Latest News & Updates
COVID-19 Boosters
Published 25th November 2021
Recommendations regarding COVID -19 Boosters have been released 28/10/21 by the Australian Technical Advisory group on Immunisation (ATAGI). ATAGI advises that, the highest priority groups to receive booster doses are those with risk factors for severe COVID-19 and/or those at increased occupational risk, notably:
- People at greater risk of severe COVID-19: individuals aged 50 years and older, those with underlying medical conditions, residents of aged care and disability facilities, and Aboriginal and Torres Strait Islander adults.
- People at increased occupational risk of COVID-19: a booster dose for individuals in this group is expected to reduce their likelihood of SARS-CoV-2 infection and associated occupation-related impacts, acknowledging that infection will be mostly mild in these individuals due to prior vaccination and younger age.
To facilitate implementation of the COVID-19 vaccine booster program, ATAGI supports the use of a single booster dose for those who completed their primary COVID-19 vaccine course ≥6 months ago; initially to include, the groups above who were prioritised in the rollout of the vaccine program from early 2021. Refer to https://www.health.gov.au/sites/default/files/documents/2021/10/atagi-recommendations-on-the-use-of-a-booster-dose-of-covid-19-vaccine.pdf
World Sepsis Day 2021 and the National Sepsis Awareness Campaign
Published 21st September 2021
- https://www.safetyandquality.gov.au/sepsis-campaign
- Monday 13 September 2021 was World Sepsis Day – an initiative of the Global Sepsis Alliance established in 2012 to draw attention to the impact sepsis has on the lives of everyday people and their families.
- World Sepsis Day provides an opportunity for clinicians and the community alike to be aware of the signs and symptoms of sepsis, encourage prompt recognition and treatment, and ensure adequate support for survivors.
- The Australian Commission on Safety and Quality in Health Care, in partnership with The George Institute for Global Health are undertaking a National Sepsis Awareness Campaign targeted towards clinicians, health service organisations and the general community, focussed on reducing preventable harm caused by sepsis.
- The Campaign commenced on World Sepsis Day 2021 – 13 September 2021 – and will run for ten weeks through to 26 November 2021.
- Campaign theme The consistent theme to raise awareness nationally is: “Could it be sepsis?”
- By simply asking whether it could be sepsis, life-saving treatment can be provided to stop severe health complications and death. “Could it be sepsis” is an enabling phrase that the public can use to engage with clinicians when concerned and it empowers clinicians to suspect sepsis where patients present with no clear provisional diagnosis and there is the possibility of infection.
- A sepsis awareness toolkit and resources can be found at https://www.safetyandquality.gov.au/sepsis-campaign. The Commission is also developing a Sepsis Clinical Care Standard
- HICMR provide a PA tool to assist in auditing responses to sepsis in the Healthcare facility environment.
NSQHS Advisory- Implementing the Preventing and Controlling Infections Standards
Published 10th July 2021
- In May 2021, ACSQHC advisory AS21/01 version 1 was released.
- The requirements in this Advisory relate to all actions in the 2021 Preventing and Controlling Infections Standard and the interrelationships between these actions and all of the NSQHS Standards, in particular the Clinical Governance and Partnering with Consumers Standards.
- The following requirements are noted in this version:
- Health service organisations are required to commence implementation of the 2021 Preventing and Controlling Infections Standard immediately following its release in May 2021.
- Transition between the current and revised Prevention and Controlling Infections Standards to be fully implemented by 21 December 2021.
- From January 2022, compliance with the 2021 Preventing and Controlling Infections Standard will be assessed at the next accreditation assessment.
- See these websites for more information: Australian Commission on Safety and Quality in Health Care
AS 4187 / ACSQHC
Published 4th May 2021
In March 2021, ACSQHC advisory AS18/0 version 7 was released.
The following requirements are noted in this version:
“To comply with the requirements of Action 3.14 health service organisations should:
- a) By June 2021, complete a gap analysis to determine its current level of compliance.
- b) By December 2021, develop and document a plan to address identified gaps in compliance, specifying timeframes, milestones, and deliverables to support implementation.
- Compliance gaps may be addressed in a standalone plan or may be addressed as part of the organisation’s capital works and/or asset management and procurement planning cycles and may form part of a jurisdictional or private sector health services group capital works or asset management plan.
- c) Demonstrate progress toward implementing the plan”
- Full compliance is required by 31st December 2022. For HCFs that will not comply by this date, an action plan detailing strategy to achieve same with Executive endorsement should be completed prior to 31st December 2022.
- See Below website for more information.
Australian Immunisation Register (AIR)
Published 25th March 2021
- The Australian Immunisation Register (AIR) is a national register that records all vaccines given to all people in Australia.
- All Immunisation providers (Healthcare Facilities and/or Corporates) should apply to have access to the Australian Immunisation Register (AIR). Reporting to the AIR of COVID-19 and Influenza vaccinations commences 1st March 2021. Mandatory reporting of all vaccines to the AIR will be effective from 1 July 2021.
- AIR site: Recognised vaccination providers and administrators can use the AIR site through HPOS to record immunisation details for individuals, view and print immunisation history statements, request reports (for example due/overdue vaccinations report) and update their contact details.
