A-Z of Infections - A Quick Reference Guide

A-Z of infections - A Quick Reference Guide Page 1 of 12 Version 1.1 January 2019

Why we have a procedure?

The Health and Social Care Act 2008: Code of Practice for the NHS for the Prevention and Control of Healthcare Associated Infections (revised January 2015) stipulates that NHS bodies must, in relation to preventing and controlling the risk of Health Care Associated Infections (HCAI), have in place appropriate core policies/procedures, including procedures for prompt identification of people who have or are at risk of developing infection, so that they receive timely and appropriate treatment to reduce the risk of transmitting infection to other people. Implementation of this procedure will contribute to the achievement and compliance with the Act. The infection prevention and control measures that are outlined in this A-Z of infections are designed to interrupt the routes of transmission of infection. The correct application of infection prevention and control procedures should be applied in conjunction with the Standard Infection Prevention and Control Precautions & Transmission Based Precautions which should be carried out at all times.

What overarching policy the procedure links to?

This procedure is supported by the Infection Prevention and Control Assurance Policy

Which services of the trust does this apply to? Where is it in operation?

Group Inpatients Community Locations

Mental Health Services all

Learning Disabilities Services all

Children and Young People Services all

Who does the procedure apply to?

All staff involved in the direct care/contact with patients who are known or suspected to have an infection.

When should the procedure be applied?

In all cases where a patient is known or suspected to have an infection or communicable

disease

Infection Prevention and Control Assurance - Standard Operating Procedure 9 (IPC SOP 9)

A-Z of Infections - A Quick Reference Guide


How to carry out this procedure

Additional Information/ Associated Documents

Infection Prevention and Control Assurance Policy

Hand Hygiene Policy

Infection Prevention and Control Assurance - Standard Operating Procedure 1 (IPC SOP 1) - Standard Infection Control Precautions

Infection Prevention and Control Assurance - Standard Operating Procedure 2 (IPC SOP 2) - Transmission Based Precautions

Infection Prevention and Control Assurance - Standard Operating Procedure 3 (IPC SOP 3) - Surveillance of Infection and Data Collection

Infection Prevention and Control Assurance - Standard Operating Procedure 6 (IPC SOP 6) - Isolation – care of patients in isolation due to infection or disease

Aims This procedure details the actions to be followed within the Black Country Partnership NHS Foundation Trust for cases of known or suspected infection. The A to Z is a quick reference tool to be used in conjunction with Infection Control policies and standard operation procedures as indicated in this guide.

Definitions

PHE Public Health England collects these notifications and publishes analyses of local and national trends every week

Notification Registered medical practitioners in England and Wales have a statutory duty to notify their local authority or local Health Protection Team of suspected cases of certain infectious diseases

The infections listed in Appendix 1 of this standard operating procedure provide a quick reference guide on the basic precautions to be implemented, however the Infection Prevention and Control Team MUST always be informed whenever a patient is known or suspected to have an infection, so that individualised patient care plans can be developed with specialist infection control input. Please note that any infection/communicable disease listed in Appendix 1 of this document and marked with an * indicates that a separate guidance standard procedure document is also available providing more detailed information.

Where do I go for further advice or information?

Infection Prevention and Control Team

Your Service Manager, Matron, General Manager, Head of Nursing, Group Director Your Group Governance Staff

Training Staff may receive training in relation to this procedure, where it is identified in their appraisal as part of the specific development needs for their role and responsibilities. Please refer to the Trust’s Mandatory and Risk Management Training Needs Analysis for


further details on training requirements, target audiences and update frequencies Monitoring / Review of this Procedure In the event of planned change in the process(es) described within this document or an incident involving the described process(es) within the review cycle, this SOP will be reviewed and revised as necessary to maintain its accuracy and effectiveness.

