Topic 2.5 Managing Infectious Diseases, Exposure Incidents and Continuity of Care

Despite the consistent application of infection prevention and control measures, Occupational Therapists (OTs) may occasionally encounter situations involving infectious diseases, accidental exposures or public health emergencies. Clients may become unwell during therapy sessions, practitioners may be exposed to blood or body fluids, assistance animals may develop suspected infectious illnesses, or services may need to adapt rapidly in response to local outbreaks or global pandemics. Effective management of these situations is essential for protecting the health and wellbeing of clients, practitioners, assistance animals and the broader community while ensuring continuity of occupational therapy services wherever possible.

Managing infectious diseases extends beyond responding to individual cases of illness. It requires preparedness, clear organisational policies, timely communication, accurate documentation and collaboration with multidisciplinary teams and public health authorities. Occupational Therapists should understand their responsibilities before an incident occurs, including recognising signs of infectious illness, implementing appropriate infection prevention measures, reporting exposures, and following organisational and legislative requirements. Being prepared allows practitioners to respond confidently and consistently while minimising disruption to service delivery.

Occupational Therapists working with assistance animals must also consider the health and welfare of the assistance animal when responding to infectious diseases. Illness affecting either the client or the animal may temporarily alter therapy goals, participation or public access arrangements. Applying a One Health approach ensures that decisions consider the wellbeing of both members of the partnership while maintaining safe, evidence-informed practice.

This topic explores the recognition and management of infectious diseases, exposure incidents, outbreak response, continuity of care, documentation, reporting obligations and the Occupational Therapist’s role in supporting safe, ethical and resilient occupational therapy services.

Recognising Infectious Illness

Early recognition of infectious disease is an important component of infection prevention and control. While Occupational Therapists do not diagnose infectious diseases, they should recognise common signs and symptoms that may indicate a client, colleague or assistance animal requires medical or veterinary assessment.

Common signs of infectious illness in humans may include:

• fever or chills
• persistent cough
• sore throat
• shortness of breath
• vomiting
• diarrhoea
• unexplained rash
• conjunctivitis
• fatigue
• unusual pain or swelling.

Signs that may indicate illness in an assistance animal include:

• coughing or sneezing
• nasal or eye discharge
• vomiting or diarrhoea
• lethargy
• reduced appetite
• changes in behaviour
• skin lesions
• unexplained lameness
• fever
• signs of pain or distress.

Recognising these signs allows Occupational Therapists to implement appropriate precautions, modify service delivery and facilitate timely referral to medical or veterinary professionals.

Responding to Suspected Infectious Disease

When an infectious disease is suspected, Occupational Therapists should respond calmly, professionally and in accordance with organisational policies and current public health guidance.

Appropriate responses may include:

• undertaking an immediate infection risk assessment
• implementing standard or transmission-based precautions
• minimising unnecessary contact
• isolating contaminated equipment where appropriate
• arranging medical or veterinary referral
• postponing or modifying therapy sessions if required
• documenting actions taken
• notifying relevant supervisors or infection prevention personnel.

Decisions should be based on evidence and the level of identified risk rather than assumptions or stigma.

Managing Exposure Incidents

An exposure incident occurs when a practitioner, client or other individual is potentially exposed to infectious material.

Examples include:

• needlestick injuries
• contact with blood or body fluids
• bites or scratches
• contact with contaminated equipment
• exposure to infectious respiratory secretions
• accidental contact with contaminated waste.

Immediate management should follow organisational procedures and may include:

1. Performing first aid.
2. Washing the affected area thoroughly.
3. Performing hand hygiene.
4. Reporting the incident immediately.
5. Seeking medical assessment where required.
6. Documenting the incident.
7. Participating in organisational follow-up processes.

Prompt reporting supports appropriate medical management and organisational learning.

Assistance Animal Illness and Fitness to Work

Assistance animals, like people, may occasionally become unwell.

