Airborne Precautions

Use Airborne Precautions for patients with known or suspected infections transmitted by the airborne route — small droplet nuclei (≤5 μm) that remain suspended in air.

When to apply

• Active or suspected pulmonary or laryngeal tuberculosis
• Measles (rubeola)
• Varicella (chickenpox / disseminated zoster)
• Smallpox
• Severe SARS-CoV-2 with aerosol-generating procedures (per current facility policy)

Patient placement — Airborne Infection Isolation Room (AIIR)

• Negative-pressure room with at least 6 air changes per hour (12 ACH for new construction).
• Air exhausted directly outside, or HEPA-filtered before recirculation.
• Door kept closed at all times except for entry/exit.
• If an AIIR is unavailable: mask the patient with a surgical mask, place in a private room with the door closed, and transfer to a facility with an AIIR as soon as possible.

Respiratory protection

• All staff entering the room must wear a fit-tested N95 respirator (or higher, e.g. PAPR for higher-risk procedures).
• Visitors should be limited; if visiting, instruct on respirator use or limit entry.
• Patient should wear a surgical mask (not an N95) when transport outside the room is unavoidable.

Aerosol-generating procedures

When performing AGPs (intubation, bronchoscopy, suctioning, BiPAP, nebulizer treatment):

• Use PAPR or N95 + eye protection.
• Limit personnel in the room to those essential.
• After the procedure, wait the manufacturer-specified room-clearance time before doffing or admitting non-protected staff.

Discontinuation

• TB: minimum 3 negative AFB sputum smears collected ≥8 hours apart, or until clinically improving on therapy with the agreement of public health.
• Measles: 4 days after rash onset (immunocompetent); duration of illness for immunocompromised.
• Varicella: until all lesions are crusted.

Notification

Report suspected TB, measles, or smallpox to public health within facility-defined timeframes (usually within hours).