AMENDED NHS Mf:L(1997)70 THE SCOTTISH OFFICE ..--
1ath Oc:tober 19$1 Dear Colleague
HIGH ISOLATION PROVISION 'OR ACTUAL OR Add••••• SUSPEC'I'J;D CASES OF VIRAL HAEMORRBAGIC FEVER IN SCOTLAND .~~Med1J'~d··~ ••• ADVISORY COMMITTEE ON DANGEROUS ~~.MHST •• PATHOGENS: GtJmANCltOl4 'DIE MANAGEMENT Por~~ AND CON'.t1tOL OF ~ BAEMO~GIC FEVERS ~ Maaqer. StlteHespitals Bo8Id tor Sc:sdaad SD:m.mary GeRemI ~ COmmon Scrriccs Aphcy . ·CbWExecutlve, Hcahh ~ 1. Thi$ lett~r )'rQvi.cSe$ ig:tQtmatioQ.OJitarranls ••. _ ••• fOr ScetfaJad ac~~1or $~t.~ ~. of"ridl haem~ic fewr(VllF)i~ ~ ~ C¥••fOr Inf'cetioB and Eavil'DR1tHlDtII HJIbh ··fIt. SeotlU8. Wherehisb~9mi:tyi~tioJit :i$,~. a.pprt)pnate b'"ntmryfacititi.eI·t •• CMS wUl ,.n1y .&e.•~«d by ~ N.'\~le Unit when .• hq...Ma ~. fbata...-femd is En, ••• to: appr()pri_~a$ d~teGf in .J\.nb. H'. Dr Iarfaara oms P\lWic fIca1tb P8Iiq Unit 2. 't'1.Jis lettera.lsodmws attmtionto~tf1 pUbl~ Aoom 126 st AadIew's Neuse guidanceprodueed .b, ·'~.A4v1gy Conmdtto ·on ~ I()IN8UftGH EHI.3DQ r.g.nsCACDI'). Ftnther bae_puml mmrmanonisim;Iu41C!i in A.1111ex A. Td:0:13t·Z44 21" Fax: 01:1'1 ••2,"2&30 Action 3. Health Board General Managers and Trust Chief Executives are asked toeftSute that all appropriate managers and staff (Consultants in ~ublic: Health Medicine (CD ct EH)t Specialists in Infection aad Tropical Disease, CAMOsIDPHs, CANOst Medical Directors NHS Tmstst Executive Nurse Direct~.rs, Directors .of OecupatioMl Health and. Directors of Laboratory Services) are aware o.t the arrangements with the Newc~tle 11nit and that their attention is drawn t'O the ACDP guidance on the management and control ofVHFs. YO~incerelY ~JWOODS Director of Strategy ~nd Performance Management FRPO~039 Background Newcastle Unit 1. $ince theclosareoftlwmghSect11'i~ .Inf'ectlous~ase Unit ~t..RuclJ.iU H0$piwin 1992:,Scotland bt1$Md no hi,ghl~vel$eCmty f~ility.X' b ~ or~ple with htecdoU$ di~s l:J\J.ch as VHF.Casesm eilt'Cremmy Me bu~ with.inC1':~mtetna1ib1tal ..nvel~ plans need to be in t)l.a.CI to ~. wtthdi~Qft1ds ~tw.'e·qtai.lYliJ1d .• ectively, should .it occU1'~i\e M~ontDxectitivehag thetefolenegottated an~ement with the·.·hi.Sh $eCurityunitin New~e ·to.anowSOf)Ui$h:pa.~n~·to·.t...~ ...fm'on Qe~~ basis at at cost of aRproxitnatelY~6,oooper e&$e ~~l111nuallt},plnspa1ient ttm$pottation~. A redu~ e1!un'gewiII be.,li~le wh~pati~. mfeJ:£ed to N~easfle·ate $U~equ_t1Y(Q1.1J:1dt:I.Qt m roqwem=atl11_ itth~h seeurity isolationfacnities. 2. The direct cost of patients' ueatments and tbeir tra.n:sportation 'COsts are to be met by Scottish Health Boards. As in the past, provision for the treatment of high. security infectious diseases should he met from Health Boards' oormal aUocations. 3. Ref~ to _high .cmity 'Unit 8.t.N~t1ewi1.19'1.Y ·~··xnl<1eas~y ~ertiat:1refe~" follo~'Qi .m-\Utatj~lI~~n , d~_t"3~.$.IM~Jlljst·~·~~m and tr()pioal~i_a~satt' ~8.,pt()pri.cUnical.