Direct Laboratory Notification of Communicable Diseases

Appendix 2: List of Public Health Units and Medical Officers of Health

PHU	Medical officers of health	Phone	Fax
Northland District Health Board Public Health	Jonathan Jarman Loek Henneveld	[phone]	[phone]
Auckland District Health Board Public Health	Sheryl Jury Craig Thornley Greg Simmons Cathy Pikholz Julia Peters Andrew Lindsay Simon Baker Denise Barnfather	[phone]	[phone] Healthlink address (HL7): adhbphth
Waikato District Health Board Public Health	Dell Hood Felicity Dumble Anita Bell	[phone]	[phone]
Toi Te Ora Public Health Tauranga Office	Phil Shoemack	[phone]	[phone]
Toi Te Ora Public Health Whakatane Office	Phil Shoemack (based in Tauranga)	[phone]	[phone]
Toi Te Ora Public Health Rotorua Office	Phil Shoemack (based in Tauranga)	[phone]	[phone]
Tairawhiti District Health Board Public Health Unit	Bruce Duncan Geoffrey Cramp	[phone]	[phone]
Hawke’s Bay District Health Board Public Health Unit	Lester Calder Caroline McElnay	[phone]	[phone]
Taranaki Health Public Health Unit	Richard Hoskins	[phone]	[phone]
Wanganui Public Health Units	Patrick O’Connor	[phone]	[phone]
Mid Central District Health Board Public Health Units Palmerston North	Jill McKenzie	[phone]	[phone]
Regional Public Health Hutt Valley District Health Board (covering Wellington, Hutt Valley and Wairarapa)	Annette Nesdale Margot McLean Stephen Palmer Deborah Read	[phone] A/H: [phone]	[phone]
Nelson Marlborough District Health Board Public Health Unit – Nelson Office	Ed Kiddle	[phone]	[phone]
Nelson Marlborough District Health Board Public Health Unit – Blenheim Office	Maree Leonard	[phone]	[phone]
Community & Public Health Christchurch Office	Mel Brieseman Alistair Humphrey Ramon Pink	[phone]	[phone]
Community & Public Health South Canterbury Office	Daniel Williams	[phone]	[phone]
Community & Public Health West Coast Office	Cherly Brunton	[phone]	[phone]
Public Health South Dunedin Office	John Holmes Marion Poore Derek Bell	[phone]	[phone]

Appendix 3: Members of the Advisory Group and Project Team

Direct Laboratory Notification Project Team

Don Bandaranayake Senior Advisor Public Health Medicine, Ministry of Health

Rebecca Blackmore Team Leader, Communicable Diseases, Ministry of Health

Shayne Hunter Senior Information Management Consultant, Ministry of Health

Mark Jacobs Director of Public Health (sponsor)

Colin Kumpula Analyst, Communicable Diseases, Ministry of Health

Ruth Wiltshire Project Manager, Wiltshire Hogan Ltd

Direct Laboratory Notification Advisory Group

Don Bandaranayake Senior Advisor Public Health Medicine, Ministry of Health

Timothy Blackmore Clinical Microbiologist, Capital and Coast Laboratory

Mel Brieseman Medical Officer of Health, Community and Public Health

Carole Hazelman Portfolio Manager, Public Health Operations, Ministry of Health

Mark Jacobs, Chair Director of Public Health

Sheryl Jury Medical Officer of Health, Auckland Regional Public Health

Iain Loan General practitioner, Taupo Health Centre

Colin Meehan Senior Advisor, Sector Accountability & Funding Directorate, Ministry of Health

Ruth Pirie ESR, Kenepuru Science Centre

Susan Taylor Clinical Microbiologist, Microbiology Department,

Middlemore Hospital

Appendix 4: Complete Set of Laboratory Notification Flowcharts

Campylobacteriosis


Notes.

1. 
   Recommend that any sterile site isolates are identified to the species level by primary or reference laboratory
   

Salmonella including typhoid and paratyphoid fever


Notes

1. 
   Salmonella serology may provide evidence of past infection but is not useful for diagnosis of acute illness. Requests for salmonella serology should be replaced with or performed in conjunction with blood cultures if the patient has a febrile illness.
   

