Notifiable diseases

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The information on this page relates to the position in the UK

please see lists below for other nations

We have attempted, in the absence of a useful summary available from elsewhere, to summarise the new situation, as it has applied in England since 6 April 2010, on this page. This should not be considered definitive, and may include errors. The the list at the HPA web site should be consulted, or the following definitive documents are available:

Note that the usual rules on confidentiality are over-ridden by these Regulations: where a practitioner is obliged to notify a disease, they are not subject to the normal restrictions on maintaining patient confidentiality for the purposes of the notification.

Contents

Notifiable diseases, with explanatory notes and guidance on the need for urgent notification

Time frame and process for notifications

The registered medical practitioner (RMP) should send a written notification to the proper officer of the local authority so that it is received within three days, beginning with the day on which the RMP forms the clinical suspicion or makes the clinical diagnosis.

However, if the RMP considers the case requires urgent notification, they need to notify it orally – usually by telephone – as soon as reasonably practicable and follow this up with written notification within three days. It is recommended that urgent notifications are made as soon as possible after the RMP forms the clinical suspicion or makes the clinical diagnosis, and always within 24 hours.

Guidance on the procedures for notification, and a notification form, are available on the HPA web site. (Notifiers may modify the form to suit their requirements. Some HPUs have altered the form for local use; other RMPs can alter the form if they choose (e.g. to create a template containing their details), but the amended form must continue to include all the fields on the official form.

There is an aspiration that GPs should be able to notify electronically, so that their computer systems automatically recognise a diagnosis of a notifiable disease, and automatically notify it to the proper officer. This will require considerable development work.

According to the guidance:

"Written notifications to the proper officer of the local authority are either paper-based or, if the receiving local authority consents and facilities are available, may be made electronically by secure online reporting, by secure e-mail or by secure fax.

"The details of notification arrangements will usually be available on the local authority’s website. The local authority may indicate its consent to receiving electronic notification on their website."[2]

Data to be included

According to the guidance, the following data must have been included (to the best of the RMP's knowledge) for each case notified:[3]

  • name, date of birth and sex;
  • home address including postcode;
  • contact telephone number;
  • current residence (if it is not the home address);
  • NHS number;
  • occupation (if the RMP considers it relevant);
  • name, address and postcode of place of work or educational establishment (if the RMP considers it relevant);
  • ethnicity;
  • relevant overseas travel history;
  • contact details of a parent (if the patient is a child);
  • disease or infection which the patient has or is suspected of having or the nature of the patient’s contamination or suspected contamination;
  • date of onset of symptoms; and
  • date of diagnosis; and
  • the name, address and telephone number of the RMP making the notification.

Table 1: Notifiable diseases, with explanatory notes and guidance on the need for urgent notification

Notifiable diseases, with explanatory notes and guidance on the need for urgent notification
Disease Definition / comment Likely to be urgent?
Acute encephalitis Viral and bacterial Yes, if suspected bacterial infection
Acute poliomyelitis Yes
Acute infectious hepatitis Close contacts of acute hepatitis A and hepatitis B cases need rapid prophylaxis. Urgent notification will facilitate prompt laboratory testing. Hepatitis C cases known to be acute need to be followed up rapidly as this may signify recent transmission from a source that could be controlled. Yes
Anthrax Yes
Botulism Yes
Brucellosis No – unless thought to be UK-acquired
Cholera Yes
Diphtheria Yes
Enteric fever (typhoid fever or paratyphoid fever) Clinical diagnosis of a case before microbiological confirmation (e.g. case with fever, constipation, rose spots and travel history) would be an appropriate trigger for initial public health measures, such as exclusion of cases and contacts in high risk groups (e.g. food handlers). Yes
Food poisoning Any disease of infectious or toxic nature caused by, or thought to be caused by consumption of food or water (definition of the Advisory Committee on the Microbiological Safety of Food). Clusters and outbreaks, yes. For specific organisms see Table 2
Haemolytic uraemic syndrome (HUS) Yes
Infectious bloody diarrhoea See also HUS in Table 1 (Schedule 1) and VTEC in Table 2 (Schedule 2). Yes
Invasive group A streptococcal disease and scarlet fever Yes, if IGAS. No, if scarlet fever
Legionnaires’ Disease Yes
Leprosy No
Malaria No, unless thought to be UK-acquired
Measles Yes
Meningococcal septicaemia Yes
Mumps Post-exposure immunization (MMR or HNIG) does not provide protection for contacts. No
Plague Yes
Rabies A person bitten by a suspected rabid animal should be reported and managed urgently, but if a patient is diagnosed with symptoms of rabies, they will not pose a risk to human health. Yes
Rubella Post-exposure immunisation (MMR or HNIG) does not provide protection for contacts. No
SARS Yes
Smallpox yes
Tetanus No, unless associated with injecting drug use
Tuberculosis No, unless healthcare worker or suspected cluster or multi drug resistance
Typhus No
Viral haemorrhagic fever (VHF) Yes
Whooping cough (Pertussis) Yes, if diagnosed during acute phase
Yellow fever No, unless thought to be UK-acquired

NB: RMPs are also required to notify suspected cases of other infections (“other relevant infection”) or contamination (“relevant contamination”) that present, or could present, significant harm to human health - see Health Protection Legislation (England) Guidance 2010 sections 3.2 and 3.3 located at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4068403

Causative agents, with explanatory notes and guidance on the need for urgent notification

As regards urgency, the key consideration will be the likelihood that an intervention is needed to protect human health and the urgency of such an intervention. The likelihood of the diagnosis of an infection being considered urgent may also increase if it is part of a known or suspected cluster, or in someone with increased risk of transmission such as enteric infection in a food handler.

