Precaution
Infection/Condition	Type∗	Duration†	Comments
Abscess
Draining, major	C	DI	No dressing or containment of drainage; until drainage stops or can be contained by dressing.
Draining, minor or limited	S		Dressing to cover and contain drainage.
AIDS/HIV	S		Postexposure chemoprophylaxis for some blood exposures.865
Actinomycosis	S		Not transmitted from person to person.
Adenovirus infection (see agent-specific guidance under gastroenteritis, conjuctivitis, pneumonia)
Amebiasis	S		Person-to-person transmission is rare. Transmission in settings for the mentally challenged and in a family group has been reported.1041 Use care when handling diapered infants and mentally challenged persons.1042
Anthrax	S		Infected patients do not generally pose a transmission risk.
Cutaneous	S		Transmission through nonintact skin contact with draining lesions possible; thus, use Contact Precautions if a large amount of uncontained drainage is present. Handwashing with soap and water is preferable to the use of waterless alcohol-based antiseptics, because alcohol does not have sporicidal activity.979
Pulmonary	S		Not transmitted from person to person.
Environmental: aerosolizable spore-containing powder or other substance		DE	Until decontamination of environment complete.203 Wear respirator (N95 mask or PAPR), protective clothing; decontaminate persons with powder on them (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5135a3.htm).
			Hand hygiene: Handwashing for 30 to 60 seconds with soap and water or 2% chlorhexidene gluconate after spore contact. (Alcohol handrubs are inactive against spores.)979
			Postexposure prophylaxis after environmental exposure: 60 days of antimicrobials (either doxycycline, ciprofloxacin, or levofloxacin) and postexposure vaccine under IND.
Antibiotic-associated colitis (see Clostridium difficile)
Arthropod-borne viral encephalitides (eastern, western, Venezuelan equine encephalomyelitis; St Louis, California encephalitis; west Nile virus) and viral fevers (dengue, yellow fever, Colorado tick fever)	S		Not transmitted from person to person except rarely by transfusion, and for West Nile virus by organ transplant, breastmilk or transplacentally.528, 1043 Install screens in windows and doors in endemic areas.
			Use DEET-containing mosquito repellants and clothing to cover extremities.
Ascariasis	S		Not transmitted from person to person.
Aspergillosis	S		Institute Contact Precautions and Airborne Precautions if massive soft tissue infection with copious drainage and repeated irrigations required.154
Avian influenza (see influenza, avian below)
Babesiosis	S		Not transmitted from person to person except rarely by transfusion.
Blastomycosis, North American, cutaneous or pulmonary	S		Not transmitted from person to person.
Botulism	S		Not transmitted from person to person.
Bronchiolitis (see respiratory infections in infants and young children)	C	DI	Use mask according to Standard Precautions.
Brucellosis (undulant, Malta, Mediterranean fever)	S		Not transmitted from person to person except rarely through banked spermatozoa and sexual contact.1044, 1045 Provide antimicrobial prophylaxis following laboratory exposure.1046
Campylobacter gastroenteritis (see gastroenteritis)
Candidiasis, all forms, including mucocutaneous	S
Cat-scratch fever (benign inoculation lymphoreticulosis)	S		Not transmitted from person to person.
Cellulitis	S
Chancroid (soft chancre) (Haemophilus ducreyi)	S		Transmitted sexually from person to person.
Chickenpox (see varicella)
Chlamydia trachomatis
Conjunctivitis	S
Genital (lymphogranuloma venereum)	S
Pneumonia (infants ≤ 3 mos. of age))	S
Chlamydia pneumoniae	S		Outbreaks in institutionalized populations are rarely reported.1047, 1048
Cholera (see gastroenteritis)
Closed-cavity infection
Open drain in place; limited or minor drainage	S		Contact Precautions if copious uncontained drainage is present.
No drain or closed drainage system in place	S
Clostridium spp
C botulinum	S		Not transmitted from person to person.
C difficile (see gastroenteritis, C difficile)	C	DI
C perfringens
Food poisoning	S		Not transmitted from person to person.
Gas gangrene	S		Transmission from person to person is rare; 1 outbreak in a surgical setting has been reported.1053 Use Contact Precautions if wound drainage is extensive.
