CDC: Notify EMS of life-threatening diseases

Hospitals required to provide info promptly

When emergency responders transport an incoming patient who is later found to have a potentially life-threatening disease, they need to receive prompt notification from the hospital about the exposure risk. The Centers for Disease Control and Prevention has proposed a list of the diseases for which hospitals must notify the emergency medical services.

The Ryan White HIV/AIDS Treatment Extension Act of 2009 requires the notification and calls for the U.S. Department of Health and Human Services to list the diseases covered by the act.

"If an exposure occurs, there's to be an exchange of information in a very timely manner no later than 48 hours," says Katherine West, MSEd, CIC, BSN, a consultant with Infection Control/Emerging Concepts in Manassas, VA, who works with emergency medical services around the country.

The importance of timely notification was highlighted in a recent incident in California. On Dec. 3, 2009, an Oakland police officer responded to a 911 call to check on someone who had failed to show up for work. Finding the person unconscious in his home, the officer tried to clear his airway and called for emergency medical assistance. The officer didn't wear respiratory protection, but paramedics from the Oakland Fire Department and a local ambulance service did.

By the next morning, the hospital, Alta Bates Summit Medical Center, determined that the patient had N. meningitidis, but didn't notify Alameda County Public Health Department until Dec. 7, more than 78 hours after meningitis was first suspected, according to a Cal-OSHA citation. The police officer contracted meningitis and spent five days in the hospital.

Medical facilities "have an immediate responsibility to notify their designated infection control officer for the emergency medical services or law enforcement" under the Ryan White Act, says West.

"This law, when it came to be, was one of the most important pieces of legislation for fire rescue and law enforcement."

Infections requiring notification

NIOSH proposed the following potentially life-threatening infectious diseases on a notification list. (Newly emerging infectious diseases that fit the criteria may be added to the list.)

Routinely transmitted by contact or body fluid exposures

Hepatitis B (HBV).

Hepatitis C (HCV).

Human immunodeficiency virus (HIV) infection.

Rabies (Rabies virus).

Vaccinia (Vaccinia virus).

Routinely transmitted through aerosolized airborne means

Measles (Rubeola virus).

Tuberculosis (Mycobacterium tuberculosis) infectious pulmonary or laryngeal disease; or extrapulmonary (draining lesion).

Varicella disease chickenpox, disseminated zoster (Varicella zoster virus).

Routinely transmitted through aerosolized droplet means

Avian Influenza (Avian influenza A virus).

Diphtheria (Corynebacterium diphtheriae).

Meningococcal disease (Neisseria meningitidis).

Mumps (Mumps virus).

Plague, pneumonic (Yersinia pestis).

Rubella (German measles; Rubella virus).

SARS-CoV.

Smallpox (Variola virus).

Viral hemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo, and other viruses yet to be identified).