management of common diseases april 2018

Management of Common Diseases – April 2018 Transmissible

Disease Incubation

Period Infectious

Agent Period of

Communicability Mode of

Transmission Type of Precautions / Comments

Copyright – HICMR Pty Ltd 1

ADENOVIRUS Group of viruses that can infect the membranes of the respiratory tract, eyes, intestines, urinary tract, and nervous system.

Respiratory infection - 2 to 14 days for symptoms to appear after exposure. Intestinal about 3 – 10 days.

Adenoviruses

Considered infectious whilst symptomatic. Adenoviral conjunctivitis is highly contagious, with a duration of 4 to 6 wks.

Transmission is person-to-person via respiratory secretions, ocular discharge, hands, faecal-oral, urine, contaminated fomites, and swimming pools.

Contact and Droplet Precautions

Adenoviruses account for ~10% of fever-related illnesses/acute respiratory infections in children and are a frequent cause of diarrhoea, conjunctivitis (pink eye) and bladder infections.

ASPERGILLOSIS Infection or allergic response due to the Aspergillus fungus.

Reported to be from a few days to months.

Aspergillus fungus Nil person to person spread. Inhalation of airborne spores.

Standard Precautions

CAMPYLOBACTER Bacterial infection causing Gastroenteritis symptoms. Notifiable Disease

Usually 2 – 5 days, Range of 1 – 10 days.

Campylobacter jejuni and Campylobacter coli

Cases infectious whilst symptomatic and for 48 hours after symptoms cease.

Faecal-oral route. Contact with infected animals. Shedding in faeces may continue for wks after symptoms resolve.

Contact Precautions Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan.

CHICKEN POX (VARICELLA) Viral infection causing slight fever and cold-like symptoms, followed by an itchy rash that appears as blisters over several days, which crust to form scabs. Notifiable Disease

2-3 weeks. (Usually 14-16 days).

Varicella Zoster Virus (VZV)

From 2 days before the rash appears, until at least 5 days after the rash and all blisters have crusted over. Consider susceptible contacts to be infectious 10-21 days following exposure.

Direct contact, Droplet and Airborne spread or from articles contaminated with respiratory tract secretions or fluid from vesicles.

Airborne Precautions (Negative Pressure Room immediately) Zoster Immunoglobulin may be indicated for immunocompromised / pregnancy / neonates. Contact IPC team. Initiate Varicella Patient Management plan. Refer to Infectious Diseases Physician (IDP) for advice. Notify the Public Health Unit on 92228588

CHOLERA Bacterial infection causing Gastroenteritis Notifiable Disease

Few hours - 5 days. (Usually 2-3 days).

Vibrio cholerae Cases infectious whilst symptomatic, and for at least 48 hours after symptoms cease.

Faecal-oral route. Contact Precautions

Isolate / exclude from work, until 48 hours symptoms free.

CLOSTRIDIUM DIFFICILE A spore forming bacterium that causes Gastroenteritis symptoms.

Not precisely known. Usually less than 7 days.

Clostridium difficile

Cases infectious while symptomatic, and for at least 48 hours after symptoms cease.

Faecal-oral route. Contact Precautions Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan.


Disease Incubation

Period Infectious

Agent Period of




CLOSTRIDIUM PERFRINGENS A spore forming bacteria that causes Gastroenteritis

Can be from 6 – 24 hours. Usually 8-12 hours.

Clostridium Perfringens

Nil person to person spread. Faecal -oral route. Standard Precautions

CONJUNCTIVITIS - BACTERIAL Bacterial infection of the conjunctiva of the eye.

Usually 24-72 hours Haemophilus influenza and Streptococcus pneumoniae are most common.

Infectious whilst discharge present.

Contact with discharge from conjunctivae or upper respiratory tract of infected persons. Neonates may acquire infection during vaginal delivery.


Infections with Neisseria meningitides, Chlamydia trachomatis and Neisseria gonorrhea are notifiable.

CONJUNCTIVITIS – VIRAL Viral infection of the conjunctiva of the eye.

Usually 12-72 hours Adenovirus Enterovirus Coxsackie A 24 is the most common.

Infectious whilst discharge present.

Via contact with discharge from the conjunctivae or upper respiratory tract of infected persons. Neonates may acquire infection during vaginal delivery.

Contact Precautions

Highly contagious; causes outbreaks in Eye Clinics, Paediatric and Neonatal Settings.