- PRODA: PRODA is an online identity verification and authentication system. It lets you securely access online government services. PRODA is digital and portable across web enabled devices. You can use it from anywhere if you have internet access. Vaccination providers must first register for Provider Digital Access (PRODA) as an individual to access the AIR through Health Professional Online Services (HPOS). All vaccination providers and administrators who need access to the AIR site will need to have an individual PRODA account. This includes if you are a:
- medical practitioner, midwife, or nurse practitioner
- delegate of a medical practitioner, midwife, or nurse practitioner
- member of an organisation registered with the AIR as an ‘other’ vaccination provider such as a council, pharmacy, or commercial organisation.
See below website for more information.
COVID-19 UPDATES – VACCINE PREPAREDNESS
Published 25th January 2021
- The vaccine will be tested to ensure it is safe before it is made available to people. To make a vaccine available in Australia it needs to pass Australian safety standards set by the Therapeutic Goods Administration (TGA).
- The vaccine will be free.
- Australia plans to be ready to administer the first doses of the vaccine in February / March 2021, (To be confirmed) if the vaccine is safe and approved by the TGA. It is expected that there will be limited doses of the coronavirus (COVID-19) vaccine initially with certain groups to be prioritised for the first doses. Check the Australian Government website for latest updates.
- It is highly likely people will need two doses of the vaccine.
- Health care workers (HCWs) will play a key role in ensuring people in each state can get safely vaccinated. HCWs have been identified as a priority group to receive the vaccine.
- Each State Government is currently working with the Australian Government on the following elements to ensure they are prepared to roll out the vaccine:
- Strategy for roll out
- Safety - including monitoring, reporting and follow up
- Logistics including distribution and storage
- Workforce capacity and training to administer the vaccine
- Identifying priority groups that will be able to access the vaccine first
- Systems to support the vaccine roll out
- Evaluation
- Communication and engagement including engagement with the health care sector and priority populations.
Refer to your State COVID website for latest information.
COVID-19 UPDATES – Fit testing
Published 29th November 2020
The COVID-19 situation is changing rapidly and each state has a different epidemiological situation that is depicting guidelines. It is prudent to check the National and State COVID-19 sites daily. The below have been recently updated:
COVID-19 – CDNA National Guidelines for Public Health Units – SoNG, v3.9, 09 October 2020
https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm
There are currently programs in each state that are advocating / reviewing the requirement for fit testing:
Fit-testing measures the effectiveness of the seal between the respirator and the wearer’s face. It is required for all tight-fitting respirators, including:
• half-face disposable
• half-face reusable
• full-face reusable
• tight-fitting powered air purifying respirators (PAPR).
There are two methods of fit-testing that meet AS/ NZS 1715:2009 Selection, use and maintenance of respiratory protective equipment:
• Qualitative – a pass/fail test that relies on the wearer’s ability to taste or smell a test agent. This type of test can only be used on half-face respirators.
• Quantitative – uses specialised equipment to measure how much air leaks into the respirator. This type of test can be used on half-face respirators, full-face respirators and PAPR. Quantitative fit-testing results are more objective than qualitative testing because some workers have difficulty with their ability to taste or smell. This can result in a potential for a false pass to the qualitative fit-test and worker health not being adequately protected. For further information refer to www.standards.org.au and search AS/NZS 1715 and / or state direction / recommendations.
COVID UPDATES
Published 2nd September 2020
The COVID situation is changing rapidly and each state has a different epidemiological situation that is depicting guidelines. It is prudent to check the National and State COVID-19 sites daily. The below have been recently updated:
COVID-19 – CDNA National Guidelines for Public Health Units – SoNG, v3.8, 23rd August 2020 - https://www1.health.gov.au/internet/main/publishing.nsf/Content /cdna-song-novel-coronavirus.htm
For specific State and Territory information, including testing information, refer to:
ACT - https://health.act.gov.au/health-professionals/chief-health-officer-alerts
NSW - https://www.health.nsw.gov.au/Infectious/covid- 19/Pages/default.aspx
NT - https://coronavirus.nt.gov.au/stay-safe/if-you-are-unwell
SA - www.sahealth.sa.gov.au/healthalerts
TAS - https://www.coronavirus.tas.gov.au/keeping-yourself-safe/testing-for-covid19
VIC - https://www.dhhs.vic.gov.au/health-services-and-general-practitioners-coronavirus-disease-covid-19
RETURNING TO WORK POST POSITIVE COVID RESULT
Published 20th July 2020
*Diagnosis and management of COVID-19 must be undertaken by medical practitioners in accordance with the current guidelines from the State Health Depts/Public Health Units.
*Healthcare workers (HCWs) should NOT be their own testing or treating doctor.
*Clearance testing should be arranged by the HCWs worker’s employer, the HCWs treating doctor, or at a coronavirus assessment centre if testing by the treating doctor is not feasible.
*HCWs and workers in aged care facilities who meet the below criteria can be released from isolation and do not require further testing to return to work or an at-risk setting.
*However, these individuals must meet additional criteria before they can return to work.
