[Sharon]

Thinking of your current or a past practice area provide an example of the train of transmission specific to that area. Fill in all ‘links’ in the chain with an example for each link:

Infectious Agent:

Reservoirs:

Portals of Exit:

Modes of Transmission:

Portals of Entry:

Susceptible Host:

Attachments:

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[Catherine]

Resident on isolation with parainfluenza:

Infectious agent: parainfluenza

Reservoirs: resident and their environment (room and contents)

Portal of exit: other staff, wandering residents, family member who come to visit
Items removed from environment (dirty linens, food containers)

Mode of transmission: staff (hands), inanimate objects (drinking glasses), infectious resident clothing

Portal of entry: passed by staff to others (residents, other staff)

Susceptible host: other residents, staff, visitors

[Carmen]

Great example! It’s interesting to see how our entries line up on the chain of transmission. It shows how crucial these fundamental concepts are in understanding the spread of infection.

[Laura]

Resident isolated for Staphylococcus aureus

Infectious agent > Staphylococcus aureus

Reseviour > caregiver, residents handling soiled tissue/gauze for wound dressing

Portal of exits > Open wounds, pus, and broken skin

Mode of transmission > Seeps from a wound

Portal of entry > Broken skin from wounds of residents

Susceptible host >Immune compromised host /elderly/Diabetes

[Josephine]

Laura, this is an excellent example; It is very painful, especially for elder patients who have been infected. I have seen a few in the shelters and community.

[Patrice]

Infectious Agent: C. difficile is a type of bacteria that can make people sick, especially in their stomach and intestines.

Reservoirs: C. difficile can be found inside the bodies of patients, mainly in their colon, or it can live on things like surfaces and medical equipment.

Portals of Exit: C. difficile leaves the patient’s body through their poop (feces) when they have an infection.

Modes of Transmission: It can spread when healthcare workers or patients touch things that have C. difficile on them, or when people touch each other.

Portals of Entry: C. difficile gets into a person’s body through their mouth, usually when they touch something dirty and then put their hands in their mouth or eat contaminated food or drink dirty water.

Susceptible Host: People who are more likely to get sick from C. difficile are those taking antibiotics, with weak immune systems, or who recently had stomach procedures. They are more at risk of getting infected.

[Antoinette]

Hi Patrice, great post. I find that c.difficile has been fairly common in the facility where I work, and has even required the entire hospital to be on heightened awareness for c.difficile. We always talk about hand hygiene amongst healthcare workers however, it is easy to bypass this for patients too. Especially patients who are frequently in bed. I try my best to help them with hand hygiene prior to their meals as this can help stop the spread of infections such as c.diff.

[Carmen]

Elderly resident with influenza

Infectious Agent: Influenza virus
Reservoirs: Resident, resident’s room & belongings
Portals of Exit: Respiratory secretions (coughing and sneezing)
Modes of Transmission: Respiratory droplets, hands, contaminated surfaces
Portals of Entry: Mouth, nose, eyes
Susceptible Host: The elderly resident with diabetes, immunocompromised host, residents who have not received their influenza vaccine

[Brittany]

I appreciate that you chose to specifically discuss the elderly. Unfortunately due to weakened immune systems, co-morbidities, and not receiving vaccine due to weighing risk/benefit the elderly are our most susceptible hosts. It usually comes with the territory to become forgetful so often times hand hygiene and other preventative measures are overlooked. When you factor in living in close quarters if ltc plus staff shortages the modes of transmission become ever increasing. The question is how to prevent/resolve, programs like this is definitely a start. Thanks Carmen

[Josephine]

YOUNG ADULT WITH VARICELLA-ZOSTER VIRUS (VZV)

INFECTIOUS AGENT: Varicella-Zoster Virus (VZV)

RESERVOIR: Humans are known to be the only reservoir

PORTAL OF EXIT: Droplets, Blister Pus

MODES OF TRANSMISSION: Direct Contact with secretions from infected patients with VZV or inhalation of aerosolized respiratory droplets

PORTAL OF ENTRY: Respiratory Tract, Eyes, Nose, Mouth

SUSCEPTIBLE HOST: Unvaccinated, Those who have not had Varicella-Zoster Virus

[Patrice]

Hi Josephine,
I completely agree with your points. It’s really important to be aware of the ways that the Varicella zoster virus virus can enter and exit our bodies. Direct contact and inhaling are the modes of transmission. Vaccination plays a role, in safeguarding those who are vulnerable.

