Download Infection Control Updates: Three-level Response Alert System

Three-level Response Alert
System &
Infection Control in the
Community
Dr Rodney Lee
Clinical Microbiology and Infection
Pamela Youde Nethersole Eastern Hospital
Framework of Government’s
Preparedness Plan for Influenza
Pandemic
Health Welfare and Food Bureau
February 2005
Hong Kong Government
Response Systems
• Three-level
response
system
have been based on risk-graded
epidemiological scenarios
• 1. Alert Response Level
• 2. Serious Response Level
• 3. Emergency Response Level
Alert Response Level
• HPAI in poultry outside HK
• HPAI in HK •
•
•
•
•
1.
2.
3.
4.
5.
quarantined imported birds
wild birds
recreational parks
pet shops
natural environment
• Human cases of HPAI outside HK
Serious Response Level
• HPAI outbreaks in HK poultry in
• 1. retail markets
• 2. wholesale markets
• 3. Farms
• Human cases in HK without
evidence of efficient human-tohuman transmission
Emergency Response
Level
• Efficient
human-to-human
transmission of novel influenza
• Pandemic influenza - the strain is
causing
several
outbreaks
a
country, and spread to other
Human transmission of Avian Flu
人類感染禽流感的途徑
countries
Source: Next Magazine
GUIDELINES ON INFECTION CONTROL
PRACTICE
Serious Response Level or
Emergency Response Level
Incorporation of droplet and contact
precautions in standard
practice
• Surgical mask must be worn in clinic areas.
Incorporation of droplet and contact
precautions in standard
practice
• (c) Handwashing is mandated after
each patient contact
• (d) Protective clothing, for example,
white coat, or gown should be worn in
clinic areas within the designated clinic
boundary.
Precaution focusing on
patients/clients
• Advising all patients/clients specifically
requiring those with respiratory
signs/symptoms or fever to wear
surgical mask
Patient triage
• (i) Patients asked to self-identify if high risk.
• (ii) A client at higher risk of infection must
wear a surgical mask and the consultation
should be in a designated room.
• (iii) N95 mask, gloves, goggles and protective
clothing should be worn during high risk
procedures.
Designated room
• (a)Good ventilation and preferably separate
hand washing facilities.
• (b) Avoid aerosol-generating procedure.
Designated room
• (c) Wastes should be placed in waste
bags, which are tied and put in covered
containers for disposal in the normal
channels.
• (d) Contaminated PPE and other items
should not be brought into non-clinic
areas.
Following the care of a patient
suspected with or known to
have novel influenza
• (a) The area should be closed for
disinfection as soon as possible.
• (b) Consultation area/equipment should
be disinfected with 1:49 household
bleach (or 70% alcohol for metallic
surfaces).
Thank You
Alert Response Level
Medical Services
• Stockpile medications for public
hospitals and clinics. (HA)
• Formulate clinical management
guideline. (HA)
• Monitor bed occupancy, and review
mobilization/compliance with admission
guidelines.
• Assess and plan for scaling down nonemergency activities. (HA)
Serious Response Level
Essential medical services
• Set up designated clinics and
protocol for triaging patients with
influenza-like illness at primary
care level. (HA)
• Isolate and treat confirmed cases in
designated hospitals. (HA)
Serious Response Level
Essential medical services
• Update / revise clinical guidelines
on management/admission criteria
for various specialties.
• Reduce non-urgent and nonemergency services. (HA)
• Discussion with private hospitals on
patients transfer/diversion/sharing
workload. (HA)
Emergency Response Level
Essential medical services
• Additional hospitals for isolation
• Further re-organize or reduce nonurgent services
• Mobilize convalescent
hospitals/wards and private sector
to increase capacity to treat acute
cases
Emergency Response Level
Essential medical services
• Updated guidelines and protocols
• Mobilize more designated clinics
and centres in collaboration with
the private sector and voluntary
agencies
• Review and update protocols on
research projects