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Examples of hierarchy of control measures in veterinary hospitals

Click on the control measures below for guidance on disrupting pathogen transmission.4,7, 13–17

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Elimination

Measures for All Transmission Routes

Early identification of infectious cases (e.g., phone triage) to prevent exposures within the main hospital areas

Additional Measures for Vector-Borne Transmission

Implement pest management (extermination) for the practice

Engineering

Measures for All Transmission Routes

  • Establish a dedicated isolation room (preferably with a direct to outside or alternate entrance in a lower-traffic area)
  • Place dedicated equipment within the isolation room
  • Place hand hygiene and cleaning and disinfection resources near exam rooms to improve compliance
  • Install (or use) nonporous materials for work surfaces and floors for more effective disinfection

Additional Measures for Aerosol Transmission

Isolation room with separate ventilation (negative-pressure ventilation possibly an additional benefit)

Administrative

Measures for All Transmission Routes

  • Develop and implement infection control policies and procedures (written infection control plan)
  • Provide staff training on infection control protocols: isolation, infectious disease outbreaks, use of PPE, disinfection procedures, proper animal handling and restraint
  • Limit staff access to patients with suspected or known infectious diseases
  • Place signs to deter unauthorized persons from entering isolation areas
  • Limit and control infectious patient transport throughout the hospital to essential purposes only
  • Require hand hygiene between patients
  • Provide rabies pre-exposure vaccination for staff
  • Establish effective waste management and soiled laundry protocols
  • Implement proper disinfection protocols for equipment, work areas, and traffic areas

Additional Measures for Vector-Borne Transmission

Remove vectors from infested patients

PPE

Measures for All Transmission Routes

  • Use gloves and gowns when in contact with infected animals, their bodily fluids, or contaminated surfaces/equipment or bedding
  • Use higher levels of protection (e.g., masks, eye protection) when performing necropsies, dental procedures, obstetrics, or other procedures for which there is a splash or aerosol hazard depending on the target pathogen

Additional Measures for Aerosol Transmission

Use gloves, gowns, masks, and eye protection as appropriate for the pathogen

Additional Measures for Vector-Borne Transmission

Use gloves when performing vector removal or extermination tasks

These guidelines are supported by a generous educational grant from Virox Animal Health™.