Professor Karl Ekdahl is the CEO for ‘Prosanis Sverige AB’ and Medical Director for ‘Reserådet’, Sweden’s largest Internet portal on vaccines and travel medicine. Dr. Norman Begg is a vaccine consultant who acts as a regular advisor to the World Health Organization. Professor Ralf Reintjes is a Full Professor for Epidemiology and Public Health Surveillance in Hamburg, Germany and Adjunct Professor for Infectious Disease Epidemiology in Tampere, Finland. Dr. Obaghe Edeghere is the Deputy Director for the Field Services division at the UK Health Security Agency.

• About the Authors ixForeword xiList of Abbreviations xiiiSection A: Basic conceptsA. 1 How to use this book 3A. 2 Basic concepts in the epidemiology and control of infectious diseases 4A. 3 Basic concepts in the prevention of infection 9A. 4 Emergency risk communication 13A. 5 Health protection on call 15Section B: SyndromesB. 1 Meningitis and meningism 23B. 2 Gastrointestinal infection 26B. 3 Community- acquired pneumonia 32B. 4 Rash in pregnancy 35B. 5 Rash and fever in children 36B. 6 Illness in returning travellers 38B. 7 Jaundice 40B. 8 Infection in the immunocompromised 41Laboratory diagnosis 42Prevention and control 43Section C: DiseasesC. 1 Amoebic dysentery 47C. 2 Anthrax 48C. 3 Bacillus cereus 51C. 4 Botulism 52C. 5 Brucellosis 56C. 6 Campylobacter 58C. 7 Chickenpox and shingles (varicella zoster infections) 62C. 8 Chikungunya 64C. 9 Chlamydophila pneumoniae 66C. 10 Chlamydia trachomatis 67C. 11 Cholera 69C. 12 CJD and other human transmissible spongiform encephalopathies 71C. 13 Clostridioides difficile 74C. 14 Clostridium perfringens 76C. 15 Coronavirus (excluding COVID- 19) 78C. 16 Covid- 19 81C. 17 Cryptosporidiosis 84C. 18 Cyclosporiasis 88C. 19 Cytomegalovirus 89C. 20 Dengue fever 91C. 21 Diphtheria 92C. 22 Enterococci including glycopeptide- resistant enterococci 95C. 23 Enterovirus infections (including hand foot and mouth disease) 96C. 24 Epstein–Barr virus 98C. 25 Giardiasis 100C. 26 Gram- negative bacteraemia (including carbapenem- resistant enterobacterales) 102C. 27 Gonorrhoea syphilis and other acute STIs 107C. 28 Hantavirus 113C. 29 Head lice 114C. 30 Helicobacter pylori 116C. 31 Hepatitis A 117C. 32 Hepatitis B 120C. 33 Hepatitis C 123C. 34 Delta hepatitis 125C. 35 Hepatitis E 126C. 36 Herpes simplex 127C. 37 Haemophilus influenzae type b (Hib) 129C. 38 HIV and AIDS 131C. 39 Influenza 136C. 40 Japanese B encephalitis 141C. 41 Legionellosis 141C. 42 Leprosy 145C. 43 Leptospirosis 146C. 44 Listeriosis 148C. 45 Lyme disease (borreliosis) 150C. 46 Malaria 152C. 47 Measles 154C. 48 Meningococcal infection 156C. 49 Meticillin- resistant Staphylococcus aureus (mrsa) 160C. 50 Mumps 163C. 51 Mycoplasma pneumoniae 165C. 52 Norovirus 166C. 53 Paratyphoid fever 169C. 54 Parvovirus B19 (fifth disease) 172C. 55 Plague 173C. 56 Pneumococcal infection 175C. 57 Poliomyelitis 178C. 58 Psittacosis 180C. 59 Q fever 182C. 60 Rabies 184C. 61 Relapsing Fever 186C. 62 Respiratory Syncytial Virus (RSV) 187C. 63 Ringworm 189C. 64 Rotavirus 193C. 65 Rubella 194C. 66 Salmonellosis 196C. 67 Scabies 199C. 68 Schistosomiasis 202C. 69 Shigellosis 204C. 70 Shiga Toxin- Producing