1. Confirmed cases who are asymptomatic
The HCW can be released from isolation if at least 10 days have passed since the first respiratory specimen positive for SARS-CoV-2 by PCR was taken and no symptoms have developed during this period.
2. Confirmed or probable cases with mild illness who did not require hospitalisation
The case can be released from isolation if they meet all of the following criteria:
- at least 10 days have passed since the onset of symptoms; and
- there has been resolution of all symptoms of the acute illness for the previous 72 hours.
3. Confirmed or probable cases with more severe illness who have been in hospital
a. Confirmed and probable cases clinically ready for hospital Discharge - then they can be discharged to isolation at home or another facility. The case can be released from home isolation if they meet all of the following criteria:
- at least 10 days have passed since hospital discharge; and
- there has been resolution of all symptoms of the acute illness for the previous 72 hours.
b. Confirmed and probable cases who will be remaining in Hospital: A case that remains in hospital can be released from isolation if they meet all the following criteria:
- at least 10 days have passed since the onset of symptoms; and
- there has been resolution of all symptoms of the acute illness for the previous 72 hours and
- the case has had two consecutive respiratory specimens negative for SARS-CoV-2 by PCR taken at least 24 hours apart at least 7 days from symptom onset.
4. Significantly immunocompromised persons
In addition to meeting the appropriate criteria described in points 1, 2, or 3 above, persons who are significantly immunocompromised and are identified as confirmed or probable cases must meet a higher standard requiring additional assessment. They can be released from isolation when they meet the following additional criterion:
- PCR negative on at least two consecutive respiratory specimens collected at least 24 hours apart at least 7 days after symptom onset.
Nb: Refer to Current State Guidelines for Health Care workers guidelines as advice is updated regularly.
CLEANING REQUIREMENTS FOR CONFIRMED / SUSPECTED COVID-19 PATIENT ENVIRONMENT
Published 7th May 2020
The virus that causes COVID-19 infection is transmitted via droplets when an infected person coughs, sneezes or exhales. As these droplets are heavy and fall onto horizonal surfaces or the floor.
Therefore the importance of social distancing (1.5m), & the requirement to not touch eyes nose or mouth and routinely clean frequently touched surfaces is emphasized.
- The period of time the virus (SARS-COV-2) survives on inanimate surfaces varies dependent on the amount of soil and material present. Environmental temperature and humidity are also compounding factors.
- Cleaning is an essential component of the disinfection process, as organic material inactivates many disinfectants.
- Cleaning programs should include frequently touched surfaces (e.g.door handles, bed rails, call bells, lift buttons, stair rails, hand rails) and minimally touched surfaces (e.g. floors, blinds, walls).
- The cleaning of frequently touched surfaces should be undertaken more frequently within COVID-19 isolation rooms and / or intensive care units.
- Disinfection should be undertaken following cleaning, the choice of product is based on the manufacturers’ antiviral claims / ability of the product to kill the virus. Most chlorine based products are effective and are commonly used.
- Some disinfectants have 2 in 1 properties, i.e they have the ability to clean and disinfect using the one product. This is also the case for some disposable detergent / disinfectant wipes.
- Cleaning staff should receive explicit training regarding use of cleaning / disinfectant agents and donning / doffing of PPE.
Coronavirus (COVID-19)
Published 25th March 2020
The information on this page relates to the health and safety precautions and the business continuity plan that HICMR has put in place in response to the COVID-19 pandemic.
HICMR are closely monitoring and proactively responding to the developments associated with the coronavirus (COVID-19).
Current Status:
We understand that the rapidly evolving and unprecedented and widespread effects of COVID-19 may result in high levels of concern, however we want to reassure you that we are well-prepared and well-resourced to manage the impacts and will provide ongoing support.
Health and Safety
Our priority as always remains the health and safety of all customers, their patients, staff and families. Further, as an integral part of Australia's healthcare system, our priority is to ensure the service we provide to the Healthcare sector is not interrupted.
HICMR Response Team
A Pandemic Response Team has been established and is meeting regularly to monitor and respond to the situation. HICMR has established a Business Continuity Plan to ensure continuity of service to our customers and the Healthcare sector.
Continuity of Service
Our priority is to ensure our services remain uninterrupted. Accordingly a number of directives have been implemented to reduce any risk to our business operations.
- Our Support desk and IPC consultancy will continue to operate as per normal with enhanced response.
We appreciate this situation is unprecedented and changing by the day. We will provide updates in the event of changes to our response. In the meantime please do not hesitate to contact your IPC Consultant or Support desk for any further details.
JUST for your information: -
Social distancing
It is important to practise social distancing to stop or slow the spread of infectious diseases, such as COVID-19. The more space between you and others, the harder it is for the virus to spread.
Important tips include:
- You should aim to remain 1.5 metres apart from other people at all times. If you are required to move closer than 1.5 metres, ensure that the time spent within this proximity does not exceed 15 minutes
- Do not shake hands
- Do not share food
Where can I get more information?
Visit the Australian Government Department of Health homepage at www.health.gov.au
Call the Public Health Information Line on 1800 004 599.
Discuss any questions you have with the Public Health Agency monitoring you.
