High Consequence Infectious Diseases (HCID): summary and FAQs
Summary of HCIDs
In the UK, a high consequence infectious disease (HCID) is defined according to the following criteria:
- acute infectious disease
- typically has a high case-fatality rate
- may not have effective prophylaxis or treatment
- often difficult to recognise and detect rapidly
- ability to spread in the community and within healthcare settings
- requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely.
There are 2 groups: those that spread by contact with infected blood/ tissues/ fluids and those with respiratory transmission - airborne
NB: Mpox is no longer classified as HCID in the UK
Contact HCIDs
- Argentine haemorrhagic fever (Junin virus)
- Bolivian haemorrhagic fever (Machupo virus)
- Crimean Congo haemorrhagic fever (CCHF)
- Ebola virus disease (EBOD)
- Lassa fever
- Lujo virus disease
- Marburg virus disease (MVD)
- Severe fever with thrombocytopaenia syndrome (SFTS)
Airborne HCIDs
- Andes virus infection (hantavirus)
- Avian influenza A(H7N9) and A(H5N1)
- Avian influenza A(H5N6) and A(H7N7)
- Middle East respiratory syndrome (MERS)
- Nipah virus infection
- Pneumonic plague (Yersinia pestis)
- Severe acute respiratory syndrome (SARS)
When should I think of HCID?
When should I think of HCID?
· Viral haemorrhagic fever (contact HCID):
o Has the patient travelled to any area where there is a current VHF outbreak?
Check here:
o AND, does the patient have an illness with a history of feverishness?
If YES to both questions, then go to "actions to take if you suspect HCID"
· Respiratory HCID
o MERS
Any person with severe acute respiratory infection
PLUS at least one of the following in the 14 days before the onset of symptoms:
§ a history of travel to, or residence in, an area where infection with Middle East respiratory syndrome coronavirus (MERS-CoV) could have been acquired [footnote 1]
§ close contact with a confirmed case of MERS-CoV infection (close contact is defined below)
§ the person has been in a healthcare setting in a country in list A [footnote 1]
§ the person is a healthcare worker caring for patients with severe acute respiratory infection, regardless of travel or personal protective equipment (PPE) use
If YES to both questions, then go to "actions to take if you suspect HCID"
Which countries should I be concerned about?
Ø Which countries should I be concerned about?
Look up a country here
And information about outbreaks here
Actions to take if you suspect HCID
Actions to take if you suspect HCID
o Patient in hospital or on way to hospital?
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- Isolate patient in side room (if ED go to room 9) – no touch
- Call the infectious diseases team to discuss risk assessment – bleep 5885 in working hours including weekend – ask for infection Reg or Consultant through switch after 5pm and over night (Including weekends)
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o Patient at home?
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- Take details of how to contact patient
- Call the infectious diseases team – bleep 5885 in working hours including weekend – ask for infection Reg or Consultant through switch after 5pm and over night (Including weekends)
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HCID key links
References/ Guidelines
https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid
https://www.who.int/emergencies/disease-outbreak-news
https://www.gov.uk/guidance/high-consequence-infectious-disease-country-specific-risk
https://www.gov.uk/guidance/monkeypox
Mpox: guidance on when to suspect a case of mpox - GOV.UK