Stericycle Inc.

12/02/2024 | News release | Distributed by Public on 12/02/2024 10:37

Infection Prevention: Safe Handling and Management of Special Pathogens

December 02, 2024

Infection Prevention: Safe Handling and Management of Special Pathogens

Earlier this year, The Joint Commission approved new and revised requirements for the Infection Prevention and Control chapter for critical access hospitals and general hospitals. In lieu of the recent outbreaks of infectious diseases including, severe acute respiratory syndrome (SARS), H1N1 influenza, Middle East respiratory syndrome (MERS), Ebola, and the COVID-19 pandemic, a new Standard IC.07.01.01 and two new elements of performance were introduced to enhance hospitals' and critical access hospitals' preparedness for high-consequence infectious diseases or special pathogens.

What are High-Consequence Infectious Diseases or Special Pathogens?

There is no standard definition for high-consequence infectious diseases (HCIDs) or special pathogens, but expert consensus defines these as novel or reemerging infectious agents that are easily transmitted from person-to-person, have limited or no medical countermeasures (such as an effective vaccine or prophylaxis), have a high mortality, require prompt identification and implementation of infection control activities (for example, isolation, special personal protective equipment), and require rapid notification to public health authorities and special action. Examples of high-consequence infectious diseases or special pathogens include MERS, novel influenzas, and Ebola or other viral hemorrhagic fever (VHF) diseases such as Marburg Virus Disease (MVD) and Lassa.

Infectious diseases pose a serious threat to human health and have the potential to cause major disruptions to health care systems. It is critical that healthcare facilities are prepared to safely manage patients and the waste that is generated from their care.

Recently, the Centers for Disease Control and Prevention (CDC) issued statements regarding two different types of VHF. In October, a Health Alert Network Health Advisory was issued about the Republic of Rwanda's first confirmed outbreak of MVD. Also in October, the CDC and the Iowa Department of Health investigated a suspected case of Lassa fever, which was diagnosed in an Iowa resident who returned to the U.S. from West Africa.

What is Marburg Virus Disease and Lassa Fever?

MVD is a rare and highly fatal VHF that can cause serious illness and death. It is a special pathogen and select agent caused by one of two zoonotic viruses, both of which are in the virus family that includes the Ebola viruses.

Lassa fever is an acute viral hemorrhagic illness caused by the Lassa virus, a member of the arenavirus family of viruses. People usually get infected with Lassa virus after being exposed to food or household items contaminated by infected Mastomys rats.

MVD and Lassa waste, like Ebola waste, generated from cultures or patient care generated waste are Category A regulated medical waste.

Waste Management Plan

According to the CDC, in preparing an effective waste management plan for the handling of special pathogens-waste, a healthcare facility should:

  • Comply with any applicable regulations. Make sure to follow the federal, state, and local regulations for handling, storage, treatment, and disposal of special pathogen waste. Check with your local public health department for more information.

  • Establish effective communication. Ensure communication between healthcare facilities, waste management vendors, and federal, state, and local regulators.

  • Determine whether the waste will be inactivated onsite or offsite. Special pathogen associated waste can be inactivated through incineration or by autoclaving, which can occur either onsite (at the healthcare facility) or offsite (at a waste vendor facility).

    If transporting offsite for treatment, there are additional packaging and transportation considerations. Comply with federal, state, and local regulations.

  • Train the team. Identify a waste management team and train those responsible for handling, packaging, storing, and transporting the waste. Training should cover wearing appropriate PPE and the protocols for bagging and packaging waste.

  • Identify a designated storage area. If you are evaluating patients with a possible special pathogen, you should identify a designated area for waste storage pending a determination of whether the patient has a special pathogen associated disease or not.

  • Select appropriate personal protective equipment (PPE) and train staff. PPE should be used according to the Occupational Safety and Health Administration's Act of 1970 (OSHA) requirements, including the Bloodborne Pathogens (29 CFR 1910.1030), PPE (29 CFR 1910.132) standards, and other requirements under OSHA and your facility policy.

Specific Guidance for Ebola and MVD Waste

  • The U.S. Department of Transportation (DOT) classifies waste known or reasonably expected to contain the Marburg or Ebola virus as a Category A infectious substance. As a result, certain additional requirements apply to its packaging and transportation compared to other infectious wastes. Facilities should package MVD or Ebola-related waste following the requirements in Special Permit 16279, which your waste hauler should have party status to. Requirements include placing waste materials in at least two red bags that meet certain strength and testing standards. Once closed and disinfected, the red bags should be placed in an outer packaging that is a rigid UN standard or DOT approved non-bulk packaging. The outer packaging cannot exceed a capacity of 55 gallons and must be tested and certified to the PG II level for solids or liquids. Absorbent material should be placed at the bottom of the outer packaging. Keep in mind that your waste vendors may have additional requirements, which must also be taken into consideration. Also, as Special Permit 16279 is only for MVD, Lassa, or Ebola wastes, if a different VHF or special pathogen is causing waste to be generated, that waste would require a different Special Permit, which your waste hauler would be responsible for acquiring.

Stericycle has over 30 years of experience serving hospitals and health systems through public health threats, including VHF-related waste such as Ebola, and we are equipped to help support your special pathogen waste management needs.

Receive Stericycle's latest content, including news and regulations on how you can maintain business compliance.

Thank You!

We have received your request and a representative will contact you shortly to discuss your business needs.

Submission Error - Please Refresh and Try Again

First Name*

(Required)

Please enter a valid value

Last Name*

(Required)

Please enter a valid value

Email*

(Required)

Please enter a valid value

Submit

To find out what personal data we collect and how we use it, please visit our Privacy Policy.