High Priority Infectious Disease Standard Operating Guidelines (HPID SOG) DRAFT January 22, 2020 SAN BERNARDINO COUNTY Department of Public Health High Priority Infectious Disease Standard Operating Guide (HPID SOG) RECORD OF CHANGES ...................................................................................................................... 4 SECTION I: OVERVIEW ....................................................................................................................... 5 A. INTRODUCTION ............................................................................................................................. 6 1. BACKGROUND ........................................................................................................................... 6 2. PURPOSE AND SCOPE .............................................................................................................. 6 3. HPID SOG ORGANIZATION........................................................................................................ 7 B. DEPARTMENT OPERATIONS CENTER (DOC) ............................................................................ 8 1. ACTIVATION ............................................................................................................................... 8 2. COMMUNICATIONS .................................................................................................................... 8 3. NOTIFICATION ............................................................................................................................ 9 4. ROLES AND RESPONSIBILITIES ............................................................................................. 10 C. EPIDEMIOLOGY ........................................................................................................................... 11 1. CASE DEFINITIONS .................................................................................................................. 11 2. CONFIDENTIAL MORBIDITY REPORT (CMR) ......................................................................... 12 3. UNUSUAL CONDITIONS TO REPORT ..................................................................................... 14 D. MONITORING ............................................................................................................................... 15 1. REPORTING A SUSPECT CASE/PERSON UNDER INVESTIGATION (PUI) TO PUBLIC HEALTH ........................................................................................................................................... 15 2. CONTACT INVESTIGATION AND CASE MANAGEMENT STAFFING ...................................... 15 3. MONITORING STEPS ............................................................................................................... 15 4. POST-INCIDENT PERSONNEL MONITORING ......................................................................... 17 SECTION II: HIGH PRIORITY INFECTIOUS DISEASES (HPID) ........................................................ 18 A. HPID MATRIX ............................................................................................................................... 19 B. HPID CATEGORIZATION ............................................................................................................. 23 C. HPID INFORMATION SHEETS .................................................................................................... 24 1. Anthrax* – Bacillus anthracis ...................................................................................................... 24 2. Botulism – Clostridium botulinum ............................................................................................... 24 3. Brucellosis – Brucella species .................................................................................................... 25 4. Cholera – Vibrio cholerae ........................................................................................................... 25 5. Viral Hemorrhagic Fevers – Ebola, Marburg, Lassa Viruses....................................................... 25 6. Glanders* – Burkholderia mallei ................................................................................................. 26 7. Pandemic Influenza – Orthomyxoviridae Influenzavirus A, B, C ................................................. 26 8. Middle Eastern Respiratory Virus (MERS) / Severe Acute Respiratory Virus (SARS) – Coronavirus ...................................................................................................................................... 30 9. Measles – Paramyxioviridae Morbillivirus ................................................................................... 27 10. Melioidosis (Whitmore’s Disease) – Burkholderia pseudomallei .............................................. 27 11. Smallpox* – Poxviridae Orthopoxvirus .................................................................................... 28 12. Tularemia* – Francisella tularensis ......................................................................................... 28 13. Plague* – Yersinia pestis ........................................................................................................ 29 14. Zika Virus – Flavivirus ............................................................................................................. 29 Updated: 01/22/2020 FOR OFFICIAL USE ONLY (FOUO) Page 2 of 69 SAN BERNARDINO COUNTY Department of Public Health High Priority Infectious Disease Standard Operating Guide (HPID SOG) SECTION III: NON-PHARMACEUTICAL INTERVENTIONS (NPI) AND INFECTION CONTROL PRECAUTIONS ................................................................................................................................... 31 A. NPI OVERVIEW ............................................................................................................................ 32 B. NPI IMPLEMENTATION TIMELINE .............................................................................................. 32 1. TRIGGERS FOR NPI USE ......................................................................................................... 32 2. DURATION OF NPI USE ........................................................................................................... 32 3. DE-ESCALATION OF NPI USE ................................................................................................. 32 C. PERSONAL NPI .......................................................................................................................... 33 1. PERSONAL PROTECTIVE EQUIPMENT .................................................................................. 33 2. PERSONAL PROTECTIVE MEASURES FOR EVERYDAY USE .............................................. 33 D. COMMUNITY NPI ......................................................................................................................... 34 1. SOCIAL DISTANCING MEASURES .......................................................................................... 34 2. SCHOOL CLOSURES AND DISMISSALS ................................................................................. 34 3. TEMPORARY CLOSURE OF PUBLIC GATHERINGS .............................................................. 34 4. EVACUATION ............................................................................................................................ 36 E. ENVIRONMENTAL NPI ................................................................................................................ 37 F. INFECTION CONTROL PRECAUTIONS ...................................................................................... 37 1. OVERVIEW ................................................................................................................................ 37 2. MATRIX – SUMMARY OF INFECTION CONTROL PRECAUTIONS ......................................... 38 3. STANDARD PRECAUTIONS ..................................................................................................... 42 4. TRANSMISSION-BASED PRECAUTIONS ................................................................................ 45 G. ISOLATION AND QUARANTINE ................................................................................................. 48 1. INTRODUCTION ........................................................................................................................ 48 2. RESPONSIBILITY AND AUTHORITY ........................................................................................ 48 3. PROCEDURE FOR AN ORDER FOR ISOLATION OR QUARANTINE ..................................... 49 4. ENFORCEMENT OF QUARANTINE AND ISOLATION ............................................................. 50 5. LAW ENFORCEMENT FOR NON-COMPLIANCE ..................................................................... 50 H. MENTAL AND BEHAVIORAL HEALTH CONSIDERATIONS ...................................................... 51 I. NPI FOR TOP 3 NATURAL DISASTERS AND SEVERE WEATHER .......................................... 52 SECTION IV: APPENDIX ................................................................................................................... 55 A. PUBLIC HEALTH INFECTIOUS DISEASE EMERGENCY ALGORITHM ..................................... 56 B. ACRONYMS ................................................................................................................................. 57 C. DEFINITIONS ..............................................................................................................................