Infection Control Nurse's Quick-Reference Table

This table organizes key infectious diseases relevant to Hong Kong healthcare settings from an infection control nurse's perspective. The core decision flow is: identify the transmission route, then immediately determine whether Standard, Contact, Droplet, or Airborne precautions are needed, along with triage, isolation, PPE, exposure follow-up, and reporting. Transmission-Based Precautions should always be used in addition to Standard Precautions when a specific infection is suspected or confirmed .

Disease	Primary Transmission Route	Key Points for Infection Control Nurses
Measles	Airborne (high risk); CDC requires Airborne + Standard precautions	Highest alert. Suspect cases: immediately mask patient, fast-track to airborne isolation/negative pressure room. CDC: Airborne + Standard precautions until 4 days after rash onset; for immunocompromised, for duration of illness . Susceptible healthcare personnel (HCP) should not enter the room . Check staff MMR immunity records; rapid contact tracing; protect pregnant women, immunocompromised patients, and infants under 1 year. Hong Kong DH advises these groups to avoid travel to measles/rubella outbreak areas; symptomatic returnees should wear a mask, avoid contact with non-immune persons, and seek medical care .
Mpox (Monkeypox)	Direct contact with lesions/scabs, body fluids, contaminated fomites; possible but minimal airborne role	Suspect cases: immediately notify infection control team, place in single-person room, use PPE upon entry . Key actions: cover skin lesions, avoid sharing linens/towels, properly handle contaminated bedding. Follow local/ facility guidance for post-exposure assessment, vaccination, and medical monitoring .
Hand, Foot, and Mouth Disease (HFMD)	Fecal-oral, contact with respiratory secretions/vesicle fluid; common in children	Watch for clusters in schools, childcare centers, pediatric wards. HK DH reports seasonal rise in Guangdong, Japan, South Korea since May 2026 . Infection control: Contact + Standard precautions, strict hand hygiene (note: alcohol-based hand rub is not effective against some enteroviruses — soap and water are preferred ), environmental cleaning, toy disinfection, handwashing after diaper changes. Children with fever, oral ulcers, or vesicular rash should follow facility/school exclusion policies .
COVID-19	Respiratory droplets/aerosols; risk-based assessment for Droplet vs. Airborne + Contact	Use risk assessment to decide Droplet or Airborne + Contact precautions. Transmission-Based Precautions are added to Standard Precautions for patients with confirmed or suspected infection . For high-risk procedures, use appropriate PPE. Standard Precautions (hand hygiene, environmental cleaning, minimizing blood/body fluid exposure) always apply . Consider lower thresholds for testing, triage, and sick leave in elderly homes, medical wards, oncology/renal/ICU .
Seasonal Influenza	Respiratory droplets	Standard + Droplet precautions. Patients with fever and respiratory symptoms should mask immediately, be triaged, and practice hand hygiene and cough etiquette . High-risk groups: elderly, young children, pregnant women, and those with chronic conditions. Follow local/facility policy for vaccination, staff sick leave, and outbreak surveillance .
Dengue Fever	Mosquito-borne (Aedes); travel-related fever assessment	Infection control focus is mosquito prevention and public health reporting, not contact isolation. HK DH advises travelers to prevent mosquito bites . Ask about travel history, notify public health unit, remove standing water, implement mosquito control in the ward. Avoid further mosquito bites while patient is febrile .
Chikungunya	Mosquito-borne (Aedes); travel-related fever assessment	Same principle as dengue: Standard precautions are sufficient, but emphasize mosquito prevention, travel history, reporting, and vector control . For patients with fever, joint pain, or rash, follow local public health and facility assessment/reporting protocols .
Chickenpox (Varicella)	Airborne and contact; high alert	Suspect cases require Airborne + Contact + Standard precautions, ideally in a negative pressure room or appropriate isolation area . Special protection needed for non-immune pregnant women, immunocompromised patients, newborns, and unvaccinated individuals .
Foodborne/Waterborne Gastroenteritis, Food Poisoning	Fecal-oral, contaminated environment, contact with vomit/diarrhea	When a ward outbreak occurs: immediately intensify Contact precautions, hand hygiene, environmental disinfection, proper management of vomit/stool, patient cohorting, and staff scheduling . Report clusters involving institutions or schools according to facility and public health protocols .

Practical Priority Order for Infection Control Nurses

1. First Priority: Measles, Chickenpox
   Both require airborne precautions. Measles in particular requires Airborne + Standard precautions; suspect cases must not remain in a general waiting area .

2. Second Priority: Mpox, HFMD, Gastroenteritis
   Primarily Contact precautions, hand hygiene, environmental cleaning, and management of linens/contaminated items and post-exposure follow-up. For mpox, immediately notify infection control personnel, arrange single room, and use PPE upon entry .

3. Third Priority: COVID-19, Influenza
   Early masking and triage for patients with respiratory symptoms. Add appropriate Transmission-Based Precautions on top of Standard Precautions based on risk assessment .

4. Fourth Priority: Dengue, Chikungunya
   Key actions in the healthcare setting are: travel history, mosquito prevention, public health reporting, and avoiding further mosquito bites while the patient is febrile — not simply ward isolation .

Universal Principle: Standard Precautions (hand hygiene, environmental cleaning and disinfection, injection and medication safety, risk-based use of PPE, and minimizing blood/body fluid exposure) apply to the care of all patients in all healthcare settings . Transmission-Based Precautions are added on top of Standard Precautions when a specific infection is suspected or confirmed .