CREUTZFELD-JAKOB DISEASE (CJD) (vCJD variant CJD and cCJD – classical CJD) A progressive fatal disease of the brain caused by an infectious protein particle called a prion.

Notifiable Disease

15 months - to greater than 30 years.

Prion - From a group of brain diseases known as Transmissible Spongiform Encephalopathies

Central Nervous System tissue is infectious during symptomatic illness of CJD.

Iatrogenic. Rare cases of transmission via direct / indirect contact with brain tissue / CSF fluid of cadavers. Zoonotic spread - vCJD Spontaneous onset of disease most common.

Standards Precautions

Contact the IPC team for additional information regarding a possible / confirmed CJD patient undergoing surgery on high infectivity tissue.

CRYPTOSPORIDIUM Parasitic infection of the bowel causing Gastroenteritis. Notifiable Disease

1-12 days Average 7 days.

Cryptosporidium parvum

From onset of symptoms to several weeks after symptoms have resolved.


Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan.


Disease Incubation

Period Infectious

Agent Period of




CYTOMEGALOVIRUS INFECTIONS Viral Infection, often asymptomatic in adults and children, but can cause severe disease in neonates or immunocompromised.

Perinatal 3-12 wks after delivery. Adult 3-8 wks after blood transfusion, & 4 wks-4 mths post-transplant

Cytomegalovirus Excreted in urine and saliva for months to years after primary infection.

Contact with urine, saliva, breast milk, cervical secretions and semen. Blood transfusion. Vertical transmission before and during birth.


Pregnant HCWs to avoid contact. 5-10% of children with asymptomatic congenital infections develop mild neurosensory disability.

DENGUE FEVER Viral infection caused by serotypes of the Dengue Virus. Notifiable Disease

3-14 days (commonly 4 - 7 days).

Dengue virus (Flavivirus -types 1-4)

Nil person to person spread.

Vector borne transmission. Standard Precautions

In Australia, the Dengue virus is transmitted by a bite from the Aedes aegypti mosquito.

DIPHTHERIA Acute bacterial infection caused by toxigenic strains of Corynebacterium diphtheriae that primarily affects the tonsils, pharynx, nose and larynx. Notifiable Disease

2 – 5 days but occasionally longer.

Corynebacterium diptheria

2-4 weeks, ceases promptly with antibiotic management. (Rare carrier to 6 months)

Respiratory Droplet spread.

Direct spread from nose / throat secretions, skin lesions, articles soiled with discharges from infected lesions.


Continue precautions until antimicrobial treatment completed and culture negative. Check immunisation status of all contacts. All contacts to have throat and nasal swabs and antimicrobial prophylaxis. Contact IPC team / ID Physician for advice. Notify the Public Health Unit on 9222 8588 immediately on clinical suspicion.

EBOLA VIRUS DISEASE – SEE VIRAL HAEMORRHAGIC FEVERS (VHF) ESCHERICHIA COLI – E. COLI (STEC / EHEC / VTEC) Some kinds of E. Coli cause disease by making toxins. Bacterial infection causing Gastroenteritis symptoms. Notifiable Disease

2-10 days (Median 3-4 days).

Shiga toxin producing E. coli (STEC). Entero- haemorrhagic E. coli (EHEC). Vero toxin producing E. coli (VTEC)

Whilst organism present in faeces ~ 1 week in adults, 3 weeks in children.

Faecal-oral route. (Person / animal to person). From contaminated food, milk and water. Reservoir in cattle.


Consider use of Contact Precautions for diapered or incontinent persons for duration of illness. Food Handler HCWs to be excluded until 2 negative faecal specimens taken 24 hours apart.

GIARDIASIS Protozoan infection causing Gastroenteritis symptoms. Notifiable Disease

Usually 3 – 25 days. (Average 7-10 days).

Giardia lamblia Communicable for the entire period of cyst excretion.

Faecal-oral route.

Person/animal to person.

Contact Precautions Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan.


Disease Incubation

Period Infectious

Agent Period of




GLANDULAR FEVER Viral infection causing fever, sore throat, swollen glands, abdominal pain and jaundice.

4-6 weeks. Epstein Barr Virus (EBV)

Not accurately known. The virus is shed in the saliva for up to a year after illness and intermittently thereafter.

Contact with Saliva. Standards Precautions

Also, known as ‘kissing disease’, by adulthood, 90-95% of people have had EBV.

