Communicable Diseases at the Department of Public Health - PowerPoint PPT Presentation


Title: Communicable Diseases at the Department of Public Health


1
Communicable Diseases at the
Department of Public Health
2
Settings for Spread
  • Household
  • Day Care Center
  • School
  • Workplace

3
Facts
  • Approximately 1/5 of the U.S. population attends
    or works in schools. (U.S. Dept of Ed, 1999)
  • Some viruses and bacteria can live from 20
    minutes up to 2 hours or more on surfaces like
    cafeteria tables, doorknobs, and desks. (Ansari,
    1988 Scott and Bloomfield, 1989)
  • Nearly 22 million school days are lost annually
    due to the common cold alone. (CDC, 1996)
  • Addressing the spread of germs in schools is
    essential to the health of our youth, our
    schools, and our nation
  • Students need to get plenty of sleep and physical
    activity, drink water, and eat good food to help
    them stay healthy in the winter and all year.

4
Day Care CentersConducive to the Spread of
Infectious Diseases
  • Individual Characteristics
  • Diapered infants toilet trained children
  • Body secretion control
  • Normal infant behavior
  • oral environment exploration
  • body part exploration
  • biting
  • Pool of susceptibles
  • Adult interaction

5
Day Care Centers (cont.)
  • Environmental Characteristics
  • Staffchild ratios
  • Crowded quarters/decreased air flow
  • Contaminated toys
  • Direct contact during play
  • Common changing tables
  • Staff duties
  • changing diapers
  • preparing food

6
Look what I brought home from school, Mommy!!!
  • Droplet or Respiratory
  • Colds, chickenpox, flu, parvovirus, strep
  • Viral or bacterial meningitis
  • Fecal-oral
  • hepatitis A, shigella,salmonella, giardia,
    pinworms, coxsackievirus,
  • Direct contact
  • impetigo, ringworm, conjunctivitis, scabies, head
    lice

7
Infections in Day Care
8
Disease Transmission
  • Direct Contact
  • Respiratory or Droplet
  • Bloodborne
  • Fecal-Oral
  • Zoonotic

9
Stop-spread guidelines(direct contact)
  • Follow handwashing cleanliness guidelines
  • Do not permit the sharing of personal items
  • Provide individual storage areas for outer
    clothing items
  • Wash cover sores, cuts scrapes promptly and
    keep infected eyes wiped dry
  • Notify parents of rashes, sores, runny eyes and
    itching for hcp referral

10
Stop-Spread Guidelines(fecal-oral)
  • Handwashing, handwashing, handwashing
  • Attend to environmental cleaning sanitation
  • Keep track of of cases of diarrhea
  • Exclude students with severe diarrhea
  • Discourage the practice of reptiles as classroom
    pets
  • Strictly monitor reptile visits
  • handwashing after any contact with reptile or
    cage
  • barriers between reptiles and students

11
Stop-spread guidelines(droplet spread)
  • Follow handwashing cleanliness guidelines
  • Discourage the sharing of food and do not permit
    the sharing of water bottles during sports
  • Air out classrooms daily, even in winter
  • Teach children staff to cough or sneeze toward
    the floor or to one side, away from others
  • Keep a supply of disposable towels and tissues in
    each classroom
  • Dispose of used towels or tissues in a step-can
    with a plastic liner

12
Parvovirus(Fifth Disease)
  • 5th of 6 similar rash-causing illnesses caused by
    Parvovirus B19
  • Symptoms
  • 1st stage (2-3d) cold or flu-like lasting 2-3 d
  • 2nd stage (7d) maybe asymptomatic
  • 3rd stage (?) slapped cheek rash
  • Incubation period
  • 4-14 days to 1st stage
  • 2-3 weeks to rash

13
Parvovirus Control Prevention Measures
  • Do not exclude children - not contagious
  • Use routine hygienic practices
  • careful handwashing
  • proper disposal of tissues
  • frequent cleaning of toys and other shared
    objects
  • Pregnant women
  • rare reports of stillbirths miscarriages
  • tested for immunity
  • no recommendation to exclude

14
Parvovirus (cont.)
  • Transmitted by respiratory route
  • sneezing, talking, coughing, touching secretions
  • infectious before rash usually not infectious
    when rash appears
  • 50 of people infected by adulthood
  • Diagnosis
  • symptoms
  • immunity by blood test

