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HOHENSTEIN LAUNDRY INFORMATION
1
Preliminary remarks
The infectivity (highly infectious/
highly contagious, infectious or su-
spected of being infectious) indi-
cates the degree of risk of actual-
ly becoming infected. In turn, the
risk of contamination depends on
the infectivity of the disease and
the transmission route to humans.
How the disease is transmitted
is determined by where the pa-
thogens are located (Pathogen-
containing material) and how or
by which means they could be
spread (Transmission by). The
risk of infection posed by linen/
laundry during handling depends
on whether the pathogens can sur-
Dangerous pathogens in the laundryProf. Dr. Klaus-Dieter Zastrow, German Hospital Hygiene Society Petra Klein, Hohenstein Institute
vive for some time on dry linen and
on whether the linen is contamina-
ted with material containing patho-
gens. There are only a few patho-
gens for which there is evidence
that they can survive on dry linen,
such as MRSA and the spores of
fungi. However, since the possi-
bility of pathogen-free linen being
mixed with material containing pa-
thogens can never be ruled out,
especially where textiles from dif-
ferent patients or residents are
mixed together, it can be assumed
that there is a risk of infection, and
we therefore speak of linen that
is suspected of being infectious
and must be given a disinfection
treatment. The aim of professi-
onal cleaning is always to break
the chain of infection, so that the
linen/laundry that is sent back to
patients or residents is free of pa-
thogens.
Highly infectious diseases
Even today, in Central Europe in-
cluding Germany, there are still
highly infectious/contagious di-
seases which require special at-
tention and where
all available means must be used
to stop them spreading further into
the environment and among the
population.
The following list in tabular form shows the risk of infection in relation to used linen. It includes all the
possible infectious diseases that could occur in Germany but does not claim to be an exhaustive list. An
extract from this complete list has been prepared for care homes, taking account of the status of the
residents and the potential contamination of linen/laundry. This list can be found in the "Guidelines
on Textiles in Care Homes" on the website of the German Certification Association for Professional
Textile Services at www.waeschereien.de.
No. 2063rd edition(August 2016)
Hygiene
2
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
These diseases include
cholera, hemorrhagic fe-
vers (Ebola fever, Lassa
fever, Marburg virus), an-
thrax, plague, poliomyeli-
tis, rabies and echinococ-
cosis.
Taking comprehensive
hygiene measuresIn terms of numbers, the diseases mentioned abo-ve no longer play a signifi-cant role in the overall pic-ture of infectious diseases. This is due to the fact that both vaccination strategies and comprehensive hygi-ene measures have been implemented.
Drastic measures re-
quired
Linen from patients suffe-
ring from these diseases
(see Table 1) must be dis-
posed of as special wa-
ste and does not belong
in a laundry. These drastic
measures are intended
to ensure that diseases
which have now been lar-
gely eradicated or sup-
pressed do not break out
again. No risk of infection
through linen For another
group of diseases (Table
2a/2b), which, after cau-
sing the patient to be se-
riously ill, can then result
in considerable damage to
their health or even death,
the pathogens are normal-
ly not found in the linen, be-
cause the patient does not
excrete them. By using
the appropriate proce-
dures with proven disinfec-
tion effect, this linen can be
processed safely and does
not pose any kind of risk for
employees in the laundry.
Exclusion of risk by correct handling of "infectious linen"
The "Infectious linen" group
(see Table 3a - 3c) also po-
ses no risk for employees,
provided it is handled cor-
rectly. Nevertheless, it is
of the utmost importance
to prevent these pathogens
being spread further in the
linen, so they must be coll-
ected in separate, liquid-
proof bags and processed
in accordance with Section
18 of the German Protec-
tion Against Infection Act
(IfSG), e.g. RKI listing (see
Table 3a - 3c).
DiarrhoeaPatients suffering from di-
seases causing acute di-
arrhoea (infectious enteri-
tis) represent a large group
(see Table 4a and 4b).
These diseases are always
spread by contaminated
excretions, food and wa-
ter. Since these pathogens
are transmitted, and there-
fore disease caused, rela-
tively easily, materials con-
taminated in this way must
always be transported to
the laundry in liquid-proof
bags. It is sufficient to use
an appropriate cleaning
process that has a proven
disinfection effect. Pro-
vided that the protective
measures prescribed by
the trade unions (see also
BGR 500) are observed,
there is no risk of infection
for employees in RAL-cer-
tified laundries.
