2013 Public Health Disease Notification Manual

Transcription

1

2 2013 Public Health Disease Notification Manual Notification of communicable and other diseases by Medical Practitioners and laboratories in New Zealand is a requirement under the Health Act 1956 and Tuberculosis Act The primary purpose of this notification is to prompt public health action to manage the cases and reduce the risk to the wider community. This manual aims to inform and assist those at the frontline providing health services namely: General Practitioners (GPs), practice nurses, primary care nurses, hospital clinicians, laboratory staff and other practitioners with notifying Regional Public Health (RPH). This manual should be used in conjunction with other best practice guidelines, including the Immunisation Handbook. Users are also encouraged to use this manual with the existing evidence-based effective practices. Disease information and/or resources can also be downloaded in PDF format from our web page This manual contains the following information: Annex A B1 B2 C D E F Contents Disease notification process, key points for notifying RPH, relevant legislation, and conditions requiring urgent and non-urgent notifications Exclusion and clearance criteria for people at high risk of transmitting an infection to others (source: ESR 2012 guidelines for investigating communicable disease outbreaks) Exclusion and clearance criteria for gastrointestinal infections Instructions for completing the case report forms, including RPH contact numbers and where to send them (for Wairarapa Health District) Instructions for completing the case report forms, including contact numbers where to send them (for Greater Wellington region) A to Z of notifiable diseases with corresponding case report forms Case report forms used in notifying diseases to RPH Examples of available resources/brochures on diseases (Source: RPH and Ministry of Health)

3 Regional Public Health Medical Officers and Notification Staff Dr. Annette Nesdale Medical Officer of Health Dr. Margot McLean Medical Officer of Health Dr. Stephen Palmer Medical Officer of Health. Dr. Dilip Das Medical Officer Dr. Jill McKenzie Clinical Head of Department Pauline Manion Technical Officer Ellana McKay Technical Officer

4 Disease notification process Annex A Urgent telephone notifications A verbal notification is required for the following diseases: Acute gastroenteritis 1 Anthrax Avian influenza (highly pathogenic) Botulism Chemical Poisoning arising from hazardous substances or from chemical contamination of the environment 2 Cholera Diphtheria Haemophilus influenzae B invasive disease Hepatitis A and B (acute illness only) 3 Measles 4 Meningoencephalitis primary amoebic Neisseria meningitidis invasive disease Plague Poliomyelitis Rabies and other lyssaviruses 5 Severe Acute Respiratory Syndrome (SARS) Shigellosis Toxic shellfish poisoning Tuberculosis (all forms) Typhoid and paratyphoid fever Yellow fever Verocytotoxic Escherichia coli Viral haemorrhagic fevers Outbreak of any notifiable disease: an outbreak is classified as two or more cases linked to a common source. Monday Friday between hours 8am 5pm, telephone the Notifications Officer on After hours, telephone HealthLink (Wgtn) on , ask to speak to the On-call Medical Officer of Health Fax and or notifications Fax or to RPH the following case report forms: Acquired Immunodeficiency Syndrome (AIDS) (for example Dengue fever)6 Brucellosis Campylobacteriosis Creutzfeldt Jakob disease (CJD) and other spongiform encephalopathies Cryptosporidiosis Cysticercosis Decompression sickness E. sakazakii invasive disease (Cronobacter species) Giardiasis Hepatitis C (acute or incident cases only) Hepatitis (viral) not otherwise specified (acute illness only) Hydatid disease Invasive pneumococcal disease Lead absorption 10 ug/dl (0.48 umol/l) Legionellosis Leprosy Leptospirosis Listeriosis Malaria Mumps4 Non-seasonal influenza capable of being transmitted between human beings Pertussis Pneumococcal disease (invasive disease only) Rheumatic fever Rickettsial diseases and Q fever7 Rubella4 Salmonellosis Taeniasis Tetanus Trichinosis Yersiniosis Monday Friday between hours 8am 5pm, fax notifications to Acute gastroenteritis is only notifiable if suspected outbreak or linked to common source or person in high risk category e.g., food worker, caregiver, etc. (check list of high risk category) 2 Chemical poisoning is notifiable under the Hazardous Substances and New Organisms Act of 1996 (HSNO Act) 3 Notification must include a faxed copy of serology confirming acute hepatitis and LFTs 4 Notify on suspicion and send confirmatory serology (IgM) for Measles/Mumps/Rubella or Nasopharyngeal swab result (Pertussis) to RPH when available. 5 Currently, only rabies is listed in the notifiable infectious diseases schedule. Reporting of other lyssavirus infections by medical practitioners is recommended with informed patient consent 6 Acute dengue fever or Ross fever notifiable by telephone if there is NO recent overseas travel; if there is recent overseas travel, notify by fax 7 Q fever is now classified separate to the Ricketssial genus but the notifiable infectious diseases schedule had not yet been updated to include Q fever. Reporting by medical practitioners is recommended with informed patient consent.