15
Pediculosis(head lice)
  • Lice
  • tiny insects that live on hair but cannot survive
    away from the scalp for more than 48 hours
  • Transmission
  • they crawl from person to person directly or
    through shared items
  • Diagnosis by observation
  • Treatment
  • removing lice from individuals, surroundings
    personal items

16
Pediculosis Control Prevention
  • Refer students with active head lice to their
    health care provider
  • Exclude infested students until treated (check
    school or town no nit policy)
  • Treat personal items and surroundings in school
    environment
  • wash, dry, quarantine, vacuum
  • Discuss notification guidelines
  • Check student heads in affected classrooms
    regularly

17
Salmonella sp.
  • Bacteria that must be swallowed (fecal-oral)
  • Incubation period 12 - 36 hrs
  • Sx Diarrhea, cramps, nausea, vomiting, headache,
    fever, chills, dehydration
  • Duration few days - few weeks. May be fatal.
  • Sources undercooked foods of animal origin i.e.
    eggs, milk, beef, poultry. Reptiles, other people
    with salmonella
  • Seasonal variation

18
Reptile Salmonellosis
  • All reptiles shed salmonella in their feces
  • Increased popularity of reptiles as pets in
    households and classrooms
  • Special risk to infants, children,
    immunocompromised, pregnant women and the elderly
  • Lack of awareness

19
Two Excedrin Headaches
  • Hepatitis A
  • fecal-oral transmission
  • long incubation period
  • symptoms in younger children
  • infectious before symptoms
  • immune globulin for prevention
  • Meningococcal Illness
  • salivary spread
  • serious,10 fatal
  • hysteria producing
  • antibiotics for prevention

20
E. coli O157H7
  • First identified as human pathogen in 1982
  • Incubation period 48 - 96 hrs
  • Symptoms
  • diarrhea (bloody), cramps, headache
  • 2-7 develop HUS
  • Duration 6 - 8 days
  • Imp. foods beef, raw milk, apple cider

21
E. coli O157H7 in Massachusetts
  • 1991 - Southeastern Ma.
  • apple cider implicated
  • 23 cases
  • 4 cases HUS
  • no deaths
  • 1995 - Barnstable County
  • hamburger implicated
  • 9 primary cases
  • 1 primary and 1 secondary HUS

22
Field Trip Safety
  • Traveling animals shows exhibits
  • reptiles - salmonella
  • bats, raccoons, skunks - rabies
  • Field trips
  • farms, zoos, orchards
  • no raw milk
  • no unpasteurized apple juices cider
  • strict supervision, limited animal contact
  • handwashing

23
Tools for Teaching
  • Handwashing posters
  • Handwashing brochures
  • Handwashing demonstrations
  • Glo-Germ

24
Hand Hygeine 101
  • Cleaning visibly soiled hands
  • Use either a non-antimicrobial or antimicrobial
    soap
  • Wet hands first with water, apply soap to hands
    and rub hands together vigorously for at least 15
    seconds covering all surfaces of hands fingers
  • Rinse hands with water and dry thoroughly with a
    disposable towel
  • Use towel to turn off faucet

25
Hand Hygiene 101
  • Cleaning hands not visibly soiled
  • May use alcohol based gel
  • Apply product to palm of one hand and rub hands
    together, covering all surfaces of hands and
    fingers, until hands are dry.
  • Wear gloves when contact with blood or other
    potentially infectious materials, mucous
    membranes, and non-intact skin could occur.

26
(No Transcript)
27
Controlling Spread through Isolation and/or
Quarantine
  • Isolation
  • Separation of persons who have a specific
    infectious disease, and are infectious, from the
    general population
  • Quarantine
  • Separation and restriction of movements of
    persons who have been exposed to an infectious
    agent but are not yet ill

28
Legal Authority
  • The Massachusetts Department of Public Health in
    cooperation with local public health authorities,
    has the legal authority to enforce isolation and
    quarantine (105 CMR 300.200)
  • Federal isolation and quarantine orders are
    issued through executive order of the President.

