Communicable Disease Control Guidelines



Republic of Iraq

Ministry of Health

Public Health Directorate

Communicable Diseases Control Center

COMMUNICABLE DISEASES CONTROL

GUIDELINES

By

CDC Center

Iraq-Baghdad Feb, 2012 Second Edition

Major Contributors

Dr. Hassan H. Baker, M.B.Ch.B., F.I.C.M.S. (FM)

Public Health Directorate Director General

Dr. Hassan Muslem Abdul Hussein, M.B.Ch.B., D.C.M., F.I.C.A.M. (O&E)

Communicable Diseases Control Center Director

Dr. Anwar Noah Ghazala, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Other Contributors

Dr. Mohammed Khider, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Mr. Hussein Salman Yousif, D.C.M.

Communicable Diseases Control Center

Dr. Adnan Nawar, M.B.Ch.B., M.P.H.

Communicable Diseases Control Center

Dr. Munir Kubba, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Dr. Shaker Mahsen, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Dr. Karim A. Moftin, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Dr. Sinan Ghazi, M.B.Ch.B., F.I.C.M.S

Communicable Diseases Control Center

Dr. Sumaia Albadri, B.V.M., M.Sc.

Communicable Diseases Control Center

Dr. Sabah Mahdi, M.B.Ch.B., D.C.M.

Communicable Diseases Control Center

Dr. Yusra Khalif, M.B.Ch.B., M.Sc.

Communicable Diseases Control Center

Dr. Ataallah M. Turkey, M.B.Ch.B., M.Sc.

Communicable Diseases Control Center

Mrs. Wasan Abdulaziz Al.Tamimi, BSc. MPH.

Communicable Diseases Control Center

Table of Contents

Introduction 4

Group 1: Immediate Notification Diseases 5

1.1 Acute Flaccid Paralysis (AFP) Surveillance 6

1.2 Anthrax 8

1.3 Cholera 11

1.4 Crimean-Congo Hemorrhagic Fever 14

1.5 Diphtheria 16

1.6 Influenza H1N1, H5N1 19

1.7 Plague 22

1.8 Pertussis (whooping cough) 24

1.9 Acute Poliomyelitis 27

1.10 Rabies 30

1.11 Rubella (German measles) 32

1.12 Meningococcal Disease 35

1.13 Malaria 38

1.14 Measles 42

1.15 Tetanus 45

1.16 Food Poisoning 48

Group 2: Weekly Reported Diseases 49

2.1 Acute Diarrhea 50

2.2 Cutaneous Leishmaniasis 51

2.3 Visceral Leishmaniasis 53

Group 3: Monthly Reported Diseases 55

3.1 Viral Hepatitis 56

3.2 Brucellosis 64

3.3 Chicken pox 66

3.4 Echinococcosis (Hydatid disease) 69

3.5 Leprosy 71

3.6 Mumps 74

3.7 Schistosomiasis 77

3.8 Ascariasis 80

3.9 Ancylostomiasis (Hookworm disease) 83

3.10 Trichuriasis 86

3.11 Strongloidiosis 88

3.12 Enterobiasis 90

3.13 Cestodiasis (Hymenolepis) 93

3.14 Taeniasis (taenia saginata) 95

3.15 Amoebiasis 98

3.16 Giardiasis 101

3.17 Acute Lower Respiratory Infections (ALRI) 104

3.18 Toxoplasmosis 106

3.19 Typhoid and Paratyphoid fever 108

Annex 1: Communicable Diseases notified in 2011 in comparison with 2010 111

Annex 2: Toolkit for the Important Vectors and Vector-borne Diseases in Iraq 112

Annex 3: Toolkit for the Pesticides used in the field of Public Health 114

Annex 4: Communicable Diseases Classification Instructions 116

References 118

Introduction

The first edition of the communicable diseases control guidelines, published in 1999, was widely appreciated and has been used as a reference for more than a decade. Given that Iraq is currently experiencing a period of growth, development, and reform, we feel it is an opportune time to write the second edition of these guidelines. This is an ongoing and evolving process – we hope to continue editing the guidelines every three years to provide medical and paramedical staff with the most up-to-date information as they work to promote public health, deal with outbreaks of communicable diseases, and improve early detection and surveillance systems through Iraq.

The guidelines cover the diseases that are currently included in the Iraq surveillance system. These diseases are broken down into three main groups:

• Group 1: Immediate Notification Diseases

• Group 2: Weekly Reported Diseases

• Group 3: Monthly Reported Diseases

Each individual guideline also includes:

1. Identification of the disease (Case Definition of Suspected, Probable, and Confirmed cases).

2. Infectious agent

3. Occurrence

4. Reservoir

5. Mode of Transmission

6. Incubation Period

7. Period of Communicability

8. Susceptibility and resistance

9. Methods of Control, which include:

a. Preventive Measures

b. Control of patient, contacts, and immediate environment

c. Epidemic measures

d. Disaster implications

e. International measures

Group 1: Immediate Notification Diseases

1.1 Acute Flaccid Paralysis (AFP) Surveillance

ICD-10 AFP

It is an essential strategy of Polio Eradication Initiative (PEI), which aims to look for wild poliovirus circulation in the community, to investigate all possible polio cases. AFP surveillance is surveillance for all suspected or possible polio cases. Its purpose is to detect areas and groups where poliovirus transmission is occurring or likely to occur and to allow supplementary immunization to be focused where needed.

Case classification

AFP case: Any patient under 15 years of age with acute, flaccid paralysis, or any person of any age in whom a clinician suspects polio.

Contact: A contact is defined as a child less than 5 years of age who has been in direct contact with the index AFP cases within one week prior to the onset of paralysis and/or within two weeks after onset of paralysis.

Types of AFP surveillance

1. Routine surveillance for AFP (“zero reporting”)

Immediate notification of AFP in children ................
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