Chapter 29
Communicable disease control
Managing single cases of communicable diseases (Figure 29a)
The following issues need to be considered in assessing risk:
- Who is at risk?
- From what?
- How is it spread?
- What control measures are necessary?
- Who/what are the sources of advice?
- Where are the policies and guidelines?
Individual control measures that can be used include
- removal of the source of infection if possible
- treatment of the case as appropriate to reduce infectivity
- isolation/exclusion as necessary
- prophylaxis to close contacts (drugs, vaccine, immunoglobulin).
Case studies
Antibiotic prophylaxis to close contacts to prevent transmission
Meningococcal disease is spread from person to person, requiring close contact for transmission to occur. Close contacts of an infected individual are, therefore, offered antibiotic prophylaxis to prevent disease if they are not incubating it already, and eradicating meningococcal carriage to prevent further transmission.
Immunisation to contacts to prevent transmission
Hepatitis B is usually transmitted via infected body fluids or transplacentally. In the case of an infected pregnant woman, her newborn child is offered a course of immunisation after birth (with or without immunoglobulin) to prevent disease.
Isolation and treatment of the case to prevent transmission
Influenza can be infectious even before the onset of symptoms, making control of infection difficult. Isolation measures and antiviral treatment of the case reduce infectivity and the length of the infectious period.
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