 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
|
Background |
|
|
|
The
new procedures for responding to cases of travel associated
legionnaires' disease, as outlined in the European guidelines,
came into use on 1 July 2002. As a consequence, tour operators
are no longer routinely informed about clusters of cases
associated with tourist accommodation. However, occasions
will arise when tour operators will still be informed about
clusters. This short briefing in the form of questions and
answers has been prepared to help tour operators understand
the different aspects of the new procedures. |
|
| |
|
|
|
|
|
|
How
does information about a cluster get back to the country
of infection, how long does it take and to whom does the
information go? |
|
|
|
When
a cluster (two cases linked in time and to the same accommodation)
is identified or received at the co-ordinating centre in
London, a cluster alert is prepared and sent by fax on the
same day, to the EWGLINET collaborators in the country of
infection and to the collaborators in all the other EWGLI
countries. The cluster alert is also sent to the European
office of the World
Health Organization (WHO) and the European
Centre for Disease Prevention and Control (ECDC)
based in Sweden. |
|
| |
|
|
|
|
|
|
How
many days does the country of infection have to respond
to the cluster alert? |
|
|
|
If
the country of infection is using the guidelines, it must
return information about follow up measures at the accommodation
site within two weeks of receipt of the cluster alert. This
information is sent using Form A from the guidelines. Form
B should be returned within six weeks of receipt of the
cluster alert. This form contains summary information on
the investigations, results and control measures taken at
the site. |
|
| |
|
|
|
|
|
|
What
happens if no information is sent either at two weeks or
six weeks? |
|
|
|
Details
of the cluster and the name of the hotel will be posted
in the Site Updates
section of the EWGLI website and the reason for the posting
will be given. |
|
| |
|
|
|
|
|
|
Are
tour operators informed when accommodation site names are
published? |
|
|
|
We
maintain a list of tour
operators and tour operator organisations/
federations who are informed of intended publication details
in advance of the accommodation site name/ cluster information
being posted on the EWGLI website. |
|
|
|
Any other tour operator may request to be added to the list
by getting in touch with us at the email address listed
in the Contact Us
section. |
|
|
|
Tour
operators can also sign up to the EWGLINET email
subscription service that will inform them
when information is added to or removed from the website. |
|
| |
|
|
|
|
|
|
Should
an individual tour operator pass on the information to other
tour operators? |
|
|
|
If
there is a mechanism for you to do this in your country,
we believe this is a good idea. The best way to ensure that
all the major tour operators in your country are informed
is to ask your national federation of tour operators or
equivalent body to send a request to be added to the advance
notification group, or alternatively to sign up to the email
subscription service. The national body can then forward
this information to its members. |
|
|
|
Tour
operators who do not subscribe to the email system should
check the EWGLI website on a regular basis for posting of
hotel names. |
|
| |
|
|
|
|
|
|
What
are the procedures if the country of infection is not using
the guidelines? |
|
|
|
The
co-ordinating centre in London will inform the country of
infection about the cluster (assuming we have a contact
in that country – alternatively we would send the
cluster alert to the World Health Organisation, who are
then responsible for contacting the national Ministry of
Health in the country of infection). On the day following
the initial alert, the co-ordinating centre issues an alert
to the tour operators listed here.
We expect the country of report to also inform their tour
operators so that they can make decisions about continuing
to use the accommodation site. We do not propose publishing
the name of the accommodation site in the Site
Updates section where the site is in a country
not using the guidelines. |
|
| |
|
|
|
|
|
|
What
are the procedures when three (or more) cases are reported
(and which form a cluster) all with onset in a short space
of time? |
|
|
|
If
the country of infection is not using the guidelines, tour
operators should be informed about the cluster as before.
If the country of infection is using the guidelines, they
will be expected to return Forms A and B in the usual way.
However, because of the seriousness of the cluster, tour
operators will also be informed if the onsets of infection
in the three (or more) cases are close together. The country
of report should also consider informing their tour operators
directly. If tour operators decide to withdraw from a hotel
associated with three cases, EWGLINET would like to be informed. |
|
| |
|
|
|
|
|
|
What
should tour operators do when people report directly to
them that they know of cases of legionnaires' disease in
a particular hotel? |
|
|
|
The
information should always be verified before action is taken.
The best way to do this is to contact the collaborator in
the country of report or the co-ordinating centre in London
to see whether they have any details of the report, including
any medical information about the cases. Names and addresses
of the collaborators are listed in the Collaborators
section. If the report turns out to be true, the EWGLI procedures
for reporting and responding to cases will be followed in
the usual way. |
|
| |
|
|
|
|
|
|
Which
countries have agreed to use the guidelines? |
|
|
|
A
full list of the countries which have signed up to follow
the European guidelines is available in the Collaborators
section. |
|
|
|
