Notifiable diseases in 1984 Public Health Act

This page has been created to capture the information that was available on ganfyd, and which applied prior to the introduction, on 6 April of the new regulations. Please see the Notifiable diseases page for the current information. The rest of this page is copied directly from the old page.

The idea of having notifiable diseases is to be able to initiate appropriate public health action.^[1] This has come to include monitoring of vaccine preventable diseases and identification of vaccine failures, and there are additional benefits in terms of epidemiological data.^[2]

However, a cursory glance at the included diseases reveals that there a number of historically interesting conditions that are no longer relevant, and that there are many excluded conditions where notification would seem to offer advantages. Some examples of the latter are described below as diseases where public health should be informed.

Suspected cases of notifiable diseases must be reported to the Proper officer. This is a statutory duty on all clinicians. (If a diagnosis subsequently turns out to be incorrect, the notification can be updated.) There is a small fee payable for each report. A book of forms is provided on request by the Proper officer.

If the the local CCDC or equivalent is not also the proper officer (usually they are not), they should arrange to be informed where urgent action is required.

If a patient is in hospital, the hospital infection control team should also be notified promptly, according to local protocols.

Contents 1 Diseases notifiable under the Public Health (Control of Disease) Act 1984: 2 Diseases notifiable under the Public Health (Infectious Diseases) Regulations 1988: 3 Diseases which are not staturily notifiable, but which should nevertheless be reported to the local CCDC or equivalent by phone or fax 4 Notification by laboratories 5 Notification for under 8s day care and childminding 6 References

Diseases notifiable under the Public Health (Control of Disease) Act 1984:

NB - the 1984 Act has been modified by subsequent legislation (Health and Social Care Act) following a review of public health law. New regulations came into force on 6 April. They affect only England. For details see:

• Health Protection (LA powers) Regulations
• Health Protection (Part 2A orders) Regulations
• Health Protection (Notification) Regulations
• Health Protection Legislation (England) Guidance from Department of Health, Health Protection Agency, and Chartered Institute of Environmental Health^[3]

Notifiable diseases (PHA 1984) NB - this list cannot be guaranteed to be correct. For definitive list, see list at HPA web site

Disease	Suggested urgency. (Same day includes non-working days; your local protocols and clinical judgement take precedence over these suggestions - if in doubt, notify earlier, by telephone)	Notes
Food poisoning including suspected food poisoning	Immediately if VTEC (E coli O157); Same day (next day if after 23:00) if suspected to be part of an outbreak, if patient or any household contact is a food handler, or for any other reason considered urgent; Otherwise next working day	Note definition: "Any disease of an infectious or toxic nature caused by or thought to be caused by the consumption of food or water" If any any enteric pathogen is isolated from a stool sample, the case should be notified as food poisoning.
Cholera	Same day, unless after 23:00 when it can wait until 08:00	Remember to ask if patient or any household contact is a food handler
Plague	Same day, unless after 23:00
Relapsing Fever	Next working day
Smallpox	Immediately, on suspicion, even at night	Needs urgent action - could indicate bioterrorist activity
Typhus	Next working day

Diseases notifiable under the Public Health (Infectious Diseases) Regulations 1988:

Notifiable diseases (1988 regulations) NB - this list cannot be guaranteed to be correct. For definitive list, see list at HPA web site

