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Flashcards in Comm Disease Deck (33):

Risk factors for STEC

Animal/farm environment
Raw milk
Produce - leafy greens
Untreated water/rec water


Restriction for case/contact STEC

High risk cases clearance (2x negative stool)
High risk contacts 1x negative stool


Enterics - high risk groups

Food prep workers
Staff/patients in healthcare/residential/ECE
Children <5 at ECE
Others at high risk of spreading infection due to illness/diability


Risk factors for legionella

Longbeachae - soil
Pneumophilia - warm water (cooling towers, spas)
No person to person spread (ie no contact)


Risk factors for yersinia

Contaminated food - pork, unpasturised milk, fruit and vege, tofu
Contaminated water, infected animals
Person to person does occur


Risk factors for Hep A

Contaminated food (raw/undercooked seafood, produce such as berries, lettuce)
Contaminated water
Infected food handler


Restriction for Hep A case

Exclusion for 1 week from onset of jaundice/symptoms


Definition of Hep A contact

2 weeks pre and 1 week post jaundice onset
All household contacts, staff and kids at ECE


Hep A contact managment

Offer vaccine within 2 weeks of last contact
Offer immunoglobulin for those who vaccine is contraindicated (eg <1 year)


R0 and period of communicabiltiy for pertussis

No treatment - 3 weeks post onset of cough
Effective ABs - 2 days post starting abs
Other ABs - 5 days post startig


Treatment of pertussis

Antibiotics only alter course of illness during early stages; however does reduce infectivity by eradicating organism from secretions


Restriction of pertussis case

Exclude form school, ECE, work until received 5 days of ABs


High risk pertussis contacts

Children <12 months
Kids/adults who live/work with <12 month olds
Pregnant women


What is the goal of contact management in pertussis?

Protect infants, pregnant women and peopel at risk of complications


Management of high risk contacts in pertussis

Give prophylaxis, but not necessary to exclude if asymptomatic. Offer vaccine if not likely immune


Other control measures for pertussis

Immunisation during pregnancy, every pregnancy (28-38 weeks). On time imms for infants. Encourage close family contacts of infants to have booster (booster every 10 years for LMCs, ECE workers, WCTO workers)


Exclusion for mumps

5 days post swelling onset


Definition of susceptible contact mumps

Close (<1m) contact 2 days pre and 5 days post parotitis
Born after 1981 and not fully vaccinated


Exlclusion for mumps contacts

Consider exclusion of susceptible contact with no MMR form uni/school/ECE/work for 25 days post last exposure - can be readmitted after first dose of MMR
- those with 1 dose should be offered 2nd dose and then can return
The goal of this is to increase overall immunity and limit spread, whilst minimising disruption from secondary infection


Clinical description of measles

Generalised maculopapular rash - starting on the head and neck
Fever at time of rash
Cough or coryza or conjunctivitis present at rash onset


Why do we care about measles?

10% of complications such as otitis media, pneumonia, croup
1 in 1000 encephalitis


Measles period of communicailtiy

5 days pre to 5 days post rash


Definition of contact measles

Susceptible contact

Confined space with case during communicability, person in waiting room or consult room with case or 1 hour after is considered a contact
- born after 1969 and not fully vaccinated
- Born 69-81 who only received single dose of measles
**If in doubt vaccinated (no undue effects of vaccinating someone who's already immune)


Restriction for susceptible measles contacts

14 days after last contact with case
If given 2nd dose of MMR can return
MOsH may decide not to exclude if 1st dose of MMR given within 72 hours and returning to setting where unimmune have been excluded and person is monitored for signs and symptoms


Other control measures for measles

2 doses of MMR
Encourage ECEs to keep vaccination records
Practices and labs understanding importance of isolation of suspected cases


Case management meningococcal

Must be given AB that eliminate carriage pre hospital discharge


Definition of contacts meningococcal

Anyone with close contact 7 days pre and 24 hours post ABs - overnight household, HCW with unprotected contact, ambulance, kissing, others at discretion


Treatment of meningococcal contact

Prophylaxis - given ASAP (<24hours) Purpose is to eradicate nasopharyngeal colonization ad therefor prevent transmission to others
Immunization - if case is group A, C, W, Y (if group B currently only for multi-occupancy residential outbreak emergency supplies)


Counselling for meningococcal contacts

Prophylaxis doesn't treat incubating disease. See Dr if symptoms develop.


Risk factors for typhoid/paratyphoid

Shellfish from sewage contaminated water
International - shellfish, raw fruit and vege, milk/milk products


Restriction for typhoid cases

High risk - 3 consecutive negative stool
2-5% may become carriers - risk assessment ? alternative work ? treatment (d/w ID)


Restriction of typhoid contacts

High risk - exclude until 2 x negative samples
Not high risk - collect sample, exclusion not required


Basic frame work for responding to notification

Case Managment (Investigaiton, treatment, Restriction, Counselling)
Contact Managment (investigaiton, treatment eg vaccinate, prophylaxis, restriction, counselling)
Other control and preventive measure