29
Cleaning Sanitizing
  • Routine cleaning with detergent and water is most
    useful for removing germs from surfaces
  • Additional step of sanitizing kills germs on
    surfaces

30
Bleach
  • Household bleach with water
  • Effective, economical, convenient and readily
    available
  • Weakened by heat and sunlight
  • Make new each day and discard leftover
  • Choose household bleach
  • 5.25 hypochlorite (regular)
  • 6.00 hypochlorite (ultra)
  • Recipe for use on surfaces that have been
    detergent-cleaned and rinsed (CT2 minutes)
  • ¼ cup bleach 1 gallon cool water
  • 1 TBS. Bleach 1 quart cool water
  • Recipe for submerging of eating utensils
    detergent-cleaned and rinsed (CT1 minute)
  • 1 TBS. Bleach 1 gallon cool water

31
Using Sanitizers
  • Application
  • Spray bottle
  • Cloths
  • Dipping
  • Use appropriate concentration
  • Follow directions to ensure sufficient contact
    time
  • Air-dry bleach sanitized surfaces
  • Other chemicals may require additional fresh
    water rinsing
  • Label spray bottles and containers with name,
    dilution and date
  • Keep out of reach of children

32
Cleaning for Prevention
  • Clean frequently touched surfaces, toys, and
    commonly shared items at least daily and when
    visibly soiled.
  • Use an Environmental Protection Agency
    (EPA)-registered household disinfectant labeled
    for activity against bacteria and viruses, an
    EPA-registered hospital disinfectant, or
    EPA-registered chlorine bleach/hypochlorite
    solution.
  • Always follow label instructions when using any
    EPA-registered disinfectant. If EPA-registered
    chlorine bleach is not available and a generic
    (i.e., store brand) chlorine bleach is used, mix
    ¼ cup chlorine bleach with 1 gallon of cool
    water.
  • Keep disinfectants out of the reach of children.

33
Cleaning for Prevention
  • Care providers and children should use soap and
    water to wash hands when hands are visibly
    soiled, or an alcohol-based hand rub when soap
    and water are not available, and hands are not
    visibly soiled.
  • Children should wash hands with soap and water
    15-20 seconds (long enough for children to sing
    the Happy Birthday song twice).
  • Care providers should wash their hands between
    contacts with infants and children, such as
    before meals or feedings, after wiping the
    childs nose or mouth, after touching objects
    such as tissues or surfaces soiled with saliva or
    nose drainage, after diaper changes, and after
    assisting a child with toileting.
  • Care providers should wash the hands of infants
    and toddlers when the hands become soiled.

34
Cleaning for Prevention
  • Oversee the use of alcohol-based hand rubs by
    children and avoid using these on the sensitive
    skin of infants and toddlers.
  • Keep alcohol-based hand rubs out of the reach of
    children to prevent unsupervised use.
  • Keep sink locations and restrooms stocked with
    soap, paper towels or working hand dryers.
  • Keep each child care room and diaper changing
    area supplied with alcohol-based hand rub when
    sinks for washing hands are not readily
    accessible.

35
Cleaning for Prevention
  • Advise children and care providers to cover their
    noses and mouths with a tissue when sneezing or
    coughing, and to put their used tissue in a waste
    basket.
  • Make sure that tissues are available in all
    nurseries, child care rooms, and common areas
    such as reading rooms, classrooms, and rooms
    where meals are provided.
  • Encourage care providers and children to wash
    their hands or use an alcohol-based hand rub as
    soon as possible, if they have sneezed or coughed
    on their hands.

36
Five Commandments of Infectious Disease Control
  • Prevent illness from spreading
  • Require immunizations
  • Report some illnesses (city/town or state)
  • individual illnesses
  • outbreaks
  • Exclude, cohort or treat some children and/or
    staff
  • Be prepared
  • hire health care consultant
  • inform parents about policies

37
State Health Dept.
  • Videos
  • Pamphlets
  • Control materials
  • Human Resources - us!
  • 617-983-6800 (24/7)

38
MDPH Educational Materials Handwashing
39
Check out all the information on the internet!
MA Department of Public Healths Web Page
Address
http//www.state.ma.us/dph/
Centers for Disease Control Preventions Web
Page Address
http//www. cdc.gov/
http//www.cdc.gov/germstopper/resources.htm
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Communicable Diseases at the Department of Public Health

