All of us who work in healthcare epidemiology and infection prevention in healthcare settings are very familiar with this process and the need for the words to be very accurate because what we know , since we ourselves are and have been consumers of CDC guidelines , is that once it gets out of the room where we have crafted the guidance , it goes to the hundreds and thousands of hospitals and care providers across the entire country .” — Hilary M . Babcock ,
MD , MPH
2024 pre-final guideline tells us , “ Transmission occurs when an at-risk person acquires a pathogen from an infectious person . Transmission is determined by pathogen , environmental and person factors at the time of event . While pathogen factors are often biologically intrinsic ( e . g ., the ability of a pathogen to remain viable during transit ), environmental and person-specific factors may vary by location and over time . Environmental variables include air ( e . g ., temperature , humidity , ventilation ) and surface ( e . g ., material , porosity ) conditions . Factors that vary among infectious persons include pathogen load and shedding rate . Factors that vary among at-risk persons include host defense mechanisms that are non-immune-based ( e . g ., intact skin ) and immune-based ( e . g ., pathogen-specific immunity from prior infection or vaccination ).”
Transmission is significant in the healthcare setting because it can result in colonization or infection . As the guideline emphasizes . “ Based on the health impact that a pathogen is expected to have on
an individual or the community , some pathogens are recognized as requiring intensive efforts to prevent transmission , while others may not rise to that level . Less intensive effort might be indicated when outcomes are not usually severe , the population has a high degree of immunity , and effective therapeutics and vaccines are available . The boundaries describing those categories require risk assessment and can vary by setting and population at risk .”
Because there is so much at stake relating to transmission-based precautions , the pre-final review and revision of the recommendations by the nine HICPAC members were precise , as anyone who watched the recordings of the two-day November meetings can attest .
“ All of us who work in healthcare epidemiology and infection prevention in healthcare settings are very familiar with this process and the need for the words to be very accurate because what we know , since we ourselves are and have been consumers of CDC guidelines , is that once it gets out of the room where we have