The Management of Viral Haemorrhagic Fevers in Ireland - Health ...

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If presentation is a point of entry If incident first identified at point of entry – consider arrangements for provision of information, follow upof co travellers, staff etcLiaison with NIU and ambulance service re transfer Ensure arrangements are in place for secure transfer of patient to NIU, if stable. See Chapter 6.Infection control issues Consider infection control issues that might arise, particularly outside hospital sites. These includecleaning of ambulance, GP surgery, Out of Hours offices, health clinic etc. See Chapter 3.3. Actions once notified of a confirmed caseCommunications Inform Department Public Health staff Inform HPSC, Assistant National Director Health Protection – who will notify WHO of a Public HealthEmergency of International Concern (PHEIC) Put Regional Crisis Management Team on standby alert Inform media leadsLogistics/management Deploy Department staff to work on management of the incident - invoke the Departmental Public HealthEmergency Plan Convene and Chair Local Outbreak Control Team, in consultation with hospital where patient is beingmanaged. Team should include Admitting/ID physician, hospital occupational health, hospital infectionteam, microbiology, communications person, representative from HPSC, and/or National Director HealthProtection. OCT to meet regularly to manage situation: case, contacts, infection control, patient transfer,epidemiological and laboratory investigation, public perceptions of risk etc. Assign media spokespersons. Link with the National Public Health Outbreak Response Team (NPHORT), and the National IHR FocalPoint( NFP) at HPSC Prepare regular briefing reports for the NFP and WHO Debrief and review procedures, write the reportContact tracing Identify the type of VHF, and from this any possibility of potential airborne spread (see Table 1 andAppendix C) Determine if the patient has/had acute respiratory symptoms with intense coughing or sneezing prior todiagnosis. Trace the movements of the patient for up to 3 weeks prior to onset of illness with a view to establishingthe source of infection and preparing a list of all contacts who are at risk of developing the disease Identify and interview all potential contacts using a standardised form (Appendices K and L) and assign arisk category to these potential contacts. [Note: If the VHF can be spread via aerosol, and/or the patienthad acute respiratory symptoms, this will then affect the type of surveillance needed – may need toexpand contact tracing to include those who shared the same airspace].Surveillance of close/low risk and high risk contacts (non- airborne VHF) Follow Table 13 There is no need for restriction on work or movement within Ireland unless they suffer a rise in temperatureabove 38 O C at which time they should be immediately isolated and treated as a potential VHF patient The close/low-risk and high-risk contact should not donate blood when under surveillanceAppendix O: VHF Checklists of actions for Director of Public Health The Management of Viral Haemorrhagic Fevers in Ireland/HPSC 2012Chemoprophylaxis (Lassa fever or CCHF) Consider Ribavirin for post-exposure prophylaxis for high-risk contacts of patients with Lassa fever orCCHF – experience is limited.- 115 -
Appendix P:Campus Map, Mater Misericordiae University Hospital, DublinAA: Ambulance entrance to NIU (corner of Eccles Street and Berkley Road)B: Ward BlockC: Accident and Emergency; Out-patients departmentD: Mater Private HospitalCBDSource: OpenStreetMapsAppendix P: Campus Map, Mater Misericordiae University Hospital, Dublin The Management of Viral Haemorrhagic Fevers in Ireland/HPSC 2012- 116 -
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The Management ofViral Haemorrhagic
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3.5 Infection prevention and contro
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The Viral Haemorrhagic Fever Sub-Co
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• As soon as VHF is being conside
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BackgroundIntroductionViral haemorr
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The search strategy for these guide
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1.3 Overview of VHFsVHFs share a nu
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1.6 Marburg haemorrhagic feverMarbu
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1.9 FlavivirusesThe flaviviruses ca
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1.10 Requirement to notify VHF to t
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Table 3. Clinical presentation of C
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Patient Risk Assessment Key Points
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2.4 Initial management of patient c
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If the malaria test is positive:•
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3. Infection Prevention and Control
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- All acute hospitals should have a
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- For larger spills, cover the area
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3.8 Handling human remainsThe gener
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4.3 Packaging and transport of biol
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4.5 Laboratory testing for High Ris
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5. Public Health Management of Impo
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In the case of suspected Lassa feve
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Box 1Risk CategorisationCasual/no-r
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5.4.4 Management of contactsThis is
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5. Public Health Management of Impo
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Figure 3 Summary of notification pr
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should be identified in a bid to av
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The procedure for cleaning and disi
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Page 67 and 68: References1. Scientific Advisory Co
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Page 77 and 78: coughing. They advise that the stag
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Page 95 and 96: Malaria Test Results:Malaria test 1
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Page 99 and 100: VHF Case Exposure Assessment & Cont
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Page 103 and 104: Total number of contactsVHF Case Ex
Page 105 and 106: Category of worker:CleanerDoctorIf
Page 107 and 108: Relationship to case:PassengerIf ot
Page 109 and 110: Are you currently well?Have you fev
Page 111 and 112: VHF High Risk Contact Surveillance
Page 113 and 114: VHF High Risk Contact Surveillance
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