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					         Date of Issue: April 2007


 GUIDELINES FOR THE CONTROL
AND NOTIFICATION OF INFECTIOUS
           DISEASES




        Community Infection Control Team
              1 Stancliffe Road
                   Sharston
                Wythenshawe
                   M22 4PJ


             Tel No 0161 946 8242
             Fax No 0161 946 8244
CONTENTS

1     Trust Statement ......................................................................................................... 2
2     Introduction ................................................................................................................ 2
3     Notifiable Diseases .................................................................................................... 2
    3.1    Under the Public Health (Control of Disease Act) 1984 ....................................... 2
    3.2    Under the Public Health (Infectious Disease) Regulations 1988.......................... 3
    3.3    Reporting of other infectious diseases ................................................................ 3
    3.4    Acquired Immune Deficiency Syndrome (AIDS) .................................................. 4
4     TB .............................................................................................................................. 4
    4.1    Referral and Management .................................................................................. 4
    4.2    Surveillance ........................................................................................................ 4
    4.3    Contact Tracing .................................................................................................. 4
5     Meningococcal Disease ............................................................................................. 4
    5.1    Referral and Management .................................................................................. 4
6     Outbreaks .................................................................................................................. 4
7     Exclusion Guidelines – General Infections ................................................................. 5
8     Exclusion Guidelines - Gastro-Intestinal Illness .......................................................... 7
9     Exclusion Guidelines – Skin Infections ....................................................................... 8




                                                                                                                                       1
1 Trust Statement
This policy has been drawn up to inform health professionals of the mode of
transmission, incubation period, infectivity and recommendations for exclusion
from (nursery, school or work), for many common infectious diseases.

2 Introduction
This policy is intended as a practical guide for General practitioners and other
health care staff. They give details of all notifiable disease according to current
legislation and provide an overview of the management of communicable disease.

Further guidance should be obtained from the Greater Manchester Health
Protection Unit on 0161 786 6710.

3 Notifiable Diseases
Under the Public Health (Control of Disease Act) 1984 and the Public Health
(Infectious Disease) Regulations 1988 notification of the following
communicable diseases is a legal requirement, the diagnosing Doctor should
notify the Greater Manchester Health Protection Unit (GMHPU), 7th Floor Peel
House, Albert Street, Eccles, M30 0NJ, Tel No 0161 786 6710, Fax No 0161 707
9686

Notification of disease is important for the following reasons:-

 Case management e.g. food poisoning where the Environmental Health
  Department helps to identify the source.

 Detection of outbreaks of infection.

 Monitoring trends and the effectiveness of infection control policies
  immunisation programmes.

It is a legal requirement for which the Doctor receives a fee. (However, payment
may not be made for illegible forms)

It is important that there is a high level of reporting of infectious disease from GP’s
for effective control measures to be implemented.

Notification on standard notification forms should be returned for all of the
infections listed below. It is important that all sections are completed including
the date of onset.

3.1   Under the Public Health (Control of Disease Act) 1984

           * Cholera
           * Plague                                 * Smallpox
           * Relapsing Fever                        * Typhus



                                                                                      2
3.2   Under the Public Health (Infectious Disease) Regulations 1988

       Acute encephalitis
       Acute poliomyelitis
       Anthrax
       *Diphtheria
       Dysentery (amoebic or bacillary)
       Food poisoning
       Leprosy
       Leptospirosis
       Malaria
       Measles
       *Meningitis
       *Meningococcal septicaemia (without meningitis)
       Mumps
       Ophthalmia neonatorum
       *Paratyphoid fever
       Rabies
       Rubella
       Scarlet fever
       Tetanus
       *Tuberculosis
       *Typhoid fever
       *Viral haemorrhagic fever
       Viral hepatitis
       Whooping Cough
       Yellow fever

       *Initial telephone notification requested on suspicion of diagnosis

The statutory requirements are now considered to be out of date, therefore,
Doctors are asked to also notify the GMHPU of the following infections:-

       Cryptosporidiosis
       Giardiasis
       Campylobacter
       Salmonella
       Rotavirus Diarrhoea
       Enteropathogenic ‘E-coli’
       Legionella
       Haemophilus Influenza type B

3.3   Reporting of other infectious diseases

A perceived increase in other infections such as clusters of impetigo, scabies,
diarrhoea or an unusual increase of patients with the same illness should also be
reported to the GMHPU.




