How should I manage a patient presenting with symptoms of a notifiable disease, and when should I consider urgent referral?

When managing a patient presenting with symptoms of a notifiable disease, immediate assessment to identify signs of serious or life-threatening illness is essential, especially in children under 5 years old, where symptoms such as non-blanching rash, neck stiffness, bulging fontanelle, or decreased consciousness require urgent action ².

Notify the appropriate public health authorities promptly as per statutory requirements for the specific notifiable disease.

Urgent referral should be considered when the patient exhibits symptoms indicating severe or progressive disease or complications, such as unexplained lymphadenopathy with systemic symptoms (night sweats, weight loss, pruritus, splenomegaly) in children and young people, which may suggest malignancies like Non-Hodgkin's or Hodgkin's lymphoma; these cases warrant a very urgent referral for specialist assessment within 48 hours ¹.

For suspected tuberculosis, urgent referral to a TB clinic is recommended when active TB is suspected, ensuring that initial diagnostic results (e.g., sputum smear, chest X-ray) are available but without delaying referral ³.

In all cases, ensure clear communication, appropriate infection control measures, and coordination with multidisciplinary teams and public health services to manage the patient safely and effectively ³.