Infectious Disease Outbreak (Emergency measures)

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Practice Leads

  • Doctors: Ramesh Mehay & Sudhir Krishnan
  • Nurse: Zoe Booth
  • Admin: Chris Rushton

Date Reviewed

9th August 2016

Date of Next Review

September 2017

This protocol has been developed for big things like suspected cases of Ebola, Swine Flu, Bird Flu and so on.  It has been adapted from: "Information for Primary Care: Managing patients who require assessment for Ebola virus disease";  2014 Public Health England

Local health protection team contact details:

  • In-hours number: 0113 386 0300  (Leeds).  Fax 0113 386 0306
  • Out-of-hours number: 0114 304 9843 (ask for public health on-call)

Local infectious disease physician contact details:

  • Name: Dr P McWhinney – lead physician infectious diseases
  • Hospital: Bradford Royal Infirmary
  • Contact number: 01274 382 248

General Principles

  1. If a suspected serious infectious disease case presents to primary care, the primary care clinician is responsible for ensuring that the suspected case is referred appropriately to the local acute trust for review.
  2. The primary care clinician should seek urgent clinical advice, in the first instance, from a local infection specialist (consultant microbiologist, virologist or infectious disease physician), and the risk assessment should be completed in conjunction with (and led by) them and in discussion with their local PHE centre.
  3. The physician is advised to read up about the serious infectious illness to equip themselves with the knowledge needed to manage patients appropriately and keep others safe.

As soon as you are aware of the possibility of a serious infectious disease, leave the patient in an isolate'able room and remove yourself to seek advice ASAP.  Keep your distance.  Do not touch the patient.   Sanitize your hands with alcohol.  And remember - watch out for touching things the patient may have touched e.g door handles

What to do when a patient presents with a serious suspected infectious disease

  • If  a patient with suspected signs and symptoms presents to the reception staff, isolate patient - do not let them sit in the waiting room. Instead, put them in isolation in a single side room that is not being used IMMEDIATELY in order to limit contact.   Do not escort them but point where to go and keep your distance.   Do not allow them to touch doors or handles.   Then immediately inform the emergency on-call doctor.
  • The emergency doctor should not enter the room but instead seek advise from the local infection specialist.
  • If the patient presents to the GP in their surgery: keep them in your room, advise to stay there.  The doctor should leave, wash their hands and  then seek advice from the local infection specialist.  Do not return to the room unless advised to do so.
  • If you have touched the patient at any point, sanitise hands with alcohol gel.
  • In all cases, contact your local infection specialist (consultant microbiologist, virologist or infectious disease physician) who will lead the risk assessment and arrange clinical review.
  • If the patient needs to be transferred to hospital, it is essential to alert the ambulance staff about the possibility of the serious infectious disease.  They will need to put special precautions in place to ensure the vehicle and personal protective equipment (PPE) are appropriate to the condition of the patient.
  • Alert the appropriate hospital about the arrival of the patient.
  • In the event of a case being confirmed identification and follow up of contacts will be undertaken by the local health protection team

Disposing of Waste & Decontamination of Rooms or Areas

  • All waste, including used cleaning equipment such as gloves, paper towels and mops, should be put into impermeable waste bags, secured and stored in a safe undisturbed place until the suspected case has been assessed by a healthcare professional and/or a test result is available
  • Once the suspected case has been transferred to secondary care, other patients and staff should not use the room in which the patient has been isolated or any potentially contaminated areas until they have been decontaminated. This includes toilets and other high contact surfaces as outlined above.
  • Cleaning and decontamination of any rooms in which a suspected or confirmed infectious disease patient has been isolated or any facilities used by the patient (like the toilet) should be discussed with the local health protection team. They will advise you about potentially contaminated areas. Do not use these areas until they have been decontaminated and the all-clear given.
  • It may be necessary to quarantine the room for up to 24 hours if the patient is being tested for the specific disease of extreme concern.
  • Public areas where the suspected case has passed through and spent minimal time in (such as corridors), but which are not visibly contaminated with bodily fluids, may or may not need to be specially cleaned and disinfected - again discuss with the infection specialist.

Notification of infectious disease requirements

  • The hospital clinicians will inform the local PHE health protection team to ensure a thorough public health response and appropriate follow up of contacts. At that point, the health protection team will identify and organise follow for any primary care contacts.
  • If there any specific concerns in the primary care setting, your local health protection team can be contacted to discuss any specific public health issues at the point of referral to hospital or if the patient has additional high-risk factors.

How to prevent suspected patients coming to the surgery

  • If a patient with a suspected infectious disease phones the surgery - tell them NOT to visit the surgery or walk-in centre.  Instead, stay at home and someone will be in touch.  Keep near the phone.
  • If there is a potential outbreak of something, put out SEVERAL LARGE POSTERS on outside surgery doors to inform patients what the signs and symptoms are and NOT TO ENTER the surgery premises (in order to protect other people) and instead go back home and telephone the surgery