Communicable disease

EMTs are adequately prepared to identify, isolate, treat, safely refer and report communicable disease while providing adequate protection to other patients, staff and the environment.

Communicable diseases can pose a major health threat to populations after a disaster or in other emergencies when population density is high. EMTs must provide clinical management and public health interventions for patients and communities served by them and be aware of endemic communicable diseases that may be prevalent within the context they are working in, diarrhoea and acute respiratory infections being the most common. For specific communicable diseases such as cholera, severe acute respiratory infections (SARI) and viral haemorrhagic fever (VHF), specialized highly infectious disease EMTs can be deployed with the capacity to set up appropriate systems for triage, diagnostics, isolation, case management and referral of patients with the use of proper infection prevention and control (IPC) measures.

1. Establish case definitions at the triage area, screen for and identify potential communicable disease and create a dedicated patient pathway.
2. Isolate patients with potential communicable disease.

Type 1 Fixed, Type 2 and 3

• • Provide isolation facilities
  • Ensure availability of handwashing and separated sanitation facilities
  • Establish infectious water waste treatment
  • Separate donning (at entrance) and removal area (at exit) for PPE.

Type 2 and Type 3

• • Care for cases of communicable disease that need to be hospitalized.
  • Provide separate inpatient capacities with own access to hygiene facilities such as toilets and showers for patients in isolation.
  • Refer for further treatment as needed.

3. Report on a regular basis using the Minimum Data Set (MDS) or the format agreed with the health authorities. Data management will require sufficient resources which should not be underestimated.

1. Perform rapid diagnostic tests if available.
2. Establish functional linkages with other existing and available public health resources and capacities.

• EMTs might do the sampling, given they have access to the right PPE and other equipment and have received adequate training. The sample could then be transferred to a laboratory offsite, using necessary protective measures. Some outbreaks can only be confirmed by laboratory analysis, however, by having clearly defined alert and outbreak thresholds immediate action may be taken for suspected outbreaks.
• Type 1 teams often use isolation areas, using an additional smaller rapid set-up tent, with a basic design: separated donning (at entrance) and re-moval area (at exit) for PPE, handwashing facilities, infectious water waste treatment and separated sanitation facilities.
• EMTs with inpatient capacities managing complex cases, such as larger facilities, are cohorting confirmed cases.
• Isolation areas in EMTs might need to scale up if an outbreak enlarges, for example, a flood situation with diarrhoeal disease.