Coccidioidomycosis (valley fever)
Draining lesions	S		Not transmitted from person to person except under extraordinary circumstances, because the infectious arthroconidial form of Coccidioides immitis is not produced in humans.1049, 1050
Pneumonia	S		Not transmitted from person to person except under extraordinary circumstances (eg, inhalation of aerosolized tissue phase endospores during necropsy, transplantation of infected lung), because the infectious arthroconidial form of C immitis is not produced in humans.1050, 1051
Colorado tick fever	S		Not transmitted from person to person.
Congenital rubella	C	Until age 1 year	Standard Precautions if nasopharyngeal and urine cultures are repeatedly negative after age 3 months.
Conjunctivitis
Acute bacterial	S
Chlamydial	S
Gonococcal	S
Acute viral (acute hemorrhagic)	C	DI	Adenovirus most common; enterovirus 70,1052 Coxsackie virus A241054 also associated with community outbreaks. Highly contagious; outbreaks in eye clinics, pediatric and neonatal settings, institutional settings reported. Eye clinics should follow Standard Precautions when handling patients with conjunctivitis. Routine use of infection control measures in the handling of instruments and equipment will prevent the occurrence of outbreaks in this and other settings.458, 459, 812, 1054, 1055, 1056
Corona virus associated with SARS (SARS-CoV) (see severe acute respiratory syndrome)
Coxsackie virus disease (see enteroviral infection)
Creutzfeldt-Jakob disease (CJD, vCJD)	S		Use disposable instruments or special sterilization/disinfection for surfaces and objects contaminated with neural tissue if CJD or vCJD has not been ruled out; no special burial procedures.1057
Croup (see respiratory infections in infants and young children)
Crimean-Congo Fever (see viral hemorrhagic fever)	S
Cryptococcosis	S		Not transmitted from person to person, except rarely through tissue and corneal transplantation.1058, 1059
Cryptosporidiosis (see gastroenteritis)
Cysticercosis	S		Not transmitted from person to person.
Cytomegalovirus infection, including in neonates and immunosuppressed patients	S		No additional precautions for pregnant HCWs.
Decubitus ulcer (see Pressure ulcer)
Dengue fever	S		Not transmitted from person to person.
Diarrhea, acute-infective etiology suspected (see gastroenteritis)
Diphtheria
Cutaneous	C	CN	Until 2 cultures obtained 24 hours apart are negative.
Pharyngeal	D	CN	Until 2 cultures obtained 24 hours apart are negative.
Ebola virus (see viral hemorrhagic fevers)
Echinococcosis (hydatidosis)	S		Not transmitted from person to person.
Echovirus (see enteroviral infection)
Encephalitis or encephalomyelitis (see specific etiologic agents)
Endometritis (endomyometritis)	S
Enterobiasis (pinworm disease, oxyuriasis)	S
Enterococcus spp (see multidrug-resistant organisms if epidemiologically significant or vancomycin-resistant)
Enterocolitis, Clostridium difficile (see C difficile, gastroenteritis)
Enteroviral infections (ie, group A and B Coxsackie viruses and Echo viruses) (excludes polio virus)	S		Use Contact Precautions for diapered or incontinent children for duration of illness and to control institutional outbreaks.
Epiglottitis, due to Haemophilus influenzae type b	D	U 24 hours	(See specific disease agents for epiglottitis due to other etiologies.)
Epstein-Barr virus infection, including infectious mononucleosis	S
Erythema infectiosum (also see parvovirus B19)
Escherichia coli gastroenteritis (see gastroenteritis)
Food poisoning
Botulism	S		Not transmitted from person to person.
Clostridium perfringens or C welchii	S		Not transmitted from person to person.
Staphylococcal	S		Not transmitted from person to person.
Furunculosis, staphylococcal	S		Contact if drainage not controlled. Follow institutional policies if MRSA.
Infants and young children	C	DI
Gangrene (gas gangrene)	S		Not transmitted from person to person.
Gastroenteritis	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks for gastroenteritis caused by all of the agents listed below.