HAEMOPHILUS INFLUENZAE B (HIB) Bacterial infection that can cause serious infections, such as meningitis, sepsis epiglottis, pneumonia and cellulitis. Notifiable Disease

Probably 2-4 days. Haemophilus influenzae type B

While organism present in nose and throat.

Eradicated within 24-48 hrs of appropriate antibiotic therapy.

Droplet/direct contact from nose/throat secretions.

Droplet Precautions

To be initiated until > 24 hours of appropriate antibiotic therapy.

HAND, FOOT AND MOUTH DISEASE Viral infection causes sore throat, fever and vesicular lesions on buccal surfaces of the cheeks, gums and sides of the tongue.

Usually from 3-7 days.

Enteroviruses (Coxsackie virus type) Enterovirus 71 (EV71)

The blisters are infectious as long as they contain fluid. The faeces can remain infectious for several weeks.

Direct contact with fluid from the vesicular lesions and nose and throat discharges, and faeces. Aerosol droplet spread.

Standard Precautions for Adults Contact Precautions for infants and young children Isolate until all blisters have dried.

HEPATITIS A VIRUS (HAV) Virus causing acute fever, malaise, anorexia, nausea and abdominal discomfort. Notifiable Disease

15 – 50 days Average 28-30 days.

Hepatitis A virus Maximum infectivity during the latter half of the incubation period, until a few days after onset of jaundice.

Faecal-oral or via fomites. Standard Precautions

Food Handler HCWs - follow up should be instigated.

HEPATITIS B VIRUS (HBV) Virus causing inflammation of the liver. Major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Notifiable Disease

From 45-180 days (Average 60 – 90 days).

Hepatitis B virus Blood infectious from weeks before onset of symptoms, through acute clinical disease and during chronic carrier state. (? Lifelong) Persons who are HBV DNA positive are highly infectious.

Transmitted by contact with blood, semen or vaginal secretion from an HBsAg positive person.

May be introduced through broken skin, via placenta or contact with mucous membranes.


Vaccination and testing recommended for all HCWs.

Occupational exposure protocols should be in place for blood borne viruses.


Disease Incubation

Period Infectious

Agent Period of




HEPATITIS C VIRUS (HCV) Virus - often no S&S. Chronic infection can lead to scarring of the liver, cirrhosis, liver failure or liver cancer. Notifiable Disease

2 weeks to 6 months, (Usually 6-9 weeks).

Hepatitis C virus During acute clinical stage and indefinitely in the chronic carrier stage. Risk is minimal in the non-viraemic (PCR negative) individual.

Blood to blood transmission via inoculation, sexual contact or Intravenous drug use.

Standard Precautions Occupational exposure protocols should be in place for blood borne viruses.

HEPATITIS D VIRUS (HDV) Abrupt onset with S&S like Hepatitis B infection. Always associated with a co-existent HBV infection. Notifiable Disease

Approximately 2-8 weeks.

Hepatitis D virus Similar to HBV. Most infectious before onset of symptoms. Persons with symptomatic infection, acute disease, and chronic carriage are infectious to others.

Infected blood & serous body fluids, contaminated needles, syringes or blood/plasma product transfusions. Sexual transmission may occur. Perinatal infection rare.


HDV requires co-infection with HBV to replicate; therefore, humans with HBV infection act as reservoirs. Vaccination against Hepatitis B prevents HDV infection.

HEPATITIS E VIRUS (HEV) Clinical course like Hepatitis A with no evidence of chronic form. Notifiable Disease

15-64 days (Average 26-42 days).

HEV Not known. Faecal shedding from 4 weeks after exposure, lasting until 14 days from onset of jaundice.

Faecal-oral route, mostly from contaminated drinking water. Person to person transmission possible.


Case fatality rate up to 20% in pregnant women infected in 3rd trimester.

HERPES SIMPLEX HSV type 1 - vesicular lesions in & around the mouth / eye eg. Cold sores. HSV type 2 - usually causes genital herpes.

2 - 12 days. Human herpes simplex virus types 1 & 2

Secretion of virus in saliva may occur up to 7 weeks.

HSV type 2: 7-10 days.

HSV type 1- Contact of saliva of carriers.

HSV type 2 - sexual contact.


Consider Contact Precautions for disseminated/severe lesions until dry and crusted. HCWs can develop Herpetic Whitlow.