5 Key points Notify communicable and other diseases to RPH, not ESR Some diseases require you to notify RPH on suspicion GP fast fax and public health alerts can be found on our web page Visit RPH web page from time to time and download latest information, pamphlets & or posters This manual contains case exclusion & clearance criteria for people at high risk of transmitting infectious diseases to others (see list of high risk category) Bookmark the RPH web page Notification to Regional Public Health The notifiable disease schedule is a list of conditions that require public health investigation or follow-up. Notification allows for appropriate public health control measures to be taken to reduce the risk of further spread, for disease surveillance and for monitoring of the effectiveness of control measures. The diagnosing medical practitioner is required by Section 74 of the Health Act 1956 to report to the Medical Officer of Health any patient who, they have reasonable suspicion, is suffering from a notifiable condition. Laboratories notify test results directly to RPH. This provides limited information that invariably needs supplementation from the clinician and medical centre Direct laboratory notification of positive results does not replace clinician notification Notification should be discussed with the patient but patient consent to notification is not necessary. Clusters of illness that could be due to a common source should also be notified, even for conditions that would otherwise not be notifiable. For example, a cluster of severe skin infection related to tattooing, or cluster of severe respiratory illness in a Long Term Care Facility. NOTE: Rheumatic fever (an initial attack or a recurrence) is a notifiable disease. Significant chemical poisoning is notifiable under the Hazardous Substances and New Organisms Act 1996 (HSNO Act). Notification on suspicion Notification on suspicion is particularly important for illnesses that may be due to a common source and/or are highly infectious. In these cases, early public health interventions can reduce disease transmission and secondary cases. Examples are: measles, tuberculosis and gastroenteritis outbreaks due to norovirus.

6 Additional notification At times, the Medical Officer of Health may request that a specific disease not listed in the schedule be notified for disease control purposes. Information about cases could be required at short notice. RPH would contact primary and secondary care services and the regional laboratories to make any such request. International reporting requirements Where an outbreak or cases of notifiable conditions are thought to have arisen overseas, RPH may notify relevant international health authorities. Some diseases such as cholera and polio are also notifiable to the World Health Organisation under the International Health Regulations This will also be done by RPH. Relevant legislation Health Act 1956, sections A and associated regulations Tuberculosis Act 1948 sections 1-10 and associated regulations Hazardous Substances and New Organisms Act 1996 section 143 Urgent notifications (notify by telephone as soon as you are aware of the condition): During office hours, phone the Communicable Disease Notification Direct line on The Technical Officer will record the name, DOB, NHI number and contact details of the ill person and if required, transfer you to the relevant clinical person. After hours until 10pm (including on weekends and public holidays), contact the on-call Health Protection Officer or Medical Officer of Health via Healthlink on Overnight, in cases of exceptional circumstances or urgency, phone the on-call Medical Officer of Health via Healthlink on

7 Notifiable Diseases requiring urgent notification Notify within 1 working day the following diseases: Acute gastroenteritis/food poisoning: two or more cases of acute gastroenteritis are suspected to be linked to a common source. a person with acute gastroenteritis is at high risk of infecting others (for example someone who works as a food handler or childcare worker). single case of chemical, bacterial, or toxin food poisoning such as botulism, toxic shellfish poisoning or scromboid poisoning. Anthrax Avian influenza (highly pathogenic) Botulism Chemical poisoning arising from hazardous substances or from chemical contamination of the environment¹ Cholera Diphtheria Haemophilus influenzae B invasive disease Hepatitis A (acute illness only) Hepatitis B (acute illness only) Measles Meningoencephalitis primary amoebic Neisseria meningitidis invasive disease Plague Poliomyelitis Rabies and other iyssaviruses Severe acute respiratory syndrome Shigellosis Toxic shellfish poisoning Tuberculosis (all forms) Typhoid and paratyphoid fever Yellow fever Verocytotoxic escherichia coli Viral haemorrhagic fevers Outbreak of any notifiable disease: an outbreak is classified as two or more cases linked to a common source.

