What precautions should be taken for rhinovirus?

Precautions for Rhinovirus Infections

Standard and contact precautions should be implemented for rhinovirus infections, with hand hygiene using soap and water being the most effective measure to prevent transmission. 1

Hand Hygiene

Hand hygiene is the cornerstone of rhinovirus prevention:

• Soap and water washing is superior to alcohol-based rubs for rhinovirus specifically 2

  • Hand washing with soap and water removes rhinovirus much more efficiently than alcohol-based hand rubs
  • Thorough hand washing should be performed after contact with infected patients or their respiratory secretions 1

• When to perform hand hygiene:

  • Before and after direct contact with patients
  • After contact with inanimate objects in the patient's vicinity
  • After removing gloves
  • After touching respiratory secretions or contaminated surfaces 3

Personal Protective Equipment

When caring for patients with rhinovirus infections:

• Gloves: Wear when entering the room of patients with confirmed or suspected rhinovirus infection 1

  • Change gloves between patients or after handling respiratory secretions
  • Change gloves frequently to avoid spreading organisms on gloves 3

• Gowns: Wear when entering the room of infected patients and when contact with respiratory secretions is anticipated 1

  • Change gowns after patient contact and before providing care to another patient 3

• Masks and eye protection: Wear surgical masks and eye protection or face shields when performing procedures that might generate sprays of respiratory secretions 1

Patient Placement and Movement

• Place patients with rhinovirus infection in a private room when possible 1
• Alternatively, cohort patients with the same viral infection together 3
• Limit patient movement or transport to essential purposes only 1
• When transport is necessary, ensure the patient does not touch other persons' hands or environmental surfaces with contaminated hands 3

Environmental Cleaning

Rhinoviruses can survive on environmental surfaces for several hours:

• Common contaminated sites include door handles, pens, light switches, TV remote controls, faucets, and telephones 4
• Rhinovirus can be transferred from surfaces to fingertips up to 18 hours after contamination 4
• For disinfection of surfaces:
  • Sodium hypochlorite (bleach) solutions are effective with sufficient contact time 5
  • Lysol spray containing o-phenylphenol and ethanol can effectively reduce virus infectivity 5

Respiratory Hygiene/Cough Etiquette

Implement respiratory hygiene/cough etiquette measures:

• Visual alerts instructing patients to inform staff of respiratory symptoms
• Cover nose/mouth when coughing or sneezing; cough/sneeze into elbow rather than hand
• Use tissues to contain respiratory secretions and dispose of them promptly
• Perform hand hygiene after contact with respiratory secretions
• Consider providing masks for symptomatic patients in waiting areas 3
• When possible, maintain at least 3 feet of separation between symptomatic patients and others 3

Special Considerations

• Healthcare worker compliance: Strict adherence to hand hygiene protocols is essential but often poor in practice 1
• Duration of precautions: Maintain precautions for the duration of symptomatic illness, as rhinoviruses can be shed for prolonged periods 1
• Immunocompromised patients: Require more stringent isolation measures 1

Common Pitfalls to Avoid

1. Relying solely on alcohol-based hand rubs: Unlike many other viruses, rhinoviruses are not effectively eliminated by alcohol-based hand rubs alone 2

2. Inadequate environmental cleaning: Rhinoviruses can persist on surfaces for hours, facilitating transmission through self-inoculation 4

3. Discontinuing precautions too early: Rhinoviruses can be shed for prolonged periods, especially in immunocompromised patients 1

4. Neglecting respiratory hygiene education: Patient and visitor education about proper respiratory hygiene is essential for preventing transmission 3, 1