Download 32 Isolation Methods For Individual Diseases

Title
Document Type
Infection Control Manual
Section 3.2 – Isolation Methods for Individual
Diseases
Policy
Document Number
IPCT001/02
Version Number
3rd Edition
Approved by
Infection Control Committee
Issue date
December 2010
Review date
March 2015
Distribution
All NHS Borders Staff
Prepared by
Infection Prevention Control Team
Developed by
Infection Prevention Control Team
Equality & Diversity
Impact Assessed
No
3.2 ISOLATION METHODS FOR INDIVIDUAL DISEASE
Below is a table of possible diseases/infectious agents, together with a note of methods of minimising spread of infection.
There may be others which do not appear on the list, please seek advice form the Infection Prevention Control Team
CPHM = Consultant in Public Health Medicine
IPCT = Infection Prevention Control Team
If you suspect that a patient has an infectious condition, please notify a member of the Infection Prevention Control
Team immediately
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
AIDS
Adenovirus (Respiratory)
INCUBATION
PERIOD
4-12 days
Droplet & Contact
Amoebiasis
2-4 weeks
Standard
Precautions
Anthrax
1-7 days:
pulmonary
1-60 days:
Cutaneous
Standard
Precautions
IPCT001/02
Issue Date: December 2010
PRECAUTIONS
REQUIRED
Contact
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
Single
Room/Cohort
See remarks
2 negative NPA if
under two years
Single room –
consider transfer to
ID unit
On advice of IPCT
UNCONTROLLED WHEN PRINTED
ADDITIONAL REMARKS
See HIV
Spread Droplet and
Contact
Single Room only
required if patient
hygiene is poor
Bacillus anthracis:
Notifiable organsism
Anthrax:
Notifiable disease
See Appendix 1
Review Date: March 2015
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Antibiotic associated
colitis
Aspergillosis
Bordetella pertussis
β-haemolytic
Streptococci
Group A (Strep.
Pyogenes)
Group B
Burkholderia cepacia
Burkholderia
(Pseudomonas) mallei
Burkholderia
(Pseudomonas)
pseudomallei
Campylobacter
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
Up to 8
weeks
Enteric & contact
Single room source
isolation
Days to
weeks
Standard
Precautions
Open Ward
Not
applicable
Contact
Single Room
Not
applicable
Contact
Single Room /
cot/incubator for
neonates
PRECAUTIONS TO
BE LIFTED
48hrs after
diarrhoea stops
and patient has
passed a formed
stool
Not applicable
See also Clostridium
difficile
See Whooping Cough
48hrs correct
antibiotics
1-14 days
Contact
Single Room
On advice of IPCT
2 daysmonths
Standard
Precautions
Open Ward
On advice of IPCT
1-10 days
Enteric & Contact
Single Room source
isolation
48hrs after
diarrhoea has
stopped
IPCT001/02
Issue Date: December 2010
ADDITIONAL REMARKS
See Pneumonia
Notifiable Disease
3
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Chickenpox see also
Herpes zoster/shingles
INCUBATION
PERIOD
12-21 days
PRECAUTIONS
REQUIRED
Respiratory and
Contact
ACCOMMODATION
Single room source
isolation
PRECAUTIONS TO
BE LIFTED
When last vesicle
crop dry. Patients
are infectious from
day 10 to day 21
post exposure
Cholera
Hours-5 days
Enteric & Contact
Single room
consider transfer to
ID ward/ID unit
3 negative stool
cultures at least
24hrs apart
Clostridium difficile
Not
applicable
Enteric & Contact
Single room source
isolation
48hrs after
diarrhoea stops
and patient has
passed a formed
stool
IPCT001/02
Issue Date: December 2010
ADDITIONAL REMARKS
KEEP DOOR CLOSED
Risk to non-immune
pregnant staff.