Treating linen sus-pected of being in-fectious
The vast majority of di-
seases where the linen is
categorised as "suspected
of being infectious" (see
Table 5a - 5e) are caused
by droplet or smear infec-
tion. The pathogens are
normally very sensitive, so
their chances of surviving
on dry linen are slight. The
only exception to this is the
group comprising staphy-
lococci and, in particular,
MRSA. However, all patho-
gens are safely rendered
inactive by the appropri-
ate procedure with proven
disinfection effect. If linen
is correctly handled in ac-
cordance with the protec-
tive measures prescribed
by the trade unions, there
1) See tables 3a, 3b, 4b, 5c; 2) RKI procedure acc. Section 18 IfSchG; 3) Laundry procedure with proven disinfection effect and appropriate level of effectiveness
Infection status of the disease Linen processing
Highly infectious Special waste,does not belong in a laundry
InfectiousDepends on the pa-thogen 1)
Linen and water are disinfected (single-bath )
Linen is disinfec-ted 3)
Suspected of being infectious
Linen is disinfected 3)
3
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
is no risk of infection for the
employees of the laundry.
Linen coming from hospi-
tal patients should always
be categorised as potenti-
ally infectious (suspected
of being infectious).
Unknown infection status
It is important to empha-
sise here once again that
the protective measures
prescribed by the unions
must be strictly obser-
ved and processing pro-
cedures with proven dis-
infection effect used. This
is particularly important be-
cause the infection status
of many patients in hospital
or residents in care homes
is not known, or may not
become known, partly be-
cause the time spent in
hospital has become very
short and certain diseases
which the patient may be
incubating are not recog-
nised because the patient
is not tested for that infec-
tious diseases, but is ne-
vertheless excreting pa-
thogens. It is also entire-
ly conceivable that there
may be undiagnosed pa-
tients or residents suffe-
ring from open (smear-po-
Effective levels of effectiveness according to the RKI list - Tested and recognised disinfection agents and procedures:
sitive) tuberculosis, excre-
ting salmonella or carrying
MRSA in the hospital or
care home.
Summary
To sum up, while there may
certainly be a large number
of dangerous pathogens in
the linen that is sent to the
laundry for processing,
with the right protective
measures they do not find
their way to the employees
and, by using procedures
with proven disinfection ef-
fect, they can be safely kil-
led. Procedures that have
been tested for their level
of effectiveness can be
found in the lists published
by the Robert Koch Insti-
tute - RKI (www.rki.de) or
the Association for Applied
Hygiene - VAH (available
from www.mhp-publisher.
de). Provided these condi-
tions are met, it can be gu-
aranteed that the linen pro-
vided to patients and care
home residents is free of
disease pathogens and will
not have a detrimental ef-
fect on their well-being.
A Suitable for killing vegetative bacteria including myobacteria and fungi including fungal spores
B Suitable for rendering viruses inactive
C Suitable for killing the spores of anthrax pathogens
DSuitable for killing the spores of gas-oedema and tetanus pathogens (for killing these spores, sterilisation procedures in accordance with the relevant norms must be used).
4
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Hig
hly
infe
ctio
us /
Hig
hly
cont
agio
us li
nen
Nev
er s
ent t
o th
e la
undr
y! S
peci
al w
aste
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Spe
cial
was
teC
ases
of
dise
ase
in
Ger
man
y in
20
12
Not
ifiab
leR
isks
to th
e la
undr
y w
ould
be
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en
& in
fect
ion
Cho
lera
Faec
es,
vom
itFo
od, w
ater
, fa
ecal
mat
ter
AIn
cine
ratio
n0
XX
maj
or
Hem
orrh
agic
fe
vers
, Ebo
la
feve
r, La
ssa
feve
r, M
arbu
rg v
irus
Sec
retio
ns fr
om
rode
nts?