Adenovirus	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Campylobacter spp	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Cholera (Vibrio cholerae)	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Clostridium difficile	C	DI	Discontinue antibiotics if appropriate. Do not share electronic thermometers;851, 852 ensure consistent environmental cleaning and disinfection. Hypochlorite solutions may be required for cleaning if transmission continues.845 Handwashing with soap and water is preferred because of the absence of sporicidal activity of alcohol in waterless antiseptic handrubs.979
Cryptosporidium spp	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Escherichia coli
Enteropathogenic O157:H7 and other shiga toxin–producing strains	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Other species	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Giardia lamblia	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Noroviruses	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks. Persons who clean areas heavily contaminated with feces or vomitus may benefit from wearing masks, because virus can be aerosolized from these body substances;142, 147, 148 ensure consistent environmental cleaning and disinfection with focus on restrooms even when apparently unsoiled.272, 1060 Hypochlorite solutions may be required when there is continued transmission.289, 290, 291 Alcohol is less active, but there is no evidence that alcohol antiseptic handrubs are not effective for hand decontamination.293 Cohorting of affected patients to separate airs paces and toilet facilities may help interrupt transmission during outbreaks.
Rotavirus	C	DI	Ensure consistent environmental cleaning and disinfection and frequent removal of soiled diapers. Prolonged shedding may occur in both immunocompetent and immunocompromised children and the elderly.930, 931
Salmonella species (including S typhi)	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Shigella species (bacillary dysentery)	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Vibrio parahaemolyticus	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Viral (if not covered elsewhere)	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
Yersinia enterocolitica	S		Use Contact Precautions for diapered or incontinent persons for the duration of illness or to control institutional outbreaks.
German measles (see rubella; see congenital rubella)
Giardiasis (see gastroenteritis)
Gonococcal ophthalmia neonatorum (gonorrheal ophthalmia, acute conjunctivitis of newborn)	S
Gonorrhea	S
Granuloma inguinale (donovanosis, granuloma venereum)	S
Guillain-Barré syndrome	S		Not an infectious condition.
Haemophilus influenzae (see disease-specific recommendations)
Hand, foot, and mouth disease (see enteroviral infection)
Hansen's disease (see leprosy)
Hantavirus pulmonary syndrome	S		Not transmitted from person to person.
Helicobacter pylori	S
Hepatitis, viral
Type A	S		Provide hepatitis A vaccine postexposure as recommended.1061
Diapered or incontinent patients	C		Maintain Contact Precautions for the duration of hospitalization in infants and children under age 3 years, for 2 weeks after onset of symptoms in children age 3 to 14 years, and for 1 week after onset of symptoms in those over age 14 year.831, 1062, 1063
Type B-HBsAg positive; acute or chronic	S		See specific recommendations for care of patients in hemodialysis centers.776
Type C and other unspecified non-A, non-B	S		See specific recommendations for care of patients in hemodialysis centers.776
Type D (seen only with hepatitis B)	S
Type E	S		Use Contact Precautions for diapered or incontinent individuals for the duration of illness.1064
Type G	S
Herpangina (see enteroviral infection)
Hookworm	S
Herpes simplex (Herpesvirus hominis)
Encephalitis	S
Mucocutaneous, disseminated or primary, severe	C	Until lesions dry and crusted
Mucocutaneous, recurrent (skin, oral, genital)	S
Neonatal	C	Until lesions dry and crusted	Also for asymptomatic, exposed infants delivered vaginally or by C-section and if mother has active infection and membranes have been ruptured for more than 4 to 6 hours until infant surface cultures obtained at 24 to 36 hours of age negative after 48 hours of incubation.1065, 1066
Herpes zoster (varicella-zoster) (shingles)
Disseminated disease in any patient	A,C	DI	Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for protection of immune HCWs; no recommendation for type of protection (ie surgical mask or respirator) for susceptible HCWs.
Localized disease in immunocompromised patient until disseminated infection ruled out
Localized in patient with intact immune system with lesions that can be contained/covered	S	DI	Susceptible HCWs should not provide direct patient care when other immune caregivers are available.
Histoplasmosis	S		Not transmitted from person to person.
Human immunodeficiency virus (HIV)	S		Postexposure chemoprophylaxis for some blood exposures.864
Human metapneumovirus	C	DI	HAI reported,1067 but the route of transmission is not established.821 Assumed to be contact transmission as for RSV since the viruses are closely related and have similar clinical manifestations and epidemiology. Wear masks according to Standard Precautions.