Contact your state or territory public health agency:
ACT call 02 5124 9213
NSW call 1300 066 055
NT call 08 8922 8044
QLD call 13HEALTH (13 43 25 84)
SA call 1300 232 272
TAS call 1800 671 738
VIC call 1300 651 160
WA visit www.healthywa.wa.gov.au or call your local public health unit.
Coronavirus (COVID-19) – Background information only – This is a rapidly changing situation
Published 9th March 2020
Background
- December 2019, cluster of pneumonia cases occurred in Hubei Province in central China linked to a previously unknown virus.
- Identified as a Coronavirus which are known to cause differing illnesses including respiratory and gastrointestinal disease which can range from mild to very severe. Now named COVID-19 originally occurred in a group of people associated with a seafood and live animal market in Wuhan, the disease then spread to their families and HCWs.
- The disease spread outside China in January and has now been confirmed in 58 countries including Australia.
- As of 3/3/20 WHO reports 93,006 cases have been confirmed worldwide with 80,152 of those cases being in China; 3162 deaths have been reported with 2873 of those occurring within China. Refer to Coronavirus COVID-19 Global Cases for updated Global numbers.
- Coronaviruses circulate in a range of animals and sometimes ‘spill over’ from animals to humans occurs possibly due to a change in the virus or the increased contact between humans and animals, the animal reservoir for COVID-19 is not known yet.
Transmission
- While the exact transmission route is yet to be determined, COVID-19 is transmitted from person to person and likely to be through contact with droplets from an infected person’s cough or sneeze or touching objects or surfaces (like doorknobs or tables) that have cough or sneeze droplets from an infected person, and then touching your mouth or face including eyes.
Presenting symptoms
- These can be mild to severe eg. fever, cough and shortness of breath to pneumonia, kidney failure and death.
Diagnosis
- COVID-19 PCR testing of nasopharyngeal or oropharyngeal swab or sputum.
Treatment
- No specific treatment, supportive care only and currently no vaccine available to prevent the infection.
Preventing Transmission
- Travel restrictions are in place for visitors from mainland China and Iran (NSW) These restrictions will be continually reviewed.
- Quarantine of known possible contacts such as those returning from mainland China and Iran is currently being used to prevent transmission within Australia both in the form of self/home isolation and the use of formal quarantine stations.
Case Definition
Confirmed A person who tests positive to a validated COVID-19 test.
Suspect Person with history of travel to (including transit through) a country considered to pose a risk of transmission in the 14 days before the onset of illness. OR Close or casual contact in 14 days before illness onset with a confirmed case of COVID-19. AND Fever OR Acute respiratory infection (e.g. shortness of breath or cough) with or without fever.
Person under investigation It is recommended that clinicians should consider testing people with a clinically compatible illness who travelled to any of the following countries in the 14 days before onset of symptoms:
Higher risk: Mainland China (excludes Hong Kong, Macau and Taiwan), Iran, Italy, South Korea.
Moderate risk: Japan, Singapore, Cambodia, Hong Kong; Indonesia and Thailand.
(This list is based on the risk of the person having been exposed to COVID-19 due to travel to a country with sustained community transmission and other epidemiological evidence. Clinical and public health judgement should be applied).
For Hospital Presentations
- Standard plus Contact and Droplet Precautions, including eyewear to be used for routine care of suspected or confirmed cases of COVID-19 and patients that fit the criteria of Persons under Investigation.
- Standard plus Contact and Airborne Precautions, including eyewear to be used where aerosol generating procedures are undertaken eg. intubation, bronchoscopy or suctioning and for care of critically ill cases in ICU which should occur in a NP Room.
Refer to COVID-19 CDNA National Guidelines for Public Health Units for latest updates.
State Guidelines are being frequently revised
Refer daily to your state health website for up to date information and below guidelines/information.
https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm
https://www.health.gov.au/health-topics/novel-coronavirus-2019-ncov
https://openwho.org/courses/introduction-to-ncov
ACSQHC Education Modules updates
Published 9th March 2020
The Commission has a number of education resources to support healthcare workers (HCWs) and health service organisation’s (HSOs) in implementing effective infection prevention and control (IPC) practices.
The resources include:
- The Basics of Infection Prevention and Control: This module is suitable as an orientation for HCWs working in clinical and non-clinical settings, whether having direct, indirect or minimal contact with patients. The module includes a short quiz between sections to assess knowledge.
- Hand Hygiene Modules, which are designed for HSOs to use as part of their orientation program for HCWs. There are nine modules available which provide education on hand hygiene practices in a range of clinical areas. There are modules for Nursing and Midwifery, Medical and Surgical staff, Renal/Dialysis, Allied health, Dental, Student Health Practitioners, Non-Clinical staff and a Standard Theory Module for those who require hand hygiene knowledge but do not fit into the categories above.
- The Commission’s Infection Prevention and Control learning modules (modules 1 -10) which are designed to develop HCWs knowledge, understanding and implementation of the principles of IPC in the Australian healthcare setting. The modules include; Principles of IPC, risk management systems for infectious agents and infectious diseases, basic microbiology and multi-resistant organisms, cleaning, disinfection and sterilisation, infectious agent health screening and immunisation of HCWs, outbreak investigation and management, management of occupation exposure, renovation, repairs and redevelopment, basic epidemiology/statistics and surveillance and quality improvement. These modules are based on the content of the Australian Guidelines for the Prevention and Control of Infection in Healthcare. There is an associated workbook for this course.