Equality Impact Assessment Please refer to overarching policy

Data Protection Act and Freedom of Information Act Please refer to overarching policy


Appendix 1 A – Z Guide of Infections - A Quick Reference of Infection Control Precautions Required (*see specific SOP for more information)

Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE

PPE Required Comments

Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Acinetobacter Not usually required Standard precautions

Contact precautions

Only if advised by Infection Control

No X X X Isolation only usually required in special circumstances e.g. for resistant strains

*AIDS (Acquired Immune Deficiency Syndrome) and HIV (See IPC SOP 27: Blood Borne Viruses)

Protective isolation only if immune compromised

Source isolation if bleeding /or advised by IC Team

Standard precautions

Contact precautions

Only if advised by Infection Control

No

seld

om

Isolation only usually required in special circumstances

PPE only required when exposure to blood/ body fluids is anticipated

Amoebic Dysentery Source Isolation Standard precautions

Contact precautions

Isolate for as long as cysts appear in faeces

Local Public Health

X X X Food handlers excluded until 48hrs after first normal stool

Anthrax Source Isolation Standard precautions

Contact precautions

7 days Yes X X Report to Public Health urgently

Bacillus cereus (food poisoning)

Source Isolation Standard precautions

Contact precautions

Until 48hrs after first normal stool

Local Public Health


*Bacteraemia Not usually required Standard precautions - No X X X DATIX and RCA investigation required

Reportable to National Surveillance Scheme (MRSA,

MSSA and E.coli only) Botulism Not usually required Standard precautions - Yes X X X Report to Public Health

urgently

Brucellosis Not usually required Standard precautions Isolate only if draining lesions

Yes X X X

*Campylobacter (See IPC SOP 26 Gastroenteritis)

Source isolation Standard precautions

Contact precautions


No X X X Food handlers excluded until 48hrs after first normal stool

Candida albicans (Thrush)

Not usually required Standard precautions

Contact precautions

- No X X X


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Cholera Source Isolation Standard precautions

Contact precautions


Yes X X X Rare in the UK

Microbiological clearance required

*Chickenpox

(Varicella-zoster) (See IPC SOP 28: Chickenpox & Shingles)


Contact precautions

Airborne precautions

5-7 days or until lesions are crusted and dry

No X X Non-immune, immune-compromised and pregnant staff should avoid contact

Patient infectious from 2 days before until 5 days after rash appears

Chlamydia (genital) Not usually required Standard precautions

Contact precautions

- No X X X

*Creutzfeldt-Jakob disease (CJD) and Variant Creutzfeldt-Jakob disease (V CJD) (See IPC SOP 23)


- Yes to the National

CJD surveillance

unit

X X X Infection control will give specific advise in relation to decontamination of equipment

*Clostridium difficile (See IPC SOP 20)


Contact precautions


No X X X DATIX and RCA investigation required

Reportable to National Surveillance Scheme

*Clostridium perfingens (food poisoning) (See IPC SOP 26)


Contact precautions

- Local Public Health


Notify as food poisoning

*Cryptosporidiosis (See IPC SOP 26)


Contact precautions



Notify as food poisoning

Diphtheria Source Isolation Standard precautions

Contact precautions

Until 2 clear throat swabs received

Yes X X Contact tracing required

PHE to advise IPCT

Encephalitis (acute)

Not usually required Standard precautions - Yes X X X

Epstein-Barr virus (Glandular fever)


Contact precautions

- No X X X


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

*Escherichia coli 0157, and Verocytotoxic E.coli (VTEC) (See IPC SOP 26)


Contact precautions

During diarrhoeal phase

Local Public Health

X X X Excluded until two consecutive negative stool specimens at least 48hrs apart

Notify PH urgently

*Food poisoning (See IPC SOP 26)


Contact precautions


Yes X X X Also notify local Environmental Health

*Giardiasis (See IPC SOP 26)


Contact precautions


Local Public Health


Gonorrhoea Not usually required Standard precautions

Contact precautions

- No X X X

Haemolytic Uraemic Syndrome (HUS)


Contact precautions

During diarrhoeal phase

Yes X X X Notify PH urgently - cases excluded until two consecutive negative stool specimens at least 48hrs apart

Hand, Foot and Mouth (Coxsackievirus)


Contact precautions

- No X X X Pregnant women should avoid exposure

*Head lice Not usually required Contact precautions - No X X X May need sleeved gown for heavy infestations when applying treatment or using fine tooth comb

