Infection Control Basics

Wash hands with soap and clean running water for at least 20 seconds, scrubbing palms, backs of hands, between fingers, and under nails. If soap and water are unavailable, use alcohol-based hand sanitizer with at least 60% ethanol or 70% isopropanol for 20 seconds. Wash hands before eating, after using the toilet, after touching contaminated surfaces, after coughing/sneezing, and whenever visibly soiled. Hand hygiene is the single most effective measure for breaking transmission chains.

Alcohol sanitizer does NOT work on visibly dirty hands — physical washing is required if hands are visibly contaminated with blood, saliva, or respiratory secretions.

Clean high-touch surfaces (doorknobs, light switches, rails, phones, remotes) daily with detergent and water, then disinfect with bleach solution (1 part household bleach to 9 parts water), quaternary ammonium compound, or 70% isopropyl alcohol. Allow contact time: bleach requires 1 minute, alcohol requires 30 seconds. Pay special attention to surfaces touched by sick individuals. For porous surfaces, cleaning with detergent is usually sufficient; hard surfaces require both cleaning and disinfection.

Never mix bleach with ammonia or other cleaners — this creates toxic chlorine gas. Always ventilate the area well during and after disinfection.

For airborne pathogens (measles, tuberculosis, COVID-19 variants): use N95 or FFP2 respirators in close settings, maintain 2 meters distance, and ensure room ventilation with 6-12 air changes per hour. For contact precautions (most respiratory viruses, gastrointestinal pathogens): use surgical masks and gloves when within 1 meter, perform hand hygiene after contact, and limit surface touching. Many pathogens require BOTH precautions. Fit-test N95 masks before use; a loose seal reduces protection to 50% or less.

Surgical masks protect others (source control), not the wearer — use N95 for personal protection. Cloth masks provide minimal protection and should only be used when no other option exists.

Isolate sick individuals in a separate room with a closed door for at least 5-10 days from symptom onset, or until fever-free for 24 hours without fever-reducing medication. If separate rooms unavailable, maintain at least 2 meters distance, ensure separate bathrooms if possible, and keep windows open for ventilation. Cohorting (grouping sick individuals together) is acceptable only if separate isolation is impossible and all occupants have the same confirmed illness. Use dedicated equipment (thermometers, pulse oximeters, bedding) for isolated individuals and disinfect between uses.

Isolation must be maintained even if the sick person feels better — viral shedding often continues after symptoms resolve. Premature re-entry causes rapid secondary transmission.

Segregate potentially infectious waste (tissues, masks, gloves, dressings, contaminated linens) into clearly labeled, leak-proof containers with red biohazard symbols if available. Dispose of general medical waste according to local regulations: incineration at 1000°C or secure landfill burial at least 2 meters deep. For home settings without incineration, seal contaminated items in two layers of plastic bags and arrange collection with municipal waste services. Change gloves before handling non-contaminated items. Never compost potentially infectious materials.

Never burn medical waste in open fires — incomplete combustion releases pathogens into the air. Improper disposal spreads infection to waste handlers and the environment.

Don PPE in this order: hand hygiene → gown → mask/respirator → eye protection → gloves. Doff in REVERSE order: gloves (remove outer layer first) → eye protection → mask/respirator (handle by straps only, not the front) → gown → hand hygiene. Spend at least 30 seconds on hand hygiene between each step. Store used masks in a paper bag for at least 72 hours before disposal (virus loses viability). Never touch the contaminated front of a mask; always handle by straps. Reuse N95s only if unavailable; store between uses in paper envelopes with 5-day intervals between wears.

Improper doffing negates all protection — the most common infection source is contaminating hands while removing PPE. Use the 'elbow touch' technique when possible to avoid hand contact.

Implement a three-layer strategy: (1) Source control — sick people wear masks and cough into elbows, not hands; (2) Environmental controls — open windows for 10+ minutes every hour, use HEPA filters if available, maintain 2-meter spacing in common areas; (3) Receiver protection — well individuals wear masks in high-risk settings, practice hand hygiene, avoid touching face. In shelters or group housing, rotate who uses shared bathrooms, with disinfection between users. Establish designated sick and well zones separated by doors or physical barriers. Post clear infection control signage in bathrooms and eating areas.

Shared ventilation systems spread airborne pathogens — if HVAC cannot be verified as safe, open windows are more effective. Never rely solely on air purifiers without source control and physical distancing.

Daily monitor isolated individuals for fever (temperature ≥38°C), cough, shortness of breath, chest pain, and signs of dehydration (dark urine, extreme thirst, dizziness). Check oxygen saturation if pulse oximeter available; oxygen below 94% requires urgent medical evaluation. Monitor for mental health decline in isolation — assign regular check-ins and maintain communication. Keep a written symptom log with date, time, and severity. Escalate to medical care if fever persists beyond 10 days, respiratory rate exceeds 30 breaths/minute, or altered consciousness occurs.

Do not wait for emergency symptoms — early intervention improves outcomes. Severe symptoms (severe shortness of breath, persistent chest pain, confusion) require immediate medical evacuation if available.