Escherichia coli (STEC) and Other Diarrhoeagenic E. coli 207C. 71 Smallpox and mpox 212C. 72 Staphylococcal food poisoning 217C. 73 Streptococcal infections 218C. 74 Tetanus 220C. 75 Threadworms 222C. 76 Tickborne encephalitis 223C. 77 Toxocariasis 224C. 78 Toxoplasmosis 225C. 79 Tuberculosis (and non- tuberculous mycobacteria) 227C. 80 Tularaemia 235C. 81 Typhoid fever 237C. 82 Vibrio parahaemolyticus infection 239C. 83 Viral haemorrhagic fevers including Ebola 241C. 84 Warts and verrucae 244C. 85 West Nile virus 246C. 86 Whooping cough 247C. 87 Yellow fever 250C. 88 Yersiniosis 251C. 89 Zika virus infection 253C. 90 Rare diseases 256C.90.1 Bacteria 256C.90.2 Rickettsial infections (incl. Typhus) Ehrlichia and Bartonella 256C.90.3 Viruses 263C.90.4 Protozoa 263C.90.5 Helminths 263C.90.6 Fungi and actinomycetes 271C.90.7 Bites stings and venoms 282C.90.8 Chemical foodborne illness 283Section D: Health protection services and functionsD. 1 Surveillance of communicable disease 287D. 2 Managing infectious disease incidents and outbreaks 293D. 3 Community infection control 299D. 4 Hospital infection control 304D. 5 Antimicrobial stewardship 309D. 6 Risks to and from healthcare workers 312D. 7 Immunisation services 316D. 8 Coordination of sexual health services 320D. 9 Prevention of bloodborne viral infections 322D. 10 Coordination of services for tuberculosis control 326D. 11 Travel health 328D. 12 Migrant and refugee health 331D. 13 Emergency preparedness planning and response 334D. 14 Non- infectious environmental hazards 336D. 15 Managing acute chemical incidents 342D. 16 Managing acute radiation incidents 345D. 17 Deliberate release of biological chemical or radiological hazards 348D. 18 Clinical governance and audit 356D. 19 Global health security 359Section E: Organizational arrangementsE. 1 WHO and International Health Regulations 365E. 2 Collaboration within the European Union 367E. 3 Detailed national example: Organisational arrangements for health protection England 2025 369E. 4 Austria 374E. 5 Belgium 375E. 6 Bulgaria 375E. 7 Croatia 376E. 8 Cyprus 377E. 9 Czech Republic 377E. 10 Denmark 378E. 11 Estonia 379E. 12 Finland 379E. 13 France 380E. 14 Germany 381E. 15 Greece 382E. 16 Hungary 382E. 17 Iceland 383E. 18 Ireland 384E. 19 Italy 385E. 20 Latvia 385E. 21 Lithuania 386E. 22 Luxembourg 387E. 23 Malta 388E. 24 The Netherlands 388E. 25 Norway 389E. 26 Poland 390E. 27 Portugal 391E. 28 Romania 391E. 29 Slovakia 392E. 30 Slovenia 393E. 31 Spain 394E. 32 Sweden 395E. 33 Switzerland 395E. 34 United Kingdom 396Index 399

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Professor Karl Ekdahl is the CEO for ‘Prosanis Sverige AB’ and Medical Director for ‘Reserådet’, Sweden’s largest Internet portal on vaccines and travel medicine. Dr. Norman Begg is a vaccine consultant who acts as a regular advisor to the World Health Organization. Professor Ralf Reintjes is a Full Professor for Epidemiology and Public Health Surveillance in Hamburg, Germany and Adjunct Professor for Infectious Disease Epidemiology in Tampere, Finland. Dr. Obaghe Edeghere is the Deputy Director for the Field Services division at the UK Health Security Agency.