Notifiable Disease:
See Appendix 1
See Chickenpox Policy
Notifiable disease
See Appendix 1
Refer also to enteric
precautions, Section
3.4
If relapse occurs
reinstate precautions
and inform IPCT.
See C.difficile Policy
Room must be subject
to a terminal clean
even if asymptomatic
patient remains in situ
4
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Conjunctivitis (neonatal)
Gonococcal /
Chlamydial
Adenoviral
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
4-12 days
Contact
Not
applicable
2-5 days
ADDITIONAL REMARKS
Conjunctival
secretions infectious
After 24hrs
antibiotics
When symptoms
settle
Standard Precautions
Open Ward
Not Applicable
Droplet
On advice of
IPCT/ID Physician
Notifiable disease
See Appendix 1
3-6 days
Contact
15mths-30yrs Standard Precautions
Single room
consider transfer to
ID ward/ID unit
Open Ward
Open Ward
On Discharge
Cryptococcosis
Unknown
Standard Precautions
Open Ward*
On Discharge
Cryptosporisiosis
1-21 days
Enteric & Contact
Single room –
consider transfer to
ID unit
On Discharge
See CJD Policy
See respiratory
infections in infants
and young children
*If immunocompromised may
need protective
isolation
Risk to Immunocompromised
patients.
See enteric
precautions policy
Corynebacterium
diphtheriae [toxigenic
strain]
Coxsackievirus
Creutzfelt Jakob Disease
Croup
Contact
PRECAUTIONS TO
BE LIFTED
Single room source
isolation
Single room source
isolation
Other
2-7 days
ACCOMMODATION
IPCT001/02
Issue Date: December 2010
Conjunctival and
nasal secretions may
be infectious
5
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
INCUBATION
CONDITION OR
PERIOD
INFECTING AGENT
Cytomegalovirus (CMV) 3-8 weeks
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Standard Precautions
Open Ward
On Discharge
Single room source
isolation
48 hours clear of
symptoms
See
Corynebacterium
diphtheriae
On advice of
IPCT
On advice of
IPCT
Immunocompromised patients
may excrete virus in
urine. Risk to pregnant
staff, Infants with
congenital CMV shed
vast quantities of virus
in their respiratory
secretions and urine
Diarrhoea of unknown
origin
Diphtheria
Not
applicable
Enteric & Contact
Dysentery
Amoebic
Shigella (bacillary)
2-4 weeks
Enteric & Contact
8hrs-7days
Enteric & Contact
IPCT001/02
Issue Date: December 2010
Single room source
isolation
Single room source
isolation
Notifiable disease
See Appendix 1
Shigella genus
Notifiable organism
See Appendix 1
6
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Erysipelas (GP A Strep
Streptococcus
pyogenes)
E. coli gastro-enteritis
Enterohaemorrhagic
Gas gangrene
German measles
Giardiasis
multi drug resistant
gram negative
organisms
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
1-3 days
Contact
Single room source
isolation
48hrs correct
antibiotics
3-8 days
Enteric & Contact
Single room source
isolation
Not
applicable
Standard Precautions
Open Ward
48hrs after return
of normal bowel
habit.
Note: there are
specific
occupational
exclusions – see
advice from IPCT
Not applicable
5-28 days
Enteric & Contact
Single room source
isolation
n/a
Standard precautions
with attention to the site
of infection or
colonisation e.g.
wound, catheter urines,
sputum
Single room source
isolation
IPCT001/02
Issue Date: December 2010
On discharge or
following >48
hours free of
symptoms
Discuss with IPCT
ADDITIONAL REMARKS
Gastro-enteritis/
clinical syndrome E.