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Some viruses and bacteria can live from 20 minutes up to ... 3rd stage (?) = 'slapped cheek' rash. Incubation period. 4-14 days to 1st stage. 2-3 weeks to rash ... – PowerPoint PPT presentation

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Transcript and Presenter's Notes

Title: Communicable Diseases at the Department of Public Health


1
Communicable Diseases at the
Department of Public Health
2
Settings for Spread
  • Household
  • Day Care Center
  • School
  • Workplace

3
Facts
  • Approximately 1/5 of the U.S. population attends
    or works in schools. (U.S. Dept of Ed, 1999)
  • Some viruses and bacteria can live from 20
    minutes up to 2 hours or more on surfaces like
    cafeteria tables, doorknobs, and desks. (Ansari,
    1988 Scott and Bloomfield, 1989)
  • Nearly 22 million school days are lost annually
    due to the common cold alone. (CDC, 1996)
  • Addressing the spread of germs in schools is
    essential to the health of our youth, our
    schools, and our nation
  • Students need to get plenty of sleep and physical
    activity, drink water, and eat good food to help
    them stay healthy in the winter and all year.

4
Day Care CentersConducive to the Spread of
Infectious Diseases
  • Individual Characteristics
  • Diapered infants toilet trained children
  • Body secretion control
  • Normal infant behavior
  • oral environment exploration
  • body part exploration
  • biting
  • Pool of susceptibles
  • Adult interaction

5
Day Care Centers (cont.)
  • Environmental Characteristics
  • Staffchild ratios
  • Crowded quarters/decreased air flow
  • Contaminated toys
  • Direct contact during play
  • Common changing tables
  • Staff duties
  • changing diapers
  • preparing food

6
Look what I brought home from school, Mommy!!!
  • Droplet or Respiratory
  • Colds, chickenpox, flu, parvovirus, strep
  • Viral or bacterial meningitis
  • Fecal-oral
  • hepatitis A, shigella,salmonella, giardia,
    pinworms, coxsackievirus,
  • Direct contact
  • impetigo, ringworm, conjunctivitis, scabies, head
    lice

7
Infections in Day Care
8
Disease Transmission
  • Direct Contact
  • Respiratory or Droplet
  • Bloodborne
  • Fecal-Oral
  • Zoonotic

9
Stop-spread guidelines(direct contact)
  • Follow handwashing cleanliness guidelines
  • Do not permit the sharing of personal items
  • Provide individual storage areas for outer
    clothing items
  • Wash cover sores, cuts scrapes promptly and
    keep infected eyes wiped dry
  • Notify parents of rashes, sores, runny eyes and
    itching for hcp referral

10
Stop-Spread Guidelines(fecal-oral)
  • Handwashing, handwashing, handwashing
  • Attend to environmental cleaning sanitation
  • Keep track of of cases of diarrhea
  • Exclude students with severe diarrhea
  • Discourage the practice of reptiles as classroom
    pets
  • Strictly monitor reptile visits
  • handwashing after any contact with reptile or
    cage
  • barriers between reptiles and students

11
Stop-spread guidelines(droplet spread)
  • Follow handwashing cleanliness guidelines
  • Discourage the sharing of food and do not permit
    the sharing of water bottles during sports
  • Air out classrooms daily, even in winter
  • Teach children staff to cough or sneeze toward
    the floor or to one side, away from others
  • Keep a supply of disposable towels and tissues in
    each classroom
  • Dispose of used towels or tissues in a step-can
    with a plastic liner

12
Parvovirus(Fifth Disease)
  • 5th of 6 similar rash-causing illnesses caused by
    Parvovirus B19
  • Symptoms
  • 1st stage (2-3d) cold or flu-like lasting 2-3 d
  • 2nd stage (7d) maybe asymptomatic
  • 3rd stage (?) slapped cheek rash
  • Incubation period
  • 4-14 days to 1st stage
  • 2-3 weeks to rash

13
Parvovirus Control Prevention Measures
  • Do not exclude children - not contagious
  • Use routine hygienic practices
  • careful handwashing
  • proper disposal of tissues
  • frequent cleaning of toys and other shared
    objects
  • Pregnant women
  • rare reports of stillbirths miscarriages
  • tested for immunity
  • no recommendation to exclude

