System Features Relevant to MT
- Infection control is the foundation of safe practice with this category. Universal precautions — hand hygiene before and after every session, clean linens, sanitized surfaces, and proper disposal of any materials that contact bodily fluids — apply to every client, not just those with known infections.
- Contraindications during active infection apply to most conditions in this category. Active mononucleosis, meningitis, influenza-like illness, and shingles with open lesions are all contraindicated due to contagion risk and the body's need to direct resources toward fighting the infection. The therapist should not treat during the acute phase and should wait for medical clearance.
- Universal precautions assume that every client may carry an undiagnosed bloodborne pathogen. This eliminates the need to make treatment decisions based on perceived risk and ensures consistent safety. Gloves should be worn if the therapist has open cuts on their hands or if the client has any open lesions.
- Chronic infectious conditions like HIV/AIDS require a different approach than acute infections. With effective antiretroviral therapy, HIV-positive clients may have stable immune function and benefit fully from massage. Treatment modifications depend on current immune status (CD4 count), not the diagnosis alone.
- Shingles deserves special attention because it is both a pain condition (post-herpetic neuralgia) and an infectious condition. Active vesicles are contagious to anyone who has not had chickenpox or the varicella vaccine. Once lesions have fully crusted over, the client is no longer contagious but may still have significant nerve pain.
- MMR vaccine-preventable diseases (measles, mumps, rubella) are rare in Canada but remain clinically important. All three are reportable diseases in Ontario. Measles is one of the most contagious diseases known (R0 of 12–18) and remains infectious in the air for up to 2 hours. Mumps causes parotid swelling and carries risk of orchitis in post-pubertal males. Rubella is mild in most individuals but causes devastating congenital defects (Congenital Rubella Syndrome) when contracted in the first trimester of pregnancy — a pregnant client with suspected rubella is a medical emergency.
Condition Articles
Viral Infections
- Epstein-Barr Virus
- HIV/AIDS
- Measles (Rubeola)
- Mononucleosis
- Mumps (Epidemic Parotitis)
- Rubella (German Measles)
- Shingles (Herpes Zoster)
Bacterial and Other Infections
Key Takeaways
- Universal precautions apply to every client, every session — consistent infection control eliminates the need for risk-based decision-making.
- Active infectious conditions are generally contraindicated until the client is non-contagious and medically cleared.
- Chronic infections like HIV are not automatic contraindications — treatment decisions depend on current immune status and disease stability.
- Shingles is contagious only during the active vesicle phase; post-herpetic neuralgia may persist long after and can benefit from gentle massage.
- Measles, mumps, and rubella are reportable diseases in Ontario — suspected cases require immediate physician referral; all three are systemic contraindications during the acute phase.
- A pregnant client with suspected rubella is a medical emergency — do not treat; refer immediately.
- When in doubt about a client's infectious status, postpone treatment and request physician clearance.