coli O157/VTEC (not
UTI or wound infection)
Notifiable organism
See Appendix 1
See Rubella
7
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Glandular Fever
(Infectious
mononucleosis)
Hand, foot and mouth
disease
(coxsackie A)
Hepatitis A
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
4-6 weeks
Standard Precautions
Open Ward
3-5 days
Enteric & Contact
Single room source
isolation
On advice of
IPCT
15-50 days
Enteric & Contact
Single room source
isolation
Notifiable organism
See schedule 1 of
Public Health Act 2008
Hepatitis B
(inc HBeAg positive)
45-180 days
Standard Precautions
Single Room if
bleeding. Renal
units please check
with IPCT
After 2 weeks
illness 7 days
after onset of
jaundice
On discharge
Hepatitis C
14-80 days
Standard Precautions
Single Room if
bleeding. Renal
units please check
with IPCT
On discharge
Notifiable organism
See Appendix 1
IPCT001/02
Issue Date: December 2010
Notifiable organism
See Appendix 1
8
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Hepatitis E
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
15-64 days
Enteric & Contact
Single room source
isolation
After 2 weeks
illness
Notifiable organism
See Appendix 1
Herpes simplex (coldsore)
2-12 days
Standard Precautions
Open Ward
Not applicable
Herpes zoster (See
Shingles)
HIV
Not
applicable
1-3 mths
Risk to the
eczematous, the
immuno-suppressed
and to neonates
Standard Precautions
See remarks
On discharge
Impetigo
Not
applicable
Contact
Single room source
isolation
48hrs correct
antibiotics
See Blood and body
fluid precautions; no
isolation required,
unless one/more of
the following:
Profuse or
uncontrolled bleeding
Open drains
Incontinent
Diarrhoea/vomiting
Unconscious
IPCT001/02
Issue Date: December 2010
9
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Influenza
1-3 days
Legionnaire’s Disease
Leptospirosis
Lice
Head
Body
Pubic
INCUBATION
PERIOD
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Droplet
Single room source
isolation
Influenza virus
Notifiable organism
See Appendix 1
Refer to respiratory
precautions, Section
3.5
2-10 days
Standard Precautions
Open Ward
Usually after 7
days; in the
absence of fever
and/or other
respiratory
symptoms for
more than 24
hours
Not applicable
4-19 days
Standard Precautions
Open Ward
Not applicable
Leptospira genus
Notifiable organism
See Appendix 1
Not
applicable
Not
applicable
Not
applicable
IPCT001/02
Issue Date: December 2010
PRECAUTIONS
REQUIRED
Standard Precautions
Open Ward
Standard Precautions
Open Ward
Standard Precautions
Open Ward
Standard
precautions will
still apply
After successful
Treatment
After successful
Treatment
[Consider referral
to GUM service]
Legionella genus
Notifiable organism
See Appendix 1
See Head Lice Policy
Ensure clothing is
laundered and ironed
Ensure clothing is
laundered and ironed
10
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Listeriosis
INCUBATION
PERIOD
3-70 days
Lyme disease
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Enteric & Contact
Single room source
isolation
On advice of
IPCT
3-32 days
Standard Precautions
Open Ward
Not applicable
Listeria
monocytogenes
Notifiable organism
See Appendix 1
May be open ward if
stool, or discharges
negative
Borrelia burgdorferi
Notifiable organism
See Appendix 1
Malaria
Strain
dependent
Standard Precautions
Open Ward
On advice of
IPCT
Plasmodium spp
Notifiable organism
See Appendix 1
Measles
7-14 days
Droplet & Contact
Single room source
isolation
4 days after
onset of rash
Notifiable disease
See Appendix 1
TRUE AIRBRONE
INFECTION – KEEP
DOOR CLOSED
IPCT001/02
Issue Date: December 2010
11
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Meningitis
Meningococcal
(known or suspected)
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
After 24 hours
appropriate
therapy
2-10 days