14
Parvovirus (cont.)
  • Transmitted by respiratory route
  • sneezing, talking, coughing, touching secretions
  • infectious before rash usually not infectious
    when rash appears
  • 50 of people infected by adulthood
  • Diagnosis
  • symptoms
  • immunity by blood test

15
Pediculosis(head lice)
  • Lice
  • tiny insects that live on hair but cannot survive
    away from the scalp for more than 48 hours
  • Transmission
  • they crawl from person to person directly or
    through shared items
  • Diagnosis by observation
  • Treatment
  • removing lice from individuals, surroundings
    personal items

16
Pediculosis Control Prevention
  • Refer students with active head lice to their
    health care provider
  • Exclude infested students until treated (check
    school or town no nit policy)
  • Treat personal items and surroundings in school
    environment
  • wash, dry, quarantine, vacuum
  • Discuss notification guidelines
  • Check student heads in affected classrooms
    regularly

17
Salmonella sp.
  • Bacteria that must be swallowed (fecal-oral)
  • Incubation period 12 - 36 hrs
  • Sx Diarrhea, cramps, nausea, vomiting, headache,
    fever, chills, dehydration
  • Duration few days - few weeks. May be fatal.
  • Sources undercooked foods of animal origin i.e.
    eggs, milk, beef, poultry. Reptiles, other people
    with salmonella
  • Seasonal variation

18
Reptile Salmonellosis
  • All reptiles shed salmonella in their feces
  • Increased popularity of reptiles as pets in
    households and classrooms
  • Special risk to infants, children,
    immunocompromised, pregnant women and the elderly
  • Lack of awareness

19
Two Excedrin Headaches
  • Hepatitis A
  • fecal-oral transmission
  • long incubation period
  • symptoms in younger children
  • infectious before symptoms
  • immune globulin for prevention
  • Meningococcal Illness
  • salivary spread
  • serious,10 fatal
  • hysteria producing
  • antibiotics for prevention

20
E. coli O157H7
  • First identified as human pathogen in 1982
  • Incubation period 48 - 96 hrs
  • Symptoms
  • diarrhea (bloody), cramps, headache
  • 2-7 develop HUS
  • Duration 6 - 8 days
  • Imp. foods beef, raw milk, apple cider

21
E. coli O157H7 in Massachusetts
  • 1991 - Southeastern Ma.
  • apple cider implicated
  • 23 cases
  • 4 cases HUS
  • no deaths
  • 1995 - Barnstable County
  • hamburger implicated
  • 9 primary cases
  • 1 primary and 1 secondary HUS

22
Field Trip Safety
  • Traveling animals shows exhibits
  • reptiles - salmonella
  • bats, raccoons, skunks - rabies
  • Field trips
  • farms, zoos, orchards
  • no raw milk
  • no unpasteurized apple juices cider
  • strict supervision, limited animal contact
  • handwashing

23
Tools for Teaching
  • Handwashing posters
  • Handwashing brochures
  • Handwashing demonstrations
  • Glo-Germ

24
Hand Hygeine 101
  • Cleaning visibly soiled hands
  • Use either a non-antimicrobial or antimicrobial
    soap
  • Wet hands first with water, apply soap to hands
    and rub hands together vigorously for at least 15
    seconds covering all surfaces of hands fingers
  • Rinse hands with water and dry thoroughly with a
    disposable towel
  • Use towel to turn off faucet

25
Hand Hygiene 101
  • Cleaning hands not visibly soiled
  • May use alcohol based gel
  • Apply product to palm of one hand and rub hands
    together, covering all surfaces of hands and
    fingers, until hands are dry.
  • Wear gloves when contact with blood or other
    potentially infectious materials, mucous
    membranes, and non-intact skin could occur.

26
(No Transcript)
27
Controlling Spread through Isolation and/or
Quarantine
  • Isolation
  • Separation of persons who have a specific
    infectious disease, and are infectious, from the
    general population
  • Quarantine
  • Separation and restriction of movements of
    persons who have been exposed to an infectious
    agent but are not yet ill

28
Legal Authority
  • The Massachusetts Department of Public Health in
    cooperation with local public health authorities,
    has the legal authority to enforce isolation and
    quarantine (105 CMR 300.200)
  • Federal isolation and quarantine orders are
    issued through executive order of the President.