8 Notifiable diseases requiring non-urgent notification Please notify the following conditions by fax or telephone the communicable disease notification direct line on within 1 or 2 working days. If there is any doubt about the urgency of a case with a condition in the list below, or if additional features raise the level of concern about a case, then please treat this as with the urgent notifications above. Acquired Immunodefieciency Syndrome (AIDS) 8 (for example, dengue fever) Brucellosis Campylobacteriosis Creutzfeldt Jakob disease and other spongiform encephalopathies Cryptosporidiosis Cysticercosis Decompression sickness E. sakazakii invasive disease (Cronbacter species) Giardiasis Hepatitis C (acute or incident cases only) Hepatitis (viral) not otherwise specified (acute illness only) Hydatid disease Invasive pneumococcal disease Lead absorption 10 ug/dl (0.48 umol/l) 9 Legionellosis Leprosy Leptospirosis Listeriosis Malaria Mumps Non-seasonal influenza capable of being transmitted between human beings Pertussis Pneumococcal disease (invasive disease only) Rheumatic fever Rickettsial diseases and Q fever Rubella Salmonellosis Taeniasis Tetanus Trichinosisl Yersiniosis Annex B1 8 HIV infection in New Zealand is not notifiable. Acquired Immunodeficiency Syndrome (AIDS) is notifiable. Individual patient names are not reported; a standard code is used. The case report form H773/1A, needs to be completed and sent to the Medical Officer of Health. The form can be dowloaded from the MOH website: or from AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin 9 Blood lead levels to be reported to the Medical Officer of Health (10 µg/dl or 0.48 µmol/l) are for environmental exposure. Where occupational exposure is suspected, please notify Occupational Safety and Health (OSH) through the Notifiable Occupational Disease System (NODS) network.

9 Exclusion and clearance criteria for people at high risk of transmitting an infection to others Criteria for excluding (restricting) people from work, school or an early childhood service: Group 1 Group 2 Group 3 Group 4 Food or product handlers (including visitors or contractors who could potentially affect food safety). Staff of health care or early childhood facilities. Children under the age of 5 years attending early childhood services. Other adults or children at higher risk due to illness or disability. Each reported case in these groups needs to be assessed as to their current and ongoing risk of transmission to others. While criteria under Annex B2 are based on standard criteria at the time of writing, public health assessment and action should be based on the most up-to-date evidence and best practice. Therefore, there may be instances where the criteria are varied on a case-by-case basis according to the professional judgement of the local Medical Officer of Health. The Medical Officer of Health can also consider whether it is necessary to use exclusion provisions in the Health (Infectious and Notifiable Diseases) Regulations 1966, and from early childhood centres using the Education (Early Childhood Centres) Regulations Note that while there are provisions that apply to early childhood service workers, there are no provisions for health care workers instead, advice should be provided to employers under the Health and Safety in Employment Act 1992.

