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

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ContentsThe Viral Haemorrhagic Fever Sub-Committee 4Acknowledgements 5Foreword 6Recommendations 7Background 10Introduction 10Purpose and Scope 10Methods 111. Introduction 131.1 What are viral haemorrhagic fevers? 131.2 The need for new guidance 131.3 Overview of VHFs 141.4 Ebola haemorrhagic fever 141.5 Lassa fever 151.6 Marburg haemorrhagic fever 161.7 Crimean-Congo haemorrhagic fever 161.8 Other Old-World and New-World arenaviruses 171.9 Flaviviruses 181.10 Requirement to notify VHF to the World Health Organization under the International HealthRegulations, 2005 201.11 Establishment and role of National Isolation Centres 201.12 Web resources 202. Clinical Assessment, Risk Categorisation and Initial Management 212.1 Introduction 212.2 Clinical presentation 212.3 Assessment of sick travellers for potential Viral Haemorrhagic Fever 232.4 Initial management of patient categorised as High Risk 262.5 Initial management of patient categorised as At Risk 272.6 Patient transfer 282.7 Differential diagnosis 282.8 Clinical case management 29Contents The Management of Viral Haemorrhagic Fevers in Ireland/HPSC 20123. Infection Prevention and Control Guidance 303.1 Introduction 303.2 Mode of transmission 303.3 Incubation period and infectivity 313.4 Initial assessment 31- 1 -
3.5 Infection prevention and control precautions for managing a patient categorised as At Riskof VHF 323.6 Infection prevention and control precautions for managing a patient categorised as High Riskof VHF 343.7 Infection prevention and control precautions for managing a patient with Confirmed VHFpending transfer to the NIU, Mater Misericordiae University Hospital 383.8 Handling human remains 424. Laboratory Diagnosis of Viral Haemorrhagic Fever Viruses 434.1 Introduction 434.2 Collection of clinical specimens 434.3 Packaging and transport of biological specimens 444.4 Laboratory testing for At Risk patients 444.5 Laboratory testing for High Risk patients 464.6 Reporting of results 464.7 Disposal of residual blood samples 464.8 Contact information 475. Public Health Management of Imported VHF 485.1 Irish guidelines 485.2 Notification of a potential case 485.3 Actions to be taken by the DPH/MOH once notified of a High Risk possible case 495.4 Actions by DPH/MOH once case is Confirmed 505.5 Preparedness activities 576. Transport of Infected Patients 596.1 Introduction 596.2 Preparation of the ambulance and crew 596.3 At the pick-up location 606.4 En-route to hospital 616.5 On arrival at the hospital 616.6 Decontamination and disinfection 616.7 Post-transportation procedures 62Contents The Management of Viral Haemorrhagic Fevers in Ireland/HPSC 20127. VHF in the Context of Bioterrorism 637.1 Introduction 637.2 Which VHFs? 637.3 Outbreaks/cases due to deliberate release 637.4 Key medical and public health interventions after identification of a suspected index case of VHF 647.5 Recommendations for ribavirin therapy in patients with clinically evident VHF of unknownaetiology or secondary to arenaviruses or bunyaviruses 65- 2 -
Page 1: The Management ofViral Haemorrhagic
Page 5: The Viral Haemorrhagic Fever Sub-Co
Page 9 and 10: • As soon as VHF is being conside
Page 11 and 12: BackgroundIntroductionViral haemorr
Page 13 and 14: The search strategy for these guide
Page 15 and 16: 1.3 Overview of VHFsVHFs share a nu
Page 17 and 18: 1.6 Marburg haemorrhagic feverMarbu
Page 19 and 20: 1.9 FlavivirusesThe flaviviruses ca
Page 21 and 22: 1.10 Requirement to notify VHF to t
Page 23 and 24: Table 3. Clinical presentation of C
Page 25 and 26: Patient Risk Assessment Key Points
Page 27 and 28: 2.4 Initial management of patient c
Page 29 and 30: If the malaria test is positive:•
Page 31 and 32: 3. Infection Prevention and Control
Page 33 and 34: 3.5 Infection prevention and contro
Page 37 and 38: - All acute hospitals should have a
Page 41 and 42: - For larger spills, cover the area
Page 43 and 44: 3.8 Handling human remainsThe gener
Page 45 and 46: 4.3 Packaging and transport of biol
Page 47 and 48: 4.5 Laboratory testing for High Ris
Page 49 and 50: 5. Public Health Management of Impo
Page 51 and 52: 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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1. covert release of a biological a
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References1. Scientific Advisory Co
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55. Department of Health and Childr
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Appendix A: Search Strategies for V
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Appendix C: Published Reports on Re
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available 24 hours a day to answer
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coughing. They advise that the stag
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This was the first highly pathogeni
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Appendix D: Annex 2: Decision Instr
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Has the patient...Clinical Risk Ass
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Appendix G: Summary of VHF Risk Cat
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longer thus increasing the risk of
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In April 1990, CDC reported on filo
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24. CDC Special Pathogens Branch. K
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Appendix J: VHF Risk Assessment for
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Malaria Test Results:Malaria test 1
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Port of Arrival:Name:Via:Arrived by
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VHF Case Exposure Assessment & Cont
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Healthcare workers:1234567891011121
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Total number of contactsVHF Case Ex
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Category of worker:CleanerDoctorIf
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Relationship to case:PassengerIf ot
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Are you currently well?Have you fev
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VHF High Risk Contact Surveillance
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VHF High Risk Contact Surveillance
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Appendix O:VHF Checklists of action
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Appendix P:Campus Map, Mater Miseri
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