Shigellosis

Cholera¹


Notes

1. The notifiable condition is disease due to toxin-producing Vibrio cholerae. Rare strains of V. mimicus carry the cholera toxin gene and can produce cholera-like symptoms.

Acute gastroenteritis
Acute gastroenteritis is a clinical notification and laboratory notification is not required.
When a potential enteric pathogen is detected from a faeces sample, e.g. rotavirus, Cyclospora, Aeromonas, non-cholera Vibrio, Plesiomonas, C. difficile toxin, the laboratory will not know whether:

• 
  the person has acute symptoms
  
• 
  this case is linked to other cases
  
• 
  the affected person is in a high-risk occupation
  

However, a comment reminding clinicians of the need to notify if they are aware of further information is suggested and could be added when the above enteric pathogens are found.

For example:

“Acute gastroenteritis is notifiable to the local Medical Officer of Health when occurring in 2 or more linked persons, a person in a high risk occupation (food handler, early childhood worker, <5 year old attending child care, health care worker, or any others at higher risk of transmission because of illness or disability.”

Only if a laboratory becomes aware that cases are linked, need they notify the Medical officer of Health.

Measles



Note

1. For specimen requirements refer to www.cdhb.govt.nz/measles/ or www.labplus.co.nz

2. Recent immunization with MMR may also result in detectable anti-measles IgM or a significant increase in anti-measles IgG. Since laboratories do not necessarily have access to this information, all results consistent with possible measles infection should be reported to the Medical Officer of Health.

Mumps

Mumps


Note

1. Recent immunization with MMR may also result in detectable anti-mumps IgM or a significant increase in anti-mumps IgG. Since laboratories do not necessarily have access to this information, all results consistent with possible mumps infection should be reported to the Medical Officer of Health.

Rubella



Note

1. 
   Recent immunization with MMR may also result in detectable anti-rubella IgM or a significant increase in anti-rubella IgG. Since laboratories do not necessarily have access to this information, all results consistent with possible rubella infection should be reported to the Medical Officer of Health.
   

Tetanus

The diagnosis is clinical.

Neither culture of the organism nor presence of antibodies to the toxin is proof of disease.
No action required for laboratories.


Rheumatic fever

The diagnosis is clinical.

Detection of pharyngeal S. pyogenes or changing streptococcal serology does not make the diagnosis.

No action required for laboratories.

Trichinosis (Trichiniasis, Trichinellosis)


Note

1. Muscle biopsy for histology collected at least 10 days and ideally ~4 weeks after infection.

2. Eosinophilia is supportive but not diagnostic.



Enterobacter sakasakii invasive disease

Brucellosis


Haemophilus influenzae type b invasive disease




Legionellosis



Leptospirosis



Listeriosis


Neisseria meningitidis invasive disease


Notes

1. 
   Arrange for NAT testing on CSF if cultures sterile so that amplification product can be further characterised by ESR.
   
2. 
   Meningococcal conjunctivitis should be notified to the Medical Officer of Health because of the potential for invasive disease in contacts of case
   
3. 
   Only if clinical details provided of meningococcal disease.
   
4. 
   Meningococci isolated from genital swabs are not associated with systemic disease (except for rare neonatal meningitis in babies born to colonised mothers) and need not be reported to the Medical Officer of Health.
   

Pertussis


Rickettsial disease


Notes.

1. 
   Not routinely performed. Requires PC-3 facilities.
   
2. 
   Titres of ≥1:64 are considered presumptive evidence of recent or current infection by organisms of the appropriate Rickettsial antigen group
   

Active Tuberculosis (new case, reactivation)


Notes

1. 
   Samples should be collected for mycobacterial culture, if not already done.
   

Latent Tuberculosis (LTBI)
Latent Tuberculosis is only notified when there is a decision to treat.
Therefore no action is required by laboratories.