HERPES ZOSTER – SEE SHINGLES HUMAN IMMUNODEFICIENCY VIRUS / ACQUIRED IMMUNE DEFICIENCY SYNDROME (HIV / AIDS) Without treatment HIV infection will usually result in Acquired Immunodeficiency Syndrome (AIDS). Notifiable Disease

Primary sero- conversion 3-8 wks. Anti–HIV antibodies 3 wks –3 mths HIV- AIDS 9 mths - 20 years.

Human immunodeficiency virus type 1 & 2

Lifelong. Contact with blood, semen, vaginal secretions or breast milk of an infected person, eg. from inoculation, sexual contact, breast feeding, needle stick injury.


HIV infected HCWs must not perform exposure- prone procedures.


Disease Incubation

Period Infectious

Agent Period of




HUMAN METAPNEUMO-VIRUS Virus that causes lower respiratory tract disease.

3 to 6 days. Human metapneumo-virus (HMPV) (Paramyxovirus family)

Probably from before symptoms develop until recovery from the infection. Most people recover from the infection within about 10 days.

Spread through secretions from coughing and sneezing, close personal contact, or surfaces that have the viruses on them then touching the mouth, nose, or eyes.

Droplet Precautions

For duration of active disease.

Initiate Bronchiolitis Patient Management plan.

INFLUENZA Virus that causes respiratory disease. (Influenza A & B)

Notifiable Disease

1-4 days (Average 2 days).

Influenza virus types A, B and C

3-5 days (Up to 21 days in children) from clinical onset.

Respiratory droplet or direct contact.

Contact and Droplet Precautions Initiate Influenza Like Illness Patient Management plan.

Precautions should continue until the fever has resolved AND 3 days of anti-influenza therapy has been received OR if anti-influenza therapy is not used, for 7 days since the onset of respiratory symptoms Antiviral agents may be used for prophylaxis and treatment of Influenza A and B.

IMPETIGO Superficial skin infection. (Also, known as School Sores)

1-3 days S. Pyogenes 4-10 days S. Aureus.

Staphylococcus aureus or Streptococcus pyogenes

No longer infectious after 24 hours of appropriate antibiotic therapy.

Direct contact via hands and rarely by indirect contact via contaminated equipment.

Contact Precautions Until 24 hours after effective antibiotic therapy

LEGIONELLOSIS Legionnaires' disease: Pneumonic form & Pontiac fever: Non-pneumonic form. Notifiable Disease

Legionellosis 2-10 days, (Usually 5-6 days).

Legionella pneumophila Legionella longbeachae and other Legionella species.

No person-person transmission recorded.

Only Legionnaire's Disease has been reported in Australia.

Generally transmitted through inhalation of contaminated aerosols of water or of dust.


LICE – HEAD Insect parasites that live and breed in human hair and feed by sucking blood from the scalp.

Lifecycle 3 stages: Eggs hatch in 7-10 days. days; Nymph 1-8 days; Adult 32-35 days.

Pediculus humanus var. capitus

Whilst eggs/lice are alive. Once hatched, lice are capable of laying eggs after 10 days, and live for up to 35 days on the scalp.

Direct head to head transmission.

Contact Precautions Re-treatment after 7-10 days necessary because lice in unhatched eggs may not be killed by the first treatment. They don’t survive more than 2 days away from a human host.


Disease Incubation

Period Infectious

Agent Period of




MALARIA Parasitic infection that causes fever chills, sweating. Notifiable Disease

Varies with type: P. falciparum 9-14 days; P. vivax 12- 18 days; some strains 8-10 mths or longer. P.ovale 12- 18 days; P. Malariae 18-40 days.

Plasmodium vivax P. malariae P. falciparum and P. ovale

Not transmitted person to person, except rarely through blood transfusions. Infected cases may remain infectious for years if untreated or inadequately treated so that gametocytes persist.

Transmitted by the bite of an infective female Anopheles mosquito.


MEASLES (RUBEOLA) Highly infectious viral infection causing prodromal fever, severe cough, Coryza and Koplik's spots on the buccal mucosa and rash.

Notifiable Disease

10 – 14 days, usually 10 days. Rash appears 14 days.

Measles virus (Morbillivirus)

From up to 5 days before the rash appears until 4 days after the rash appears.

Airborne by droplet spread or direct contact with nasal or throat secretions of infected persons.

Virus can persist in the environment for up to two hours.

