PACIFIC OUTBREAK MANUAL Pacific Public Health Surveillance Network (PPHSN) March 2016 The information contained in this manual may be reproduced or translated for scientific or educational use, but not for sale or for use in conjunction with any commercial purpose. Any use of the information in the manual should be accompanied by an acknowledgment of the source. Acknowledgements This manual has been developed by the Pacific Public Health Surveillance Network (PPHSN). PPHSN is a voluntary network of countries and organisations dedicated to the promotion of public health surveillance and appropriate response to the health challenges of 22 Pacific island countries and areas. This guide was originally written by Anthony Kolbe, Jennie Musto, Boris Pavlin and Jacob Kool. The Pacific Public Health Surveillance Network (PPHSN) is particularly grateful to the range of clinicians and public health workers who have provided feedback during the updating of this edition of the manual. PPHSN would also like to thank the following organisations that have supported the development of this manual: • World Health Organization (WHO) • Pacific Community (SPC) • Hunter New England Local Health District and Hunter Medical Research Institute 2 PPHSN Pacific Outbreak Manual – March 2016 PACIFIC OUTBREAK MANUAL Contents Introduction ............................................................................................................................................ 5 Section 1: General guideline for response to outbreaks ........................................................................ 7 What is an outbreak? .......................................................................................................................... 7 How are outbreaks detected? ............................................................................................................ 7 Responding to a report of a disease outbreak ................................................................................... 7 Reporting responsibility: public health emergency of international concern ................................... 14 Conditions requiring immediate response ....................................................................................... 14 Section 2: Response guidelines for core syndromic surveillance conditions ....................................... 15 Acute fever and rash (AFR) ................................................................................................................ 15 Influenza-like illness (ILI) ................................................................................................................... 18 Diarrhoea .......................................................................................................................................... 21 Prolonged fever ................................................................................................................................ 24 Section 3: Response guidelines for additional outbreak-prone syndromes and specific diseases ...... 26 Acute flaccid paralysis (AFP) / polio .................................................................................................. 26 Chikungunya ..................................................................................................................................... 28 Cholera .............................................................................................................................................. 31 Ciguatera fish poisoning ................................................................................................................... 34 Dengue .............................................................................................................................................. 36 Epidemic hepatitis ............................................................................................................................ 39 Leptospirosis ..................................................................................................................................... 42 Malaria .............................................................................................................................................. 44 Measles ............................................................................................................................................. 47 Meningococcal disease ..................................................................................................................... 50 Pertussis (whooping cough) .............................................................................................................. 54 Rubella (German measles) ................................................................................................................ 57 Severe acute respiratory infection (SARI) ........................................................................................... 60 Tuberculosis ...................................................................................................................................... 62 Typhoid fever .................................................................................................................................... 67 Zika .................................................................................................................................................... 70 Emerging Infectious Diseases ............................................................................................................... 70 Appendix 1 ............................................................................................................................................ 75 PPHSN Pacific Outbreak Manual – March 2016 3 Additional resources ......................................................................................................................... 75 Appendix 2 ............................................................................................................................................ 76 EpiNet teams – terms of reference................................................................................................... 76 Appendix 3 ............................................................................................................................................ 78 Appendix 3 ............................................................................................................................................ 79 Risk communication challenges in outbreaks ................................................................................... 79 Appendix 4 ............................................................................................................................................ 80 Situation report format for use on PacNet ....................................................................................... 80 Examples of recent PacNet situation reports ................................................................................... 81 Appendix 5 ............................................................................................................................................ 83 Decision Instrument for the Assessment and Notification of Events that may be a Public Health Emergency of International Concern ................................................................................................ 83 Appendix 6 ............................................................................................................................................. 87 Principles of infection control ........................................................................................................... 87 Appendix 7 ............................................................................................................................................ 90 Information for patients and family ................................................................................................. 90 Appendix 8 ............................................................................................................................................. 93 Glossary............................................................................................................................................. 93 Appendix 9 ............................................................................................................................................ 98 Sample outbreak investigation summary form ................................................................................ 98 4 PPHSN Pacific Outbreak Manual – March 2016 Introduction It is important to recognise infectious disease outbreaks so that control measures can be taken to stop them. Some diseases that cause outbreaks can cause serious illness and deaths if they are not rapidly brought under control. An effective surveillance system can provide early warning of disease outbreaks. Responding effectively will reduce the spread and impact of the disease. Purpose of the manual This manual is meant to be a practical guide for health-care workers in the Pacific for the management of infectious diseases of public health importance. Expert advice should always be sought if an outbreak is detected. Individual countries and areas are encouraged to adapt this manual to local conditions – for example by including local testing protocols, local treatment recommendations, forms, etc. It is also suggested that a country’s or territory’s ‘notifiable diseases’ list be attached