~m N__ tJie. As th~will be 111M formpid action it a case Q'f VBP occurs, Hea.lth.Boatds slmWc1ens.urethat.a speclali'St in iJdecuond.d tt01'ical ~.tin4! is~s~d inad:v~ .. H.utn .~~ ·.ould._to "- D9titfed when ~ a referml is m"M Q\4 ~$"1w ~. JIle\V~~e ..sl1~ I)ot...~~.~.'ot ije~th:Q.~e~:Jral~.~ tMtim~u')H'ber~f'eo-al. 4. Amimgt1n~tsha~ ~n.n. •• (.Ytta~ with th~ ~Ambman~ ~iee f()'t' the tran$POdQfpatimts tQNewcastle. - 5 , A .demiled p1'0toe()10ut1i~in$1J1epm~ thatfii~d betbn0wai in ~ 0rthe refettIUof ~cted ~'Qf VHF tQ the Ne1¥e~e Unit is a~]);ed at~:xl'l. This prmocolshouldbe br()uuUt tothe•.amm:tiOB.of allapprQptiateclimcaI stIIff amistaft~P1. ·e~. cotlttactua1refemUs- 6. In the t}I{the likeliho$d of epieiemie gpreadof VBli' inthelmtem.l popwation is ~gfbIe, but mr~t~ nta.y ·be· acqWte.d. abroadOJ!', v., tArely.,in a 1~1QryMtinI'or from aniJJiJ.pO~~. In vi~·Qf these¥entyQf tb8e' mfeeOOns,. striet precautions are inOi~ted to,~tecttbose who 51 be~posg_ Thus tbo ACDPs8.t the.·requ.em ()ftbe Department of Health, tmd~k to revise the t986pmmoe document. to remforce the m=i to ensure that the sma-UriSk of occupaUomdinfection con~ to '-~nWU~ ·and·.to take mto aceO\1Dtthe most up-to-date scientific know1edgeand ~te'f:tmJles in leplation. FRP02039 Annex A •... 7. Previous guidance doeumen.ts, the Memorandum on Lassa Fever and the Memorandum on the Control of Viral Haemorrhagic Fevers produced by tlte Department of Health in 1976 and 1986 respectively, provided a source of teference for those involved with these diseases, primarily health care staff in hospitals, clinics andsurgenes and laboratory workers. 8. This ntwguidan~ei$ ~n~ly ~n~edwith w<>rkermfetyi$s~Slmd .fo¢~ on.ri$k Z)$~sJmentllin¢t.g~~t catel~~tiong.d ~c1'USioJ1p.f~;speobDCJl bandlingandmbomtof)'proeedures; andpu&Iic health actions... Thedomunentdes mto accQt1ntthe 1n. 9. n. Hea1tbamd SmtyCommiainn has ··en~ ~ ~ti~ gm~eOQ~in this document and eommen& it. to those who womwith me Blets at VBF or who .R othe~se e~~ ittvarioDB occ.ti.Qns.11risdo~twm. he·ped by H~th andS~ Insp.ect9f$ inducrihm.gaccepable m~ of ~hievi. n.ttb. .'aIld.$dtyiD the··workplaee. 'J'hi$gui4au1ce sh()wd ·~_d m..n~tionMtb 'd:'teCOSHHlleaulatiot'1$J994. 10. Copies of the guidance are available from The Stationery Office, ISBN 0-11-321860- 5 price £11.00 net. Oetober 1997 FRPOJ039 Annex B PROTOCOL FOR THE REFERRAL OF SUSPECTED CASES OF VIRAL HAEMORRBAGIC FEVER (VHF) TO THE mGH SECURITY INFECTIOUS DISEASE UNIT AT THE ROYAL VICTORIA INFIRMARY AND ASSOCIATED HOSPITALS NUS TRUST IN NEWCASTLE 1. When a 'clinici~ 4i'2lP~S' ~.,potcmti;d ,~~ of VHF, hfaotshesho1.lld contactth~ H~th Boared's d_~d speeialistillinf'ectlOl1 and troI'i~,~iciJt~., A 1'istof d_pated $~cialistsin imecUt):g; 1;1114U'o,icalmmicm$ in Seot1md, with C0:tttaa details, is attached m Annex C. 2. Thes,ecialistand cli1:1ician will,diScuss ~, ~ ~4 Q. d~isi()n wfil be taken on the appro.priat~ OI the .