Droplet & Contact
Single room source
isolation
Meningitis
Pre-organism
identification
Not
applicable
Droplet & Contact
Single room source
isolation until
confirmed nonmeningococcal
Meningococcal
septicaemia
(known or suspected)
2-10 days
Droplet & Contact
Single room source
isolation
IPCT001/02
Issue Date: December 2010
After 24 hrs
appropriate
therapy
ADDITIONAL REMARKS
Neisseria meningitides
Notifiable organism
Meningococcal
disease:
Notifiable disease
See Appendix 1
Only patients with
meningococcal
meningitis require a
single room. For all
other causal
organisms including
viral, Standard
Precautions apply
Neisseria meningitides
Notifiable organism
Meningococcal
disease:
Notifiable disease
See Appendix 1
12
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Meticillin Resistant
Staphylococcus Aureus
(MRSA)
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Usually 3
negative sets of
swabs at least 1
week apart
9 days after
symptom onset
Discuss with IPCT
48hrs correct
antibiotics
See Strep. pyogenes
48 hrs after
symptoms stop
Norovirus:
Notifiable disease
See Appendix 1
Not
applicable
Contact
Single room source
isolation
Mumps
15-18 days
Droplet
Single room source
isolation
Necrotising enterocolitis
Not
applicable
Not
applicable
Standard Precautions
Open Ward
Contact
Single room source
isolation
6-72 hrs
Enteric/Contact/Droplet Cohort/Single room
source isolation
Necrotising fasciitis
[due to Streptococcus
pyogenes]
Norovirus
Norwalk like virus Viral
gastroenteritis
Orf
3-6 days
IPCT001/02
Issue Date: December 2010
Standard Precautions
Open Ward
Mumps virus:
Notifiable organism
Mumps disease:
Notifiable disease
See Appendix 1
Aerosolisation of the
virus may occur during
vomiting
See Last Offices SOP
13
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Paratyphoid fevers
INCUBATION
PERIOD
3-28 days
Parvovirus B19
4-20 days
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
Enteric & Contact
Single room source
isolation
Droplet
Single room source
isolation
48 hours after
Notifiable disease
symptoms cease See Appendix 1
Occupational
exclusion may
be an issue
Duration of illness
Pediculosis (see lice)
Pneumocystis
Pneumonia
Atypical
Burkholderia cepacia in
cystic fibrosis patients
Bronchopneumonia
Chlamydia
pneumoniae
Legionellosis
Multi-drug resistant
organism
ADDITIONAL REMARKS
Standard Precautions
6-32 days
Unknown
Standard Precautions
Standard precautions
Open Ward
Side Room
1-3 days
Unknown
Standard Precautions
Standard Precautions
Open Ward
Open Ward
2-10 days
Not
applicable
Standard Precautions
Droplet & Contact
Open Ward
Single room source
isolation
IPCT001/02
Issue Date: December 2010
Not applicable
On advice of
IPCT
Not applicable
Not applicable
Not applicable
Duration of illness
Avoid nursing with
other cystic patients
If ventilated take
care with
condensate from
ventilator i.e. wear
gloves and wash
hands when
emptying
14
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Mycoplasma
Pneumococcal (lobar)
Staphylococcal
S. pyogenes
S. pneumoniae
penicillin resistant
S. pneumoniae
penicillin sensitive
Poliomyelitis (acute)
Pseudomembranous
colitis
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
6-32 days
1-3 days
Not
applicable
Droplet
Standard Precautions
Standard Precautions
Not
applicable
1-3 days
Droplet
1-3 days
Standard Precautions
7-14 days
Droplet/Enteric/Contact Single room source
After week 1, faecal
isolation, consider
oral route
transfer to specialist
neurological unit
Droplet
Open Ward
Open Ward
Open Ward
[However, if this is
an MRSA and the
patient is
expectorating, then
Single room source
isolation is required]
Single room source
isolation
Single room source
isolation
Open Ward
Up to 8 wks
IPCT001/02
Issue Date: December 2010
PRECAUTIONS TO
BE LIFTED
ADDITIONAL
REMARKS
Not applicable
Not applicable