Airborne and Contact Precautions (Negative Pressure Room immediately)

Non-immune staff should not care for a patient with Measles. Contact IPC team. Initiate Measles Patient Management plan. Refer to Infectious Diseases Physician (IDP) for advice. Notify the Public Health Unit on 92228588

MENINGITIS – VIRAL Viral infection of the meninges caused by a variety of viruses, most commonly associated with Gastroenteritis.

Varies according to specific infectious virus.

Multiple viruses Often not identified.

Varies according to the specific infectious virus.

Faecal oral route and respiratory secretions.

Standard Precautions.

Viral meningitis is relatively common, but rarely serious, though symptoms may be severe. Recovery is usually complete.

MENINGOCOCCAL Severe bacterial infection, which may result in meningitis, septicaemia, joint infection, eye infection, pneumoniae and rash. Notifiable Disease

Usually 3-4 days but can vary from 1-10 days.

Neisseria meningitides

Whilst meningococcal bacteria are present in the nose and throat. The bacteria disappear within 24 hours of starting appropriate antibiotic therapy.

Direct contact and respiratory droplet spread from nose / throat secretions of an infected person who is likely to be an asymptomatic carrier.

Droplet Precautions

Precautions to be applied for 24 hours after beginning appropriate antibiotic treatment. Initiate Meningococcal Patient Management plan.


Disease Incubation

Period Infectious

Agent Period of




METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) Strain of Staphylococcus (Bacteria) resistant to antibiotic Methicillin and other antibiotics used to treat S. Aureus.

Not well defined as people can be colonised prior to infection.

Staphylococcus aureus

Whilst MRSA is detectable.

Colonisation without infection can occur.

Person to person transmission occurs through direct and indirect contact.

Contact Precautions (Standard precautions may apply in sub-acute areas – refer to relevant patient management plan/IPC team) Initiate appropriate MRSA Patient Management plan. Bacteria are easily shed from skin and purulent discharge contains high concentrations of bacteria.

MUMPS Viral infection causing painful, swollen salivary glands, fever, headache, painful testicles or ovaries. Notifiable Disease

14 – 25 days, Usually 15-18 days.

Mumps virus Transmissible from 6-7 days before, to 9 days after the onset of swelling of glands.

Respiratory aerosols, droplet spread and direct contact with contaminated saliva.


MYCOPLASMA Bacteria; common cause of mild pneumonia, bronchitis and sore throat.

2-3 weeks. Mycoplasma pneumoniae

Probably less than 20 days. Spread is by contaminated droplets produced by coughing or sneezing, or by direct contact with objects soiled by these.

Droplet Precautions

Antibiotics may speed recovery but appear not to reduce the period for which a person is able to transmit infection.

NOROVIRUS A virus that was previously called Calici virus and Norwalk-like virus that causes Gastroenteritis symptoms.

Symptoms usually begin 24-48 hours after ingestion of the virus but can appear as early as 12 hours after exposure.

Small round structured viruses (SRSVs) including Noroviruses and other Caliciviruses, Astroviruses and Adenoviruses

Infectious from the day symptoms commence until at least 48 hours after diarrhoea has ceased. Shedding in the absence of clinical illness can persist for wks/mths, especially in immunocompromised individuals.

Faecal-oral route. Norovirus can be found in the stool and vomit of infected persons.


(Droplet Precautions if patient is vomiting.) Initiate Gastroenteritis Patient Management plan. Isolate / exclude from work, until 48 hours symptoms free.

Common cause of outbreaks.

PARAINFLUENZA Virus that causes respiratory symptoms including fever, Croup, Bronchiolitis, and Pneumonia.

Ranges from 2 to 7 days.

Paramyxoviridae Virus is shed for about 1 wk, but immuno-compromised individuals may shed for much longer. Parainfluenza viruses can remain viable on surfaces for up to 10 hours.

Person-person by direct contact with infected secretions through respiratory droplets or contaminated surfaces or objects.

Droplet Precautions

(For duration of active disease) Parainfluenza virus is highly contagious. Initiate Bronchiolitis Patient Management plan.


Disease Incubation

Period Infectious

Agent Period of




PARVOVIRUS (ERYTHEMA INFECTIOSUM - B19) Viral infection causing mild illness with little or no fever but a striking redness of the cheeks. Also known as "Slapped Cheek Disease’ or "Fifth Disease".

4-20 days to development of rash.