*Hepatitis A (acute) (gastro-intestinal) (See IPC SOP 26)


Contact precautions

Until 10 days after onset of symptoms

Local Public Health

X X X

*Hepatitis B (acute) (See IPC SOP 27)

Not usually required Standard precautions - Yes X X X Consider face protection if risk of splash injury

Isolate if active bleeding

*Hepatitis C (acute) (See IPC SOP 27)

Not usually required Standard precautions - Yes X X X Consider face protection if risk of splash injury

Isolate if active bleeding

*Hepatitis E (acute) (See IPC SOP 27)


Contact precautions

Until 10 days after onset of symptoms

Local Public Health

X X X Rare in the UK


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Herpes simplex (cold sores)


Contact precautions

- No X X X

*Haemophilus influenzae type b (Hib) (See IPC SOP 24)


Droplet precautions

Until 48hrs of antibiotics completed

No X X

Impetigo Not usually required Standard precautions

Contact precautions

Until completed 24hrs effective treatment

No X X X

*Infectious bloody diarrhoea (See IPC SOP 24)


Contact precautions


Yes X X X

*Influenza (see seasonal influenza policy * (See IPC SOP 24))


Droplet precautions

While still symptomatic

No X X Outbreaks should be reported by the IPCT to the local PH Office

Symptomatic staff excluded

Intestinal roundworms Not usually required Standard precautions

Contact precautions

- No X X X

*Invasive group A

Streptococcus (See IPC SOP 25)


Contact precautions

Yes X X X Scarlet fever and Puerperal fever and post streptococcal syndromes are notifiable

Legionnaires’ disease Not usually required Standard precautions

- Yes X X X Not transmissible person-to-person

Leprosy Source isolation Standard precautions

Contact precautions


Managed in specialist units only

Yes X X Rare in the UK

Leptospirosis Not usually required Standard precautions


X X X Person-to-person spread is rare

Listeria Not usually required Standard precautions


X X X

Lyme disease Not usually required Standard precautions


X X X Not transmissible person-to-person


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Malaria Not usually required Standard precautions

- Yes X X X

Measles Source isolation Standard precautions

Droplet precautions

5-7 days Yes X X

Meningococcal septicaemia


Droplet precautions

Until completed 48 hours antibiotics

Yes X X Consider eye protection if risk of splash injury

Requires treatment at an acute hospital

Molluscum contagiosum


Contact precautions

- No X X X

*Meticillin-resistant

Staphylococcus aureus (MRSA) (See IPC SOP 19)


Contact precautions

Until advised otherwise by Infection Control

No X X X

*Multi-resistant gram

negative organisms (See IPC SOP 22)


Contact precautions

Until advised otherwise by Infection Control

Local PH if cluster of cases

X X X

Mumps Source Isolation Standard precautions

Droplet precautions

7 days Yes X X

Mycoplasma pneumoniae



Droplet precautions

While symptomatic


X X

*Norovirus (See IPC SOP 26)


Contact precautions

For at least 48hrs after last episode


X X X

Ophthalmia neonatorum


Contact precautions

- Yes X X X

*Paratyphoid fever (See IPC SOP 31)


Contact precautions

As advised by Infection Prevention and Control Team

Yes X X X Excluded food handlers until 6 consecutive negative stool specimens at least 2 weeks apart

Exclude HCWs until clinically well with formed stools and inform IPCT


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Parvovirus B19 (slapped

cheek syndrome) Source Isolation Standard precautions

Droplet precautions

Until onset of rash

No X X HCWs excluded

Pregnant women (first 20 weeks at risk) and may require testing

Pertussis (Whooping cough)



Droplet precautions

3-6 weeks Yes X X Contact tracing required

Plague (Yersinia pestis)

STRICT Isolation in a specialist unit



Droplet precautions

Yes Rare in UK – treat as public emergency

N.B. FFP3 respirator mask – fit testing required

Pneumococcal infection


Droplet precautions


Local Public

Health if cluster of

cases

X X

Poliomyelitis (acute) STRICT Isolation in a specialist unit


Contact precautions

Yes X X X Rare in UK – treat as public emergency

Psittacosis Not usually required Standard precautions


For 7 days after onset

Local Public Health

X X X

Rabies STRICT Isolation in a specialist unit


Contact precautions


Relapsing fever Source Isolation Standard precautions

Contact precautions

Until de-lousing completed

Yes X X

*Respiratory syncytial virus (RSV) (See IPC SOP 24)