Leprosy

Note

1. 
   Where confirmed by sequencing or validated species-specific PCR
   

Malaria


Notes

1. 
   This result should always be confirmed by microscopy
   

Arboviral infection – Dengue & Ross River Virus¹


Notes.

1. 
   Serology for other arboviruses (e.g. Japanese encephalitis, West nile, Chikungunya) are available through overseas reference laboratories. The referring laboratory should also report any results from an overseas laboratory that are consistent with recent infection to the Medical officer of Health.
   

Hepatitis A


Note

1. 
   Recent infection is not excluded without testing anti-HAV IgM. This should be noted on the result if the clinician specifically requests testing for HAV IgG only.
   
2. 
   Recent immunization with HAV vaccine may also result in seroconversion. Since laboratories do not necessarily have access to this information, all results consistent with possible Hepatitis A infection should be reported to the Medical Officer of Health.
   

Recent Hepatitis B infection


Recent Hepatitis C infection

Note

1. 
   A reactive anti-HCV result alone is insufficient evidence of recent HCV infection.
   

Hepatitis D



Hepatitis E


Note

1. 
   HEV serology not performed in NZ.
   

Acquired Immunodeficiency syndrome (AIDS)

AIDS is a clinical syndrome. No action is required by laboratories.

Cryptosporidiosis



Giardiasis




Cysticercosis

• 
  Cysticercosis is caused by the larval stage of T. solium after ingestion of eggs, rather than encysted larvae, from contaminated food, water or via faecal-oral autoinoculation.
  
• 
  Stool examinations can be performed; however, eggs are typically not found, since the majority of people diagnosed with cysticercosis do not have a viable T. solium tapeworm in their intestines.
  
• 
  Serology is available through overseas reference laboratories for patients with suggestive radiological findings. Occasionally, the diagnosis of extraneural cysticercosis is made by finding a larval scolex in an excisional biopsy of a skin or muscle lesion.
  

Taeniasis

• 
  Taeniasis (adult tapeworm infection) occurs after the ingestion of inadequately cooked pork containing encysted T. solium larvae.
  

Notes

1. It is not possible to differentiate the eggs of T. solium from the beef tapeworm T. saginata. Identification to species level requires examination of proglottid segments passed in the stool.

Hydatid disease



Yersiniosis



Plague



Verotoxin-producing E. coli (VTEC) also known as Shiga toxin-producing E. coli (STEC)


Diphtheria



Notes

1. The diagnosis of diphtheria is primarily a clinical one. Tox-containing, nontoxigenic isolates have been described.

Anthrax


Creutzfeldt-Jakob Disease and Other Spongiform Encephalopathies


Primary amoebic meningoencephalitis



Poliomyelitis



Notes

1. Enteroviral PCR performed on CSF may detect an enterovirus potentially including poliovirus. Unless PCR amplification product has been further characterized because of the clinical scenario, positive enterovirus PCR results need not be notified to the Medical Officer of Health.

SARS


Highly Pathogenic Avian Influenza

Notes

1. Or other novel subtype of influenza A

Rabies or other Lyssavirus
Yellow Fever
Viral Haemorrhagic Fever (e.g. Ebola)
Laboratory testing for these viruses is not performed at this time within NZ.

Specimens from suspected cases would be referred to overseas laboratories.

For further information on laboratory testing refer to http://www.health.gov.au/internet/wcms/publishing.nsf/Content/cda-surveil-nndss-casedefs-distype.htm

Streptococcus pneumoniae invasive disease (Invasive Pneumococcal Disease)

Notes

1. 
   Arrange for NAT testing on CSF if cultures sterile so that pneumococcal disease can be confirmed. Rarely, other gram-positive cocci such as beta-hemolytic streptococci and S. suis may cause meningitis, although a PICT should be negative in these cases.
   

Influenza A H1N1

1See Appendix 1: Diseases notifiable in New Zealand.

2This option may not be available to all DHB laboratories due to organisation structures and contractual arrangements.

3A copy of the test results modified to exclude all information unconnected to the notification.