Outbreaks of HSV infection have been described in neonates
which were confirmed by DNA fingerprinting.
Mothers with either genital or buccal HSV and her infant
should be nursed separately from other patients, with
gowns and gloves to be worn by attending staff.
Although there is little evidence for postpartum
transmission as a cause of neonatal herpes, the mother
should be encouraged to wash her hands before handling
the patient and to wear a protective gown.
Staff with lesions (oral or whitlows) should cover their
lesions and not care for patients at risk of serious
infection ie. the young, those who are debilitated,
immunocompromised, and those who suffer from eczema.
Patients with herpetic lesions should be nursed
separately. Those with widespread lesions should be
nursed in standard isolation.
Oral acyclovir should be offered to patients and staff
with herpetic whitlows or severe localized lesions.
Patients at risk of developing severe herpes infection
may need IV acyclovir for 1 week or longer.
2. Adenovirus
Nosocomial outbreaks of adenovirus pneumonia and URTI,
especially caused by types 3 and 7, have been described, as have
epidemic conjunctivitis.
Patients with pneumonia should be nursed in standard
isolation.
Patients with eye infections should be discharged home as
soon as possible.
Staff with eye infections should not have contact with
patients for the duration of viral shedding which lasts
for 10 days.
3. CMV
There is no evidence that CMV is acquired nosocomially.
Studies in hospital nurses caring for children have not shown any
evidence of increased infection rates when compared with women of
similar ages working in other occupations. Nonetheless, it would
seem prudent to minimize the risks of cross-infection by careful
attention to infection control measures in any patient known to
be excreting CMV. Gloves and aprons should be worn and careful
hand washing implemented. In case of pregnant women in contact
with known CMV excretors, the following should be advised.
There is no scientific reason why women of childbearing
age or pregnant women should be excluded from contact
with known excretors of CMV who constitute only a small
part of the pool of infection.
There is no indication for routine serological screening
of female staff taking care of children or adults who may
be excreting CMV, because there is no evidence that CMV
is an occupational hazard.
The most appropriate means whereby pregnant women can
protect themselves from acquiring CMV is by attention to
good hygiene, especially hand washing. For instance, a
pregnant teacher working with disabled children should
avoid teaching methods that may involve the transfer of
the child’s saliva to her mouth.
Immune status screening may be offered to the worried
pregnant women. Those who are seorpositive will be at a
far lesser risk of giving birth to a child with
cytomegalic inclusion disease should transplacental
infection occurs.
Pregnant women known to have had primary infection may be
followed up by fetal blood, amniotic fluid, and chorionic
villus sampling.