The resources are available through the National Hand Hygiene Initiative Learning Management System (NHHI LMS). To access the modules, you will need to log into the NHHI LMS using your current login details, or register as a new user via: -
Measles Outbreaks 2019
Published 18th January 2020
- Measles remains a common disease in many parts of the world, including areas of Europe, Asia, the Pacific, and Africa, with outbreaks often occurring.
- However, the number of measles cases worldwide has increased substantially in recent years, with a number of countries currently experiencing severe and prolonged measles outbreaks eg. Tonga, Samoa, New Zealand
- Anyone who is not fully vaccinated against measles is at risk of becoming infected when traveling overseas. They may also risk exposing others to this highly infectious, serious illness either while travelling, or when they return to Australia.
- In Australia, the majority of measles cases are due to unvaccinated individuals becoming infected while travelling to countries in which measles is either common or there are outbreaks occurring. As measles is highly contagious, these people can then spread the disease to others, causing outbreaks, often before they are aware that they have the virus.
- People who are experiencing signs and symptoms of measles should seek medical attention. It is recommended that you call ahead to the medical practice or hospital emergency department to alert of them of your symptoms so that measures can be taken to limit your exposure to others upon your arrival.
- The Australian Government continues to closely monitor measles outbreaks overseas and in Australia.
- In Australia, many people have had two doses of measles vaccine, and most people born in 1965 or earlier have immunity from having had the disease.
- The Australian Immunisation Handbook provides relevant information about measles vaccination for healthcare workers.
World Antibiotic Week: 18th – 24th November, 2019
Published 7th November 2019
Antibiotic Awareness Week is here soon – see below resources available to assist your campaign.
1. The Australian Commission on Safety and Quality in Health Care https://www.safetyandquality.gov.au/our-work/healthcare-associated-infection/antimicrobial-stewardship/antibiotic-awareness-week/, Selected materials from previous campaigns are also still available.
2. NPS MedicineWise campaign information available from: https://www.nps.org.au/antibiotic-awareness Further digital resources to be made available by the end of the month.
3. World Health Organisation WAAW information and updates to be made available from: http://www.who.int/campaigns/world-antibiotic-awareness-week/en/
4. The Commonwealth Department of Health information, including infographic for consumers 'Do I need antibiotics?' is available: https://www.amr.gov.au/
Buruli ulcer (Mycobacterium ulcerans infection)
Published 12th September 2019
- Buruli Ulcer is a chronic debilitating disease caused by environmental Mycobacterium ulcerans.
- M. ulcerans is a member of the Mycobacteriaceae family of acid-fast bacilli. The same family to which the causative organisms for tuberculosis and leprosy belong.
- It presents as a non-tender lump often mistaken to be an insect bite. The lump which can be itchy, occurs anywhere on the body but is commonly at the joints of an exposed limb.
- 4 – 8 weeks after appearing, the lump generally breaks down and forms an ulcer with an undermined edge. This is due to the organism producing a unique toxin mycolactone – which causes tissue damage
- If left untreated, the ulceration can become wide-spread with significant loss of tissue. This can lead to permanent disfigurement and long-term disability.
- Occasionally the disease may present as a firm, painless elevated plaque or a large area including a whole limb may be indurated by oedema without an ulcer.
- WHO data indicates that Buruli Ulcer occurs in at least 33 countries with most cases arising in tropical and subtropical regions except where those occur in Australia, China and Japan.
- Australia has seen an increase in notifications of the disease since 2013 when 74 cases were reported, compared to the 358 cases reported in 2018.
- Within Australia, the disease exists in Far North Queensland and in parts of coastal Victoria where it is firmly entrenched.
- The exact method of transmission is unclear. The one widely accepted risk factor for contracting the disease is to live in a Buruli-endemic area. Following that, exposure to contaminated environments eg. water or soil and associated skin or tissue trauma including insect bites are thought to play their part.
- Early diagnosis and treatment are important to minimise tissue damage. Swabs of the ulcer should be taken for PCR and culture, and a tissue biopsy for (AFBs). Pathology request should note suspicion of M. ulcerans.
- Treatment can be a combination of antimicrobials and wide surgical excision of affected tissue.
- In-patients are managed with Standard Precautions and ulcers should be covered.
- Disease prevention may be assisted in endemic areas with the use of protective clothing when undertaking activities in the garden or in water.
References and for further information;
https://www.who.int/en/news-room/fact-sheets/detail/buruli-ulcer-(mycobacterium-ulcerans-infection)
Infections of the Respiratory System.
Published 20th August 2019
Upper Respiratory Infections: Common cold, Sinusitis Pharyngitis, Epiglottitis and laryngotracheitis: Most are of viral etiology. Epiglottitis and laryngotracheitis are exceptions with severe cases likely caused by Haemophilus influenzae type b. Bacterial pharyngitis is often caused by Streptococcus pyogenes.
Pathogenesis: Organisms gain entry to the respiratory tract by inhalation of droplets and invade the mucosa. Epithelial destruction may ensue, along with redness, edema, hemorrhage and sometimes an exudate.