Not applicable
48 hrs correct
antibiotics
When negative
specimen 48hrs
correct antibiotics
Not applicable
Virus may be
detected in
faeces for up to 6
weeks
Polio virus:
Notifiable organism
Poliomyelitis:
Notifiable disease
See Appendix 1
See Clostridium
difficile
15
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Psittacosis
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
1-4 wks
Standard Precautions
Puerperal sepsis
Strep. pyogenes
1-3 days
Contact
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL
REMARKS
Open Ward
Coughing patients
to cover mouth
Person to person rare
Single room source
isolation
48hrs correct
antibiotics
Streptococcus
pyogenes [Gp A
Strep] from sterile
space:
Notifiable organism
See Appendix 1
Rabies
Rash undiagnosed
3-8 wks
Not
applicable
IPCT001/02
Issue Date: December 2010
Standard Precautions
Droplet & Contact
Single room source
isolation – consider
transfer to ID unit
On advice of
IPCT
Single room source
isolation
On diagnosis or
after treatment
Maintain precautions if
specimens continue
positive
Rabies virus
Notifiable organism
Rabies:
Notifiable disease
See Appendix 1
Inform IPCT
16
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Respiratory infections in
infants and young
children
Bronchiolitis/Respiratory
syncytial virus infections
in infants, young
children and immunosurppressed
Ringworm
Rotavirus gastroenteritis
Rubella [German
Measles]
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Includes Adenovirus,
Parainfluenza and
Influenza
It may be necessary to
remove some
immuno-compromised
patients to avoid
exposure
See Tinea
(Aerosolisation of the
virus may occur during
vomiting)
Rubella virus:
Notifiable organism
Rubella:
Notifiable disease
See Appendix 1
Pregnant staff should
seek advice from
occupational health
before nursing patient
3-8 days
Droplet & Contact
Single room source
isolation or Cohort
5-8 days
Droplet
Single room source
isolation or Cohort
4-10 days
24-72 hrs
2 Negative NPA
taken 24hrs
apart
On advice of
IPCT in adults or
two negative
NPA’s in the
under 2 year old
Droplet & Enteric
Single room source
isolation or Cohort
On advice of
IPCT
14-17 days
Droplet
Single room source
isolation
7 days after
onset of rash
IPCT001/02
Issue Date: December 2010
17
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Congenital Rubella
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Infants with congenital
rubella syndrome shed
vast quantities of virus
in their respiratory
secretions and urine
See also Typhoid,
Paratyphoid
Not
applicable
Droplet & Contact
Single room source
isolation
On advice of
IPCT
Salmonella species
6-72 hrs
Enteric & Contact
Single room source
isolation
Scabies
2-6 wks
Contact
Single room source
isolation required
for ‘Norwegian’
Scabies [drop
comment in from
scabies policy]
Scalded skin syndrome
Not
applicable
Standard Precautions
Open Ward
48 hours after,
On advice of
IPCT
Completion of
first course of
treatment unless
diagnosed with
‘Norwegian’
Scabies, then
please contact
IPCT for advice
Not applicable
2-6 wks
8hrs-8days
Standard Precautions
Enteric & Contact
Scarlet fever
Schistomosomiasis
Shigella
IPCT001/02
Issue Date: December 2010
See Streptococcus
pyogenes
Open Ward
Single room source
isolation
Not applicable
48 hours
Shigella genus:
On advice of
Notifiable organism
IPCT/ID physician See Appendix 1
18
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Shingles (herpes zoster)
(For immunocompromised treat as
chickenpox)
Staphylococcus aureus
Most strains
MRSA not VISA/VRSA
Streptococcus
pyogenes
(Gp A)
Erysipelas
Tonsillitis
INCUBATION
PERIOD
Not
applicable
Not
applicable
PRECAUTIONS
REQUIRED
Contact
Standard Precautions
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Single room source
isolation until
vesicles dry
When vesicles
dry.