Impetigo	C	U 24 hours
Infectious mononucleosis	S
Influenza
Human (seasonal influenza)	D	5 days except DI in immuno- compromised persons	Single patient room when available or cohort; avoid placement with high-risk patients; mask patient when transported out of room; chemoprophylaxis/vaccine to control/prevent outbreaks.609 Use of gown and gloves according to Standard Precautions may be especially important in pediatric settings. Duration of precautions for immunocompromised patients cannot be defined; prolonged duration of viral shedding (ie for several weeks) has been observed; implications for transmission are unknown.928
Avian (eg, H5N1, H7, H9 strains)			See http://www.cdc.gov/flu/avian/professional/infect-control.htm for current avian influenza guidance.
Pandemic influenza (also a human influenza virus)	D	5 days from onset of symptoms	See http://www.pandemicflu.gov for current pandemic influenza guidance.
Kawasaki syndrome	S		Not an infectious condition.
Lassa fever (see viral hemorrhagic fevers)
Legionnaires' disease	S		Not transmitted from person to person.
Leprosy	S
Leptospirosis	S		Not transmitted from person to person; see
Lice			http://www.cdc.gov/ncidod/dpd/parasites/lice/default.htm.
Head (pediculosis)	C	U 4 hours
Body	S		Transmitted person to person through infested clothing. Wear gown and gloves when removing clothing; bag and wash clothes according to CDC guidance.
Pubic	S		Transmitted person to person through sexual contact.
Listeriosis (Listeria monocytogenes)	S		Person-to-person transmission rare; cross-transmission in neonatal settings reported.1068, 1069, 1070, 1071
Lyme disease	S		Not transmitted from person to person.
Lymphocytic choriomeningitis	S		Not transmitted from person to person.
Lymphogranuloma venereum	S
Malaria	S		Not transmitted from person to person except rarely through transfusion and due to failure to follow Standard Precautions during patient care.1072, 1073, 1074, 1075 Install screens in windows and doors in endemic areas. Use DEET-containing mosquito repellants and clothing to cover extremities.
Marburg virus disease (see viral hemorrhagic fevers)
Measles (rubeola)	A	4 days after onset of rash; DI in immune compromised	Susceptible HCWs should not enter room if immune care providers are available; no recommendation for face protection for immune HCW; no recommendation for type of face protection for susceptible HCWs (ie, mask or respirator).1023, 1025 For exposed susceptible HCWs, postexposure vaccine within 72 hours or immune globulin within 6 days when available.17, 1028, 1030 Place exposed susceptible patients on Airborne Precautions and exclude susceptible HCWs from duty from day 5 after first exposure to day 21 after last exposure, regardless of postexposure vaccine.17
Melioidosis, all forms	S		Not transmitted from person to person.
Meningitis
Aseptic (nonbacterial or viral; also see enteroviral infections)	S		Contact for infants and young children.
Bacterial, gram-negative enteric, in neonates	S
Fungal	S
Haemophilus influenzae, type b known or suspected	D	U 24 hours
Listeria monocytogenes (See listeriosis)	S
Neisseria meningitidis (meningococcal) known or suspected	D	U 24 hours	See meningococcal disease below.
Streptococcus pneumoniae	S
Mycobacterium tuberculosis	S		Concurrent, active pulmonary disease or draining cutaneous lesions may necessitate addition of Contact and/or Airborne Precautions.
			For children, airborne precautions until active tuberculosis ruled out in visiting family members (see tuberculosis below).42
Other diagnosed bacterial	S
Meningococcal disease: sepsis, pneumonia, meningitis	D	U 24 hours	Postexposure chemoprophylaxis for household contacts, HCWs exposed to respiratory secretions; postexposure vaccine only to control outbreaks.15, 17
Molluscum contagiosum	S
Monkeypox	A,C	A-Until monkeypox confirmed and smallpox excluded	See http://www.cdc.gov/ncidod/monkeypox for most current recommendations. Transmission in hospital settings unlikely.267 Preexposure and postexposure smallpox vaccine recommended for exposed HCWs.
