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					           Policy on the response to key alert organisms in Manchester

Greater Manchester Health Protection Unit (GMHPU) coordinate the response to key
alert organisms for communicable diseases of public health significance in the
community on behalf of Manchester Primary Care Trust (PCT). The details of this
arrangement are outlined in the memorandum of understanding (MoU) between
these two organisations. This MoU originally drafted in 2004 and re-drafted in 2005 is
currently in the process of being revised on account of recent organisational

Key alert organisms
The key alert organisms for communicable diseases include all the diseases
notifiable under the public health legislation as well as several others of public health
significance including legionella, E coli O157 and CJD. These alert organisms include
all the alert organisms of public health significance outlined in The Health Act: Code
of Practice for the Prevention and Control of Health Care Associated Infections (i.e.
tuberculosis, respiratory viruses, diarrhoeal infections, viral heamorrhagic fevers and
legionella). All these organisms are listed in the table below.

Surveillance of key alert organisms
The Health Protection Agency (HPA) undertakes ongoing surveillance of all key alert
organisms listed in the table below as well other organisms including all healthcare
acquired infections from the community and acute hospital trusts (see PCT
surveillance policy). The aim of this surveillance is to monitor trends and identify
outbreaks to enable prompt action to be undertaken

Data on all key alert organisms is collected from clinicians and laboratories on a
routine basis in accordance with national legislation relating to notifiable diseases
and agreed arrangements around reporting between the HPA and laboratories
across Greater Manchester.

Response to key alert organisms
GMHPU respond to all key alert organisms following guidance detailed in local
standard operating procedures (SOPs) or adhering to regional or national guidelines
from the HPA or other national organisations (see table below).
There is no specific regional or national guidance for a few of the diseases notifiable
under the current public health legislation and no local SOPs have been developed to
deal with these organisms specifically, although outbreaks of these organisms would
be dealt with in accordance with generic outbreak policies. The reason why no
specific guidance exists for these organisms is that today there is general consensus
among HPA experts that these organisms are now of lesser public health
significance than when the legislation was drawn up and therefore do not warrant
specific guidance.

Table: List of SOPs and guidelines for key alert organisms
                               GMHPU SOP     Regional       National        National
                                           HPA Policy     guidelines -    guidelines -
                                                              HPA         other source
Diseases          notifiable
under the Public Health
(Infectious       Diseases)
Regulations 1988:
Acute encephalitis
Acute poliomyelitis                                             x
Anthrax                                                         X
Cholera                                                                        x
Diphtheria                                                      x
Dysentery                          x                                           x
Food poisoning                     x                                           x
Malaria                            x                                           x
Measles                            x                            x
Meningitis/septicaemia             x                            x
Meningitis (pneumococcal,          x
haemophilus influenzae or
Mumps                                                           x
Ophthalmia neonatorum
Paratyphoid fever                  x                                           x
Plague                                                          x
Rabies                             x                            x
Relapsing fever
Rubella                                x
Scarlet fever
Smallpox                               x
Tetanus                                x
Tuberculosis                                        x
Typhoid fever                 x                     x
Typhus fever
Viral haemorrhagic fever               x            X

Viral hepatitis A             x   x    x
Viral hepatitis B             x        x
Viral hepatitis C             x        x
Whooping cough                    x    x
Yellow fever
Other communicable
diseases of public health
Influenza (including avian,   x        x            x
seasonal & pandemic)
Brucellosis                            X
Chickenpox                             X
CJD                               x    X
Clostridium botulinum                  X            x
E Coli O157                   x        X            x
Group A streptococci                   X
Legionnaires disease          x   x    X
Melioidosis                            x
Outbreaks due to              x
infections of an enteric,
respiratory or other nature
Shigellosis                   x                     x
Tularemia                              x

                                      Updated October 2008
                                              Erika Duffell