10 Exclusion and clearance criteria for gastrointestinal infections Annex B2 Disease Group(s) Exclusion from work or early childhood centre advised until symptom free for: Exclusion for close contacts (usually household) Campylobacter 1, 2, 3, 4 48 hours Not required Cryptosporidium 1, 2, 3, 4 48 hours (Avoid swimming until 14 days with no symptoms) Not required Giardia 1, 2, 3, 4 48 hours (Avoid swimming until 14 days with no symptoms) Not required Yersinia 1, 2, 3, 4 48 hours Not required Rotavirus 1, 2, 3, 4 48 hours Not required Norovirus 1, 2, 3, 4 48 hours Not required Gastroenteritis (unknown organism) 1, 2, 3, 4 48 hours (During Cryptosporidium outbreaks use exclusion advice above Not required Salmonella 1 48 hours and until two consecutive negative stools have been provided at least 48 hours apart For contacts also in group 1: exclude until one negative faecal specimen has been provided 2, 3, 4 48 hours For contacts in group 1: exclude until one negative faecal specimen has been provided Shigella 1, 2, 3, 4 48 hours and until two consecutive negative stools have been provided at least 48 hours apart Typhi and paratyphi 1, 2, 3, 4 48 hours and until two consecutive negative stools have been provided at least 48 hours apart after completing appropriate antibiotics. If not treated with effective antibiotics then no earlier than 1 month after onset of symptoms. School children Until the above clearance criteria are satisfied or as discussed with the Medical Officer of Health VTEC/STEC 1, 2, 3, 4 48 hours and until two consecutive negative stools have been provided at least 48 hours apart Group 1. Food product handlers including visitors or contractors who could potentially affect food safety. Group 3. Children under the age of 5 attending early childhood services. For contacts in groups 1,2,3 or 4: exclude until one negative faecal specimen has been provided All household, close and travel contacts and other contacts in groups 1,2,3 or 4 are in some cases required to provide one negative faecal sample All household, close and travel contacts and other contacts in groups 1,2,3 or 4 are in some cases required to provide one negative faecal sample For contacts in groups 1,2,3 or 4: exclude until one negative faecal specimen has been provided Group 2. Staff of health care or early childhood facilities. Group 4. Other people at higher risk due to illness or disability.

11 Annex C Instructions for completing case report forms (Wairarapa Health District) Case report forms that are to be faxed to RPH can be downloaded from RPH website (see details in Annex E). Please print the forms onto an A4 sheet and fax to RPH. Compulsory fields for completion are: disease name - Please tick the correct enteric disease on the enteric case form notifier identification details - GP name and practice, phone number and date of notification case identification criteria - Surname, given name, address and contact phone numbers, including cell phone numbers, if available case demography criteria - DOB, gender, ethnicity, NHI number - Occupation and place of work/school/pre-school if known (occupation is important for us to determine whether the case should be considered as Priority 1 or 2) clinical criteria - For the enteric form please fill-in date of onset (referring to the onset date of illness) for all vaccine preventable diseases, please provide a copy of the case s vaccination history if known for all diseases, please send a copy of relevant laboratory results if you have them For any clarification, please call Where to send case report forms: Please fax the case report form and any other relevant information to: (0800 EPISURV) or please phone Alternatively, you can forms to: Enteric_Disease_Reports_TLAs@huttvalleydhb.org.nz After hours, please phone Healthlink on

12 Instructions for completing case report forms (Greater Wellington region) Case report forms that are to be faxed to RPH can be downloaded from RPH website (see details in Annex E). Please print the forms onto an A4 sheet and fax to RPH. Compulsory fields for completion are: disease name - Please tick the correct enteric disease on the enteric case form notifier identification details - GP name and practice, phone number and date of notification case identification criteria - Surname, given name, address and contact phone numbers, including cell phone numbers, if available case demography criteria - DOB, gender, ethnicity, NHI number - Occupation and place of work/school/pre-school if known (occupation is important for us to determine whether the case should be considered as Priority 1 or 2) clinical criteria - For the enteric form please fill-in date of onset (referring to the onset date of illness) for all vaccine preventable diseases, please provide a copy of the case s vaccination history if known for all diseases, please send a copy of relevant laboratory results if you have them For any clarification, please call Where to send case report forms Please fax the case report form and any other relevant information to: or please phone Alternatively, you can forms to: Enteric_Disease_Reports_TLAs@huttvalleydhb.org.nz After hours, please phone Healthlink on

13 Annex D A to Z of notifiable diseases with corresponding case report forms A Disease Case report form* AIDS (Acquired Immunodeficiency Syndrome) Send to Otago Medical School 1 Acute gastroenteritis/gastroenteritis Amnesic shellfish poisoning Anthrax s Avian influenza (highly pathogenic) (HPAI) B Barmah Forest virus infection Botulism Brucellosis C Campylobacteriosis Cholera Congenital rubella Creutzfeld Jakob Disease and other spongiform encephalopathies Cryptosporidiosis Cysticercosis D Decompression sickness Dengue fever Diarrhoeic shellfish poisoning Diphtheria EF Ebola Enterobacter sakazakii invasive disease G Giardiasis H Haemophilus influenzae type b Hepatitis A Hepatitis B Hepatitis C Hepatitis NOS TSP Highly pathogenic avian influenza Brucellosis Contact Ministry of Health 2 TSP see note H. influenzae type b Hepatitis A Hepatitis B, C, NOS Hepatitis B, C, NOS Hepatitis B, C, NOS 1 AIDS notifications should be completed on the MOH 1A form and then sent to the AIDS Epidemiology Group, Department of Social & Preventive Medicine, Otago University Medical School, Box 913, Dunedin. 2 For information on notification of Creutzfeld Jakob Disease and other spongiform encephalopathies contact the Ministry of Health. Cases must be reported to the Direct of Public Health at the Ministry of Health and the New Zealand CJD register, Department of Preventative and Social Medicine, University of Otago, Dunedin