~. fur Nfemd ·to ~ w,p ·~tr·il'1feetioti di~1U1it in New~e. 3. The ~~iaJ.ist will then tel~e tbe1\()y~.Vi¢t()ri~mt1m~'sVira1Haemorth.c Fever U11it(tel 00 01191.•273.;8111) tt>di:$CUS$the CUe witll. Dr Qug Qf Dr SItQW of the Newcastle U11it. Ontea final.tleqisioA _ .~ ~~d ~ent .reachedon the arrangemM~ for tnedie$.l/n~ cQ"efdtJ.dn8the tram.pnrtati~ Q·ftbe~tienl, .the~otti.$:b specialist wiUadvisetheappropria.te. Jo~tlinititU1 dea1i»gwith the case. 4. Where it has beenestablisbed that it is necessary to refer the patient ta the Newcastle Unit, this will be done as an emergency tettiaJiy relerml. The local clinician 'Will require to contact the Scottish Ambulance Service at Mr Marsden, Medieal Director - 0131447-7711 (office hours) page on 013"1133 71&886 or contact on mobile phone 0411 650359(out ofhonts) Ambulance Air Desk - 0345 123999 (24 hows) S. The SC0W$hAa1bmancegetVicewWthmmakethe'l\tJc~~xn •• fot the patient to De ~tted by :theP1o$t.'p'o~emodfaat\d t'outeto the .'Newcastle Unit. 6. ThetefertingloealclWcfml _we! _11 m"ethe 11~'" attmlgementSfat the DirectoroI 'ubJi~He~thof·.d1tpement's .1w:atth}ward nf'resid~ce .••tU1d. Tbesoottishotftce DepattmentofHealth, to be info~ pX<1fmptly of the refma1to ·tne··.N~le Unit. October 1'97 FRP02039 ANNEX C , - DESIGNATED SPECIALISTS FOR VHF JULY 1997 Dr Olyn Williams Department of Infectious Diseases Crossbouae Hospital KILMARNOCK KA2 Tel No ..Qt&e Hours 01563 577970 Tel No. Other Times 01292317534 Fax N'mnber 01563 577978 Fife Heattb. ·Boaui Dr Dip Bhattacharyya Victoria Hospital Hayfield Road KIRKCALDY Fife KY2 SAM Telephone Nwnber 01592043355 Fax Number 015'92647041 Forth V~JJ,Ya~tb· ~"'·(tb~It.~.~ ~iana~th~~ Dr C C Snrlth Dr J G DoQ;glas Consultant in Communicable Diseue Infection Unit Aberdeen !.oyal Hospitals Trost Foresterhill ABERDEEN Telephone Number 01224681818 Fax Number 012246&5307 Greater Glas~ow Health Board On Call ID Consultant Ruchill Hospital Bilsland Drive GLASGOW G209NB Telephone Number 0141 9467120 Fax Number 0141 8468945 MOVING 1 APRIL 1998 TO Gartnavel General Hospital 1053 Great Western Road GLASGOW G12 Telephone Number 0141 211 3000 Fax Number 0141 3574552 Highland Health Board Dr D H Franklin, Consultant Chest Physician Dr G Hulks, Consultant Chest Physician Raigmore Hospital INVERNESS Telephone Number 01463 704000 Fax Number 01463 711322 Lanarkshire Health Board DrWT A Todd Dr A K R Chaudhuri Monklands Hospital Monkscourt Avenue AIRDRIE ML6 OSJ Telephone Number 01236748748 Fax Number 01236760015 VHFSPC Dr R Brettle Dr C Leen Dr P Welsby DrDWilb City Hospital 51 Oretmbimk Drive EDINBURGH ERIO 5SB Telephone N\1mkr 01315366000 Fax Num:ber a13t 5366001 Dr D Nathwani Dr T France Dr P Davey King's Cross HO$pitaJ: ClepID,gton Road DUNDEE DD38EA Telephone Number 01382660111 Fax Number 01382 816118 DrKNAcIm Western Isles Hospital Maeaulay Road Stomoway ISLE OF LEWtS HSI 2AP Telephone Number 01,351 104104 Fax Number 01851 7051411105262 VHFSPC