Table 2.

The greatest challenges to infection control

Disease	Infection control measures
Smallpox	All hospital employees as well as patients in hospital need to be vaccinated.
	Individuals for whom vaccination is contraindicated; VIG should be provided.
	Patients should be isolated in rooms with negative airflow and equipped with HEPA filtration.
	Standard precautions such as gloves, gowns, and masks should be observed.
	All laundry and waste shoud be placed in biohazard bags and autoclaved before being laundered or incinerated.
	Laboratory examination requires high-containment (BL-4) facilities.
	Mortuary workers need to be vaccinated, and cremation is recommended.
Plague	Respiratory droplet precautions (gown, gloves, and eye protection).
	Patient needs to be isolated during first 48 h of antibiotic treatment.
	Patients who require surgery that can generate particulate aerosols need to be cared for in negative pressure rooms, and operating room personnel should use HEPA filtered masks.
Tularemia	Standard precautions; no need for isolation.
	Patients who require surgery that can generate particulate aerosols need to be cared for in negative pressure rooms, and operating room personnel should use HEPA filtered masks.
Anthrax	Standard barrier precautions for all types of anthrax infections
Hemorrhagic fever viruses	Strict adherence to hand hygiene, double gloves, impermeable gowns, N-95 masks or powered air-purifying respirators
	Negative isolation room
	Leg and shoe coverings
	Face shields, goggles
	Dedicated medical equipment
Botulinism	Standard precautions