Overview

This publication is an update to the World Health Organization (WHO) interim guidelines Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care (2007). These updated guidelines incorporate the emergency guidance given in the WHO publication Infection prevention and control during health care for confirmed, probable, or suspected cases of pandemic (H1N1) 2009 virus infection and influenza-like illness (2009). The revision was informed by both evidence that has emerged since the first edition was published and the practical lessons learnt during the influenza pandemic in 2009.

The WHO guidelines Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care provide recommendations, best practices and principles for non-pharmacological aspects of infection prevention and control (IPC) for acute respiratory infections (ARI) in health care, with special emphasis on ARI that can present as epidemics or pandemics. The guidelines are intended to help policy-makers, administrators and health-care workers to prioritize effective IPC measures.

The document also provides guidance on the application of basic IPC precautions, such as Standard Precautions, and on the importance of maintaining appropriate IPC measures in routine circumstances to strengthen a healthcare facility’s capacity to put them into practice during outbreaks. These measures should therefore be part of the hospital’s permanent IPC strategy.

Contents

• Foreword
• Acknowledgements
• Abbreviations and acronyms
• Glossary
• Executive summary
• 1. Introduction and scope of the guidelines
  • 1.1 Acute respiratory infections in health care
  • 1.2 Scope of the current guidelines
  • 1.3 ARIs that may constitute a public health emergency of international concern covered in the current document
  • 1.4 Infection prevention and control guiding principles
  • 1.5 Guideline development process
• 2. Infection prevention and control recommendations
  • 2.1 Recommendations for early recognition and source control
  • 2.2 Recommendations for administrative control strategies for health-care facilities
  • 2.3 Recommendations for engineering and environmental control for acute respiratory infection
  • 2.4 Recommendations for use of personal protective equipment
  • 2.5 Recommendations for care of the deceased
• 3. Health-care facility preparedness planning for acute respiratory infection epidemics
  • 3.1 Components of health-care facility pandemic acute respiratory infection preparedness plans
• 4. Research gaps
  • 4.1 Aerosol-generating procedures
  • 4.2 Epidemiology of transmission
  • 4.3 Duration of IPC precautions
  • 4.4 Cohorting and special measures
  • 4.5 Other interventions
• Annex A Respiratory protection
• Annex B Isolation precautions
• Annex C Sample checklist assessment of environmental conditions for home care of patients with ARIs of potential concern
• Annex D Sample health-care worker influenza-like illness monitoring form for workers exposed to patients with ARIs of potential concern
• Annex E Isolation rooms or areas
• Annex F Mortuary care and postmortem examination
• Annex G Use of disinfectants: alcohol and bleach
• Annex H Surge capacity: personal protective equipment needs of health-care facilities during epidemics or pandemics
• Annex I Cleaning and disinfection of respiratory equipment
• Annex J Infection prevention and control across the continuum of health care
• Annex K Strength of infection prevention and control recommendations based on GRADE
• Annex L Summaries of relevant systematic reviews of the literature
• Annex M Management of conflict of interest
• References

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