Outbreak management Flashcards
how can an outbreak or incident be defined as?
an incident in which two or more people experiencing a similar illness are linked in time or place
a greater than expected rate of infection compared with the usual background rate for the place and time where the outbreak has occurred
a single case for certain rare diseases such as diphtheria, botulism, rabies, viral haemorrhagic fever or polio
a suspected, anticipated or actual event involving microbial or chemical contamination of food or water
what are common outbreaks?
Gastroenteritis (usually viral caused by Norovirus)
Clostridium difficile infection (CDI)
Methicillin resistant Staphylococcus aureus (MRSA)
Multi-resistant gram negative bacilli
Influenza / other respiratory illnesses
what makes up the Problem Assessment Group (PAG) & Incident Management Team (IMT)?
NHS board chair (usually a CPH(M))
Health Protection Nurse Specialist
Local authority Environmental Health Officer
Specialist with expertise in the detection and characterisation of the hazardous agent involved in the incident e.g. a consultant microbiologist, public analyst
Infection Control Doctor and Infection Prevention and Control Team representative, if appropriate
Appropriate Health Protection Scotland/Public Health Scotland representation
Corporate communications officer
Administrative support
SGHSCD representative (e.g. Senior Medical Officer or policy officer) may attend in an observer capacity
what is a point source?
single person, ie food handler
what is a continuous common source?
ongoing contamination ie water source
what is propagated source?
person to person spread
what should a case definition include?
the people involved (patients, staff, visitors);
the pathogen (SARS-CoV-2);
the place (the ward and hospital);
a time period (commencing 48 hours prior to index case symptom onset or positive test if asymptomatic
what are 3 case categories?
Confirmed – patient has predetermined signs and symptoms or positive lab test
Probable - patient has predetermined signs and symptoms or close contact
Possible – patient has one or few predetermined signs and symptoms
what would a confirmed case of COVID entail?
A laboratory confirmed detection of SARs-CoV-2 by polymerase chain reaction (PCR) in a clinical specimen.
what would a probable COVID case entail?
A person with a positive lateral flow device (LFD) test for COVID-19
what would a possible COVID case entail?
A person presenting recent onset of one or more of the following cardinal COVID-19 symptoms:
new continuous cough
fever/temperature ≥37.8°C
Loss of, or change in, sense of smell (anosmia) or taste (ageusia)
who should be notified in the scenario of a positive case?
It is essential that NHS Boards have systems in place to ensure that laboratory confirmed cases of SARS-CoV-2 isolated from patients are reported to Infection Prevention and Control Teams (IPCTs) as promptly as possible to allow any inappropriately placed patients to be identified and isolated
Reporting systems should also be in place to alert the relevant teams of any positive staff cases. There must be a robust and clear process in place for recording and communication of results to staff members
what is the Criteria to declare a COVID-19 cluster/incident in an inpatient setting?
Two or more patient and/or staff cases of COVID-19 within a specific setting where nosocomial infection and ongoing transmission is suspected. For the purposes of this reporting, a high degree of suspicion should be applied and should be completed for any ward on the non-respiratory pathway where there are unexpected cases of suspected or confirmed COVID-19. e.g. any cases that were not confirmed or suspected on admission. No time limit should be applied to determining whether a case is nosocomial e.g. 48 hours.
On the respiratory pathway where two or more staff cases of suspected or confirmed COVID-19 are identified.
what is the Criteria to determine that a COVID-19 cluster/incident in an inpatient setting has ended?
No new test-confirmed or suspected cases with illness onset date 10 days following the last new confirmed case (from date of symptom onset or date of positive test if case has remained asymptomatic), within the affected ward or department.
