There have been >100 patients identified as having Mpox in the UK during the current outbreak. Most of these cases have been amongst men who have sex with men.
Reports have suggested that although lesions occur any where including palms and soles. Genital lessons and lymphadenopathy are very common
March 2024 – UKHSA warn there is increasing cases in DRC (Democratic Republic of Congo), so stay vigilant in travellers from central Africa.
Prevent the spread of infections by ensuring: routine immunisation, high standards of personal hygiene and practice, particularly hand-washing, and maintaining a clean environment. However, Public Health England recommend exclusion in some conditions.
Avian flu is droplet spread and can sometimes effect humans as well as birds. Severity varies in human cases varies widely from mild to severe and deaths have been reported.
In 2022 we can now refer Covid-19 patients who are being discharged into the “Oximetry @home” pathway.
CHFT staff need to complete the attached referral form and email it to the LCD email address on the form. LCD will then make contact with the patient within 24 hours and onboard them (as it’s an 8am-6pm service).
Study Running – Send Urine Sample prior to Antibiotics
(if this does not interfere with treatment of Red-Flag Sepsis)
Imaging in ED is only required if ED suspects:
There has been a resent increase in cases of Legionnaires Disease in the North West. So remember to request Urine Legionella Antigen test, if you have suspicions.
Recent Incident: Bat contact was not recognized (effectively touching a bat without gloves means treatment is recommended)
Rabies is an acute viral encephalomyelitis caused by members of the lyssavirus genus. The UK has been declared “Rabies-Free”. However, it is known that even in “Rabies-Free” counties the bat population posse a risk.
In the UK the only bat to carry rabies is the Daubenton’s Bat [Picture on the Left] and this is not a common bat in the UK. The UK and Ireland are Classified as “low-risk” for bat exposure. Despite our “low-risk” status in 2002 a man died from rabies caught in the UK from bat exposure.
Although rabies is rare it is fatal so we must treat appropriately, Public Health England – Green book details this.
To establish patients risk and thus treatment you need to establish the Exposure Category and Country Risk [Link to Country Risk]
Obviously patients with wounds will need appropriate wound care and cleaning, specifics for rabies are below.
If in ANY doubt, or you feel you need advice about treatment contact: On-Call Microbiologist (who will contact PHE or Virology advice)
You will likely need to liaise with the duty pharmacist to obtain vaccine or HRIG – which may need to be sent from a different hospital. [it is probably worth trying to obtain the 1st weeks treatment if possible, to avoid treatment delays]
Rabies and Immunoglobulin Service (RIgS), National Infection Service, Public Health England, Colindale (PHE Colindale Duty Doctor out of hours): 0208 327 6204 or 0208 200 4400