Dro
plet
s,
dust
, blo
od
BIn
cine
ratio
n0
XX
maj
or
Ant
hrax
Sec
retio
ns fr
om
the
sour
ce o
f in
fect
ion
Dus
t, pu
sC
Inci
nera
tion
0X
Xm
ajor
Pla
gue
Sec
retio
ns fr
om
the
sour
ce o
f in
fect
ion
Rat
bite
A
Inci
nera
tion
0X
Xm
ajor
Pol
iom
yelit
is /
in
fant
ile p
aral
ysis
wat
er,
faec
al
Wat
er, f
aeca
l B
Inci
nera
tion
0X
Xm
ajor
Sm
allp
oxEr
adic
ated
BIn
cine
ratio
n0
Xm
ajor
Rab
ies,
Ly
ssa
viru
sIn
fect
ed a
nim
als
Blo
od,
saliv
a/cl
othi
ngB
Inci
nera
tion
Unk
now
nX
Xm
ajor
Tula
rem
ia (
rabb
it
feve
r) F
ranc
isel
la
tula
rens
is, f
roze
n m
eat,
heat
, di
sinf
ectio
n
Lesi
on s
ecre
c-tio
ns, p
us,
bloo
d
Infe
cted
ro
dent
s, h
ighl
y co
ntag
ious
Th
erm
alIn
cine
ratio
n20
Xm
ajor
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 1
5
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
No
rout
e fo
r inf
ectio
n th
roug
h lin
en
No
risk
of in
fect
ion
thro
ugh
linen
!!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Asp
ergi
llus
(mou
ld fu
ngi)
Res
pira
tory
se
cret
ions
Soi
l, co
mpo
st,
airb
orne
spo
-re
s, b
uild
ing
dust
AS
tand
ard
unkn
own
Non
e
Bilh
arzi
a Fa
eces
, urin
e
Wor
ms
in
war
m w
ater
in
ende
mic
re-
gion
s /A
sia/
A
fric
a/S
outh
A
mer
ica
Ther
mal
Sta
ndar
dun
know
nN
one
Bor
relio
sis
Tick
sTi
cks
AS
tand
ard
unkn
own
XN
one
Bot
ulis
mFo
od, i
n
anae
robi
c
pack
agin
g
Food
, in
an
aero
bic
pa
ckag
ing
DS
tand
ard
unkn
own
XX
Non
e
Bru
cello
sis
Raw
milk
, sic
k an
imal
s, b
lood
, pu
s
Not
hum
an-t
o-hu
man
AS
tand
ard
28X
Non
e
Cre
utzf
eld-
Ja
kob
Prio
nsV
iruse
sC
hem
o-th
erm
alS
tand
ard
114
XN
one
Den
gue
feve
rM
osqu
itoes
/
Yello
w fe
ver
Iatr
ogen
ic
inte
rven
tion
BS
tand
ard
600
XN
one
Gon
orrh
oea
(c
lap)
Inte
rcou
rse
Inte
rcou
rse
AS
tand
ard
unkn
own
Non
e
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 2a
6
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
No
rout
e fo
r inf
ectio
n th
roug
h lin
en
No
risk
of in
fect
ion
thro
ugh
linen
!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Tick
-bor
ne
ence
phal
itis
Tick
sTi
cks
A
Pat
hoge
ns a
re
not f
ound
in
linen
! Use
nor
mal
di
sinf
ectin
g pr
oced
ure
for
hosp
ital l
inen
!
