For Health Professionals - High consequence infectious diseases

High consequence infectious diseases (HCIDs) are rare, acute and potentially fatal infections that can spread between humans and pose a threat to healthcare workers and the community. Any suspected HCID requires individual, community and system-level responses.

Examples of HCIDs include:

Viral Haemorrhagic Fevers (VHF)

Ebola
Marburg
Lassa
Crimean-Congo Haemorrhagic
South American VHFs
Severe Fever with Thrombocytopenia Syndrome

Respiratory HCIDs

Avian influenza and other novel influenza
MERS (Middle East respiratory syndrome)
Pneumonic plague
Hantavirus infection

Encephalitis HCIDs

Nipah virus infection
Hendra virus infection

Pox viruses

Smallpox

Newly emerged severe infections

The NSW Specialist Service for HCIDs (1800 424 300 - note this is a resource for health professionals only) at Westmead Hospital can provide health professionals 24/7 advice on any aspect of a suspected HCID case.

The NSW Specialist Service for HCIDs will initiate a case teleconference to address urgent issues related to safe immediate care, transport, and testing.

Suspected and confirmed HCIDs will be managed under the NSW Health Early Response to High Consequence Infectious Diseases Policy Directive (PD2024_005).

When to consider a HCID

Implement infection control precautions and take a detailed exposre history if your patient has:

febrile illness OR acute respiratory illness OR rash

AND

overseas travel in the 21 days¹ prior to illness onset OR direct physical contact with sick animals in Australia^2,3 .

^{1 Incubation periods range from a few days to three weeks for most HCIDs. For Andes hantavirus it can be up to 6 weeks.}

^{2 Consider Hendra virus in someone with an encephalitic illness and close contact}^{with sick horses.}

³ ^{Consider avian influenza in someone with close contact with dead or sick birds.}

If the above criteria are met:

Request the patient to wear a face mask and isolate from others
Implement contact + airborne precautions (including eye protection), including:

P2/N95 respirator
Non-sterile gloves
Eye protection
Long sleeved fluid resistant gown
Closed in shoes

If possible, place patient in negative pressure/single room with door closed.

A HCID may be considered if the travel history prior to illness onset includes one or more of the following.

Exposure to sick animals or birds, live animal or poultry markets, poultry or pig farms, animal slaughter or bats (including in caves or mines)
Significant exposure to rural areas or living conditions where rodents may be abundant
Tick bite
Participation in funeral rites
Overseas hospital admission
Travel to specific regions with current outbreaks of HCIDs
Contact with individuals with a suspected or proven HCID
Consumption of date palm sap
Exposure to laboratory specimens from a suspected or proven HCID case

If yes to any of these, call the NSW Specialist Service for HCIDs on 1800 424 300 and speak to the on-call HCID Physician.

Do not collect blood or clinical samples for testing before consulting the NSW Specialist Service for HCIDs.

The local Public Health Unit will assist in the risk assessment and management of any community contacts.

Hospital clinicians should refer to their hospital's contingency plan for assessing and managing patients who may have a HCID. Your local PHU (1300 066 055) can advise on contingency plans if necessary.

The NSW Specialist Service for HCIDs has a resource to support hospital clinicians in triaging patients with possible HCIDs in Emergency Departments.