                                                                               3
3.4   Acquired Immune Deficiency Syndrome (AIDS)

The Acquired Immune Deficiency Syndrome (AIDS) is NOT a statutory notifiable disease.
Instead Doctors are urged to participate in a voluntary confidential reporting scheme.
AIDS cases should be reported on a special AIDS clinical report form in STRICT
MEDICAL CONFIDENCE to the Director, PHLS Communicable Disease Surveillance
Centre, 61 Colindale Avenue, London, NW9 5EQ. Advice about the reporting of cases
may be obtained from CDSC (0208 200 4400), or locally from physicians in genito-urinary
medicine and infectious diseases physicians.

4 TB
4.1   Referral and Management

All cases of TB should be managed by, or in consultation with, a Chest Physician or
Infectious Disease Physician specialising in this disease should be notified to the GMHPU
who then refer to the TB Unit at MRI.

4.2   Surveillance

The aim of surveillance is to collect all information pertinent to the control of tuberculosis
in a timely manner. It enables the monitoring of trends and detection of outbreaks so that
preventive and treatment services can be planned and targeted appropriately and the
effectiveness of interventions monitored.

The GMHPU are responsible for local surveillance, for maintaining a register/database of
cases, and for contributing to national surveillance by weekly reporting to the Office for
National Statistics and participating in enhanced surveillance and research.

4.3   Contact Tracing

Contact tracing is an essential part of the routine management of patients with
tuberculosis and should be carried out according to the protocol within current BTS
Guidelines. In Manchester, local contact tracing is undertaken by the TB Unit at MRI (Tel
0161 276 4387).

5 Meningococcal Disease
5.1   Referral and Management

A confirmed, probable or possible case should be notified to the GMHPU who can be
contacted during working hours by phoning 0161 786 6710 or out of hours, the
switchboard operators at Tameside General Hospital on 0161 331 6000 to contact the
Public Health On-Call Team.

6 Outbreaks
Further advice regarding the management of outbreaks of any communicable disease
can be sought from Greater Manchester Health Protection Unit on 0161 786 6710.




                                                                                             4
7 Exclusion Guidelines – General Infections
       DISEASE            USUAL INCUBATION           PERIOD OF COMMUNICABILITY                   MINIMUM RECOMMENDED
                              PERIOD                                                        EXCLUSION OF STAFF FROM WORK
CHICKENPOX                                          From as early as 4 days                5 days from onset of rash (until spots are
                        11 - 20 days                                                       dry)
CONJUNCTIVITIS (viral                               Whilst symptoms persist                None required
or bacterial)           Depends on cause
FIFTH DISEASE                                       Not well known - a few days before     None required
(Slapped Cheek          13 - 18 days                the appearance of the rash
Syndrome)
GLANDULAR FEVER                                     Prolonged infectivity but once the     None required
                        33 - 49 days                symptoms have subsided, risk is
                                                    small apart from very close contact
                                                    i.e. kissing
HAND, FOOT AND                                      Usually while symptoms persist         None required
MOUTH DISEASE           3 - 5 days
MEASLES                                             A few days before to 4 days after      5 days from onset of rash
                        9 – 18 days                 onset of the rash
RUBELLA (German                                     About 13 days before to 6 days after   5 days from appearance from rash
Measles)                15 - 20 days                onset of rash
MENINGOCOCCAL                                       Whilst organism is present in nose     Until clinical recovery.
INFECTION               2 - 10 days (commonly 2 -   and mouth
(MENINGITIS)            5 days)
MUMPS                                               From a few days before the onset of    5 days from onset
                        15 - 24 days                symptoms to subsidence of swelling
                                                    (often 10 days)
SCARLET FEVER &                                     Whilst organism is present in the      5 days if treated
OTHER                   12 hours - 5 days           nasopharaynx or skin lesion
STREPTOCOCCAL
INFECTION
TUBERCULOSIS                                        Whilst organism is present in          CCDC will advise. Exclude until
                        25 - 90 days                sputum. Usually non-infectious 2       treatment has been commenced and
                               weeks after starting treatment with   found to be effective
                               standard anti-tubercular drugs.
WHOOPING COUGH                 7 days after exposure to 21 days      21 days from onset of paroxysmal cough,
                 2 - 21 days   after onset of paroxysmal coughing.   or 5 days after commencement of
                               Highly infectious                     antibiotics.
8 Exclusion Guidelines - Gastro-Intestinal Illness
       DISEASE             USUAL INCUBATION            PERIOD OF COMMUNICABILITY                      MINIMUM RECOMMENDED
                               PERIOD                                                          EXCLUSION OF STAFF FROM WORK
CAMPYLOBACTER                                         Whilst organism is present in stools,   All staff should be excluded until clinically
                         1 - 10 days (usually 2 - 5   but mainly until diarrhoea has          fit with no diarrhoea for at least 48 hours
                         days)                        ceased for 24 - 48 hours
CRYPTOSPORIDIOSIS                                                       "                                          "
                         1 – 14 days (usually 7
                         days)
SHIGELLA                 12 hours - 6 days (usually                     "                                          "
(DYSENTERY)              1 -3 days)
SALMONELLA FOOD                                                         "                                          "
POISONING                4 hours to 5 days