194
Xno
ne
Yello
w fe
ver
Mos
quito
esM
osqu
itoes
BU
nkno
wn
Xno
ne
Han
tavi
rus
in
fect
ion
Sec
retio
ns
from
rod
ents
Dro
plet
s,
dust
, blo
odB
2.79
7X
Xno
ne
Legi
onna
ires'
di
seas
eW
ater
Hot
wat
er
aero
sols
B64
9X
none
List
erio
sis
Che
ese,
por
k pr
oduc
ts
Che
ese,
po
rk p
rodu
cts
A41
1X
none
Lues
/S
yphi
lisIn
terc
ours
eIn
terc
ours
eA
Unk
now
nX
none
Psi
ttac
osis
/ O
rnith
osis
Bird
dro
ppin
gsB
ird d
ropp
ings
AU
nkno
wn
none
Sle
epin
g
sick
ness
M
osqu
itoes
Mos
quito
esB
Unk
now
nno
ne
Tric
hino
sis
Mea
tM
eat
Ther
mal
Unk
now
nX
none
Tric
hom
onia
sis
Inte
rcou
rse
Inte
rcou
rse
AU
nkno
wn
none
Teta
nus
(lo
ckja
w)
Wou
ndW
ound
DU
nkno
wn
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 2b
7
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
Infe
ctio
us li
nen
Sepa
rate
bag
s an
d se
para
te m
achi
nes
to a
void
furt
her s
prea
d in
the
hosp
ital a
nd a
cros
s G
erm
any,
or
pat
hoge
ns w
ith h
igh
ther
mal
resi
stan
ce
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Am
oebi
asis
/ac
ute
diar
rhoe
aFa
eces
Food
, w
ater
, fa
ecal
m
atte
r
AS
tand
ard
1)un
know
nno
ne
Am
oebi
asis
, w
hen
cyst
s ar
e ex
cret
edFa
eces
Ther
mal
RK
I pro
cedu
reun
know
nno
ne
Tape
wor
m /
po
rk ta
pew
orm
M
eat
Raw
mea
tTh
erm
alR
KI p
roce
dure
unkn
own
none
Tape
wor
m /
bo
vine
tape
-w
orm
Mea
tR
aw m
eat
Ther
mal
RK
I pro
cedu
reun
know
nno
ne
Dip
hthe
riaR
espi
rat.
sec-
retio
ns, w
ound
se
cret
ions
D
ropl
ets
AR
KI p
roce
dure
0X
Xno
ne
Ente
robi
asis
(o
xyur
iasi
s, p
in-
wor
m)
(the
rmal
trea
t-m
ent r
equi
red)
Faec
esFa
ecal
/ora
l /s
mea
r in
-fe
ctio
nTh
erm
alR
KI p
roce
dure
unkn
own
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) If
ther
e is
no
poss
ibili
ty o
f cys
ts h
avin
g be
en e
xcre
ted,
Sta
ndar
d pr
oced
ure
is s
uffic
ient
.
Table 3a
8
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Infe
ctio
us li
nen
Sepa
rate
bag
s an
d se
para
te m
achi
nes
to a
void
furt
her s
prea
d in
the
hosp
ital a
nd a
cros
s G
erm
any,
or
pat
hoge
ns w
ith h
igh
ther
mal
resi
stan
ceA
ll ar
e in
fect
iou
s if
pro
tect
ive
mea
sure
s co
mp
lyin
g w
ith B
GR
500
are
no
t o
bse
rved
!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
sD
eact
iva-
tion
Pro
cedu
reS
I D
Evid
ence
of
path
ogen
&
infe
ctio
n
Hep
atiti
s A
Faec
esFo
od, w
ater
, fa
ecal
mat
-te
rB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
828
XX
none
Hep
atiti
s B
B
lood
, in
terc
ours
eB
lood
, in
terc
ours
eB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
661
XX
none
Hep
atiti
s C
/D/E
B
lood
, in
terc
ours
eB
lood
, in
terc
ours
eB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
4.88
0X
Xno
ne
Con
junc
tiviti
s /
aden
oviru
s in
the
eye
Dro
plet
s,
smea
r
Hig
hly
con-
tagi
ous,
ai
r/ a
eros
olB
RK
I pro
cedu
re2.
053
Xno
ne
Lice
infe
stat
ion
/
pedi
culo
sis
4)H
air,
cl
othi
ng
Dire
ct,
clos
e
cont
act
Ther
mal
or
60 °
C 2)
Sta
ndar
d 1)
unkn
own
none
Lepr
osy
Sec
retio
ns
from
sou
rce
in
fect
ion
Dro
plet
sA
RK
I pro
cedu
reun
know
nX
none
Lept
ospi
rosi
sC
onta
min
ated
w
ater
, urin
eW
ound
AR
KI p
roce
dure
84X
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) S
ingl
e-ba
th p
roce
dure
(no
pre-
was
h)
2) C
hem
othe
rmal
onl
y te
sted
pro
cedu
re p
erm
itted
(Eltr
a fo
r ec
topa
rasi
tes,
incl
. egg
s )
3) S
ee a
lso
Tabl
e 5c
, with
out t
he p
rese
nce
of c
onta
min
atio
n, in
fect
ion
is o
nly
susp
ecte
d
4) T
o be
abl
e to
app
ly th
e pr
escr
ibed
pro
cedu
res,
the
bags
mus
t be
labe
lled
"lice
-infe
sted
".