• About the Authors ixForeword xiList of Abbreviations xiiiSection A: Basic conceptsA. 1 How to use this book 3A. 2 Basic concepts in the epidemiology and control of infectious diseases 4A. 3 Basic concepts in the prevention of infection 9A. 4 Emergency risk communication 13A. 5 Health protection on call 15Section B: SyndromesB. 1 Meningitis and meningism 23B. 2 Gastrointestinal infection 26B. 3 Community- acquired pneumonia 32B. 4 Rash in pregnancy 35B. 5 Rash and fever in children 36B. 6 Illness in returning travellers 38B. 7 Jaundice 40B. 8 Infection in the immunocompromised 41Laboratory diagnosis 42Prevention and control 43Section C: DiseasesC. 1 Amoebic dysentery 47C. 2 Anthrax 48C. 3 Bacillus cereus 51C. 4 Botulism 52C. 5 Brucellosis 56C. 6 Campylobacter 58C. 7 Chickenpox and shingles (varicella zoster infections) 62C. 8 Chikungunya 64C. 9 Chlamydophila pneumoniae 66C. 10 Chlamydia trachomatis 67C. 11 Cholera 69C. 12 CJD and other human transmissible spongiform encephalopathies 71C. 13 Clostridioides difficile 74C. 14 Clostridium perfringens 76C. 15 Coronavirus (excluding COVID- 19) 78C. 16 Covid- 19 81C. 17 Cryptosporidiosis 84C. 18 Cyclosporiasis 88C. 19 Cytomegalovirus 89C. 20 Dengue fever 91C. 21 Diphtheria 92C. 22 Enterococci including glycopeptide- resistant enterococci 95C. 23 Enterovirus infections (including hand foot and mouth disease) 96C. 24 Epstein–Barr virus 98C. 25 Giardiasis 100C. 26 Gram- negative bacteraemia (including carbapenem- resistant enterobacterales) 102C. 27 Gonorrhoea syphilis and other acute STIs 107C. 28 Hantavirus 113C. 29 Head lice 114C. 30 Helicobacter pylori 116C. 31 Hepatitis A 117C. 32 Hepatitis B 120C. 33 Hepatitis C 123C. 34 Delta hepatitis 125C. 35 Hepatitis E 126C. 36 Herpes simplex 127C. 37 Haemophilus influenzae type b (Hib) 129C. 38 HIV and AIDS 131C. 39 Influenza 136C. 40 Japanese B encephalitis 141C. 41 Legionellosis 141C. 42 Leprosy 145C. 43 Leptospirosis 146C. 44 Listeriosis 148C. 45 Lyme disease (borreliosis) 150C. 46 Malaria 152C. 47 Measles 154C. 48 Meningococcal infection 156C. 49 Meticillin- resistant Staphylococcus aureus (mrsa) 160C. 50 Mumps 163C. 51 Mycoplasma pneumoniae 165C. 52 Norovirus 166C. 53 Paratyphoid fever 169C. 54 Parvovirus B19 (fifth disease) 172C. 55 Plague 173C. 56 Pneumococcal infection 175C. 57 Poliomyelitis 178C. 58 Psittacosis 180C. 59 Q fever 182C. 60 Rabies 184C. 61 Relapsing Fever 186C. 62 Respiratory Syncytial Virus (RSV) 187C. 63 Ringworm 189C. 64 Rotavirus 193C. 65 Rubella 194C. 66 Salmonellosis 196C. 67 Scabies 199C. 68 Schistosomiasis 202C. 69 Shigellosis 204C. 70 Shiga Toxin- Producing Escherichia coli (STEC) and Other Diarrhoeagenic E. coli 207C. 71 Smallpox and mpox 212C. 72 Staphylococcal food poisoning 217C. 73 Streptococcal infections 218C. 74 Tetanus 220C. 75 Threadworms 222C. 76 Tickborne encephalitis 223C. 77 Toxocariasis 224C. 78 Toxoplasmosis 225C. 79 Tuberculosis (and non- tuberculous mycobacteria) 227C. 80 Tularaemia 235C. 81 Typhoid fever 237C. 82 Vibrio parahaemolyticus infection 239C. 83 Viral haemorrhagic fevers including Ebola 241C. 84 Warts and verrucae 244C. 85 West Nile virus 246C. 86 Whooping cough 247C. 87 Yellow fever 250C. 88 Yersiniosis 251C. 89 Zika virus infection 253C. 90 Rare diseases 256C.90.1 Bacteria 256C.90.2 Rickettsial infections (incl. Typhus) Ehrlichia and Bartonella 256C.90.3 Viruses 263C.90.4 Protozoa 263C.90.5 Helminths 263C.90.6 Fungi and actinomycetes 271C.90.7 Bites stings and venoms 282C.90.8 Chemical foodborne illness 283Section D: Health protection services and functionsD. 