Page content: 3.1 Notifications to the Dept. of Human Services | 3.2 Assessment of Notifications | 3.3 Referral | 3.4 Confidentiality

3.1 Notifications to the Department of Human Services

All medical practitioners and laboratories are bound by the Health (Infectious Diseases) Regulations 1990 to notify the Department of Human Services of cases of infectious diseases. The Disease Control Section of the Public Health Branch then determines, by a priority assessment process, which notifications should be referred through each region for investigation by local government and which will be handled directly by the Department.

Where local government becomes aware of a case(s) of a disease not previously notified to the Department of Human Services, it is essential that Disease Control Victoria be informed of the case(s).

3.2 Assessment of Notifications

Daily

Approximately 100 notifications of all notifiable infectious diseases are received each day by Disease Control Victoria. On the day of receipt, all notifications are visually scanned by the Surveillance Coordinator and assessed for the need to be further investigated.

Those notifications requiring further investigation are forwarded to the appropriate actioning officer in Disease Control Victoria according to an established protocol.

Weekly

All notifications are routinely reviewed on a weekly basis to identify clusters or changes in trends. Where appropriate, these are referred to the actioning officer in Disease Control Victoria.

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3.3 Referral

3.3.1 To Local Government:

Referrals to local government are those notifications identified as a priority for further investigation based on specified risk factors. This process is shown in flow chart 1.

Notifications are referred to each region within 1 working day, except in some circumstances where additional information is required to be obtained prior to referral.

Gastrointestinal Diseases Referred

• Food/Water borne illness
  
• Amoebiasis
  
• Campylobacter Infection
  
• Giardiasis
  
• Salmonellosis
  
• Shigellosis
  
• Yersiniosis

Risk Factors - Case is a:

• Food Handler
  
• Child Care Worker
  
• Health Care Worker
  
• Two or more associated cases
  
• Source of infection is implicated
  
• Where case has been a hospital inpatient
  
• Where case is a special care facility client

Cases for investigation will be referred to the local government area in which the case resides. The investigating officer may need to refer investigation of food premises, special care facilities, child care centres etc to other municipalities when a need for follow up is indicated as part of their investigation.

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3.3.2 To Region:

All priority notifications are referred through the regions for referral to local government. This enables identification of regional trends and monitoring follow up.

3.3.3 To Disease Control Victoria:

Clusters of gastrointestinal illness are generally followed up by an actioning officer within Disease Control Victoria. These cases are usually clustered in time or place with no apparent association and no other clear risk factors. Each case is followed up to determine whether there is any possible common source. Occasionally, cases are identified for priority follow up and referred to local government before being identified as part of a cluster (eg a doctor may notify a case of salmonellosis in a food handler which would be referred to local government for follow up. Results of Salmonella typing may then be received a few days later from the Microbiological Diagnostic Unit (MDU). Typing may indicate that the case belongs to a cluster of a particular serotype of Salmonella that Disease Control Victoria is following up.) Cluster investigations are also mentioned in Section 3.2 on page 5 and Section 5.3 on page 20.

3.4 Confidentiality

The health status of an individual is essentially a private matter between the patient and their doctor. Any investigation must respect the privacy of individuals.

In the course of an investigation officers will have access to a wide range of confidential information about an individual's health status.

During an investigation:

• Ensure your organisation can maintain that confidentiality
  
• Ensure that notifications and file notes are stored on confidential files to which only authorised officers (who have a need to check the details as part of their duties) have access
  
• It is preferred that information which has to be transported from DHS to local government and vice versa is sent via email. Where this is not possible, ensure that any information which is faxed is marked confidential and that officers at the receiving end, know when the information is being faxed
  
• Establish a system with the records office at local government whereby mail marked "CONFIDENTIAL" is not opened by anyone other than the person to whom it is addressed
  
• Speak about the condition only to the case, their doctor, authorised officers within your office and authorised Department of Human Services officers. Do not divulge information to other parties.

Guidelines for the investigation of gastrointestinal illness index