Table 3b
9
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
Infe
ctio
us li
nen
Sepa
rate
bag
s an
d se
para
te m
achi
nes
to a
void
furt
her s
prea
d in
the
hosp
ital a
nd a
cros
s G
erm
any,
or
pat
hoge
ns w
ith h
igh
ther
mal
resi
stan
ceA
ll ar
e in
fect
iou
s if
pro
tect
ive
mea
sure
s co
mp
lyin
g w
ith B
GR
500
are
no
t o
bse
rved
!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
sD
eact
iva-
tion
Pro
cedu
reS
I D
Evid
ence
of
path
ogen
&
infe
ctio
n
Hep
atiti
s A
Faec
esFo
od, w
ater
, fa
ecal
mat
-te
rB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
828
XX
none
Hep
atiti
s B
B
lood
, in
terc
ours
eB
lood
, in
terc
ours
eB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
661
XX
none
Hep
atiti
s C
/D/E
B
lood
, in
terc
ours
eB
lood
, in
terc
ours
eB
RK
I pro
cedu
re
only
if
cont
amin
ated
w
ith fa
eces
3)
4.88
0X
Xno
ne
Con
junc
tiviti
s /
aden
oviru
s in
the
eye
Dro
plet
s,
smea
r
Hig
hly
con-
tagi
ous,
ai
r/ a
eros
olB
RK
I pro
cedu
re2.
053
Xno
ne
Lice
infe
stat
ion
/
pedi
culo
sis
4)H
air,
cl
othi
ng
Dire
ct,
clos
e
cont
act
Ther
mal
or
60 °
C 2)
Sta
ndar
d 1)
unkn
own
none
Lepr
osy
Sec
retio
ns
from
sou
rce
in
fect
ion
Dro
plet
sA
RK
I pro
cedu
reun
know
nX
none
Lept
ospi
rosi
sC
onta
min
ated
w
ater
, urin
eW
ound
AR
KI p
roce
dure
84X
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) S
ingl
e-ba
th p
roce
dure
(no
pre-
was
h)
2) C
hem
othe
rmal
onl
y te
sted
pro
cedu
re p
erm
itted
(Eltr
a fo
r ec
topa
rasi
tes,
incl
. egg
s )
3) S
ee a
lso
Tabl
e 5c
, with
out t
he p
rese
nce
of c
onta
min
atio
n, in
fect
ion
is o
nly
susp
ecte
d
4) T
o be
abl
e to
app
ly th
e pr
escr
ibed
pro
cedu
res,
the
bags
mus
t be
labe
lled
"lice
-infe
sted
".
Infe
ctio
us li
nen
Sepa
rate
bag
s an
d se
para
te m
achi
nes
to a
void
furt
her s
prea
d in
the
hosp
ital a
nd a
cros
s G
erm
any,
or
pat
hoge
ns w
ith h
igh
ther
mal
resi
stan
ce
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Foot
and
mou
th d
isea
se
(viru
s)
Pus
, sec
retio
ns
from
sou
rce
of
infe
ctio
n
Pat
hoge
n-co
ntai
ning
m
ilkB
RK
I pro
cedu
reun
know
nno
ne
Men
ingo
cocc
al
men
ingi
tis
Blo
od, l
iquo
r,
secr
etio
ns fr
om
nose
, thr
oat
Dro
plet
sA
RK
I pro
cedu
re35
4X
none
Q fe
ver
Res
pira
tory
se
cret
ions
, bl
ood,
dus
t
Aer
osol
, dr
ople
tsA
RK
I pro
cedu
re19
7X
none
Tube
rcul
osis
Res
pira
tory
sec
re-
tions
, blo
od, d
ust
Dro
plet
sA
RK
I pro
cedu
re4.