Human Parvovirus B19

Usually only before the onset of the rash. People with aplastic crisis, infectious for a further week.

Contact with infected secretions. Vertical transmission from mother to foetus. Blood transfusion.


Exclude HCWs with symptoms from high-risk patients. No vaccine for Human Parvovirus 19. Seek specialist advice if patient / HCW pregnant or immune deficient. Immunocompromised persons may become chronic carriers.

PERTUSSIS – SEE WHOOPING COUGH RESPIRATORY SYNCITIAL VIRUS Virus that causes lower respiratory tract disease. Commonly causes Bronchiolitis in children

2 to 8 days. Respiratory syncytial virus (RSV)

Uncertain, but probably from before symptoms develop until recovery from the infection. Most people recover from the infection within about 10 days.

Spread through secretions from coughing and sneezing, close personal contact, such as touching or shaking hands, and touching objects or surfaces that have the viruses on them then touching the mouth, nose, or eyes.

Droplet Precautions Initiate Bronchiolitis Patient Management plan.

ROTAVIRUS Viral infection causing Gastroenteritis. Common in children.

24 – 72 hours. Rotavirus Until 48 hours symptom free.

Faecal -oral route. Respiratory - oral route.

Contact Precautions (add Droplet if vomiting)

Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan.

RUBELLA A virus causing fever, sore eyes, swollen glands, generalised rash.

Notifiable Disease

14-17 days, (range from 14-21 days).

Rubella virus One week before and 4 days after the onset of rash.

Spread directly by mucous membrane contact with infected airborne droplets from nose and throat, and indirectly by contact with hands, tissues and other infected items.



Disease Incubation

Period Infectious

Agent Period of




SALMONELLA Bacterial infection causing symptoms of Gastroenteritis.

Notifiable Disease

6 – 72 hours, (Usually 12-36 hours).

Salmonella spp. (2000 known serotypes)

Course of infection usually several days to several weeks. Faeces always infectious whilst symptoms are present.


Isolate / exclude from work, until 48 hours symptoms free. Initiate Gastroenteritis Patient Management plan. HCWs, including Food Service staff, to be excluded until they have had 3 consecutive negative faecal specimens. Antibiotics given in the acute illness can prolong the carrier state.

SCABIES Parasitic infection, caused by a mite, which burrows beneath the surface of the skin.

2 - 6 weeks in a person not previously exposed. 1-4 days if re- exposure has occurred. Norwegian Scabies - 10-14 days.

Sarcoptes scabiei Scabies is transmissible until mites and eggs are destroyed by treatment, usually two courses one week apart.

Itching may persist for 1 - 2 weeks after eradication of the mite.

Skin-to-skin contact with an infected person or contact with infested clothing, towels or bedding.

Scabies may survive off the skin for up to 48 hours in room conditions.

Contact Precautions

Precautions required until 24 hours after treatment commenced. Initiate Shingles Patient Management plan.

Norwegian Crusted Scabies is a virulent infestation that is highly infective and difficult to treat. Maybe misdiagnosed as psoriasis or eczema.

SHINGLES (HERPES ZOSTER) Shingles infection results from reactivation of the person's endogenous Chicken pox virus.

Notifiable Disease

N/A Varicella Zoster Virus

From when the rash appears until all blisters have dried up.

Generally considered infectious up to 1 week after the appearance of the lesions.

A person with Shingles cannot transmit Shingles to another person. Persons not immune to Chicken pox can contract Chicken pox following contact with the fluid from the vesicular lesions.

Contact Precautions

HCWs that are not immune to Chicken pox should not care for patients with Shingles.

Lesions should be covered if possible to reduce transmission risks. Lesions usually follow dermatome patterns of spread. Post neuralgic pain can persist for months.

STAPHYLOCOCCAL DISEASE (Staphylococcus aureus – MSSA) Gram positive bacteria that causes a wide variety of diseases. NB: Multiple species of Staphylococci.

The incubation period is variable and indefinite. It is most commonly 10 – 14 days.

Staphylococci species

As long as the organism is carried on the skin. A person does not have to have symptoms of infection to be able to transmit the bacteria.

Direct and Indirect contact.

Standard Precautions Virulence varies greatly amongst the bacterial strains.


Disease Incubation

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Agent Period of




TUBERCULOSIS - PULMONARY Acute or chronic pulmonary bacterial infection. Common symptoms include chronic cough, haemoptysis, fever, night sweats and loss of weight.