Clinical Manifestations: Initial symptoms of a cold are runny, stuffy nose and sneezing, usually without fever. Other upper respiratory infections may have fever. Children with epiglottitis may have difficulty in breathing, muffled speech, drooling and stridor. Children with serious laryngotracheitis (croup) may also have tachypnea, stridor and cyanosis.
Microbiologic Diagnosis: Common colds can usually be recognised clinically. Bacterial and viral cultures of throat swab specimens are used for pharyngitis, epiglottitis and laryngotracheitis. Blood cultures are also obtained in cases of epiglottitis.
Prevention and Treatment: Viral infections are treated symptomatically. Streptococcal pharyngitis and epiglottitis caused by H influenzae are treated with antibacterials.
Lower Respiratory Infections: Bronchitis, Bronchiolitis and Pneumonia: Causative agents are viral or bacterial. Viruses cause most cases of bronchitis and bronchiolitis. In community-acquired pneumonias, the most common bacterial agent is Streptococcus pneumoniae. Atypical pneumonias can be caused by Mycoplasma pneumoniae, Chlamydia spp, Legionella, Coxiella burnetti and viruses. Nosocomial pneumonias and pneumonias in immunosuppressed patients have etiology with gram-negative organisms and staphylococci as predominant organisms.
Pathogenesis: Organisms enter the distal airway by inhalation, aspiration or by hematogenous seeding. The pathogen multiplies in or on the epithelium, causing inflammation, increased mucus secretion, and impaired mucociliary function; other lung functions may also be affected. In severe bronchiolitis, inflammation and necrosis of the epithelium may block small airways leading to airway obstruction.
Clinical Manifestations: Symptoms include cough, fever, chest pain, tachypnea and sputum production. Patients with pneumonia may also exhibit non-respiratory symptoms such as confusion, headache, myalgia, abdominal pain, nausea, vomiting and diarrhea.
Microbiologic Diagnosis: Sputum specimens are cultured for bacteria, fungi and viruses. Culture of nasal washings is usually sufficient in infants with bronchiolitis. Fluorescent staining technic can be used for legionellosis. Blood cultures and/or serologic methods are used for viruses, rickettsiae, fungi and many bacteria. Detection of nucleotide fragments specific for the microbial antigen in question by DNA probe or polymerase chain reaction can offer a rapid diagnosis.
Prevention and Treatment: Symptomatic treatment is used for most viral infections. Bacterial pneumonias are treated with antibacterials. A vaccine against 23 serotypes of Streptococcus pneumoniae is recommended for individuals at high risk
Reference: Dasaraju PV, Liu C. Infections of the Respiratory System. Medical Microbiology. 4th edition. https://www.ncbi.nlm.nih.gov/books/NBK8142/
Refer to HICMR Information Sheets - Common Causes of Respiratory Infections (New); Influenza; Human Metapneumovirus; RSV & Bronchiolitis and Legionella.
Therapeutic Goods Administration (TGA) - Listed hard surface disinfectants.
Published 9th July 2019
The new NHMRC Australian IPC Guidelines recommend the use of TGA-listed hospital-grade disinfectants with specific claims for the disinfection of hard surfaces in healthcare facilities.
This changes reflects regulation for hard surface disinfectants which have been implemented by the TGA. The streamlining of the regulatory pathway has resulted in changes to terminology and requirements of entry:
- Hard surface disinfectants which were previously “listed” (hospital grade without specific claims) are now exempt from the requirements of entry in the ARTG.
- Hard surface disinfectants which were previously ‘registered’ (hospital grade with specific claims) are now “listed” other therapeutics goods (OTG)
In addition, TGO 54 (Standard for Disinfectants and Sterilants) was superseded by TGO 104 (Standard for Disinfectants and Sanitary Products) on 1st April 2019.
Refer to TGA website for more information. - https://www.tga.gov.au/therapeutic-goods-order-54-standard-disinfectants-and-sterilants-tgo-54
6 WAYS TO FIGHT THE FLU
Published 1st May 2019
- Get a flu shot - It is important to get the influenza vaccination each year to continue to be protected, since it wears off after 3 to 4 months. Flu strains (types) also change over time.
- Wash your hands - In addition to vaccination, good hygiene is one of the best ways to help prevent colds and flu from spreading. Wash your hands regularly.
- Cover coughs and sneezes - Cover your mouth and nose when coughing or sneezing.
- Bin your tissues - Throw disposable tissues in the bin immediately after using them.
- Avoid sharing - Don't share cups, plates, cutlery and towels with other people, if you can.
- Keep surfaces clean - Clean surfaces such as your keyboard, telephone and door handles regularly to get rid of germs.
- Self-care at home - In most cases you can treat mild cold or flu symptoms at home.
- NOTE: Antibiotics won't help - Antibiotics do not reduce symptoms of colds and flu as these illnesses are caused by viruses. Antibiotics only work for bacterial infections.
WHO: 2019 WHO Global Survey on IPC and Hand Hygiene
Published 6th March 2019
- WHO has launched the 2019 WHO Global Survey on IPC and Hand Hygiene.