1 Surveillance of communicable disease 287D. 2 Managing infectious disease incidents and outbreaks 293D. 3 Community infection control 299D. 4 Hospital infection control 304D. 5 Antimicrobial stewardship 309D. 6 Risks to and from healthcare workers 312D. 7 Immunisation services 316D. 8 Coordination of sexual health services 320D. 9 Prevention of bloodborne viral infections 322D. 10 Coordination of services for tuberculosis control 326D. 11 Travel health 328D. 12 Migrant and refugee health 331D. 13 Emergency preparedness planning and response 334D. 14 Non- infectious environmental hazards 336D. 15 Managing acute chemical incidents 342D. 16 Managing acute radiation incidents 345D. 17 Deliberate release of biological chemical or radiological hazards 348D. 18 Clinical governance and audit 356D. 19 Global health security 359Section E: Organizational arrangementsE. 1 WHO and International Health Regulations 365E. 2 Collaboration within the European Union 367E. 3 Detailed national example: Organisational arrangements for health protection England 2025 369E. 4 Austria 374E. 5 Belgium 375E. 6 Bulgaria 375E. 7 Croatia 376E. 8 Cyprus 377E. 9 Czech Republic 377E. 10 Denmark 378E. 11 Estonia 379E. 12 Finland 379E. 13 France 380E. 14 Germany 381E. 15 Greece 382E. 16 Hungary 382E. 17 Iceland 383E. 18 Ireland 384E. 19 Italy 385E. 20 Latvia 385E. 21 Lithuania 386E. 22 Luxembourg 387E. 23 Malta 388E. 24 The Netherlands 388E. 25 Norway 389E. 26 Poland 390E. 27 Portugal 391E. 28 Romania 391E. 29 Slovakia 392E. 30 Slovenia 393E. 31 Spain 394E. 32 Sweden 395E. 33 Switzerland 395E. 34 United Kingdom 396Index 399

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Professor Karl Ekdahl is the CEO for ‘Prosanis Sverige AB’ and Medical Director for ‘Reserådet’, Sweden’s largest Internet portal on vaccines and travel medicine. Dr. Norman Begg is a vaccine consultant who acts as a regular advisor to the World Health Organization. Professor Ralf Reintjes is a Full Professor for Epidemiology and Public Health Surveillance in Hamburg, Germany and Adjunct Professor for Infectious Disease Epidemiology in Tampere, Finland. Dr. Obaghe Edeghere is the Deputy Director for the Field Services division at the UK Health Security Agency.

• About the Authors ixForeword xiList of Abbreviations xiiiSection A: Basic conceptsA. 1 How to use this book 3A. 2 Basic concepts in the epidemiology and control of infectious diseases 4A. 3 Basic concepts in the prevention of infection 9A. 4 Emergency risk communication 13A. 5 Health protection on call 15Section B: SyndromesB. 1 Meningitis and meningism 23B. 2 Gastrointestinal infection 26B. 3 Community- acquired pneumonia 32B. 4 Rash in pregnancy 35B. 5 Rash and fever in children 36B. 6 Illness in returning travellers 38B. 7 Jaundice 40B. 8 Infection in the immunocompromised 41Laboratory diagnosis 42Prevention and control 43Section C: DiseasesC. 1 Amoebic dysentery 47C. 2 Anthrax 48C. 3 Bacillus cereus 51C. 4 Botulism 52C. 5 Brucellosis 56C. 6 Campylobacter 58C. 7 Chickenpox and shingles (varicella zoster infections) 62C. 8 Chikungunya 64C. 9 Chlamydophila pneumoniae 66C. 10 Chlamydia trachomatis 67C. 11 Cholera 69C. 12 CJD and other human transmissible spongiform encephalopathies 71C. 13 Clostridioides difficile 74C. 14 Clostridium perfringens 76C. 15 Coronavirus (excluding COVID- 19) 78C. 16 Covid- 19 81C. 17 Cryptosporidiosis 84C. 18 Cyclosporiasis 88C. 19 Cytomegalovirus 89C. 20 Dengue fever 91C. 21 Diphtheria 92C. 22 Enterococci including glycopeptide- resistant enterococci 95C. 23 Enterovirus infections (including hand foot and mouth disease) 96C. 24 Epstein–Barr virus 98C. 25 Giardiasis 100C. 26 Gram- negative bacteraemia (including carbapenem- resistant enterobacterales) 102C. 27 Gonorrhoea syphilis and other acute STIs 