14 Disease Highly pathogenic avian influenza (HPAI) Hydatid Disease IJK Invasive pneumococcal disease Japanese encephalitis Kunjin L Latent tuberculosis infection Lassa fever (viral haemorrhagic fever) Case report form* Highly pathogenic avian influenza (HPAI) Invasive pneumococcal disease Tuberculosis see note Lead absorption 10 g/dl (0.48 mol/l) Lead absorption Legionellosis Leprosy Leptospirosis Listeriosis Listeriosis - perinatal M Malaria Marburg virus disease Measles Meningococcal disease Meningoencephalitis primary amoebic Mumps Murine typhus Murray Valley encephalitis NO Neisseria meningitidis invasive disease Neurotoxic shellfish poisoning Non-seasonal influenza P Paralytic shellfish poisoning Paratyphoid fever Pertussis Plague Poliomyelitis Poisoning arising from chemical contamination of the environment Presumed rheumatic heart disease (under the age of 20) Primary amoebic meningoencephalitis Q Q fever R Rabies and other lyssaviruses Rheumatic fever - initial attack Rheumatic fever - recurrence Rheumatic heart disease (presumed, under the age of 20) Legionellosis Leptospirosis Listeriosis Listeriosis Malaria MMR Meningococcal MMR Meningococcal TSP Non-seasonal influenza TSP Pertussis Rheumatic fever see note Rheumatic fever Rheumatic fever Rheumatic fever see note

15 Disease Rickettsial disease see note 3 Ross River virus infection Rubella: congenital Rubella (not congenital) S Salmonellosis Severe Acute Respiratory Syndrome (SARS) Shigellosis Shiga toxin producing or verotoxigenic Escherichia coli (STEC/VTEC) infection T Taeniasis Tetanus Toxic shellfish poisoning - unspecified Trichinellosis Tuberculosis: latent infection (LTBI) Tuberculosis: old disease on preventive treatment Tuberculosis: new case Tuberculosis: relapse or reactivation Typhoid fever Typhus UV Verotoxigenic or Shiga toxin producing Escherichia coli, (VTEC/STEC) nfection Viral haemorrhagic fever WXYZ Yellow fever Yersiniosis Viral haemorrhagic fever Yellow fever Yersiniosis MMR Case report form* No form available in EpiSurv, contact ESR VTEC/STEC infection TSP Tuberculosis see note Tuberculosis Tuberculosis Tuberculosis VTEC/STEC infection * Please note that not all these case report forms (CRF) might be useful for Primary Care Source: Ministry of Health 3 There are three disease options within EpiSurv for Rickettisal disease: murine typhus, typhus, or Rickettsial disease. Only select Rickettsial disease if the case does not have murine typhus or typhus.

16 Case report forms used in notifying diseases to Regional Public Health Hepatitis A Hepatitis B,C NOS Legionellosis Listeriosis Malaria Measles, Mumps, Rubella Rheumatic fever Pertussis (complete case report form and shorter version of case report form) Annex E Note: These case report forms (CRFs) need to be photocopied, completed and faxed to Regional Public Health Notifications Office: and/or to Enteric_Disease_Reports_TLAs@huttvalleydhb.org.nz Complete list of case report forms can be downloaded from RPH website Notifiable Diseases link under the Health Professionals tab (see attached web page print). Note that hospital clinicians are generally responsible for notification of: Tuberculosis Meningococcal disease AIDS (CRF is found after all the enteric diseases CRFs in the following pages). Please note that AIDS notifications are forwarded to AIDS Epidemiology Group, Otago University Medical School, PO Box 913, Dunedin (not to Regional Public Health) * Sample case report forms are found in the following pages

17 Useful webpage to Bookmark as a favourite