Requires risk
assessment by
IPCT
Non chicken pox
immune staff are also
advised to avoid
contact with patients
Open Ward
Not
applicable
Contact
Single room source
isolation
On advice of
IPCT
1-3 days
Contact
1-3 days
Droplet
Single room source
isolation
Single room source
isolation
48hrs correct
antibiotics
48hrs correct
antibiotics
IPCT001/02
Issue Date: December 2010
Staphylococcus
aureus [all blood
isolates]:
Notifiable organism
See Appendix 1
May need single room
source isolation if
oozing pus
See section 7
19
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Scarlet fever
INCUBATION
PERIOD
1-3 days
PRECAUTIONS
REQUIRED
Droplet
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Single room source
isolation
48hrs correct
antibiotics
Streptococcus
pyogenes [Gp A
Strep] from sterile
space:
Notifiable organism
See Appendix 1
Necrotising fasciitis
Not
applicable
Contact
Single room source
isolation
48hrs correct
antibiotics
Puerperal fever
1-3 days
Contact
Single room source
isolation
48hrs correct
antibiotics
Syphilis [same as H
simplex
Primary or secondary
Syphilis Tertiary or latent
Necrotising fasciitis:
Notifiable disease
See Appendix 1
Streptococcus
pyogenes [Gp A
Strep] from sterile
space:
Notifiable organism
See Appendix 1
10days3mths
Weeks-years
IPCT001/02
Issue Date: December 2010
Standard Precautions
Single Room
Standard Precautions
Single Room if
lesions present
48hrs correct
antibiotics
On advice of
IPCT
20
UNCONTROLLED WHEN PRINTED
Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Tetanus
INCUBATION
PERIOD
3-21 days
PRECAUTIONS
REQUIRED
Standard Precautions
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Open Ward
Not applicable
Notifiable disease
See Appendix 1
Standard Precautions
Open Ward
Not applicable
Standard Precautions
Open Ward
Not applicable
Single Room if severe
Toxic shock syndrome
[see Gp A strep]
Toxocara
Toxoplasmosis
Not
applicable
Not
applicable
Not
applicable
4-10 yrs
10-23days
Single room may be
needed for general
care [see also ‘non
meningococcal
meningitis’]
See Candidiasis
Standard Precautions
Open Ward
Not applicable
Standard Precautions
Standard Precautions
Open Ward
Open Ward
Not applicable
Not applicable
Trichomonas
4-20days
Standard Precautions
Open Ward
Not applicable
Thrush [Candidiasis]
Tinea (fungus infection)
IPCT001/02
Issue Date: December 2010
Toxoplasma gondii
Notifiable organism
See Appendix 1
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DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Tuberculosis –
pulmonary smear
positive
Tuberculosis – multiresistant (suspected or
proven)
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
2-10weeks
for reaction.
Years for
infection
Droplet & Contact
2-10weeks
for reaction.
Years for
infection
IPCT001/02
Issue Date: December 2010
Droplet & Contact
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Single room source
isolation*
After 2 wk
compliant
treatment plus
clinical
improvement
e.g. remaining
afebrile for at
least 48hrs.
TB patients
should not be
removed from
isolation unless
on the advice of
the IPCT
M. tuberculosis & M.
bovis:
Notifiable organisms
Tuberculosis
[respiratory or nonrespiratory]:
Notifiable disease
See Appendix 1
Transfer to
ID unit/ID ward
On advice of
IPCT
Preferably Single room
source isolation
negative pressure for
patients with open
pulmonary TB
As above
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DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Tuberculosis Draining
abscess or cavity e.g.
meningitis
Typhoid/Paratyphoid
Typhoid fever and
carriers
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
2-10 weeks
for reaction.