NB: The table below is only for guidance and each case should be considered individually.

Table 2: Causative agents, with explanatory notes and guidance on the need for urgent notification

Causative agents, with explanatory notes and guidance on the need for urgent notification
Notifiable organism Definition / comment Likely to be urgent?
Bacillus anthracis Yes
Bacillus cereus Only if associated with food poisoning No, unless part of a known cluster
Bordetella pertussis Yes if diagnosed during acute phase
Borrelia spp No
Brucella spp No, unless thought to be UK-acquired
Burkholderia mallei Yes
Burkholderia pseudomallei Yes
Campylobacter spp No, unless part of a known cluster
Chikungunya virus No, unless thought to be UK-acquired
Chlamydophila psittaci Yes if diagnosed during acute phase or part of a known cluster
Clostridium botulinum Yes
Clostridium perfringens Only if associated with food poisoning No, unless known to be part of a cluster
Clostridium tetani No, unless associated with injecting drug use
Corynebacterium diphtheriae Notify without delay, before results of toxigenicity tests are known Yes
Corynebacterium ulcerans Notify without delay, before results of toxigenicity tests are known Yes
Coxiella burnetii Yes if diagnosed during acute phase or part of a known cluster
Crimean-Congo haemorrhagic fever virus Yes
Cryptosporidium spp No, unless part of known cluster, known food handler or evidence of increase above expected numbers
Dengue virus No, unless thought to be UK-acquired
Ebola virus Yes
Entamoeba histolytica No, unless known to be part of a cluster or known food handler
Francisella tularensis Yes
Giardia lamblia No, unless part of known cluster, known food handler or evidence of increase above expected numbers
Guanarito virus Yes
Haemophilus influenzae Invasive i.e. from blood, cerebrospinal fluid or other normally sterile site Yes
Hanta virus No, unless thought to be UK-acquired
Hepatitis A, B, C, delta, and E viruses All acute and chronic cases All acute cases and any chronic cases who might represent a high risk to others, such as healthcare workers who perform exposure-prone procedures
Influenza virus No, unless known to be a new sub-type of the virus or associated with known cluster or closed communities such as care homes
Junin virus Yes
Kyasanur Forest disease virus Yes
Lassa virus Yes
Legionella spp Yes
Leptospira interrogans No
Listeria monocytogenes Yes
Machupo virus Yes
Marburg virus Yes
Measles virus Yes
[Mumps|Mumps virus]] No
Mycobacterium tuberculosis complex No, unless healthcare worker or suspected cluster or multi-drug resistance
Neisseria meningitidis Excluding asymptomatic cases (e.g. throat carriage) Yes
Omsk haemorrhagic fever virus Yes
Plasmodium falciparum, vivax, ovale, malariae, knowlesi No, unless thought to be UK-acquired
Polio virus Wild or vaccine types Yes
Rabies virus Classical rabies and rabies-related lyssaviruses Yes
Rickettsia spp No, unless thought to be UK-acquired
Rift Valley fever virus Yes
Rubella virus No
Sabia virus Yes
Salmonella spp Including S. Typhi and S. Paratyphi Yes, if S. Typhi or S. Paratyphi or suspected outbreak or food handler or closed communities such as care homes No, if sporadic case of other Salmonella species
SARS coronavirus Yes
Shigella spp Yes, except Sh. sonnei unless suspected outbreak or food handler or closed communities such as care homes
Streptococcus pneumoniae Invasive i.e. from blood, cerebrospinal fluid or other normally sterile site No, unless part of a known cluster
Streptococcus pyogenes Invasive i.e. from blood, cerebrospinal fluid or other normally sterile site, or associated with necrotising soft tissue infection Yes
Varicella zoster virus No
Variola virus Yes
Verocytotoxigenic Escherichia coli Including E. coli O157 Yes
Vibrio cholerae Yes
West Nile Virus No, unless thought to be UK-acquired
Yellow fever virus No, unless thought to be UK-acquired
Yersinia pestis Yes

Notification for under 8s day care and childminding

QuotationMarkLeft.png Ofsted should be notified of any food poisoning affecting two or more children looked after on the premises, any child having meningitis or the outbreak on the premises of any notifiable disease identified as such in the Public Health (Control of Disease) Act 1984 or because the notification requirement has been applied to them by regulations (the relevant regulations are the Public Health (Infectious Diseases) Regulations 1988). QuotationMarkRight.pngSureStart National Standards paragraph 7.12 (Sick Children)

According to the HPA website, national standards for childminders and day care organisations for children aged under 8 now require childminders to inform OFSTED of any child with a notifiable disease.[4]

History of disease notification

History of disease notification in England

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This section applies to England only

Notification was first made mandatory (London 1891, rest of England 1899) the responsibility for notification fell both on the head of household - (or nearest relative - or person in charge of the building), as well as the attending phyisician. This situation existed right up until 1968, when it became sole responsibility of the attending physician

Please see Notifiable diseases in 1984 Public Health Act for the situation as it applied in the UK until 6 April 2010, and as it may still apply in Scotland, Wales, and Northern Ireland since that date.

History of disease notification elsewhere

Template:Sweden According to this ProMED report,<refsec>ProMED-mail. MEASLES UPDATE (09). 2013; 20130303.1568573: ProMED-mail, Updated 3 March; Accessed: 2013 (3 March)</refsec> "Swedes are required by law to report falling ill to their doctor." It is not clear from the report which illnesses need to be reported, or how "illness" is defined.

External links


References

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