Disease	Suggested urgency. (Same day includes non-working days; your local protocols and clinical judgement take precedence over these suggestions - if in doubt, notify earlier, by telephone)	Notes
Acute encephalitis	Same day (next day if after 23:00) if suspected to be part of an outbreak; Otherwise next working day
Acute poliomyelitis	Same day (next day if after 23:00) if suspected to be part of an outbreak; Otherwise next working day
Anthrax	Same day, or next day if after 23:00	Cutaneous anthrax much less urgent than pulmonary anthrax, which could be due to bioterrorism. If an outbreak is suspected, notify earlier; if deliberate release is suspected, notify immediately, even at night
Diphtheria	Same day (next day if after 23:00)	Remember to ask about vaccination status of case and contacts. (Check also - if it's a lab result, is it a toxin-producing strain?)
Dysentery (amoebic or bacillary)	Same day, or next day if after 23:00	Remember to ask if patient or any household contact is a food handler
Leprosy	Next working day
Leptospirosis	Next working day
Malaria	Next working day
Measles	Same day (next day if after 23:00)	Remember to ask about vaccination status of case and contacts; and remember infection risk to staff and other patients (measles is very infectious)
Meningitis	Next working day if viral; as meningococcal disease if thought to be meningococcal or pneumococcal	Remember to ask about vaccination status of case and contacts
Meningococcal septicaemia	Same day, or next day if after 23:00 where hospital provides chemoprophylaxis for immediate household contacts; immediately if local arrangements are that CCDC or public health on call person does this.	Remember to ask about vaccination status of case and contacts
Mumps	Next working day	Remember to ask about vaccination status of case and contacts; and remember infection risk to staff and other patients (mumps is very infectious)
Ophthalmia neonatorum	Next working day
Paratyphoid fever	Same day, or next day if after 23:00	Remember to ask if patient or any household contact is a food handler
Rabies	Same day, or next day if after 23:00	Ask about exposure and vaccination status. Vaccine may need to be obtained from national centre
Rubella	Same day (next day after 23:00) when exposure of pregnant patients has occurred; Otherwise next working day	Ask about vaccination status of case and contacts
Scarlet fever	Next working day	Check appropriate samples (including for group A streptococcus) have been sent
Tetanus	Next working day	Ask about vaccination status
Tuberculosis	Next working day
Typhoid fever	Same day, or next day if after 23:00	There are very stringent requirements for food handlers who are contacts of cases, as well as for those with the condition
Viral haemorrhagic fever	Immediately	See VHF page for list of diagnoses in this category
Viral hepatitis	Same day, or next day if after 23:00	Includes hepatitis A, hepatitis B, hepatitis C, hepatitis E, and any other viral hepatitis including chronic cases unless previously notified. Remember to ask about vaccination status, vaccination of contacts, and occupational risk factors - health care workers and/or food handlers may have to be excluded from work. Urgent treatment may be required for contacts, especially for cases of hepatitis A.
Whooping cough (Pertussis)	Next working day
Yellow fever	Same day, or next day if after 23:00

Diseases which are not staturily notifiable, but which should nevertheless be reported to the local CCDC or equivalent by phone or fax

Not necessarily notifiable diseases but nevertheless should be reported (some may sometimes be notifiable e.g. as "food poisoning")

Disease	Suggested urgency. (Same day includes non-working days; your local protocols and clinical judgement take precedence over these suggestions - if in doubt, notify earlier, by telephone)	Notes
Acute necrotising skin/soft tissue infections in drug abusers	Same day, or next day if after 23:00
Avian influenza	Notify immediately, even at night
Borreliosis (Lyme disease)	Next working day
Chickenpox when exposure of immunocompromised or pregnant patients or neonates has occurred	Same day (next day if after 23:00)
Chlamydia psittaci (psittacosis)	Next working day	Check particularly about contact with birds
Enteric infections not classed as food poisoning	As food poisoning	For hospital patients, the hospital infection control team should also be notified promptly
Streptococcus group A (when not causing scarlet fever, which is notifiable)	Notify Invasive group A streptococcal disease on same day (next day if after 23:00) if suspected to be part of an outbreak, e.g. if due to use of intravenous drugs; Otherwise next working day	Street supplies of drugs and needles have been associated with outbreaks
Haemophilus influenzae type B	Same day, or next day if after 23:00	Check immunisation status. Contacts sometimes require chemoprophylaxis and vaccination
Legionellosis	Same day, or next day if after 23:00	Patient will need to have legionellosis questionnaire administered
Listeria monocytogenes infection	As food infection
SARS	Immediately
Staphylococcus aureus if invasive, PVL positive infection	Next working day
West Nile Virus	Same day, or next day if after 23:00

Notification by laboratories

As well as clinician notification, reports of the following will usually be forwarded to the Health Protection Agency or its equivalent:

• Bacillus cereus food poisoning
• Campylobacter spp. infection
• Chlamydia pneumoniae
• Clostridium perfringens food poisoning
• Cryptosporidium spp. infection
• Dengue fever
• Entamoeba histolytica infection
• Food-borne infections (other)
• Giardia spp. infection
• Influenza
• Leprosy
• Lyme disease
• Malaria
• Mumps
• Norovirus infection
• Ophthalmia neonatorum (chlamydial or gonococcal)
• Pertussis
• Relapsing fever
• Rubella
• Salmonella spp.
• Shigella spp. (other than S. dysenteriae)
• Syphilis
• Tetanus
• Tuberculosis (smear negative)
• Vibrio parahaemolyticus infection
• Viral hepatitis carriers (e.g. B, C)

Notification for under 8s day care and childminding

According to the HPA website, national standards for childminders and day care organisations for children aged under 8 now require childminders to inform OFSTED of any child with a notifiable disease.^[4]

References