Management in Custody

Staff with disease should report to occupational health and stay off work until the end of the infective period. Those in contact with disease (either through exposure at home or from an infected detainee) should receive prophylactic treatment as soon as possible (see Subheading 8.3.7.).

Table 8 Suspicion of Exotica? History and Examination Aide Memoir

• Has the detainee traveled to Africa, South East Asia, the Indian subcontinent, Central/South America, or the Far East in the last 6-12 months?

• Ascertain whether he or she received any vaccinations before travel and, if so, which ones.

• Ask if he or she took malaria prophylaxis, what type, and whether he or she completed the course.

• Ask if he or she swam in any stagnant lakes during the trip.

• If the answer to any of the above is yes, ask if he or she has experienced any of the following symptoms:

■ A fever/hot or cold flushes/shivering.

■ Diarrhea ± abdominal cramps ± blood or slime in the stool.

■ Persistent headaches ± light sensitivity.

■ Aching muscles/joints.

■ A persistent cough (dry or productive) lasting at least 3 weeks.

• Take temperature.

• Check skin for signs of a rash and note nature and distribution.

• Listen carefully to the lungs for signs of infection/consolidation._

To minimize the risk of acquiring disease in custody, staff should wear gloves when dealing with the detainee and then wash their hands thoroughly. Gloves should be disposed of only in the clinical waste bags.

Detainees with disease should be kept in custody for the minimum time possible. They should only be sent to the hospital if fulminant hepatitis is suspected. The cell should be quarantined after use and professionally cleaned. Any bedding or clothing should be handled with gloves and laundered or incinerated according to local policy. Detainees reporting contact with disease should be given prophylactic treatment as soon as possible (see Subheading 8.3.7.).

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