Years for
infection
Standard Precautions
8-14days
Enteric & Contact
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Single room source
isolation
When lesions no
longer draining
Notifiable disease:
See Appendix 1
Occupational
exclusion may
be an issue
Do not aerosolise
exudate from
tuberculosis cavities or
draining lesions
Salmonella [human]
species:
Notifiable organisms
Single room source
isolation
Notifiable diseases:
See Appendix 1
Vancomycin resistant
enterococci;
Multi drug resistant
gram negatives
Not
applicable
Varicella
IPCT001/02
Issue Date: December 2010
Enteric & Contact
Single room source
isolation – Risk
assessment will be
carried out in
Mental Health
Partnership Sites
Requires risk
assessment by
IPCT
See Chickenpox
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Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Viral Haemorrhagic
Fevers [VHF’s]
(suspected or
confirmed)
INCUBATION
PERIOD
6-21days
PRECAUTIONS
REQUIRED
Contact
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
ADDITIONAL REMARKS
Discuss with ID unit
in first instance and
alert on-call
Microbiology
Consultant
On advice of
IPCT
VHF viruses:
Notifiable organisms
VHF’s:
Notifiable disease
See Appendix 1
Viral hepatitis
Whooping cough
(Pertussis)
7-20days
Droplet
Single room source
isolation
After 7 days
erythromycin
See VHF Policy
Notifiable Organism/
Disease.
See Hepatitis
Bordetella pertussis:
Notifiable organism.
Pertussis: Notifiable
disease
See Appendix 1
Infectious for 3 weeks
after onset if no
antibiotics
IPCT001/02
Issue Date: December 2010
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Review Date: December 2013
DISEASE, CLINICAL
CONDITION OR
INFECTING AGENT
Worms
Threadworms
Yellow fever
INCUBATION
PERIOD
PRECAUTIONS
REQUIRED
Standard Precautions
3-6days
IPCT001/02
Issue Date: December 2010
Standard Precautions
ACCOMMODATION
PRECAUTIONS TO
BE LIFTED
On advice of IPCT
Until treated
Open Ward
Until 2 negative
stools cultures
commencing 1
and 2 weeks
post treatment
Not applicable
ADDITIONAL REMARKS
Yellow fever virus:
Notifiable organism
Yellow Fever:
Notifiable disease
See Appendix 1
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Infections which should be referred to a specialist Infectious Disease Unit
Although many infections can be dealt with adequately in a general
hospital, there are some diseases which require very strict source
isolation. Such patients should ideally never be admitted but sent to a
specialist Infectious Diseases Unit.
If a patient is suspected to have one of the following, please contact
the Infection Prevention Control Team immediately
•
•
•
•
•
•
•
•
Anthrax
Diphtheria
Plague
Viral Haemorrhagic Fever, e.g. Lassa, Marburg, Ebola.
Rabies
Smallpox
Tuberculosis (suspected / known Multi Drug Resistant, MDR)
SARS
Notification of infectious disease
Implementation commenced on 1st Jan 2010 of part 2 Public Health
etc. (Scotland) Act 2008: notifiable diseases, organisms and health risk
states. A duty is placed on a registered medical practitioner, who has
reasonable grounds to suspect (i.e. not await laboratory confirmation),
that a patient they are attending to has a notifiable disease to:
Notify in writing to Public Health using the specified ‘Notification Form’
(available from Public Health or the ‘Health Protection’ Intranet
microsite) within 3 days of forming that suspicion
Make an urgent telephone notification as soon as reasonably
practicable if significant concern exists regarding the nature of the
disease, the ease of transmission of that disease, the patient’s
circumstances and any guidance issued by Scottish Ministers. All urgent
oral notifications must be followed up, with the completed ‘Notification
Form’, within 3 days of suspicion.
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Issue Date: December 2010
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Appendix 1
SCHEDULE 1 [Public Health etc. (Scotland) Act 2008]
LISTS OF NOTIFIABLE DISEASES AND NOTIFIABLE ORGANISMS
Part 1
Notifiable Diseases
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Anthrax
Botulism
Brucellosis
Cholera
Clinical syndrome due to E.coli O157 infection (see Note 1)
Diphtheria
Haemolytic Uraemic Syndrome (HUS)
Haemophilus influenzae type b (Hib)
Measles
Meningococcal disease
Mumps
Necrotizing fasciitis
Paratyphoid
Pertussis
Plague
Poliomyelitis
Rabies
Rubella
Severe Acute Respiratory Syndrome (SARS)
Smallpox
Tetanus
Tuberculosis (respiratory or non-respiratory) (see Note 2)
Tularemia
Typhoid
Viral haemorrhagic fevers
West Nile fever
Yellow Fever
*It is recommended that those diseases above marked with an *
require urgent notification, i.e. within the same working day.
