VHF preparedness in designated and non-designated health services and primary care

Designated health services

All cases of confirmed VHF in Victoria should be managed at a designated health service. In Victoria, the designated quarantine hospitals to receive suspected and confirmed cases of VHF are:

• The Royal Melbourne Hospital (RMH) for suspected or confirmed cases of VHF aged 16 and above. A suspected or confirmed case of VHF in a pregnant woman, including a woman in labour, will be directed to RMH. RMH will activate a request to the Royal Women's Hospital to provide assistance as needed, including obstetric and midwifery expertise, so that all required care can be provided at RMH.
• The Royal Children’s Hospital (RCH) for suspected or confirmed VHF cases aged under 16 years. These patients will be admitted to the RCH for assessment and testing, after a discussion between the Chief Health Officer or delegate, and the duty emergency department consultant at RCH.

Non-designated health services

There is a department expectation that non-designated health services with sufficiently senior staff and the capacity to hold and test a low-possibility suspected case of VHF (see VHF case investigation flow chart) will do so, if requested by the department, in accordance with the principles outlined in Transfer to a designated health service to assess the need for transfer.

In addition to the steps outlined in Transfer to a designated health service, non-designated health services should consider having an internal escalation arrangement when a suspected or confirmed VHF case presents to an outpatient or subacute setting where there are limited facilities for effective isolation.

This arrangement can outline:

• systems to identify and notify suspected cases of VHF to the LPHU and relevant staff within the health service (infectious diseases, infection prevention, pathology and executive)
• an interim arrangement to safely manage a suspected case of VHF temporarily before transfer to a designated health service, in discussion with the department. This arrangement can focus on isolation of the patient, avoidance of direct contact and timely transfer of the patient, in discussion with the department.

Primary care

Primary care services and facilities should refer to Immediate actions on suspicion of VHF disease regarding initial actions for a suspected case of VHF.

For more information, primary case services may refer to their Primary Health Networks and HealthPathways at:

• North Western Melbourne and Eastern Melbourne Public Health Network
• Eastern Melbourne Public Health Network
• South Eastern Melbourne Public Health Network
• Gippsland Public Health Network
• Murray Public Health Network
• Western Victoria Public Health Network

Airports and seaports

The Biosecurity Act 2015 outlines how human health risks from arriving aircraft and vessels are managed, including suspected cases of VHF at port of first entry (for example, airport or seaport).

The Commonwealth Department of Health, Disability and Ageing is responsible for administering human health aspects of the Biosecurity Act 2015, but administrative arrangements are in place for Biosecurity Officers from DAFF to perform these functions, supported by state and territory health departments.

If VHF is suspected:

• a DAFF Biosecurity Officer will call the state HBO.
• the HBO will assess the likelihood of VHF and provide direction on case management, contact management, and provide advice on precautionary environmental cleaning and disinfection, in accordance with the Human Biosecurity Guidelines and the VHF Control Guidelines.
• following assessment, the patient will be transferred via AV to the designated health service for further investigation and treatment.