Bloodborne Pathogens: The Chain of Infection

1. INFECTIOUS AGENT.  This is any organism with the ability to cause disease. When discussing bloodborne pathogens, the infectious agents are Hepatitis B, Hepatitis C, and HIV.
2. RESERVOIR.  This is any place where the infectious agent is happy to live and grow!  The reservoir for Hepatitis B, Hepatitis C, and HIV is the blood of the person who is infected.
3. PORTAL OF EXIT.  This is any opening on the infected person that allows the harmful germ to leave the reservoir. In the case of Hepatitis B, Hepatitis C, and HIV, the portal of exit may be a cut or sore. Or, it may be equipment (like needles or lancets) that pierce the skin and come in contact with the blood.
4. MODE OF TRANSMISSION.  This is how the harmful germs travel from one place to another. Transmission can be direct or indirect. (More about direct vs. indirect transmission on page 8.)
5. PORTAL OF ENTRY.  Common portals of entry are breaks in the skin, mucous membranes, or puncture sites from injections or finger sticks.
6. SUSCEPTIBLE PERSON.  This is any person who cannot block germs from invading the body, or from multiplying and causing an infection.  Age, stress, other diseases, a poor immune system, and poor nutrition all put people at risk of becoming infected.  Most of your clients are considered susceptible people.

In order for an infection to occur, each link in the chain of infection must exist.  That means removing just one link can break the chain!  Here’s how!

1. Remove the infectious agent.  When a person receives treatment for hepatitis B or C, they are removing this link in the chain.
2. Limit the reservoir.  The Hep B virus can live on surfaces outside of the body for a week.  Hep C can survive for three weeks.  Disinfect clothing, bedding, hard surfaces, and equipment to destroy infectious agents.
3. Minimize portals of exit. Cover open wounds, manage drainage. Help clients safely dispose of bloody tissues, sputum cups, and menstrual products.
4. End the mode of transmission.  Wash hands.  Never share blood glucose monitoring equipment.  Never share needles or syringes.
5. Minimize the portal of entry.  Cover open wounds and use PPE (gloves, gown, eye wear, masks).
6. Protect the susceptible person.  Encourage vaccination against hepatitis B.  Help keep skin healthy and promote a healthy lifestyle (rest, proper nutrition, personal hygiene) to maintain strong immune system.