29
Cleaning Sanitizing
  • Routine cleaning with detergent and water is most
    useful for removing germs from surfaces
  • Additional step of sanitizing kills germs on
    surfaces

30
Bleach
  • Household bleach with water
  • Effective, economical, convenient and readily
    available
  • Weakened by heat and sunlight
  • Make new each day and discard leftover
  • Choose household bleach
  • 5.25 hypochlorite (regular)
  • 6.00 hypochlorite (ultra)
  • Recipe for use on surfaces that have been
    detergent-cleaned and rinsed (CT2 minutes)
  • ¼ cup bleach 1 gallon cool water
  • 1 TBS. Bleach 1 quart cool water
  • Recipe for submerging of eating utensils
    detergent-cleaned and rinsed (CT1 minute)
  • 1 TBS. Bleach 1 gallon cool water

31
Using Sanitizers
  • Application
  • Spray bottle
  • Cloths
  • Dipping
  • Use appropriate concentration
  • Follow directions to ensure sufficient contact
    time
  • Air-dry bleach sanitized surfaces
  • Other chemicals may require additional fresh
    water rinsing
  • Label spray bottles and containers with name,
    dilution and date
  • Keep out of reach of children

32
Cleaning for Prevention
  • Clean frequently touched surfaces, toys, and
    commonly shared items at least daily and when
    visibly soiled.
  • Use an Environmental Protection Agency
    (EPA)-registered household disinfectant labeled
    for activity against bacteria and viruses, an
    EPA-registered hospital disinfectant, or
    EPA-registered chlorine bleach/hypochlorite
    solution.
  • Always follow label instructions when using any
    EPA-registered disinfectant. If EPA-registered
    chlorine bleach is not available and a generic
    (i.e., store brand) chlorine bleach is used, mix
    ¼ cup chlorine bleach with 1 gallon of cool
    water.
  • Keep disinfectants out of the reach of children.

33
Cleaning for Prevention
  • Care providers and children should use soap and
    water to wash hands when hands are visibly
    soiled, or an alcohol-based hand rub when soap
    and water are not available, and hands are not
    visibly soiled.
  • Children should wash hands with soap and water
    15-20 seconds (long enough for children to sing
    the Happy Birthday song twice).
  • Care providers should wash their hands between
    contacts with infants and children, such as
    before meals or feedings, after wiping the
    childs nose or mouth, after touching objects
    such as tissues or surfaces soiled with saliva or
    nose drainage, after diaper changes, and after
    assisting a child with toileting.
  • Care providers should wash the hands of infants
    and toddlers when the hands become soiled.

34
Cleaning for Prevention
  • Oversee the use of alcohol-based hand rubs by
    children and avoid using these on the sensitive
    skin of infants and toddlers.
  • Keep alcohol-based hand rubs out of the reach of
    children to prevent unsupervised use.
  • Keep sink locations and restrooms stocked with
    soap, paper towels or working hand dryers.
  • Keep each child care room and diaper changing
    area supplied with alcohol-based hand rub when
    sinks for washing hands are not readily
    accessible.

35
Cleaning for Prevention
  • Advise children and care providers to cover their
    noses and mouths with a tissue when sneezing or
    coughing, and to put their used tissue in a waste
    basket.
  • Make sure that tissues are available in all
    nurseries, child care rooms, and common areas
    such as reading rooms, classrooms, and rooms
    where meals are provided.
  • Encourage care providers and children to wash
    their hands or use an alcohol-based hand rub as
    soon as possible, if they have sneezed or coughed
    on their hands.

36
Five Commandments of Infectious Disease Control
  • Prevent illness from spreading
  • Require immunizations
  • Report some illnesses (city/town or state)
  • individual illnesses
  • outbreaks
  • Exclude, cohort or treat some children and/or
    staff
  • Be prepared
  • hire health care consultant
  • inform parents about policies

37
State Health Dept.
  • Videos
  • Pamphlets
  • Control materials
  • Human Resources - us!
  • 617-983-6800 (24/7)

38
MDPH Educational Materials Handwashing
39
Check out all the information on the internet!
MA Department of Public Healths Web Page
Address
http//www.state.ma.us/dph/
Centers for Disease Control Preventions Web
Page Address
http//www. cdc.gov/
http//www.cdc.gov/germstopper/resources.htm
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