		C-Until lesions crusted
Mucormycosis	S
Multidrug-resistant organisms (MDROs), infection or colonization (eg, MRSA, VRE, VISA/VRSA, ESBLs, resistant S. pneumoniae)	S/C		MDROs judged by the infection control program, based on local, state, regional, or national recommendations, to be of clinical and epidemiologic significance. Contact Precautions recommended in settings with evidence of ongoing transmission, acute care settings with increased risk for transmission or wounds that cannot be contained by dressings. See recommendations for management options in Management of Multidrug-Resistant Organisms In Health care Settings, 2006.868 Contact state health department for guidance regarding new or emerging MDROs.
Mumps (infectious parotitis)	D	U 9 days	After onset of swelling; susceptible HCWs should not provide care if immune caregivers are available. (Note: Recent assessment of outbreaks in healthy 18- to 24-year-olds has indicated that salivary viral shedding occurred early in the course of illness and that 5 days of isolation after onset of parotitis may be appropriate in community settings; however, the implications for health care personnel and high-risk patient populations remain to be clarified.)
Mycobacteria, nontuberculosis (atypical)			Not transmitted person-to-person.
Pulmonary	S
Wound	S
Mycoplasma pneumonia	D	DI
Necrotizing enterocolitis	S		Contact Precautions when cases clustered temporally.1076, 1077, 1078, 1079
Nocardiosis, draining lesions, or other presentations	S		Not transmitted person-to-person.
Norovirus (see gastroenteritis)
Norwalk agent gastroenteritis (see gastroenteritis)
Orf	S
Parainfluenza virus infection, respiratory in infants and young children	C	DI	Viral shedding may be prolonged in immunosuppressed patients.1005, 1006 Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.
Parvovirus B19 (Erythema infectiosum)	D		Maintain precautions for duration of hospitalization when chronic disease occurs in immunocompromised patients. For patients with transient aplastic crisis or red cell crisis, maintain precautions for 7 days. Duration of precautions for immunosuppressed patients with persistently positive PCR not defined, but transmission has occurred.927
Pediculosis (lice)	C	U 24 hours after treatment
Pertussis (whooping cough)	D	U 5 days	Single patient room preferred. Cohorting an option. Postexposure chemoprophylaxis for household contacts and HCWs with prolonged exposure to respiratory secretions.861 Recommendations for Tdap vaccine in adults under development.
Pinworm infection (Enterobiasis)	S
Plague (Yersinia pestis)
Bubonic	S
Pneumonic	D	U 48 hours	Antimicrobial prophylaxis for exposed HCW.207
Pneumonia
Adenovirus	D, C	DI	Outbreaks in pediatric and institutional settings reported.375, 1080, 1081, 1082 In immunocompromised hosts, extend duration of Droplet and Contact Precautions due to prolonged shedding of virus.929
Bacterial not listed elsewhere (including gram-negative bacterial)	S
B cepacia in patients with CF, including respiratory tract colonization	C	Unknown	Avoid exposure to other persons with CF; private room preferred. Criteria for D/C precautions not established. See the Cystic Fibrosis Foundation guidelines.20
B cepacia in patients without CF (see multidrug-resistant organisms)
Chlamydia	S
Fungal	S
Haemophilus influenzae, type b
Adults	S
Infants and children	D	U 24 hours
Legionella spp	S
Meningococcal	D	U 24 hours	See meningococcal disease above.
Multidrug-resistant bacterial (see multidrug-resistant organisms)
Mycoplasma (primary atypical pneumonia)	D	DI
Pneumococcal pneumonia	S		Use Droplet Precautions if evidence of transmission within a patient care unit or facility.196, 197, 198, 1083
Pneumocystis jiroveci (Pneumocystis carinii)	S		Avoid placement in the same room with an immunocompromised patient.
Staphylococcus aureus	S		For MRSA, see MDROs.
Streptococcus, group A
Adults	D	U 24 hours	See streptococcal disease (group A streptococcus) below.
			Contact precautions if skin lesions present.
Infants and young children	D	U 24 hours	Contact Precautions if skin lesions present.
Varicella-zoster (see varicella-zoster)
Viral
Adults	S
Infants and young children (see respiratory infectious disease, acute, or specific viral agent)
Poliomyelitis	C	DI
Pressure ulcer (decubitus ulcer, pressure sore) infected
Major	C	DI	If no dressing or containment of drainage; until drainage stops or can be contained by dressing.