210
XX
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 3c
10
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
AC
UTE
DIA
RRH
OEA
: Alw
ays
in a
liq
uid
-pro
of
bag
, bu
t st
and
ard
dis
infe
ctin
g p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Acu
te d
iarr
hoea
En
terit
is in
fect
iosa
Pat
hoge
n al
way
s in
moi
st c
ondi
-tio
ns
Virt
ually
nev
er in
dr
y du
st
Ther
efor
e fo
r sa
fety
al
way
s in
liqu
id-p
roof
co
ntai
ners
(bag
s)--
Clo
strid
ium
diffi
cile
Faec
es
Hos
pita
l-acq
ui-
red,
from
food
, w
ater
faec
al
mat
ter
DS
tand
ard
A/B
1)un
know
nX
none
Cam
pylo
bact
erFa
eces
Food
, wat
er,
faec
al m
atte
rA
Sta
ndar
d62
.626
Xno
ne
Cry
ptos
porid
ium
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
Ther
mal
Sta
ndar
d1.
379
Xno
ne
EHEC
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
AS
tand
ard
1.52
9X
none
HU
S e
nter
opat
hic
Hem
olyt
ic u
rem
ic
synd
rom
e
Faec
es o
f ru
min
ants
Food
, wat
er,
faec
al m
atte
rA
Sta
ndar
dun
know
nX
Xno
ne
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) S
ince
tran
smis
sion
is n
ot p
ossi
ble
via
linen
, the
Sta
ndar
d pr
oced
ure
is s
uffic
ient
. Pat
hoge
ns a
re n
ot k
illed
but
are
rem
oved
by
the
was
hing
pro
cess
Table 4a
11
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
AC
UTE
DIA
RRH
OEA
: Alw
ays
in a
liq
uid
-pro
of
bag
, bu
t st
and
ard
dis
infe
ctin
g p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
cti-
vatio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Nor
wal
k /
no
rovi
rus
Faec
es /
vo
mit
Food
, wat
er,
faec
al m
atte
rB
Sta
ndar
d1)11
2.36
4X
none
Par
atyp
hoid
feve
rFa
eces
Food
, wat
er,
faec
al m
atte
rA
Sta
ndar
d34
XX
none
Rot
aviru
ses
/in-
test
ine
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
BS
tand
ard
39.0
56X
none
Sal
mon
ella
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
AS
tand
ard
20.6
99
not
norm
ally
ho
spita
lised
Xno
ne
Shi
gello
sis
/
dyse
nter
y Fa
eces
Food
, wat
er,
faec
al m
atte
rA
Sta
ndar
d52
4X
none
Typh
us
abdo
min
alis
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
AR
KI-
proc
edur
e 2)
57X
Xno
ne
Yers
inio
se (E
nte-
ritis
infe
ctio
sa)
Faec
esFo
od, w
ater
, fa
ecal
mat
ter
AS
tand
ard
2.68
7X
none
Gia
rdia
sis
/
lam
blia
sis
Wat
er /
faec
esFo
od, w
ater
, fa
ecal
mat
ter
AS
tand
ard
4.32
6X
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) L
ates
t ver
sion
, rep
lace
s W
äsch
erei
-Info
rmat
ion
No.
170
2)
To
com
plet
ely
prev
ent s
prea
d in
was
te w
ater
Table 4b
12
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
No
rmal
bag
, pat
ho
gen
s re
liab
ly k
illed
in c
hem
o-th
erm
al p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
992
/2
cond
ition
sD
eact
iva-
tion
Pro
cedu
reS
I D
Evid
ence
of
path
ogen
&
infe
ctio
n
AID
S /
HIV
Blo
odB
lood
, in-
terc
ours
eB
Sta
ndar
dU
nkno
wn
none
Act
inom
ycos
is /
R
ay fu