- It will be open for four months from 16 January to 16 May 2019.
- The survey has two levels, involving the completion of two tools at the health care facility:
- the WHO Infection Prevention and Control Assessment Framework (IPCAF), and
- the WHO Hand Hygiene Self-Assessment Framework (HHSAF).
- This is a great opportunity to perform a gap analysis of your programs and also be involved in this year’s Global campaign. For all Australian organisations wanting to participate please do not use the link previously provided – please use this link instead https://www.who-ipc-survey.org/?language=en&from=YAEKV58EZ8
- All data submitted via the WHO online system will be confidential. All resources for the campaign can be found here – https://www.who.int/infection-prevention/campaigns/clean-hands/5may2019/en/
- For information about the two surveys please see here – https://www.who.int/infection-prevention/campaigns/ipc-global-survey-2019/en/
- Prior to consideration please refer to your Corporate and HCF Executive for direction.
Management of Health Care Workers known to be Infected with Blood Borne Viruses
Published 29th January 2019
- The Australian National Guidelines for the Management of Health Care Workers known to be infected with Blood-Borne Viruses from the Communicable Diseases Network of Australia (CDNA) was published in April 2012. Since then there have been several advances in treatment and testing of blood borne viruses that has led to a revision of these guidelines.
- The New and updated guidelines are aimed at the prevention of transmission from, and the management and treatment of, healthcare workers (HCWs) with hepatitis B virus (HBV), hepatitis C virus (HCV) and/or human immunodeficiency virus (HIV).
- The Guidelines outline the professional standard expected of HCWs who perform exposure prone procedures (EPPs), HCWs living with a blood borne virus (BBV) who perform exposure prone procedures, and doctors treating HCWs with a BBV who perform EPPs. The Guidelines will allow HCWs living with HIV who comply with these guidelines to return to performing EPPs (excluded in the current guidelines). A table outlining exposure prone procedures has been developed to assist HCWs in assessing whether they perform EPPs and if they require testing and a number of fact sheets have also been provided.
- The Guidelines support healthcare workers to get timely testing and treatment. All healthcare workers who are performing EPPs are required to take reasonable steps to know their BBV status and to have appropriate and timely testing after potential exposures. Refer to Department of Health Website to access the updated guidelines: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdna-bloodborne.htm
CANDIDA AURIS (C. auris)
Published 5th November 2018
Public Health Alert: Candida Auris
- C. auris is a fungus which can cause colonisation on the skin, or invasive infections ( eg. Bloodstream or urine infections) and has caused outbreaks in other countries.
- People at highest risk of infection or colonisation include those with:
- Recent overseas healthcare admission ( particularly the UK, USA, South Korea, India, Pakistan, South Africa, Kuwait, Columbia and Venezuela)
- Diabetes Mellitus
- Recent Antibiotic Use
- Recent Surgery
- Central venous catheters.
- Colonisation is asymptomatic and generally on the skin, in the urine, or around an indwelling device. Invasive infection presents as sepsis, urinary tract infections, ear infections or line infections.
- C. Auris is of a major health concern as it:
- Causes serious infections - Case fatality rate 30-60%
- It is often resistant to anti-fungal medicines and may be untreatable.
- It is becoming more common internationally. Discovered in 2009, spread quickly and caused outbreaks. Case in Victoria.
- It is difficult to identify as it can be misidentified as other Candida species.
- It can spread readily in Nursing Homes / Aged Care.
Has caused outbreaks in HCF’s and can spread through contact with affected patients and contaminated surfaces or equipment. C. auris can live on surfaces for several weeks.
- It is important for laboratories and clinicians to be aware of the possibility of C. Auris in high-risk patients.
- Any confirmed cases of C. Auris in patients should be notified to State Health department immediately.
- Confirmed isolates C. Auris should be forwarded to State Reference laboratory as required.
- Patient Management: Isolation of all colonised or infected patients during all admissions. Contact precautions, decolonisation of colonised patient and disinfection of patient rooms and equipment should be considered.
NSW: New Regulations for Managing Cooling Systems
Published 3rd September 2018
NSW Health: Public Health Amendment (Legionella Control) Regulation 2018.
- Cooling water systems must be managed safely in order to prevent the growth and transmission of Legionella bacteria. Infection may cause Legionnaires’ disease, a serious and potentially life-threatening condition.
- NSW Health has strengthened the Public Health Regulation 2012 to require a performance based (or risk management) approach to managing cooling water systems. This approach allows each system to be managed according to its risk of Legionella contamination.
- From 10 August 2018, building occupiers are required to ensure that there are six key safeguards in place for their cooling water systems:
- Risk assessment of Legionella contamination documented in a Risk Management Plan (RMP) – every five years (or more frequently if required)
- Independent auditing of compliance with the RMP and Regulation – every year
- Providing certificates of RMP completion and audit completion to the local government authority
- Sampling and testing for Legionella and heterotrophic colony count – every month
- Notifying reportable laboratory test results (Legionella count ≥1000 cfu/mL or heterotrophic colony count ≥5,000,000 cfu/mL) to the local government authority
- Displaying unique identification numbers on all cooling towers.