Minor or limited	S		If dressing covers and contains drainage.
Prion disease (See Creutzfeld-Jacob Disease)
Psittacosis (ornithosis) (Chlamydia psittaci)	S		Not transmitted from person to person.
Q fever	S
Rabies	S		Person-to-person transmission is rare; transmission via corneal, tissue and organ transplants has been reported.537, 1084 If patient has bitten another individual or saliva has contaminated an open wound or mucous membrane, wash exposed area thoroughly and administer postexposure prophylaxis.1085
Rat-bite fever (Streptobacillus moniliformis disease, Spirillum minus disease)	S		Not transmitted from person to person.
Relapsing fever	S		Not transmitted from person to person.
Resistant bacterial infection or colonization (see multidrug-resistant organisms)
Respiratory infectious disease, acute (if not covered elsewhere)
Adults	S
Infants and young children	C	DI	Also see syndromes or conditions listed in Table 2.
Respiratory syncytial virus infection, in infants, young children and immunocompromised adults	C	DI	Wear mask according to Standard Precautions24, 116, 117 In immunocompromised patients, extend the duration of Contact Precautions due to prolonged shedding.926 Reliability of antigen testing to determine when to remove patients with prolonged hospitalizations from Contact Precautions uncertain.
Reye's syndrome	S		Not an infectious condition.
Rheumatic fever	S		Not an infectious condition.
Rhinovirus	D	DI	Droplet most important route of transmission.104, 1086 Outbreaks have occurred in NICUs and LTCFs.411, 1087, 1088 Add Contact Precautions if copious moist secretions and close contact likely to occur (eg, young infants).111, 831
Rickettsial fevers, tickborne (Rocky Mountain spotted fever, tickborne typhus fever)	S		Not transmitted from person to person except rarely through transfusion.
Rickettsialpox (vesicular rickettsiosis)	S		Not transmitted from person to person.
Ringworm (dermatophytosis, dermatomycosis, tinea)	S		Rarely, outbreaks have occurred in health care settings, (eg, NICU,1089 rehabilitation hospital1090). Use Contact Precautions for outbreak.
Ritter's disease (staphylococcal scalded skin syndrome)	C	DI	See staphylococcal disease and scalded skin syndrome below.
Rocky Mountain spotted fever	S		Not transmitted from person to person except rarely through transfusion.
Roseola infantum (exanthem subitum; caused by HHV-6)	S
Rotavirus infection (see gastroenteritis)
Rubella (German measles) (also see congenital rubella)	D	U 7 days after onset of rash	Susceptible HCWs should not enter room if immune caregivers are available. No recommendation for wearing face protection (eg, a surgical mask) if immune. Pregnant women who are not immune should not care for these patients.17, 33 Administer vaccine within 3 days of exposure to nonpregnant susceptible individuals. Place exposed susceptible patients on Droplet Precautions; exclude susceptible health care personnel from duty from day 5 after first exposure to day 21 after last exposure, regardless of postexposure vaccine.
Rubeola (see measles)
Salmonellosis (see gastroenteritis)
Scabies	C	U 24
Scalded skin syndrome, staphylococcal	C	DI	See staphylococcal disease and scalded skin syndrome below.
Schistosomiasis (bilharziasis)	S
Severe acute respiratory syndrome (SARS)	A, D,C	DI plus 10 days after resolution of fever, provided respiratory symptoms are absent or improving	Airborne Precautions preferred; D if AIIR unavailable. N95 or higher-level respiratory protection; surgical mask if N95 is unavailable; eye protection (goggles, face shield); aerosol-generating procedures and “supershedders” are at highest risk for transmission through small droplet nuclei and large droplets.93, 94, 96Vigilant environmental disinfection necessary (see http://www.cdc.gov/ncidod/sars).
Shigellosis (see gastroenteritis)
Smallpox (variola; see vaccinia for management of vaccinated persons)	A,C	DI	Until all scabs have crusted and separated (3 to 4 weeks). Nonvaccinated HCWs should not provide care when immune HCWs are available; N95 or higher-level respiratory protection for susceptible and successfully vaccinated individuals; postexposure vaccine within 4 days of exposure protective.108, 129, 1034, 1035, 1036
Sporotrichosis	S
Spirillum minor disease (rat-bite fever)	S		Not transmitted from person to person.
