Contents
Preface 5
Foreword 6
Standards for managing outbreaks 7
Outbreak management overview 8
1. Introduction 9
2. Policy and legal context 9
Public Health England 9
Local authorities 10
Coordination 10
3. Aim of this guidance 11
4. Definition of an outbreak and Outbreak Control Team 11
5. Management arrangements for outbreaks 12
Risk assessments 13
Cross boundary outbreaks 13
Cross border and international outbreaks 14
6. Recognition of an outbreak and initial response 14
7. Declaration of an outbreak 14
8. Convening an Outbreak Control Team 15
9. Role of the Outbreak Control Team 15
10. Investigation and control of the outbreak 16
Descriptive epidemiology 16
Analytical studies 17
Microbiological investigations 17
11. Communications 17
12. End of outbreak 18
Constructive debrief and lessons identified 18
Outbreak report 19
13. Audit 19
Resources Contained in Appendices 20
Appendix 1. Structure and organisation of Public Health England 21
Appendix 2. Public Health England incident levels 22
A2.1. Incident levels 22
A2.2. Escalation and de - escalation of incident level 22
Appendix 3. The Outbreak Control Team 26
A3.1. Membership of the OCT 26
A3.2. OCT terms of reference 27
A3.3. Template agenda for OCT meeting 28
A3.4. Roles and responsibilities of usual members of the OCT 29
A3.5. Roles and responsibilities of organisations 32
Appendix 4. Legal Duties and Powers 37
Appendix 5. Risk assessment 39
Appendix 6. Outbreak investigation and control 42
Appendix 7. Investigation protocol 44
Appendix 8. Conducting an analytical study 46
Appendix 9. Media strategy 48
Appendix 10. Constructive debriefing and lessons identified 49
Appendix 11. Final outbreak investigation report 51
A11.1. Standard structure 51
A11.2. Legal and confidentiality issues related to final outbreak reports 54
A11.3. Disclosure of Outbreak Reports 56
Appendix 12. Audit tool for outbreak standards 59
Appendix 13. Outbreak specific guidance 61
A13.1. Outbreaks in hospitals and other health care premises 61
A13.2/A12.2. Outbreaks on LA premises 62
A13.3/A12.3. Other useful guidance 62
Appendix 14. Examples of local outbreak plans 64
Appendix 15. Bibliography 65
Appendix 16. Abbreviations list 66
Table 1. Abbreviated PHE Incident levels 22
Table 2. Escalation and de-escalation criteria 22
Table 3. Detailed PHE incident levels 23
Boxes
Box 1. Descriptive epidemiology 16