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Law and infectious diseases Marta Rorat PhD, MD The Act of 5 December 2008 on preventing and fighting infections and infectious diseases in humans THE ACT DEFINES Rules and procedures to prevent and fight infections and infectious diseases in humans including the rules and procedures of identifying and monitoring the epidemiological situation as well as taking anti-epidemic actions and immunisations Rules and tasks of public administration in prevention and fighting infections and infectious diseases in humans Rights and obligations of entities providing medical services and people residing in the territory of Poland The Act of 5 December 2008 on preventing and fighting infections and infectious diseases in humans Chapter 1 General provisions (purpose of the Act, the legal definitions, to whom and to what it applies, programmes, obligations) Chapter 2 Sanitary-epidemiological analysis, investigation (who, when and where is obliged to perform tests, verification, temporary removal from work) Chapter 3 Infections associated with providing healthcare services Chapter 4 Vaccinations Chapter 5 Other actions to prevent infections and infectious diseases Chapter 6 Proceeding in case of suspicion or recognition of infection or infectious disease, and in case of death due to infection Chapter 7 Public administration in prevention and control of infections and infectious diseases Chapter 8 Rules of proceeding in case of epidemiology threat and epidemic outbreak Chapter 9 Legal penalties Appendix The list of infections and infectious diseases Vaccination • An obligation to undergo „mandatory vaccinations” • People residing on the territory of Poland for less than 3 months are exempt from the obligation to be vaccinated • Before a vaccination physical examination has to be performed • The doctor issues a certificate confirming no contraindications to vaccination, including the date and exact time • The certificate is valid for 24 hours • Long-term postponement of obligatory vaccination requires specialist consultation Vaccination • Doctors, nurses, midwives, school hygienist qualifying patients to be vaccinated • Running medical documentation is mandatory • Obligatory vaccination has to be reported to Sanitary Inspector • Vaccine adverse reaction (or suspicion) has to be reported within 24 hours Vaccination Children under 6 years of age have to be assisted by their parents or a legal guardian Childer over 6 might be examined without presence of parents or a legal guardian, after obtaining their written consent and being given an information about their health status • A doctor is obliged to inform the person about mandatory as well as recommended vaccines • Health care providers have to send the reports about performed vaccinations to Sanitary Inspector • Sanitary Inspector calls for vaccination and indicates consequences of failure to comply with the obligation • In case of further avoiding the obligation a province governor (wojewoda) is being informed and starts administrative proceeding • Possible punishment: a fine (recovery procedure) The Misdemeanour Code of 20 May 1971 Art. 115. § 1. Who does not succumb to mandatory preventive vaccination against tuberculosis or other infectious diseases or mandatory health check-ups for the detection and treatment of tuberculosis, venereal disease or any other infectious disease, following the use of administrative enforcement means, can be fined up to 1 500 PLN or can be reprimanded. § 2. The same penalty applies to any person having custody of a minor, who does not provide the minor with a vaccination or examination specified in § 1. Infection/infectious disease If a patient is suspected of an infection or infectious disease he must be informed by doctor, nurse or midwife about ways of transmission and protection options. In case of STD (sexual transmited disease) also about necessity of doctor’s visit of his sexual partners. It must be assigned by a patient in medical records. Hospital acquired infection A doctor, who suspects or recognises an infection, infectious disease or death due to infection/ infectious disease, is obliged immediately (in less than 24 hours) to report such event to Sanitary Inspector. In case of patients admitted to the hospital, the obligation is within the hospital manager duties. The notification should contain: • patient’s personal data (name, surname, age, gender, PESEL number, address) • diagnosis of an infection or infectious disease • clinical symptoms • description of the infection, illness or death due to infection or infectious disease • risk factors • characteristics of the biological infection agent • other information, required for epidemiologic supervision There are different forms for tuberculosis, STDs, HIV/ AIDS, death due to infection or infectious disease Healthcare centre managers and individuals providing healthcare services are obliged to engage actively in actions aimed at preventing the spread of infections and infectious diseases The actions mentioned above should include in particular: 1) assessment of the risk of hospital acquired infections 2) monitoring the risk factors and hospital acquired infections 3) establishing, implementation and supervision of procedures preventing the occurrence of hospital acquired infections 4) introduction of individual and group protection, aimed at preventing the transfer of contagious biological agents to other people 5) conducting laboratory tests and analysis of local epidemiologic situation 6) internal control Hospital acquired infections 1) obligation to run the medical record documentation 2) obligation to implement system of prevention and fighting hospital acquired infection: • establishing and supervising activity of Group and Committee of Hospital Acquired Infections; • risk assessment and monitoring hospital acquired infections and alarm factors • procedures to ensure prevention of hospital acquired infections, patients’ isolation, 24/7 test performing (including microbiological), antibiotic therapy control • monitoring and registering hospital acquired infections and alarm factors • infections and outbreaks are reported to Sanitary Inspector Fines 1) for vaccinating having no formal qualification 2) for lack or improper running of medical records on vaccination 3) for not informing the patient/legal guardian about mandatory or recommended vaccines 4) for not informing a patient/legal guardian about safety measures which prevent infection transmiting from one person to another or obligation to perform sanitary-epidemiological tests 5) for not informing an infected person of the obligation to visit a doctor by his/her sexual partners 6) lack of AEFI reporting 7) for not reporting suspicion or recognition of an infection, infectious disaese, death because of infection/infectious disease 8) for not implementing and not applying procedures protecting from infections and infectious diseases 9) for not following hygienic-sanitary procedures art. 161 cc § 1. Whoever, knowing that he or she is infected by the HIV virus, directly exposes another person to infection from that disease shall be subject to the penalty of deprivation of liberty for up to 3 years. § 2. Whoever, knowing that he or she is afflicted with a venereal or contagious disease, a serious incurable disease or a disease which actually threatens life, directly exposes another person to infection from that disease shall be subject to a fine, the penalty of restriction of liberty or the penalty of deprivation of liberty for up to one year. § 3. The prosecution of the offence specified in § 1 or 2 shall occur on a motion of the injured person.