Droplet precautions

Contact precautions

7 days No X X

Ringworm Not usually required Standard precautions

Contact precautions

Local Public


cases

X X X Gloves must be worn when applying treatment

*Rotavirus (See IPC SOP 26)


Contact precautions

For at least 48hrs after last episode

No X X X


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE


Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Rubella Source Isolation Standard precautions

Contact precautions

Droplet precautions

5 days after the onset of rash

Yes X X

*Salmonella (See IPC SOP 26)


Contact precautions

For at least 48hrs after last loose stool

Local Public Health

X X X Food handlers excluded until 48hrs after the first normal stool

Scarlet fever Source Isolation Standard precautions

Contact precautions


Yes X X

*Severe Acute Respiratory Syndrome (SARS) (See IPC SOP 24)



Contact precautions


-



*Scabies (See IPC SOP 29)


Contact precautions

Until completed 2 treatments

Local Public


cases

X X X

*Scabies – Norwegian (See IPC SOP 29)


Contact precautions

Until advised by infection control

Local Public Health

X X X

Smallpox STRICT Isolation in a specialist unit


Contact precautions


-



*Staphylococcal food poisoning (See IPC SOP 26)


Contact precautions

For at least 48hrs after last loose stool

Local Public Health

X X X Also inform local Environmental Health Officer

Streptococcal infections


Contact precautions


No X X X

Tapeworms Not usually required Standard precautions

Contact precautions

- No X X X

Tetanus Not usually required Standard precautions - No X X X

Threadworms Not usually required Standard precautions - No X X X


Disease/Infection

Isolation

Requirement

Type of Precautions

Duration of

Infection Control

Precautions

Notifiable

to PHE

Comments

Glo

ves

Ap

ron

Mask

Go

gg

les

Sle

eved

Go

wn

Tick-borne encephalitis

Not usually required Standard precautions - No X X X

Toxocara Not usually required Standard precautions

- No X X X

Toxoplasmosis Not usually required Standard precautions - No X X X Risk to pregnant women

*Tuberculosis (See IPC SOP 30)



- Yes X X

*Tuberculosis – multi drug resistant (MDR-TB) (See IPC SOP 30)





Yes X X N.B. FFP3 respirator mask – fit testing required

Tularaemia Not usually required Standard precautions

- No X X X

*Typhoid fever (See IPC SOP 31)


Contact precautions


Yes X X X Food handlers excluded until 6 consecutive negative stool samples taken at 2 week intervals

*Vancomycin Resistant Enterococci (VRE) (See IPC SOP 22)


Contact precautions


Reportable to National

Surveillance Scheme

X X X Reportable to National Surveillance Scheme

Viral Haemorrhagic Fever e.g. Ebola



Contact precautions


-



Whooping Cough (Pertussis)



Droplet precautions

3-6 weeks Yes X X Contact tracing required

Yellow fever STRICT Isolation in a specialist unit


Contact precautions


-



Yersiniosis Source Isolation Standard precautions

Contact precautions


X X X


Standard Operating Procedure Details

Review and Amendment History

Version Date Description of Change

1.1 Jan

2019 Policy reviewed & cross references to all IPC SOPs included in Appendix 1

1.0 Jan

2016 New Procedure established to supplement Infection Control Assurance Policy

Unique Identifier for this SOP is BCPFT-COI-POL-05-09

State if SOP is New or Revised Revised

Policy Category Control of Infection

Executive Director whose portfolio this SOP comes under

Executive Director of Nursing, AHPs and Governance

Policy Lead/Author Job titles only

Infection Prevention and Control Team

Committee/Group Responsible for Approval of this SOP

Infection Prevention and Control Committee

Month/year consultation process completed

n/a

Month/year SOP was approved January 2019

Next review due January 2022

Disclosure Status ‘B’ can be disclosed to patients and the public