Infectious diseases & food poisoning
If a case of infectious disease is suspected by the nursing staff who are receiving patients:
- The patient should be isolated in a cubicle as early as possible
- The ED SHO should be called to examine the patient at once
- The appropriate hospital routine for isolation and/or barrier nursing of all suspected cases, until proven negative, should be followed.
Notification of cases of listed notifiable diseases and food poisoning is a statutory obligation and is the responsibility of the doctor who assumes clinical responsibility for the patient. He must notify:
- Tthe appropriate Community Physician (by telephone)
- The control of Infection Officer (by telephone)
- Public Health, by completing the standard notification form within 24 hours of diagnosis.
Notifiable Infectious Diseases
A doctor who suspects that a patient is suffering from one of the notifiable diseases listed below must notify the ept. of Public /health. Formal notification is by sending a notification form. However diseases (such as acute meningitis) which may require urgent community health action should be communicated to the Public Health Doctor on-call by telephone:
- Acute anterior poliomyelitis (Polio virus)
- Acute infectious gastroenteritis
- Ano-genital warts
- Anthrax (Bacillus anthracis)
- Bacillus cereus food-borne infection/intoxication (B. cereus)
- Bacterial meningitis (not otherwise specified)
- Botulism (Clostridium botulinum)
- Brucellosis (Brucella sp.)
- Campylobacter infection (Campylobacter sp.)
- Chancroid (Haemophilus ducreyi)
- Chlamydia trachomatis infection (genital) (C. trachomatis)
- Cholera (Vibrio cholerae)
- Clostridium difficile assocaited disease (CDAD)
- Clostridium perfringens (type A) food-borne disease (C. perfringens)
- Creutzfeldt Jakob disease nv Creutzfeldt Jakob disease
- Cryptosporidiosis (Cryptosporidium parvum)
- Diphtheria (Corynebacterium diphtheriae)
- Echinococcosis (Echinococcus sp.)
- Enterococcal bacteraemia (Enterococcus sp. (blood))
- Enterohaemorrhagic Escherichia coli (E. coli of serogroup known to be toxin producing)
- Escherichia coli infection (invasive) (E. coli (blood, CSF))
- Giardiasis (Giardia lamblia)
- Gonorrhoea (Neisseria gonorrhoeae)
- Granuloma inguinale
- Haemophilus influenzae disease (invasive) (H. influenzae (blood, CSF or other normally sterile site))
- Hepatitis A (acute) (Hepatitis A virus)
- Hepatitis B (acute and chronic) (Hepatitis B virus)
- Hepatitis C (Hepatitis C virus)
- Herpes simplex (genital) (Herpes simplex virus)
- Influenza (Influenza A and B virus)
- Legionellosis (Legionella sp.)
- Leptospirosis (Leptospira sp.)
- Listeriosis (Listeria monocytogenes)
- Lymphogranuloma venereum
- Malaria (Plasmodium falciparum, vivax, ovale, malariae)
- Measles (Measles virus)
- Meningococcal disease (Neisseria meningitidis)
- Mumps (Mumps virus)
- Non-specific urethritis
- Noroviral infection (Norovirus)
- Paratyphoid (Salmonella paratyphi)
- Pertussis (Bordetella pertussis)
- Plague (Yersinia pestis)
- Q Fever (Coxiella burnetii)
- Rabies (Rabies virus)
- Rubella (Rubella virus)
- Salmonellosis (Salmonella enterica)
- Severe Acute Respiratory Syndrome (SARS-associated coronavirus)
- Shigellosis (Shigella sp.)
- Smallpox (Variola virus)
- Staphylococcal food poisoning (Enterotoxigenic Staphylococcus aureus)
- Staphylococcus aureus bacteraemia (S. aureus (blood)
- Streptococcus group A infection (invasive) (S. pyogenes (blood, CSF or other normally sterile site)
- Streptococcus pneumoniae infection (invasive) (S. pneumoniae (blood, CSF or other normally sterile site)
- Syphilis (Treponema pallidum)
- Tetanus (Clostridium tetani)
- Toxoplasmosis (Toxoplasma gondii)
- Trichinosis (Trichinella sp.)
- Trichomoniasis (Trichomonas vaginalis)
- Tuberculosis (Mycobacterium tuberculosis complex)
- Tularemia (Francisella tularensis)
- Typhoid (Salmonella typhi)
- Typhus (Rickettsia prowazekii)
- Viral encephalitis
- Viral meningitis
- Viral haemorrhagic fevers (Lassa virus, Marburg virus, Ebola virus, Crimean-Congo haemorrhagic fever virus)
- Yellow Fever (Yellow Fever virus)
- Yersiniosis (Yersinia enterocolitica, Yersinia pseudotuberculosis)
Infection Control
Advice on general control of infection is available from the Infection Control Nurses or from the on-call Medical Microbiologist (out of hours).
- Universal precautions (Standard Infection Control Practice)
- Disease-specific precautions to prevent spread of infection
- Decontamination of equipment
- Patient infestations
- Staff contact with infectious disease
Septicaemia
- Consider source
- Take Blood Cultures
- Culture whatever else is available (ie sputum, urine, wounds, stool)
- If intra-abdominal source: Ampicillin 1g iv qds PLUS Gentamicin 4 mg/kg iv od PLUS Metronidazole 400 mg iv tds
- Source unknown:ceftriaxone 2g Bd PLUS Gentamicin 4mg/kg iv od
