PREVENTIVE AND COMMUNITY MEDICINE

PRINCIPLES OF CONTACT TRACING | Anacleto Clent L. Banaay, Jr., MD, MP| 11/23/22

 Close contact- within 6 feet for 15+ minutes

PRINCIPLES OF CONTACT TRACING  Proximate contact- more than 6 feet but in the same room
 Contact tracing- one of the best ways that we can limit the for an extended period of time
spread of disease
- Part of the active surveillance network Isolation and Quarantine
- Matter of time and scope  Isolation- separating and keeping of cases from the healthy
 Case investigation is part of the process of supporting people
patients with suspected or confirmed infection - Can utilize home or isolation center
 In case investigation, public health staff work with a patient - Separate hospital isolation room
to help them recall everyone with whom they have had close - COVID-19: should be isolated for 14 days
contact during the timeframe while they may have been Duration:
infectious  2 days before the onset of symptoms
 Public health staff then begin contact tracing by warning  At least 10 days after the onset of illness, provided
these exposed individuals (contacts) of their potential that symptoms must be improving and no fever
exposure as rapidly and sensitively as possible within the last 24 hours
 To protect patient privacy, contacts are only informed that  Quarantine- restricting the movement and contact of healthy
they may have been exposed to a patient with the infection. people who have been exposed to known case
They are not told the identity of the patient who may have
exposed them ELEMENTS OF CONTACT TRACING
 Contacts are provided with education, information, and
I. Contact Identification
support to understand their risk, what they should do to
 An essential part of epidemiologic investigation for all
separate themselves from others who are not exposed,
cases meeting the standard/ surveillance case definition
monitor themselves for illness, and the possibility that they
 Verbal autopsy- process of verifying the cause of death
could spread the infection to others even if they themselves
- Aims to establish the likely cause of
do not feel ill
death and identify chains of
 Contacts are encouraged to stay home and maintain social
transmission
distance until their last exposure, in case they also become
 Contact identification begins from a case
ill. They should monitor themselves by checking the basic
 Some information can be obtained from the patient,
vital signs
much of the information will come from the people
 Public health staff should check in with contacts to make
around the patient
sure they are self-monitoring and have not developed
 Identification of contacts is done by asking about the
symptoms. Contacts who develop symptoms should
activities of the case (whether alive or dead) and the
promptly isolate themselves and notify public health staff.
activities and roles of the people around the case
They should be promptly evaluated for infection and for the
(alive/dead) since onset of illness
need for medical care
 In many instances, the patient will have died or have
already been admitted to the isolation facility, with limited
Timeline of Infection: Infectious period
access. It is mandatory for the
 Time and scope in doing contact tracing activity is critical epidemiologist/surveillance officer to visit the home of the
because we want to limit the time of exposure for those patient
potential or future contacts with a certain contact who is  Priority should be given to high risk categories of
already infectious contacts
II. Contact listing
 All persons considered to have had significant exposure
should be listed as contacts
 The contact should also be provided with preventive
information to reduce the risk of exposing people close to
them
 Contact identification and listing, including the process of
informing contacts of their status, should be done
 The local surveillance staff/community health worker
should be introduced during the initial home visit as the
person who will conduct home visits
III. Contact follow-up
 The epidemiologist/ surveillance officer responsible for
Case and Contacts contact tracing should assemble a competent team
 Case- someone who has a confirmed diagnosis comprising local surveillance and appropriate community
- Positive for virus or infectious disease members to follow up all the listed contacts
- When someone is confirmed to have that disease,  This could include surveillance staff/ health workers from
he is considered to be part of the census/report health facilities, community health workers, volunteers
 Suspect or probable case- someone who is exposed to a  An efficient contact tracing system depends on a
case who develops symptoms but still unconfirmed relationship of trust with the community, which in turn
 Contact- someone who had contact with a case while the fosters optimum cooperation
case is in infectious state  Communities should have the confidence to cooperate
- During the day of illness with contact tracing teams and allow the referral of
- Days before their illness began symptomatic contacts to designated isolation facilities
3 kinds of contact:  Involving appropriate community members in contact
 Physical contact- contact has been physically taking care of tracing is critical in cultivating this good relationship, trust
the person or case; touching most of the time and confidence

1|PCM
Jeryl Kyra D. Vercide
 PREVENTIVE AND COMMUNITY MEDICINE
 The local surveillance staff and community health
workers should be closely supervised by trained
individuals (epidemiologists/ surveillance officers)

Steps to investigate cases and trace their contacts

Basic steps in contact tracing

Steps 1 to 4: Calling the case

 Introduction
 Inquire about the infectious period
 Identify contacts
 Instruct on how to isolate
Step 5: Call contact(s)
 Inform about exposure, ask about symptoms, instruct on
quarantine
Step 6: Implement regular check-ins with the case and contact(s)

SUMMARY
 Contact tracing is one of the most effective outbreak
containment measures and must be implemented prudently
 There are 6 basic steps in Contact tracing: Introduction,
Inquiry, Identify contacts, Isolation, Initiate contact tracing,
Implement regular check-ins
 Isolation is separating and keeping of cases from the
healthy people
 Quarantine is restricting the movement and contact of
healthy people who have been exposed to known case
 Case is someone who has a confirmed diagnosis
 Suspect or probable case is someone who is exposed to a
case who develops symptoms but still unconfirmed
 Contact is someone who had contact with a case while the
case is in infectious state
 3 kinds of contact: Physical contact, Close contact,
Proximate contact

2|PCM
Jeryl Kyra D. Vercide