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How should Child Nutrition staff handle body fluids, such as blood and vomit?

Many schools have written procedures for handling body fluids, such as vomitus, feces, urine, blood, and respiratory secretions. Because body fluids might contain pathogenic bacteria or viruses, all school personnel must know how to properly clean them up to prevent the spread of illness to students, school personnel, as well as to themselves.

Even though body fluids might contain pathogens, it is unusual for illnesses to be spread through body fluids when good hygienic practices are used.  In order to cause illness, a pathogen must find its way to the part of the body it infects through a specific route -- the mouth, nose, or a break in the skin.  The pathogen must also enter in sufficient numbers to cause infection. Most body fluids contain too few pathogens to cause infection unless they are placed directly into the blood stream or people do not wash their hands after contamination and then place their hands or contaminated food or objects into their mouths.

While illness from body fluids is unlikely to occur, all body fluid spills must be regarded as potentially infectious. Many people might be carriers without exhibiting any symptoms.  Examples of organisms that can be present without the carrier showing symptoms include hepatitis A and B, AIDS virus, Cytomegalovirus, and Salmonella.

Follow these simple steps to clean up a spill from body fluids:

  1. Always wear disposable gloves when cleaning up blood, feces, vomitus, respiratory secretions, and urine. This is in addition to and not a substitute for handwashing.
  2. Wash hands thoroughly as soon as is practical following exposure to body fluids.  Use soap and water and vigorously wash under warm running water for at least 20 seconds.  After washing, dry with a clean paper towel.  
  3. Manually remove body fluids using paper towels.  Drying or sanitary absorbent agents can also be used for large volumes of body fluids, such as vomitus. They are not, however, disinfectants.  Throw out absorbent agents and disposable paper towels in a sealed plastic bag.  
  4.  Wash all hard surfaces (e.g. desks, walls, floors) with one of the following disinfectants -- (1) phenolic germicidal detergent solution (follow the product label for use and dilution) or (2) sodium hypochlorite (mix 1/2 cup household bleach in one gallon of water, freshly prepare each time it is used).
  5. Clean carpets stained with body fluids by manually removing body fluids followed by shampooing with a commercially available rug shampoo.
  6. Remove body fluids on clothing or throw rugs with a paper towel initially followed by routine laundering.

 

BODY FLUID SOURCE ORGANISM(S) OF CONCERN PATHWAY FOR TRANSMISSION
Blood, such as cuts and abrasions, nosebleeds, contaminated needles* Hepatitis B, AIDS virus, Cytomegalovirus Cuts and abrasions; direct bloodstream inoculation
Feces Salmonella, Shigella, Rotavirus, and Hepatitis A virus Contaminated hands
Urine Cytomegalovirus Contaminated hands
Vomitus Norovirus, Rotavirus Contaminated hands
Respiratory secretions, such as nasal and salvia discharges* Mononucleosis virus, Common Cold virus, Influenza virus, Hepatitis B virus, and AIDS virus Contaminated hands; cuts and abrasions; bites

*  There is no evidence at this time to suggest the AIDS virus is present in these fluids.

Source:  Guidelines adapted from "Guidelines For Handling Body Fluids in Schools" prepared by Elaine Brainerd, M. A., R.N. Connecticut State Department of Education, December, 1984.