- The requirements for building occupiers to test for Legionella bacteria on a monthly basis and notify high ‘reportable test results’ to the local government authority commenced on 1st January 2018.
- The above information will be included in the next HICMR Maintenance Policies updates – which are currently in progress.
VACCINE PREVENTABLE DISEASES IMMUNISATION FOR HEALTH CARE WORKERS (HCWs) AUSTRALIAN GOVERNMENT DEPARTMENT OF HEALTH
Published 2nd July 2018
FACTS:
- Infectious Diseases (ID) have no boarders.
- Widespread International travel enables ID spread between countries/across borders to people in cities or communities.
- Patient diagnosis of a disease is not always clear or identified immediately on admission.
- HCWs have increased risk of acquiring vaccine preventable diseases (VPD).
- If immunity status unknown HCWs/employees may be at risk of infection from patients and/or the environment.
- All HCWS must provide documented evidence of childhood vaccination records of immunisation/serology prior to employment.
- The National Australian Immunisation Register records vaccinations given to all Australians and ensures patient immunisation records are complete and available online for medical professionals.
The Australian Government Department of Health and Aging provides updated Australian Immunisation Guidelines to reflect latest national & international evidence for vaccination. If you missed any of your childhood immunisations or require assessment of your immunisation status your GP can assist/ advise/prioritise an action plan.
Refer to your HCF Staff Health Program coordinator if you require further information on specific requirements.
1. Australian Government Department of Health. Immunisations for healthcare workers. https://beta.health.gov.au/health-topics/immunisation/health-professionals/immunisations-for-health-care-workers
2. The Australian Immunisation Handbook. www.immunise.health.gov.au/.../publishing.nsf/Content/Handbook10 -home
NHMRC Draft Revised Australian Guidelines for the Prevention & Control Of Infection in Healthcare
Published 1st May 2018
- The National health & Medical Research Council (NHMRC) draft Guidelines have been updated to reflect the latest national & international evidence on Infection Prevention & Control (IPC). They are evidence based & focus on the critical aspects of IPC, including core principles, risk assessment & priority areas for action.
- The update has been led by the Infection Control Guidelines Advisory Committee. The evidence reviews commissioned by NHMRC are publicly available for background information. Nb. These reports are not subject to consultation.
Accessing the Guidelines
- NHMRC is piloting an interactive ‘living guidelines’ model. Two IT platforms are available to access the draft Guidelines:
- MAGICapp - an online interactive platform for developing & publishing guidelines (third party website) or
- NHMRC Interactive Guideline Platform (Aust Govt website).
- Once the final updated Guideline is released, users will have the choice of accessing the contents interactively through NHMRC’s website, MAGICapp’s website or as a mobile application with online / offline capability.
For more information & to provide feedback, please visit the consultation page & make a submission by 5pm (AEST) 15/05/18. https://consultations.nhmrc.gov.au/public_consultations/infection-healthcare
IT'S INFLUENZA VACCINATION TIME AGAIN!
Published 6th April 2018
- The Northern Hemisphere has experienced a significant increase in Influenza this season – so be prepared / protected.
- The recommended composition of Quadrivalent Influenza Vaccine for Australia in 2018 introduces a new A (H3N2) like virus strain when compared to the composition of the Trivalent and Quadrivalent Vaccines for Australia in 2017.
- For adults over 65 years, in addition to the Quadrivalent Influenza Vaccines (QIVs), two higher-immunogenicity Trivalent Influenza Vaccines (TIVs) are available (one is a high dose vaccine, and the other contains an adjuvant).
- The Influenza Vaccine components for the Australian 2018 Influenza season will contain the following:
- An A/Michigan/45/2015 (H1N1) pdm09 - like virus
- An A/Singapore/INFIMH-16-0019/2016 (H3N2) - like virus;
- A B/Brisbane/60/2008-like virus (belonging to the Vic lineage)
- A B/Phuket/3073/2013-like virus
- Vaccination is your best defence as recommended by the World Health Organisation / CDC / NHMRC – Australian Immunisation Guidelines.
- The HICMR Influenza HCW Toolkit has been updated with new information and is available on the Client Portal.
- Refer to Infection Prevention and Control (IPC) for details of the HCF Vaccination Program.
REVISED NATIONAL SAFETY & QUALITY HEALTH SERVICE STANDARDS (NQSHSS)
Published 17th December 2017
- The second edition of the NSQHS. Standards is now available for use.
- Assessment to the 2nd edition will commence from 1st January 2019. The 2nd edition streamlines actions & addresses gaps identified in the 1st edition. It also updates the evidence for actions, & consolidates & streamlines the Standards to make them clearer & easier to implement.
- The Preventing & Controlling Healthcare-Associated Infection Standard in the 2nd edition continues its focus on systems & processes that prevent & control healthcare-associated infection (HAI), which promote effective prescribing & use of antimicrobials as part of antimicrobial stewardship. Actions related to standard and transmission-based precautions have been brought together, & the wording across the standard has been revised to make the requirements clear.
- The Revised NSQHSS & Summary Fact Sheets are available at: https://www.safetyandquality.gov.au/our-work/assessment-to-the-nsqhs-standards/nsqhs-standards-second-edition/
