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Explain the causes and spread of infection in care settings


This page is designed to answer the following questions:

NOTE: This page has been quality assured for 2023 as per our Quality Assurance policy.

Infections are caused by pathogens, which are harmful organisms that cause disease.


Pathogens can be:

  • Bacteria
  • Viruses
  • Fungi
  • Parasites
  • Protozoa
  • Prions

The chain of infection


The chain of infection describes the process of how infections spread and the components that must be favourable for the pathogen.

The Chain of Infection - A circular cycle of six components: Organism > Reservoir > Portal of Exit > Transmission > Portal of Entry >Vulnerable Hosts

  1. The organism or pathogen e.g. bacteria
  2. Reservoir – where the pathogen lives and multiplies e.g. in throat/nasal passages
  3. Portal of exit – the route that the pathogens leave the reservoir  e.g. nose/mucus
  4. Transmission – how pathogens pass from one person to another e.g. infected person sneezes near another person and tiny particles of mucus goes on their hand
  5. Portal of entry – route the pathogens enter the body e.g. a person touches their mouth with their hand
  6. Vulnerable hosts – the person at risk of infection. Risk can depend on factors such as the individual’s health e.g. an individual’s immune system is unable to fight the disease straight away and they become infected

The spread of infection can be prevented by breaking any of the links in the chain. For example, if the individual washed their hands at stage 4 after being sneezed on the bacteria would no longer be on their hand when they touched their mouth.

Portal of entry


The primary portals of entry for infections or ways that infections can enter the body are:

  • Physical contact with eyes, nose, mouth, ears
  • Breathed in through nose/mouth
  • Skin, especially breaks in the skin from cuts, scratches etc.
  • Eating/drinking
  • Sexual intercourse

Spread of infection in care settings

Care settings are particularly susceptible to outbreaks of infection for several reasons:

  • There are often large numbers of individuals interacting in the same space
  • Care tasks often require close contact and contact with bodily fluids
  • Individuals receiving care may have weaker immune systems and be more vulnerable to infection

Therefore it is important to take extra precautions in care settings than you may do at home. This includes using Personal Protective Equipment (PPE) such as aprons, gloves and facemasks, washing hands regularly, disposing of waste regularly and correctly, maintaining a clean environment and maintaining good personal hygiene.


Example question and answer

You have been asked to prepare three handouts for new staff attending an induction. The handouts are to provide information on the following topics.


Hand out 2 – Infection control

This handout must include:

Ciii  A description of the different routes through which infection can get into the body.

Civ   An explanation of:
a) Prevention methods including hand washing, the social care workers and other’s personal hygiene.
b) The social care workers role in supporting others to promote best practice in infection control.

Cv An evaluation of:
a) Different types of personal protective equipment (PPE).
b) How using PPE can help to prevent the spread of infection.



This handout provides information to new staff about the importance of infection control.

Routes of Infection


Infections can enter the body via several different routes:

  • Respiratory – pathogens in the air are breathed into the lungs
  • Breaks in skin – pathogens enter the bloodstream through the skin via cuts, needle pricks, insect bites etc.
  • Digestive tract – pathogens are ingested in food or drink (or other items that go into the mouth)
  • Bodily fluids – pathogens enter the body via bodily fluids (e.g. semen during sexual intercourse)


Infection can be prevented by maintaining a high level of hygiene.


This means washing hands thoroughly and regularly and always before handling food or medication.

The workplace should be kept clean and tidy and surfaces cleaned with antibacterial wipes or spray. Toilets and sinks should be cleaned with bleach regularly.


Food should be stored correctly and thrown away when it has gone past its use-by date. Bins should be emptied regularly.

Legislation should be adhered to (COSHH, RIDDOR etc.) and illness should be prevented from spreading by using tissues when coughing or sneezing and avoiding close contact.


A social care worker also has the responsibility to promote best practices for hygiene to their colleagues and other individuals in the service setting to prevent the risk of infection. This can mean encouraging individuals to maintain a high level of hygiene (reminding them to wash their hands after going to the toilet, prompting them to clean their kitchen etc.)

Personal Protective Equipment (PPE)


PPE is used to protect individuals from potential infection by creating a protective barrier between people and pathogens.

Types of PPE include:

  • Gloves – protect the hands from picking up pathogens and spreading them via touch
  • Aprons – prevents pathogens being transferred via clothing
  • Masks – prevents pathogens being breathed into the lungs
  • Hair nets – prevents contamination via hair.
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