GIARDIASIS               5 - 20 days (usually 7 -10   Whilst cysts are present in the                              "
                         days)                        stools, but mainly while diarrhoea is
                                                      present
HEPATITIS A (infective                                From 7 -14 days before, to 7 days       7 days from onset of jaundice and when
hepatitis)               2 - 6 weeks (usually28 –     after onset of jaundice                 clinically fit with no symptoms
                         30 days)
TYPHOID FEVER                                         Whilst organism is present in stools    All staff should be excluded until clinically
                         6 - 33 days (usually 14      or urine                                                     fit
                         days)
WORMS                                                 Until worms are treated                 Sexual partners should be treated at the
                         Variable                                                                        same time. None
                         Thread worms 15-28 days
9   Exclusion Guidelines – Skin Infections
       DISEASE             USUAL INCUBATION           PERIOD OF COMMUNICABILITY                    MINIMUM RECOMMENDED
                                   PERIOD                                                    EXCLUSION OF STAFF FROM WORK
IMPETIGO                 Usually 4 – 10 days, but    Whilst lesions remain moist or until   Until 48 hours after starting antibiotics.
(Streptococcus           can occur several months    48 hours after starting antibiotic     Treatment is rapidly effective.
pyogenes and             after colonisation
Staphylococcus aureus)
PEDICULOSIS (Head        Ice eggs hatch in a week    As long as eggs or lice remain alive   None
lice)                    and reach maturity in 8 -
                         10 days
RINGWORM OF FEET                                     As long as lesions are present         Not necessary
(Athletes Feet)          2-38 weeks
RINGWORM OF THE                                      As long as active lesions are                              "
SCALP                    2-4 weeks                   present
RINGWORM OF THE                                      As long as active lesions are                              "
BODY                     2-4 weeks                   present
SCABIES                                                                                     Exclusion only necessary for 24 hours
                         7-27 days                   Whilst live mites are present.         after treatment. Close contacts, i.e.,
                                                                                            family and those who have had
                                                                                            prolonged skin to skin contact will need
                                                                                            treating at the same time as they may be
                                                                                            incubating scabies.
VERRUCAE PLANTARIS                                   Unknown, probably as                   Exclusion is not necessary.
(plantar warts)          2 - 3 months, range 1 –24   long as lesion is visible
                         months
Infection Control      Updated April 2007


Author[s]              Sally Webster, Leasa Benson and Nicola Jepson


References and         Chin J. Control of Communicable Disease Manual
Sources of             APHA 17th ED 2000
Information
                       CDR 1995 The prevention of human transmission of
                       gastrointestinal infection and bacterial intoxication’s;-
                       A guide for public health physicians and
                       environmental health officers in England and Wales
                       CDR Review vol 5:11 13th Oct 1995

                       DoH 1999 Guidance on Infection Control in Schools
                       and Nurseries. DOH Nov 1999




                                                Date…………April 2007………


…………………………………………
Chair of Infection Control Committee

                                                  Review: April 2009…………..




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