HCID’s (High Consequence Infection Diseases)

High Consequence Infectious Diseases (HCIDs) include a group of rare but severe infections that require

ACTIONS – CARD HERE

Immediate isolation
Enhanced PPE
Early specialist involvement.

This page outlines the initial Emergency Department response, triage prompts, and required isolation locations

UKHSA list for HCID
UKHSA Country Specific HCID List

contact HCIDs are usually spread by direct contact with an infected patient or infected fluids, tissues and other materials, or by indirect contact with contaminated materials and fomites
airborne HCIDs are spread by respiratory droplets or aerosol transmission, in addition to contact routes of transmission

Contact HCIDs

Argentine haemorrhagic fever (Junin virus)
Chapare virus infection
Crimean Congo haemorrhagic fever (CCHF)
Ebola disease (EBOD)
Lassa fever
Lujo virus disease
Machupo virus infection
Marburg virus disease (MARD)
severe fever with thrombocytopaenia syndrome (SFTS)

Airborne HCIDs

Andes virus infection (hantavirus)
avian influenza A(H7N9) and A(H5N1)
avian influenza A(H5N6) and A(H7N7)
Middle East respiratory syndrome (MERS)
Nipah virus infection

MERS is classified as a High Consequence Infectious Disease (HCID), and although unlikely is serious and could be imported into the UK at ANY time. Risks are higher when there is increased travel to endemic areas such as Hajj.

Symptoms include fever and cough that progress to a severe pneumonia causing shortness of breath and breathing difficulties. In some cases, a diarrheal illness has been the first symptom to appear.

UKHSAThere are 3 Case definitions for assessing risk

Not just Ebola! VHFs are severe and life-threatening viral diseases that have been reported in parts of Africa, South America, the Middle East and parts of Europe. VHFs are of particular public health importance because they can spread within a hospital setting and in the community, have a high case-fatality rate and are difficult to recognise.

It may be malaria, but these patients MUST undergo a structured assessment first as per VHF algorithm and micro discussion.

Suspect VHF in any patient with;

Fever (or history of fever)
Relevant travel or exposure within the last 21 days.

Symptoms can include

Fever
Brusing or active breathing
Vomiting or diarrhoea
Headache
Myalgia

Key risk factors include travel to particularly sub‑Saharan Africa, contact with healthcare settings, funeral practices, or bodily fluids of a confirmed/suspected case.

UKHSA Viral Haemorrhagic Fever algorithm, use links at top to see individual countries as outbreaks change countries risk

This is a UK concern due to concern over mutation to human transmission. It is rare but can be fatal.

Suspect avian influenza in patients with fever, acute respiratory illness and recent exposure to birds, poultry farms,live bird markets, or travel to regions with active outbreaks.

Clinical criteria can be found – HERE

SITE Specifics

HRI:

Primary site for Pre-alerts
1 Patient – goes to Isolation Room
2 Patients – second patient goes to Minors 5
- end of corridor and lounge closed off
3+ Patients – ALL MERS patients moved to Minors Corridor
- Minors corridor closed
- Minors/UCH moved to uSDEC
- Internal Trust Critical Incident

CRH:

1 Patient – goes to “Nursing/Investigation room” Donning room is Front Door Assessment Room, Doffing Room – HCA Investigations room.
- Corridor closed from treatment room to door to ambulance corridor
- Patients moving from majors wait to department will need to go outside to ambulance entrance

CRH – If possible and with micro discussion aim to get patient to Negative Pressure rooms on Respiratory/Paeds/ICU