An assistance animal experiencing infectious illness should not continue working if doing so may:

• compromise the animal’s welfare
• increase disease transmission risks
• reduce the animal’s ability to perform safely.

Occupational Therapists should encourage handlers to seek veterinary assessment whenever an assistance animal displays signs of illness.

Depending on the situation, therapy may continue through:

• temporary service modification
• telehealth
• environmental adjustments
• rescheduling appointments
• involving support persons where appropriate.

Decisions regarding an animal’s fitness to work should always be made in consultation with the handler and the treating veterinarian.

Outbreak Management

An outbreak occurs when there is an increase in cases of an infectious disease beyond what would normally be expected within a particular setting or community.

Examples include:

• influenza outbreaks
• COVID-19 outbreaks
• gastroenteritis outbreaks
• measles exposures
• institutional respiratory illness outbreaks.

Occupational Therapists may be required to modify practice during outbreaks by:

• following public health advice
• implementing additional infection prevention measures
• screening clients before appointments
• postponing non-essential services
• increasing environmental cleaning
• using additional PPE where indicated
• limiting group programs
• utilising telehealth where appropriate.

Outbreak responses should remain proportionate and evidence-informed while minimising unnecessary disruption to therapy.

Continuity of Care

Maintaining continuity of occupational therapy services during infectious disease events is essential for supporting client health, wellbeing and occupational participation.

Strategies may include:

• telehealth services
• home-based therapy programs
• remote coaching
• virtual consultations
• modifying intervention goals
• scheduling appointments to reduce exposure risks
• prioritising urgent services
• collaborating with carers and support workers.

For clients who rely on assistance animals for daily functioning, maintaining continuity of care may also involve supporting the ongoing health and welfare of the assistance animal throughout periods of disruption.

Communication During Infectious Disease Events

Clear, timely and accurate communication is essential during infectious disease incidents.

Occupational Therapists should communicate appropriately with:

• clients
• families and carers
• multidisciplinary teams
• employers
• schools
• support services
• veterinarians
• public health authorities where required.

Communication should be:

• evidence-based
• respectful
• culturally responsive
• accessible
• timely
• free from unnecessary alarm.

Accurate communication helps reduce anxiety, supports informed decision-making and promotes confidence in infection prevention measures.

Documentation and Reporting

Accurate documentation is essential following infectious disease incidents.

Records should include:

• observations
• actions taken
• infection prevention measures implemented
• referrals made
• advice provided
• communication with relevant parties
• follow-up plans.

Occupational Therapists should also comply with organisational reporting requirements, including incident reporting systems and notifiable disease requirements where applicable.

Comprehensive documentation supports continuity of care, legal accountability and quality improvement.

Learning from Incidents

Every exposure incident or infectious disease event provides an opportunity for organisational learning.

Following an incident, organisations should consider:

• what occurred
• contributing factors
• effectiveness of existing controls
• opportunities for improvement
• staff education needs
• policy updates
• equipment or environmental modifications.

A culture of continuous improvement strengthens infection prevention systems and enhances organisational resilience.

The Occupational Therapist’s Role

Occupational Therapists contribute to effective infectious disease management by:

• recognising potential infectious illness
• implementing appropriate infection prevention measures
• responding promptly to exposure incidents
• supporting continuity of care
• educating clients and carers
• collaborating with multidisciplinary teams
• documenting accurately
• participating in quality improvement
• promoting evidence-informed, person-centred practice.

Throughout all infectious disease responses, Occupational Therapists should balance infection prevention with occupational participation, disability rights, assistance animal welfare and client-centred care.

Key Practice Principle

Occupational Therapists should be prepared to recognise, respond to and manage infectious diseases and exposure incidents using evidence-informed infection prevention practices, organisational procedures and a One Health approach. Effective infectious disease management requires timely risk assessment, clear communication, accurate documentation, interdisciplinary collaboration and a commitment to maintaining continuity of care while protecting the health and welfare of clients, assistance animals and the wider community.