107C. 28 Hantavirus 113C. 29 Head lice 114C. 30 Helicobacter pylori 116C. 31 Hepatitis A 117C. 32 Hepatitis B 120C. 33 Hepatitis C 123C. 34 Delta hepatitis 125C. 35 Hepatitis E 126C. 36 Herpes simplex 127C. 37 Haemophilus influenzae type b (Hib) 129C. 38 HIV and AIDS 131C. 39 Influenza 136C. 40 Japanese B encephalitis 141C. 41 Legionellosis 141C. 42 Leprosy 145C. 43 Leptospirosis 146C. 44 Listeriosis 148C. 45 Lyme disease (borreliosis) 150C. 46 Malaria 152C. 47 Measles 154C. 48 Meningococcal infection 156C. 49 Meticillin- resistant Staphylococcus aureus (mrsa) 160C. 50 Mumps 163C. 51 Mycoplasma pneumoniae 165C. 52 Norovirus 166C. 53 Paratyphoid fever 169C. 54 Parvovirus B19 (fifth disease) 172C. 55 Plague 173C. 56 Pneumococcal infection 175C. 57 Poliomyelitis 178C. 58 Psittacosis 180C. 59 Q fever 182C. 60 Rabies 184C. 61 Relapsing Fever 186C. 62 Respiratory Syncytial Virus (RSV) 187C. 63 Ringworm 189C. 64 Rotavirus 193C. 65 Rubella 194C. 66 Salmonellosis 196C. 67 Scabies 199C. 68 Schistosomiasis 202C. 69 Shigellosis 204C. 70 Shiga Toxin- Producing Escherichia coli (STEC) and Other Diarrhoeagenic E. coli 207C. 71 Smallpox and mpox 212C. 72 Staphylococcal food poisoning 217C. 73 Streptococcal infections 218C. 74 Tetanus 220C. 75 Threadworms 222C. 76 Tickborne encephalitis 223C. 77 Toxocariasis 224C. 78 Toxoplasmosis 225C. 79 Tuberculosis (and non- tuberculous mycobacteria) 227C. 80 Tularaemia 235C. 81 Typhoid fever 237C. 82 Vibrio parahaemolyticus infection 239C. 83 Viral haemorrhagic fevers including Ebola 241C. 84 Warts and verrucae 244C. 85 West Nile virus 246C. 86 Whooping cough 247C. 87 Yellow fever 250C. 88 Yersiniosis 251C. 89 Zika virus infection 253C. 90 Rare diseases 256C.90.1 Bacteria 256C.90.2 Rickettsial infections (incl. Typhus) Ehrlichia and Bartonella 256C.90.3 Viruses 263C.90.4 Protozoa 263C.90.5 Helminths 263C.90.6 Fungi and actinomycetes 271C.90.7 Bites stings and venoms 282C.90.8 Chemical foodborne illness 283Section D: Health protection services and functionsD. 1 Surveillance of communicable disease 287D. 2 Managing infectious disease incidents and outbreaks 293D. 3 Community infection control 299D. 4 Hospital infection control 304D. 5 Antimicrobial stewardship 309D. 6 Risks to and from healthcare workers 312D. 7 Immunisation services 316D. 8 Coordination of sexual health services 320D. 9 Prevention of bloodborne viral infections 322D. 10 Coordination of services for tuberculosis control 326D. 11 Travel health 328D. 12 Migrant and refugee health 331D. 13 Emergency preparedness planning and response 334D. 14 Non- infectious environmental hazards 336D. 15 Managing acute chemical incidents 342D. 16 Managing acute radiation incidents 345D. 17 Deliberate release of biological chemical or radiological hazards 348D. 18 Clinical governance and audit 356D. 19 Global health security 359Section E: Organizational arrangementsE. 1 WHO and International Health Regulations 365E. 2 Collaboration within the European Union 367E. 3 Detailed national example: Organisational arrangements for health protection England 2025 369E. 4 Austria 374E. 5 Belgium 375E. 6 Bulgaria 375E. 7 Croatia 376E. 8 Cyprus 377E. 9 Czech Republic 377E. 10 Denmark 378E. 11 Estonia 379E. 12 Finland 379E. 13 France 380E. 14 Germany 381E. 15 Greece 382E. 16 Hungary 382E. 17 Iceland 383E. 18 Ireland 384E. 19 Italy 385E. 20 Latvia 385E. 21 Lithuania 386E. 22 Luxembourg 387E. 23 Malta 388E. 24 The Netherlands 388E. 25 Norway 389E. 26 Poland 390E. 27 Portugal 391E. 28 Romania 391E. 29 Slovakia 392E. 30 Slovenia 393E. 31 Spain 394E. 32 Sweden 395E. 33 Switzerland 395E. 34 United Kingdom 396Index 399

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