Health Protection and iGAS Outbreak

Question 1

What is public health England and what is their mission?

Answer 1

Exits to protect/ improve nations health & wellbeing & reduce health inequalities

Through advocacy/ partnerships/ world class science/ knowledge/ delivery specialist public health services

Question 2

Three domains of public health

Answer 2

Health improvement (inequalities, education, housing, employment, family, lifestyle, survellience and monitoring specific diseases)

Health protection (infectious diseases, chemicals and poisons, radiation, emergency response and preparedness, environmental health hazards. Prevention)

Healthcare public health (clinical effectiveness, efficiency, audit and evaluation, clinical governance, equity)

Question 3

How are notfiable diseases (NoIDS) identified?

Answer 3

Clinical suspicion if urgent

Confirmatory diagnosis if not urgent

Microbiology and virology

Notifications:
Telephone urgent, online surveillance or notification systems, fax, PHE notification form

From: primary care, CCG, education, care homes, microbiology, water services, environmental health officers -> ARCs

Question 4

How can you get streptococcus pyogenes/ GAS? What can it cause? How is it typed?

Answer 4

Humans host, can survive on fomites (curtains, bedding)

Cellulitis, necrotising fasciitis, myositis

Invasive group A streptococcus

Types by variation in M protein

20% fatality rate

Question 5

How to control NOIDS?

Answer 5

Identify close contacts
Chemoprophylaxis
Environmental sampling & cleaning
Disseminate sampling including symptomology
Professional information
Quarantine

Question 6

What does it mean to be homeless and a rough sleeper?

Answer 6

Homeless - not having a home e.g. without shelter, hostels, shelters, refuges, temp circumstances, threatened with eviction, unfit housing, extreme overcrowding

Rough sleepers - sleeping in open air, buildings not designed for habitation

Question 7

Steps to investigate an outbreak

Answer 7

1. Establish case definition
2. Confirm cases are real
3. Determine background rate
4. Case finding
5. Describe cases
6. Plot epidemic curve
7. Generate hypothesis
8. Test hypothesis
9. Generate conclusions

Question 8

Who’s involved in the outbreak control team?

Answer 8

PHE East Midlands health protection team

PHE field service

PHE communications

City council

Housing/ hostel provider

Homelessness charity

Primary care street outreach nursing service

Police