ngus
Res
pira
tory
se-
cret
ions
, sal
iva,
pu
sD
ropl
ets
AS
tand
ard
Unk
now
nno
ne
Acu
te in
fect
ious
di
seas
es o
f the
re-
spira
tory
trac
ts
Res
pira
tory
se-
cret
ions
, sal
iva,
pu
sD
ropl
ets
AS
tand
ard
Unk
now
nno
ne
Acu
te v
iral i
nfec
tion
of th
e re
spira
tory
tr
acts
Sal
iva
Dro
plet
sB
Sta
ndar
dU
nkno
wn
none
Am
oebi
asis
(am
oe-
bic
dyse
nter
y)
(the
rmal
pro
cedu
-re
if c
ysts
are
pre
-se
nt)
Faec
es o
f pa
tient
Food
, wat
erTh
erm
alS
tand
ard
Unk
now
nno
ne
Asc
aria
sis
(rou
nd-
wor
k in
fest
atio
n)O
ld fa
eces
Food
con
ta-
min
ated
w
ith h
uman
fa
eces
Ther
mal
Sta
ndar
dU
nkno
wn
none
Bor
nhol
m d
isea
se
(Cox
sack
ie v
irus)
Nos
e/th
roat
- se
cret
ions
Dro
plet
sB
Sta
ndar
dU
nkno
wn
none
Bro
nchi
tisN
ose/
thro
at-
secr
etio
nsD
ropl
ets
A /
BS
tand
ard
Unk
now
nno
ne
Bro
nchi
al p
neum
o-ni
aN
ose/
thro
at-
secr
etio
nsD
ropl
ets
A /
BS
tand
ard
Unk
now
nno
ne
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 5a
13
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
No
rmal
bag
, pat
ho
gen
s re
liab
ly k
illed
in c
hem
o-th
erm
al p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Can
didi
asis
Blo
odW
eak
im
mun
e A
Sta
ndar
dun
know
nno
ne
Chl
amyd
ia in
fect
ion
Sec
retio
ns fr
om
area
of i
nfec
tion
Dro
plet
s/sm
ear
infe
c-tio
n,
inte
rcou
rse
AS
tand
ard
unkn
own
none
Cor
onav
irus
in
fect
ion
Nos
e/th
roat
se
cret
ions
Dro
plet
sB
Sta
ndar
dun
know
nno
ne
Cox
sack
ie v
irus-
in
fect
ion
Nos
e/th
roat
se
cret
ions
Dro
plet
sB
Sta
ndar
dun
know
nno
ne
Cry
ptoc
occo
se,
fung
al d
isea
se,
with
AID
S
Cer
eals
, du
st, s
oil,
bird
dro
p-pi
ng
AS
tand
ard
unkn
own
none
Cyt
omeg
alus
viru
sN
ose/
thro
at
secr
etio
nsD
ropl
ets
BS
tand
ard
unkn
own
none
Den
gue
feve
rM
osqu
itoes
/ ye
llow
feve
r V
iruse
sB
Sta
ndar
d60
0no
ne
Echi
noco
ccus
Mea
tTh
erm
alS
tand
ard
unkn
own
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Tabe 5b
14
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
No
rmal
bag
, pat
ho
gen
s re
liab
ly k
illed
in c
hem
o-th
erm
al p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Epst
ein-
Bar
r vi
rus
infe
ctio
n (P
feiff
er's
gla
ndu-
lar
feve
r, in
fect
ious
m
onon
ucle
osis
)
Nos
e/th
roat
se
cret
ions
Dro
plet
s,
kiss
ing
BS
tand
ard
unkn
own
none
Typh
us, r
ecur
rent
fe
ver,
ther
mal
pro
-ce
dure
(de-
lous
ing
of li
nen)
Lice
Lice
Ther
mal
Sta
ndar
dun
know
nX
none
Gas
gan
gren
eS
oil
Wou
ndD
Sta
ndar
dun
know
nno
ne
Hoo
kwor
m d
isea
se
Soi
l, du
st
Ora
l, th
roug
h sm
all s
kin
wou
nds
DS
tand
ard
unkn
own
none
Hep
atiti
s B
B
lood
, spe
rmB
lood
, in-
terc
ours
eB
Sta
ndar
d or
R
KI p
roce
ss if
bl
oods
tain
ed 1)
661
XX
none
Hep
atiti
s C
/ D
/ E
B
lood
, spe
rmB
lood
, in-
terc
ours
eB
Sta
ndar
d or
R
KI p
roce
ss, i
f bl
oods
tain
ed 1)
4.88
0X
Xno
ne
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
1) S
ee a
lso
Tabl