Staphylococcal disease (S. aureus)
Skin, wound, or burn
Major	C	DI	No dressing, or dressing does not adequately contain drainage.
Minor or limited	S		Dressing adequatelys cover and contain drainage.
Enterocolitis	S		Use Contact Precautions for diapered or incontinent children for duration of illness.
Multidrug-resistant (see multidrug-resistant organisms)
Pneumonia	S
Scalded skin syndrome	C	DI	Consider health care personnel as potential source of nursery, NICU outbreak.1091
Toxic shock syndrome	S
Streptobacillus moniliformis disease (rat-bite fever)	S		Not transmitted from person to person.
Streptococcal disease (group A streptococcus)
Skin, wound, or burn
Major	C,D	U 24 hours	No dressing, or dressing does not adequately contain drainage.
Minor or limited	S		Dressing covers and adequately contains drainage.
Endometritis (puerperal sepsis)	S
Pharyngitis in infants and young children	D	U 24 hours
Pneumonia	D	U 24 hours
Scarlet fever in infants and young children	D	U 24 hours
Serious invasive disease	D	U24 hours	Outbreaks of serious invasive disease have occurred secondary to transmission among patients and HCWs.162, 968, 1092, 1093, 1094
			Contact Precautions for draining wound as above; follow recommendations for antimicrobial prophylaxis in selected conditions.160
Streptococcal disease (group B streptococcus), neonatal	S
Streptococcal disease (not group A or B) unless covered elsewhere	S
Multidrug-resistant (see multidrug-resistant organisms)
Strongyloidiasis	S
Syphilis
Latent (tertiary) and seropositivity without lesions	S
Skin and mucous membrane, including congenital, primary, secondary	S
Tapeworm disease
Hymenolepis nana	S		Not transmitted from person to person.
Taenia solium (pork)	S
Other	S
Tetanus	S		Not transmitted from person to person.
Tinea (eg, dermatophytosis, dermatomycosis, ringworm)	S		Rare episodes of person-to-person transmission.
Toxoplasmosis	S		Transmission from person to person is rare; vertical transmission from mother to child, transmission through organs and blood transfusion rare.
Toxic shock syndrome (staphylococcal disease, streptococcal disease)	S		Droplet Precautions for the first 24 hours after implementation of antibiotic therapy if group A streptococcus is a likely etiology.
Trachoma, acute	S
Transmissible spongiform encephalopathy (see Creutzfeld-Jacob disease, CJD, vCJD)
Trench mouth (Vincent's angina)	S
Trichinosis	S
Trichomoniasis	S
Trichuriasis (whipworm disease)	S
Tuberculosis (M. tuberculosis)
Extrapulmonary, draining lesion)	A,C		Discontinue precautions only when patient is improving clinically and drainage has ceased or there are 3 consecutive negative cultures of continued drainage.1021, 1022 Examine for evidence of active pulmonary tuberculosis.
Extrapulmonary, no draining lesion, meningitis	S		Examine for evidence of pulmonary tuberculosis. For infants and children, use Airborne Precautions until active pulmonary tuberculosis in visiting family members ruled out.42
Pulmonary or laryngeal disease, confirmed	A		Discontinue precautions only when patient on effective therapy is improving clinically and has three consecutive sputum smears negative for acid-fast bacilli collected on separate days (see http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm?s_cid=rr5417a1_e).12
Pulmonary or laryngeal disease, suspected	A		Discontinue precautions only when the likelihood of infectious TB disease is deemed negligible, and either there is another diagnosis that explains the clinical syndrome or the results of three sputum smears for AFB are negative. The 3 sputum specimens should be collected 8 to 24 hours apart, and at least 1 specimen should be an early-morning specimen
Skin-test positive with no evidence of current active disease	S
Tularemia
Draining lesion	S		Not transmitted from person to person.
Pulmonary	S		Not transmitted from person to person.
Typhoid (Salmonella typhi) fever (see gastroenteritis)
Typhus
Rickettsia prowazekii (Epidemic or Louse-borne typhus)	S		Transmitted from person to person through close personal or clothing contact.