Notifiable Disease

2-10 wks to primary lesions or tuberculin reactivity. Latent infection may exist for a lifetime, but immune suppression may reactivate disease.

Mycobacterium tuberculosis

As long as viable bacilli are being discharged from the sputum until 2-4 weeks after appropriate chemotherapy has begun.

Airborne droplet infection spread is the predominant mode of transmission. Other modes of transmission such as invasion through mucous membranes or damaged skin are extremely rare.

Airborne Precautions (Negative Pressure Room immediately)

Contact IPC team. Initiate Pulmonary Tuberculosis Patient Management plan. Refer to Infectious Diseases Physician (IDP) for advice. Notify the Public Health Unit on 92228588

TUBERCULOSIS - EXTRAPULMONARY Tuberculosis of organs other than the lungs, such as lymph nodes, abdomen, genitourinary tract, skin, joints and bones, meninges. Notifiable Disease

Varies from 2 weeks - 4 weeks.

Mycobacterium tuberculosis

Extra pulmonary tuberculosis, other than laryngeal infection, is generally not communicable. Urine is infectious in cases of renal tuberculosis.

Indirect contact via hands and equipment.


Consider Airborne / Contact Precautions for draining lesions.

TYPHOID Bacterial infection causing high fevers, headache, malaise, anorexia enlarged spleen, dry cough, rash, constipation or diarrhoea. Notifiable Disease

From 3 days to more than 60 days. (Usually 8-14 days for Typhoid, and 1-10 days for Paratyphoid).

Salmonella typhi Salmonella paratyphi

Whilst Typhoid bacilli are in excreta. Usually from the first week of illness until completely recovered. 10% of untreated patients will remain infectious for 3 months.

Faecal-oral route or ingestion.

Contact Precautions

HCWs, including Food Service staff, to be excluded until they have had 3 consecutive negative faecal specimens.

VANCOMYCIN RESISTANT ENTEROCOCCUS (VRE) Bacterial strains of the genus enterococcus that are resistant to the antibiotic Vancomycin.

As people can be colonised for months prior to infection, the incubation period is not well defined.

Enterococcus Faecalis Enterococcus Faecium

Some people can be colonised with VRE and never get an infection.

Direct and Indirect Contact. Spread by direct contact from another colonised person, or from contact with unwashed hands or a contaminated surface. It is not spread through coughing or sneezing.

Contact Precautions

(Standard precautions may apply in sub-acute areas – refer to relevant patient management plan/IPC team)


Disease Incubation

Period Infectious

Agent Period of




VIRAL HAEMORRHAGIC FEVERS Group of viral infections causing fever, severe headache, myalgia and malaise, retrosternal chest pain, cough. Severe infections are complicated by massive haemorrhage and multi-organ failure.

Notifiable Disease

Ebola 2-21 days. Marburg 3-9 days Lassa fever 6- 21 days. Crimean- Congo 1-3 days.

Ebola virus Marburg virus Lassa Fever virus Crimean-Congo haemorrhagic fever

Ebola / Marburg: communicable as long as blood secretions contain virus. Lassa fever - acute febrile phase.

Crimean-Congo-Unknown.

Ebola / Marburg: Secondary person to person spread through direct contact with infected blood or secretions, including semen. Lassa Fever - direct contact via hands / contaminated materials of rodent’s urine / droppings. Crimean-Congo: bite of infective Hyalomma spp. Ticks.

Airborne / Contact Precautions and Quarantine Precautions

Contact IPC team. Refer to Infectious Diseases Physician (IDP) for advice.

Notify the Public Health Unit on 92228555 immediately to arrange transfer to appropriate facility.

WHOOPING COUGH (PERTUSSIS) Bacterial infection; damages respiratory epithelium causing respiratory obstruction and paroxysmal coughing. Notifiable Disease

Ranges from 6 – 20 days. (Usually 7-10 days).

Bordetella pertussis

Highly communicable in early coughing stage. Considered non-infectious 3 weeks after onset of cough, or after completion of 5 days of appropriate antibiotics.

Transmitted by droplet infection and direct contact with discharges from respiratory mucous membranes of infected persons.

Droplet Precautions Vaccination recommended for HCWs - with boosters currently recommended at approximately 10-year intervals.

Initiate Pertussis Patient Management plan.

management of common diseases april 2018

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