Overview

In an era of emerging and re-emerging communicable disease health threats, the importance of infection prevention and control measures in health-care settings should not be underestimated. Transmission of communicable disease/pathogen is an ever-evolving subject, and transmission of pathogens that cause acute respiratory diseases (ARD) is no exception. The main mode of transmission of most ARDs are through droplets, but transmission through contact (including hand contamination followed by self-inoculation) and infectious respiratory aerosols of various sizes and at short range may also occur for some pathogens. Because many symptoms of ARDs are non-specific and rapid diagnostic tests are not always available, the etiology is often not immediately known. In addition, pharmaceutical interventions (vaccine, antivirals, antimicrobials) for ARDs may not be available.

These guidelines provide recommendations for the non-pharmacological aspects of infection prevention and control for ARDs in health care. Other WHO documents address the use of vaccines and antivirals for influenza: WHO guidelines for the use of seasonal influenza vaccine in humans1 WHO rapid advice guidelines on pharmacological management of humans infected with avian influenza A (H5N1) virus.

The importance of administrative and environmental controls for decreasing transmission of acute respiratory infections was well-illustrated by SARS. Administrative and infection controls, including early detection, isolation and reporting, and establishment of infection control infrastructure, are key components for containment and mitigation of the impact of pathogens that may constitute a major public health threat. Environmental controls, such as adequate ventilation and proper patient placement, were highlighted during the SARS experience as crucial measures to help to reduce the spread of respiratory pathogens associated with health care. In these guidelines, the options of using natural ventilation and/or exhaust fan assisted ventilation in health-care facilities (HCF) are considered (Part V).

The present document is intended to help policy-makers, administrators and health-care workers (HCWs) in charge of infection control programmes to prioritize infection control measures in health care, especially in settings with limited resources.

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