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Improving infection control in general practice.

Infection control measures in the health care setting should protect patients and staff from cross-infection. The prevention of harm is an essential part of good medical practice and failure might result in professional misconduct proceedings by the General Medical Council (GMC) and prosecution under the Health and Safety at Work legislation, as well as civil liability. For a health authority, overall responsibility for public health includes arrangements for the control of communicable diseases and infection in hospital and the community (NHS Management Executive, 1993), a function usually led by the Consultant in Communicable Disease Control (CCDC). This paper describes one district's collaborative approach between public health and GPs to assess and improve local infection control standards.

Communicable Disease Control↗

Tempting fate: control of communicable disease in England.

Recent changes in the NHS have left many defects in the systems for the control of communicable diseases and infection and their surveillance and the management of outbreaks. Clear, explicit legislation is needed, placing the responsibilities on health authorities. New teams led by consultants need to be set up to investigate and manage outbreaks of communicable diseases of all types.

Communicable Disease Control↗

The contribution of international agencies to the control of communicable diseases.

Although inequality is often measured through three critical indicators-education, income and life expectancy-health-related differences are also essential elements for explaining levels of equality or inequality in modern societies. Investment and investigation in health also involve inequalities at the global level, and this includes insufficient North-South transfer of funds, technology and expertise in the health field, including the specific area of communicable diseases. Globally, epidemics and outbreaks in any geographic region can represent international public health emergencies, and this type of threat requires a global response. Therefore, given the need to strengthen the global capacity for dealing with threats of infectious diseases, a framework is needed for collaboration on alerting the world to epidemics and responding to public health emergencies. This is necessary to guarantee a high level of security against the dissemination of communicable diseases in an ever more globalized world. In response to these needs, international health agencies have put a number of strategies into practice in order to contribute to the control of communicable diseases in poor countries. The principle strategies include: 1) implementation of mechanisms for international epidemiologic surveillance; 2) use of international law to support the control of communicable diseases; 3) international cooperation on health matters; 4) strategies to strengthen primary care services and health systems in general; 5) promotion of the transfer of resources for research and development from the North to the South.

Communicable Disease Control↗

Policies for control of communicable disease in day care centres.

A survey was carried out to identify the availability and quality of guidelines for the prevention and control of communicable disease and procedures in use in child day care centres within the South West Thames Regional Health Authority. A sample of 50 day care centres was investigated including those funded by social services and privately funded day care centres. Policies for the prevention and control of communicable disease for children and staff showed a wide variation between different centres. Exclusion criteria were unclear especially in relation to carriers of the hepatitis B virus and HIV positive children. Channels for reporting and seeking advice were inconsistent. It is recommended that clear and up to date written guidelines on the prevention and control of communicable diseases should be available in all day care centres with clear indications of good practice and channels for reporting and advice. It is desirable that guidelines are agreed by the different health and local authorities throughout the region.

Child Day Care Centers↗