e 3b
, inf
ectio
us if
con
tam
inat
ion
is p
rese
nt
Table 5c
15
HOHENSTEIN LAUNDRY INFORMATION HOHENSTEIN LAUNDRY INFORMATION No. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
No
rmal
bag
, pat
ho
gen
s re
liab
ly k
illed
in c
hem
o-th
erm
al p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Influ
enza
Res
pira
tory
se
cret
ions
Dro
plet
s/
smea
r
infe
ctio
n B
Sta
ndar
d11
.477
Xno
ne
Sca
bies
Mite
sM
ites
Ther
mal
Sta
ndar
dun
know
nno
ne
Mea
sles
Res
pira
tory
se
cret
ions
Dro
plet
s/
smea
r
infe
ctio
n B
Sta
ndar
d16
7X
Xno
ne
Mol
lusc
um c
onta
-gi
osum
Res
pira
tory
se
cret
ions
Dro
plet
s/
smea
r
infe
ctio
n B
Sta
ndar
dun
know
nno
ne
MR
SA
1)R
espi
rato
ry a
nd
wou
nd s
ecre
tions
Dro
plet
s/
smea
r
infe
ctio
n A
Sta
ndar
dun
know
nX
si
nce
01.0
7.20
09no
ne
Mum
ps
Res
pira
tory
se
cret
ions
Dro
plet
s/
smea
r
infe
ctio
n B
Sta
ndar
dun
know
nX
none
Orn
ithos
isP
atho
gen-
con-
tain
ing
dust
Dro
plet
s/
smea
r
infe
ctio
n A
Sta
ndar
dun
know
nX
none
Per
tuss
isR
espi
rato
ry
secr
etio
ns
Dro
plet
s/
smea
r
infe
ctio
n A
Sta
ndar
dun
know
nno
ne
xpla
natio
n of
term
s: S
tand
ard:
ver
ifiab
le, d
isin
fect
ing
was
hing
pro
cedu
re w
ith a
ppro
pria
te le
vel o
f effe
ctiv
enes
s | R
KI p
roce
dure
: in
acc.
with
Sec
tion
18 If
SG
|
SID
: Sus
pici
on, I
llnes
s, D
eath
| D
eact
ivat
ion:
Lev
els
of e
ffect
iven
ess
acco
rdin
g to
the
RK
I
1) M
RS
A: T
o pr
otec
t la
undr
y st
aff f
rom
infe
ctio
n, th
e lin
en b
ags
mus
t be
labe
lled
"MR
SA
".
Table 5d
16
HOHENSTEIN LAUNDRY INFORMATIONNo. 206 · 3rd edition (08/2016)
Line
n su
spec
ted
of b
eing
infe
ctio
us
No
rmal
bag
, pat
ho
gen
s re
liab
ly k
illed
in c
hem
o-th
erm
al p
roce
du
re
All
are
infe
ctio
us
if p
rote
ctiv
e m
easu
res
com
ply
ing
with
BG
R 50
0 ar
e n
ot
ob
serv
ed!
Dis
ease
Pat
hoge
n-
cont
aini
ng
mat
eria
l
Tran
s-
mis
sion
by
Pro
cedu
re in
the
laun
dry
Cas
es o
f di
seas
e in
G
erm
any
in
2012
Not
ifiab
leR
isks
in th
e la
undr
y in
R
AL-
GZ
99
2/2
cond
ition
s
Dea
ctiv
a-tio
nP
roce
dure
S I
DEv
iden
ce o
f pa
thog
en &
in
fect
ion
Dis
ease
s ca
used
by
str
epto
cocc
i G
roup
AR
espi
rato
ry
secr
etio
ns
Dro
plet
s /
Sm
ear
in-
fect
ion
AS
tand
ard
unkn
own
none
Tric
huria
sis
Faec
es-c
onta
mi-
nate
d fo
od
Faec
es-
cont
amin
at-
ed fo
odTh
erm
alS
tand
ard
unkn
own
none
Chi
cken
pox
(var
icel
la, s
hing
les)
Res
pira
tory
se
cret
ions
Dro
plet
s /
Sm
ear
in-
fect
ion
BS
tand
ard
unkn
own
none
Expl
anat
ion
of te
rms:
Sta
ndar
d: v
erifi
able
, dis
infe
ctin
g w
ashi
ng p
roce
dure
with
app
ropr
iate
leve
l of e
ffect
iven
ess
| RK
I pro
cedu
re: i
n ac
c. w
ith S
ectio
n 18
IfS
G |
S
ID: S
uspi
cion
, Illn
ess,
Dea
th |
Dea
ctiv
atio
n: L
evel
s of
effe
ctiv
enes
s ac
cord
ing
to th
e R
KI
Table 5e
© Hohenstein Laboratories GmbH & Co. KG· Abt. Function and Care · Schloss Hohenstein · 74357 Bönnigheim · Germany
