Case Studies in Infection
Training in Infection Control
The Bug Blog
2007 Outbreak Management Policy
|HPA Health Protection Unit Network|
Page updated 30 April 2007
If you suspect an outbreak (two or more cases of the same syndrome / organism)
ON FIRST SUSPICION, ward staff should:
Two or more cases of infection with indistinguishable organisms in one area constitute an outbreak and suggest a breakdown in normal hygiene practice. The infections may manifest themselves in patients on the same ward. However, different wards may be involved, the patients having a common source of infection.
It is usually impossible to be absolutely certain that two isolates of bacteria or viruses are the same, so they are generally referred to as indistinguishable.
Commonly detected outbreaks involve:
Decisions as to what action to take are made in consultation with the Infection Control Team, sometimes with Unit Administration and Consultants involved.
The urgency of a situation is determined by the virulence of an organism, by the nature of the disease involved, and by the vulnerability of the patients concerned.
It may be necessary to close a high risk ward to admissions if isolation is not possible (e.g. more than 2 cases of diarrhoea).
Visiting may need to be restricted. No movement of staff or patients from the outbreak ward is allowed until the outbreak is over, except for discharge home. Nursing staff (permanent, students and agency) should remain permanently attached to the ward if at all possible. Extra domestic cleaning support may be needed.
The microbiologists may wish to screen patients, staff and the environment for a particular organism if an outbreak has occurred.
Most outbreaks are dealt with on a day-to-day basis by the Infection Control Team, but in the case of large, serious or community-associated outbreaks or epidemics, an ad hoc working committee will be formed and will meet daily to determine action. This will be convened by Microbiologists with Consultants in Communicable Disease Control and appropriate administrator, and will co-opt appropriate personnel (eg A/E Consultants, Occupational Health Physicians), depending on the nature of the outbreak and will be rapidly disbanded when the problem is resolved.
For more specific details see policies on Food Poisoning, MRSA, and Tuberculosis
Report on the Committee of Enquiry into an outbreak of food poisoning at Stanley Royd Hospital . 1986 London HMSO.
Management of outbreaks of foodborne illness. 1994 Department of Health