequential order for an infection to occur. The links are: infectious agent , reservoir, portal of exit from the reservoir, mode of transmission , and portal of entry into a susceptible host .Understanding the characteristics of each link provides the nurse with methods to support vulnerable patients and to prevent the spread of infection. An awareness of this cycle also provides the nurse with knowledge of methods of self-protection.

INFECTIOUS AGENT A microbial organism with the ability to cause disease. The greater the organism's virulence (ability to grow and multiply), invasiveness (ability to enter tissue) and pathogenicity (ability to cause disease), the greater the possibility that the organism will cause an infection. Infectious agents are bacteria, virus, fungi, and parasites. "germs." RESERVOIR A place within which microorganisms can thrive and reproduce. For example, microorganisms thrive in human beings, animals, and inanimate objects such as water, table tops, and doorknobs. Any person, animal, arthropod, plant, soil, or substance (or combination of these) in which an causative agent normally lives and multiplies, on which it depends primarily for survival, and where it reproduces in such numbers that it can be transmitted to a susceptible host. Reservoirs are usually wet. PORTAL OF EXIT A place of exit providing a way for a microorganism to leave the reservoir. For example, the microorganism may leave the reservoir through the nose or mouth when someone sneezes or coughs. Microorganisms, carried away from the body by feces, may also leave the reservoir of an infected bowel. MODE OF TRANSMISSION Method of transfer by which the organism moves or is carried from one place to another. The hands of the health care worker may carry bacteria from one person to another. PORTAL OF ENTRY An opening allowing the microorganism to enter the host. Portals include body orifices, mucus membranes,

or breaks in the skin. Portals also result from tubes placed in body cavities, such as urinary catheters, or from punctures produced by invasive procedures such as intravenous fluid replacement. SUSCEPTIBLE HOST A person who cannot resist a microorganism invading the body, multiplying, and resulting in infection. The host is susceptible to the disease, lacking immunity or physical resistance to overcome the invasion by the pathogenic microorganism. RESERVOIRS Like other organisms, germs require water to grow and reproduce, so reservoirs are commonly wet. In general, if an area is wet it is probably a reservoir unless something specific has been done to prevent bacterial growth. The bacteria may not be pathogens. Sometimes the reservoir contains our own normal flora; that is, we get our own germs in the wrong place. In some cases the environment can serve as the reservoir. For example, water supplies may carry Legionella spp. Inadequate air exchange can allow pathogens such as Mycobacterium tuberculosis and varicella-zoster virus to contaminate air supplies. Appropriate environmental infection-control measures and engineering controls can prevent these environmental reservoirs. Common reservoirs in healthcare facilities include: Ill people. Well people. Our normal flora (the germs we live with) include bacteria that can be pathogens if they get into the wrong part of the body. For example, our mouths contain many different kinds of bacteria. Soil; has rich microbial life which may include pathogens. Raw meat; may harbor pathogens. Water from fish tanks or flower vases; may contain pathogens, especially for compromised patients. Actions we take to eliminate reservoirs include: Treating people who are ill Vaccinating people Handling and disposing of body fluids responsibly Storing equipment dry Handling food safely Monitoring soil and contaminated water in sensitive areas of the hospital and washing hands carefully after contact with either HUMAN RESERVOIRS AND TRANSMISSION OF INFECTIOUS AGENTS Reservoir Transmission Vehicle Infectious Agent Blood Blood, needle stick, other contaminated equipment Hepatitis B and C; HIV/AIDS, S. aureus, S. epidermidis Tissue Drainage from a wound or incision S. aureus,, E. coli, Proteus spp Respiratory tract Droplets from sneezing or coughing Influenza viruses, Strep spp., S. aureus Gastrointestinal tract Vomitus, feces, bile, saliva Hepatitis A, Shigella spp, Salmonella spp Urinary tract Urine E. coli, enterococci Reproductive tract and genitalia Urine and semen N. gonorrhoeae, T. pallidum, Herpes simplex virus type 2, Hepatitis B