Rickettsia typhi	S		Not transmitted from person to person.
Urinary tract infection (including pyelonephritis), with or without urinary catheter	S
Vaccinia (vaccination site, adverse events after vaccination)∗			Only vaccinated HCWs have contact with active vaccination sites and care for persons with adverse vaccinia events; if unvaccinated, only HCWs without contraindications to vaccine may provide care.
Vaccination site care (including autoinoculated areas)	S		Vaccination recommended for vaccinators; for newly vaccinated HCWs: semipermeable dressing over gauze until scab separates, with dressing change as fluid accumulates, ∼3 to 5 days; gloves, hand hygiene for dressing change; vaccinated HCW or HCW without contraindication to vaccine for dressing changes.205, 221, 225
Eczema vaccinatum	C	Until lesions dry and crusted, scabs separated	For contact with virus-containing lesions and exudative material.
Fetal vaccinia	C
Generalized vaccinia	C
Progressive vaccinia	C
Postvaccinia encephalitis	S
Blepharitis or conjunctivitis	S/C		Use Contact Precautions if copious drainage is present.
Iritis or keratitis	S
Vaccinia-associated erythema multiforme (Stevens-Johnson syndrome)	S		Not an infectious condition.
Secondary bacterial infection (eg, S. aureus, group A beta hemolytic streptococcus	S/C		Follow organism-specific (streptococcal and staphylococcal most frequent) recommendations and consider magnitude of drainage.
Varicella zoster	A,C	Until lesions dry and crusted	Susceptible HCWs should not enter room if immune caregivers are available; no recommendation for face protection of immune HCWs; no recommendation for type of protection (ie, surgical mask or respirator) for susceptible HCWs. In an immunocompromised host with varicella pneumonia, prolong the duration of precautions for duration of illness. Postexposure prophylaxis: Provide postexposure vaccine as soon as possible but within 120 hours; for susceptible exposed persons for whom vaccine is contraindicated (immunocompromised persons, pregnant women, newborns whose mother's varicella onset is ≤ 5 days before delivery or within 48 hours after delivery) provide VZIG, when available, within 96 hours; if unavailable, use IVIG. Provide Airborne Precautions for exposed susceptible persons and exclude exposed susceptible health care workers beginning 8 days after first exposure until 21 days after last exposure or 28 if received VZIG, regardless of postexposure vaccination.1032
Variola (see smallpox)
Vibrio parahaemolyticus (see gastroenteritis)
Vincent's angina (trench mouth)	S
Viral hemorrhagic fevers due to Lassa, Ebola, Marburg, Crimean-Congo fever viruses	S, D, C	DI	Single-patient room preferred. Emphasize: use of sharps safety devices and safe work practices, hand hygiene; barrier protection against blood and body fluids on entry into room (single gloves and fluid-resistant or impermeable gown, face/eye protection with masks, goggles or face shields), and appropriate waste handling. Use N95 or higher-level respirator when performing aerosol-generating procedures. Largest viral load in final stages of illness when hemorrhage may occur; additional PPE, including double gloves, leg and shoe coverings may be used, especially in resource-limited settings where options for cleaning and laundry are limited. Notify public health officials immediately if Ebola is suspected.212, 313, 738, 770 Also see Table 3 for Ebola as a bioterrorism agent.
Viral respiratory diseases (not covered elsewhere)
Adults	S
Infants and young children (see respiratory infectious disease, acute)
Whooping cough (see pertussis)
Wound infections
Major	C	DI	No dressing or dressing does not contain drainage adequately.
Minor or limited	S		Dressing covers and contains drainage adequately.
Yersinia enterocolitica gastroenteritis (see gastroenteritis)
Zoster (varicella-zoster) (see herpes zoster)
Zygomycosis (phycomycosis, mucormycosis)	S		Not transmitted person to person.

^∗Type of precautions: A, airborne precautions; C, contact; D, droplet; S, standard; when A, C, and D are specified, also use S.

^†Duration of precautions: CN, until off antimicrobial treatment and culture-negative; DI, duration of illness (with wound lesions, DI means until wounds stop draining); DE, until environment completely decontaminated; U, until time specified in hours (hrs) after initiation of effective therapy; Unknown: criteria for establishing eradication of pathogen has not been determined