[Antoinette]

Infectious Agent: Tuberculosis (TB)

Reservoirs: Humans.

Portals of Exit: Excretion of respiratory secretions. ie. sneezing, coughing, talking, singing.

Modes of Transmission: Airborne. When the pathogen is suspended in the air and another person breaths it into their respiratory system.

Portals of Entry: The TB bacteria enters the human through the respiratory system ie. inhalation of the pathogen.

Susceptible Host: Any human exposed to TB through suspended airborne bacteria. However there are populations at higher risk such as those who are immunocompromised.

[Ayotunde]

Infectious Agent: microorganisms like Influenza virus

Reservoirs: Humans – people

Portals of Exit: Respiratory secretions – saliva or mucus

Modes of Transmission: airborne transmission through droplets

Portals of Entry: respiratory tracts – nose, mouth or eyes)

Susceptible Host: People who are not vaccinated or previously exposed to the virus.

[Nkechi]

Hello Ayotunde,
We can never be too careful with the influenza virus, especially during the winter season which is most common. This airborne disease can be transmitted easily, hence the need for the flu vaccine which I always encourage people to take or less unable to due to medical reasons.

[Brittany]

Brittany

Infectious agent: pt, with c.diff who is incontinent.
Reservoir: unchanged gloves w/feces contaminant
Portals of exit: rectum
Mode of transmission: nurse contaminated gloves, touched surfaces.
Portal of entry:- oral cavity, nose.
Susceptible host: health care workers, long term patients, those on antibiotics.

[Ayotunde]

Hi Brittany, I had a patient with c.dif during my placement at the hospital in my 3rd semester. It was a huge task even to get this patient to do hand hygiene after every BM and whenever necessary as one can’t be too careful, she was incontinent. Also, she can’t get out of bed, but I am glad we were able to interrupt the spread and she was fine eventually. Healthcare workers do a great job of avoiding the spread of bacteria.

[Nkechi]

Nkechi
within a hospital setting, focusing on the transmission of the influenza virus:

Infectious Agent: Influenza Virus

Reservoirs:
Example: Infected patients within the hospital, especially those in crowded waiting areas during flu season.

Portals of Exit:
Example: Respiratory secretions, such as coughing or sneezing from infected individuals.
Modes of Transmission:
Example: Airborne transmission as respiratory droplets containing the virus can be inhaled by individuals in close proximity.

Portals of Entry:
Example: Mucous membranes, particularly the respiratory tract, as the virus can enter through the nose or mouth.

Susceptible Host:
Example: Immunocompromised patients or individuals with chronic illnesses who may be more vulnerable to severe influenza infections.

[Ashly]

Ashly Pender

Infectious Agent: Covid 19

Reservoirs:
Example: Infected patients within the Emergency Department that are waiting in the emergency department waiting room with patient that could be susceptible to other disease

Portals of Exit:
Example: Cough, air droplet that are produced when patient cough , sneezing, using a cpap in a non negative pressure room.
Modes of Transmission:
The virus is producted by a pt coughing with his mask being off and it goes up in the air and that other pt inhale . On a pt sneezes ans does not wash his hands and touches the chair handle and then other patient touches the chair handle.

Portals of Entry:
Example: respiratory tract
Susceptible Host:
Example: Immunocompromised patients , pt with that are ther for other health reason and are exposed to the virus

[Olusola]

Great example Ashley,
Covid 19 being a novel disease, it is important to identify and manage the chain on infection carefully to break it and this can save countless lives.

[Erika-Joy]

Patient in respiratory in-patient unit at a hospital

**Infectious Agent**: Pneumonia (viral or bacterial; don’t recall at this time)

**Reservoirs**: patient and their environment (room)

**Portals of Exit**: secretions (oral, nasal)

**Modes of Transmission**: contact (e.g., room and its contents; patient’s gown and bed linen), droplet (e.g., coughing)

**Portals of Entry**: mucous membranes, respiratory

**Susceptible Host**: staff and visitors (improperly donned PPE or lack of); immunosuppressed individuals

[Olusola]

Infectious Agent: Plasmodium {P. falciparum}

Reservoirs: Anopheles Stephensi Mosquito

Portals of Exit: Skin

Modes of Transmission: Mosquito bite

Portals of Entry: Skin

Susceptible Host: Humans

[Author]

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