Staff disease surveillance

      1. Staff disease surveillance

Staff disease surveillance

Practices must ensure that all staff are aware that:

  • they must inform the infection prevention and control coordinator, practice manager or employer if they have a known or suspected relevant infectious disease that could be transmitted in the workplace (or are a close contact of someone with such an infectious disease) and that they should not come to work until they are considered no longer infectious
  • if they have a notifiable disease, they must not come to work until they have completed the required isolation period or met testing requirements, following health department advice.

Practices can implement routine protocols to reduce the risk of infection transmission between staff members (Table 6.2. Strategies for minimising risk of infection transmission between staff).

Practices should implement recommended exclusion periods for those with known or suspected infectious diseases (Table 6.3. Staff exclusion periods for infectious illness).

The infection prevention and control coordinator must stay up to date with health department requirements for notifiable diseases.

Table 6.2. Strategies for minimising risk of infection transmission between staff​

Practices could implement the following strategies:

  • Regularly communicate with all staff regarding the requirement to not attend the practice if they have any symptoms consistent with a current infectious disease outbreak, regardless of how mild.
  • Encourage testing in line with local public health unit advice.
  • Check the temperature of each staff member on commencement of each shift/ attendance at work and ask those with a temperature >37.5°C to seek further medical review.
  • Support any staff member who tests positive for an infectious disease, or is identified as a close contact or is required to self-isolate including by making them aware of their leave entitlements.
  • Encourage physical distancing in common areas (eg tea room), by setting density limits, by arrangement of furniture, and through floor markings and signage.
  • Require all staff to thoroughly clean communal items (eg cutlery) immediately after use by washing with hot water and detergent or by placing them in the dishwasher to be washed on the hottest possible setting.
  • During an infectious disease outbreak period:
    • require a verbal/written/electronic attestation from each staff member at the commencement of each shift confirming they do not have any symptoms consistent with the infectious disease outbreak, have not been in contact with a confirmed case, and have not been directed to isolate
    • where a staff member typically works across a number of sites within the business, minimise movement between sites by scheduling shifts at one location (where possible)
    • encourage tea breaks/lunchbreaks to be taken outside
    • stagger breaks to limit the number of people in common areas
    • encourage all team members to provide their own drinking vessels and cutlery
    • ban the sharing of food on site (eg cake and dips).

 

Table 6.3. Staff exclusion periods for infectious illness

Acute infection

Exclusion

Conjunctivitis

Must not provide patient care while eye discharge present.

Gastroenteritis – norovirus infection suspected

Must not come to work for at least 48 hours after resolution of symptoms (eg diarrhoea and/or vomiting).

Gastroenteritis – infection with other pathogen suspected

(eg giardiasis, Shigella infections, Salmonella infections, Campylobacter infections)

Must not come to work while symptomatic (eg diarrhoea and/or vomiting) and until 24 hours after symptoms have resolved.

Glandular fever

Not required (even for those with direct patient contact) if well enough to return to work and follow standard precautions.

Hand, foot and mouth disease

Must not come to work until all blisters have dried.

Exclusion not necessary for contacts of someone who has hand, foot and mouth disease.

Herpes Simplex infections (cold sores)

If exposed herpetic lesion, must not provide direct care to neonates, newborns, patients with severe immunocompromise, patients with burns or extensive eczema, or patients undergoing minor surgical procedures.

May provide direct patient care to other patients. Mask is unnecessary, but lesions should be covered with a dressing, if possible. Hand hygiene practices to minimise the risk of transmission need to be maintained.

Herpes Zoster infections (Shingles)

Must remain at home while unwell. Must not provide ANY direct patient care if lesions cannot be covered (eg ophthalmic zoster).

If active lesions can be covered, can provide care to all patients except for pregnant women, neonates, severely immunocompromised patients, burns patients and patients with extensive eczema.

Influenza

Must remain off work until at least one of the following applies:

  • The person is asymptomatic
  • The person has received 72 hours of influenza antiviral medication.
  • It is 5 days or more since onset of respiratory symptoms.
Should not participate in the care of (or enter the same area as) patients who are more susceptible to infection (such as hematopoietic stem cell transplant recipients) until symptoms have completely resolved AND it is at least 7 days from the onset of symptoms.

Pertussis infections (Whooping cough)

Staff should remain away from work for whichever specified period applies:

Those taking appropriate antibiotic

At least 5 days from commencement of antibiotic treatment

Those not taking appropriate antibiotic

At least 21 days from onset of symptoms

or

At least 14 days after the onset of paroxysmal cough (if known)

Viral respiratory tract infections: COVID-19 [SARS-COV-2], SARS-COV-1, MERS [MERS-CoV]), RSV, hMPV, common cold

Follow directives by jurisdiction health authorities.

Note: restrictions based on vaccination status may apply.

Scabies or lice infestations

Staff member should remain off work until 24 hours after first treatment started.

Staphylococcal infection (eg boils, wound infections)

Swab for culture and sensitivity. If multi-resistant organism or highly pathogenic strain identified, follow directives by jurisdiction health authorities.

Lesions must be covered with an occlusive dressing while at work.

If lesions cannot be covered, staff must not perform patient care or handle food for others until they have received appropriate antibiotic therapy and the infection has resolved.

Streptococcal infection (eg impetigo, tonsillitis)

Lesions on skin (eg impetigo) must be covered with an occlusive dressing while at work. If lesions cannot be covered, staff do not attend work until 24 hours after commencement of appropriate antibiotic therapy.

Staff with pharyngitis/tonsillitis should avoid patient contact for at least 24 hours after starting appropriate antibiotic therapy.

Tuberculosis (TB)

Exclusion until cleared – follow jurisdictional policy and TB service advice.

Viral rashes

Remain off work for specified exclusion period according to virus:

Virus

Exclusion period

Rubeola (measles)

Suspected: until test result known.

Confirmed: until serological evidence of immunity (ie IgG sero-positive and IgM sero-negative).

If measles develops: at least 4 days after appearance of rash.

Mumps virus

Suspected: until test result known.

Confirmed: until serological evidence of immunity (ie IgG sero-positive and IgM sero-negative).

If mumps develop: until resolution of parotid gland swelling or at least 9 days after the onset.

Rubella (German Measles)

Suspected: until test result known.

Confirmed: until serological evidence of immunity (ie IgG sero-positive and IgM sero-negative).

If rubella develops: until at least 4 days after appearance of rash.

Varicella (chickenpox)

Until all blisters dried (usually at least 5 days).

Human parvovirus B19 (Slapped Face)

Exclusion not necessary as non-infectious once rash develops.

Note: Staff should be screened for measles, mumps, rubella and Varicella infection before starting employment. If not immune, they should be offered vaccination unless contraindicated.

Source: NHMRC (2019)5

COV: coronavirus; COVID-19: coronavirus disease 2019; hMPV: human metapneumovirus, IgG: immunoglobulin G; IgM: immunoglobulin M; MERS: Middle Eastern respiratory syndrome; RSV: respiratory syncytial virus; SARS: Severe acute respiratory syndrome