Note 1: E.coli O157
Clinical suspicion should be aroused by (i) likely infectious bloody
diarrhoea or (ii) acute onset non-bloody diarrhoea with a biologically
plausible exposure and no alternative explanation. Examples of
biologically plausible exposures include:
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Issue Date: December 2010
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•
contact with farm animals, their faeces or environment
•
drinking privately supplied or raw water
•
eating foods such as undercooked burgers or unpasteurised
dairy products
•
contact with a confirmed or suspected case of VTEC infection.
Cases notified as HUS (Haemolytic Uraemic Syndrome) should NOT be
notified as “Clinical syndrome due to E.coli O157 infection” as well.
Note 2: Tuberculosis
Pulmonary TB is tuberculosis of the lung parenchyma and/or the
tracheobronchial tree.
Non-pulmonary TB is tuberculosis of any other site.
Where tuberculosis is clinically diagnosed in both pulmonary and nonpulmonary sites, this should be treated as pulmonary TB.
If you are in any doubt about the diagnosis of suspected cases, you
should contact the Health Protection Team for advice on 01896 825560
Part 2
Notifiable Organisms:
Bacillus anthracis
Bacillus cereus
Bordetella pertussis
Borrelia burgdorferi
Brucella genus
Campylobacter genus
Chlamydia psittaci
Clostridium botulinum
Clostridium difficile
Clostridium perfringens
Clostridium tetani
Corynebacterium diphtheriae (toxigenic strains)
Corynebacterium ulcerans
Coxiella burnetii
Crimean-Congo haemorrhagic fever virus
Cryptosporidium
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Issue Date: December 2010
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Dengue virus
Ebola virus
Echinococcus genus
Verocytotoxin-producing E.coli (VTEC)
Francisella tularensis
Giardia lamblia
Guanarito virus
Haemophilus influenzae type b (from blood, cerebrospinal fluid or other
normally sterile site)
Hantavirus
Hepatitis A virus
Hepatitis B virus
Hepatitis C virus
Hepatitis E virus
Influenza virus (all types, including those caused by a new sub-type)
Junín virus
Kyasanur Forest disease virus
Lassa virus
Legionella genus
Leptospira genus
Listeria monocytogenes
Machupo virus
Marburg virus
Measles virus
Mumps virus
Mycobacterium bovis
Mycobacterium tuberculosis complex
Neisseria meningitidis
Norovirus
Omsk haemorrhagic fever virus
Plasmodium falciparum, vivax, ovale and malariae
Polio virus
Rabies virus
Rickettsia prowazekii
Rift Valley fever virus
Rubella virus
Sabia virus
Salmonella (all human types)
SARS-associated coronavirus
Shigella genus
Enterotoxigenic Staphylococcus aureus
Staphylococcus aureus (all blood isolates)
Methicillin-resistant Staphylococcus aureus (MRSA)
Streptococcus pyogenes (from blood, cerebrospinal fluid or other
normally sterile site)
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Issue Date: December 2010
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Streptococcus pneumoniae (from blood, cerebrospinal fluid or other
normally sterile site)
Toxoplasma gondii
Trichinella genus
Varicella-zoster virus
Variola virus
Vibrio cholerae
West Nile fever virus
Yellow Fever virus
Yersinia enterocolitica
Yersinia pestis
Yersinia pseudotuberculosis
Public Health etc. (Scotland) Act 2008
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Issue Date: December 2010
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