Communicable Disease Control in Emergencies - A Field Manual (WHO - OMS, 2003, 223 p.): ANNEX 7: ORGANIZATION OF AN ISOLATION CENTRE

Communicable Disease Control in Emergencies - A Field Manual (WHO - OMS, 2003, 223 p.)

		(introduction...)
		ACKNOWLEDGEMENTS
		INTRODUCTION
		CHAPTER 1: RAPID ASSESSMENT
		CHAPTER 2: PREVENTION
		CHAPTER 3: SURVEILLANCE
		CHAPTER 4: OUTBREAK CONTROL
		CHAPTER 5: DISEASE PREVENTION AND CONTROL
		ANNEX 1: WHO REFERENCE VALUES FOR EMERGENCIES
		ANNEX 2: SAMPLE HEALTH SURVEY FORMS
		ANNEX 3: NCHS/WHO NORMALIZED REFERENCE VALUES FOR WEIGHT FOR HEIGHT BY SEX
		ANNEX 4: SAMPLE WEEKLY SURVEILLANCE FORMS
		ANNEX 5: RECOMMENDED CASE DEFINITIONS
		ANNEX 6: OUTBREAK INVESTIGATION FORMS
		ANNEX 7: ORGANIZATION OF AN ISOLATION CENTRE
		ANNEX 8: BASIC LABORATORY SERVICES
		ANNEX 9: LABORATORY INVESTIGATION KIT
		ANNEX 10: TREATMENT GUIDELINES
		ANNEX 11: MANAGEMENT OF THE CHILD WITH COUGH OR DIFFICULTY IN BREATHING6
		ANNEX 12: ASSESSMENT AND TREATMENT OF DIARRHOEA
		ANNEX 13: FLOW CHARTS FOR SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS
		ANNEX 14: SAMPLE HEALTH CARD
		ANNEX 15: LIST OF WHO GUIDELINES ON COMMUNICABLE DISEASES
		ANNEX 16: LIST OF PUBLISHERS
		ANNEX 17: GENERAL REFERENCES

ANNEX 7: ORGANIZATION OF AN ISOLATION CENTRE

Figure A7.1. Organization of an Emergency Treatment Centre and Patient-Flow

Table A7.1. Essential rules in a cholera treatment centre

Mode of transmission	Essential Rules in the CTU	Additional recommended rules
People	· Access limited to patient +one family member +staff · One way flow of people	· Ideally one carer per patient only · 3 separate spaces within CTC (see box 1)
Water	· Safe water (chlorination concentration according to specific use; see box 2) · Large quantity needed (minimum 10 liters/person/day)	· Ideally 50 liters per patient and per day
Hands	· Hand washing stations with safe water and soap in sufficient quantities · Wash hands with water and soap · before and after taking care of patients · after going to the latrines · before cooking or eating · after leaving the admission ward	Cut and clean nails
Food	· Cooked food · Health care workers should not handle food or water	Food provided by CTC (preferably not by families) Large stocks of food may be "tempting "and may lead to security problems
Clothes	Wash clothes and linen with the appropriate chlorine solution	If no chlorine available, wash clothes with soap and dry them in the sun
Environmental contamination (faeces and waste)	· Ensure exclusive latrines for the CTC · Disinfect buckets, soiled surfaces and latrines regularly with the appropriate chlorine solution (see box 2) · Incinerator for medical waste	· Latrines at least 100 metres away from wells or surface sources · Special cholera beds
Corpses	· Separate morgue · Disinfect corpses (see Box 2)	· Find ways to have safe funeral practices · Bury corpses as soon as possible

Table A7.2. Preparation and use of disinfectants

Starting with:	2% SOLUTION	0.2% SOLUTION	0.05% SOLUTION
Calcium hypochlorite at 70% active chlorine ("high-test hypo-chlorite", "HTH")	30g / litre or 2 tablespoons / litre	30g / 10 litres or 2 tablespoons / 10 l	7g / 10 litres or ½ tablespoon / 10 l
Chlorinated lime at 30% active chlorine ("bleaching powder")	66g / litre or 4 tablespoons / litre	66g / 10litres or 4 tablespoons/10 l	16g / 10litres or 1 tablespoon / 10 l
Sodium hypochlorite solution at 6% active chlorine ("household bleach")	333ml / litre or 22 tablespoons /litre	333ml / 10 litres or 22 tablespoons / 10L	83ml / 10 L or 5 tablespoons / 10l
USE FOR DISINFECTION OF:	Excreta Corpses Shoes	Floor Utensils Beds	Hands Skin Clothes

Measurements used: 1 teaspoon=5 ml 1 tablespoon = 15 ml 1 cup = 200ml
Do not use metallic bucket for preparation and storage of chlorinated solutions