Download Epidemiological Safety Law.

Disclaimer: The English language text below is provided by the Translation and Terminology Centre for information
only; it confers no rights and imposes no obligations separate from those conferred or imposed by the legislation
formally adopted and published. Only the latter is authentic. The original Latvian text uses masculine pronouns in
the singular. The Translation and Terminology Centre uses the principle of gender-neutral language in its English
translations. In addition, gender-specific Latvian nouns have been translated as gender-neutral terms, e.g.
chairperson.
Text consolidated by Tulkošanas un terminoloģijas centrs (Translation and Terminology Centre) with amending
laws of:
30 March 2000.
If a whole or part of a section has been amended, the date of the amending law appears in square brackets at the end
of the section. If a whole section, paragraph or clause has been deleted, the date of the deletion appears in square
brackets beside the deleted section, paragraph or clause.
The Saeima1 has adopted and the
President has proclaimed the following law:
Epidemiological Safety Law
Chapter I
General Provisions
Section 1.
Terms Used in this Law
The following terms are used in this Law:
1) dangerous infectious diseases - human infectious diseases and parasitic diseases
which, in relation to their malignant clinical progression, capacity for spreading rapidly and the
lack of an effective prophylaxis or means of medical treatment endanger public health. The list of
such diseases shall be approved by the Cabinet;
2) human infectious disease - a disease induced by an infectious disease-causing agent,
the spread of which may cause an epidemic (hereinafter - infectious disease);
3) deratisation - a set of measures for the extermination of mouse-like rodents;
4) disinfection - a set of measures for the extermination of infectious disease-causing
agents;
5) disinsectisation - a set of measures for the extermination of harmful arthropods;
6) epidemic - the spread of an infectious disease to such an extent which exceeds the
morbidity rate characteristic of a particular territory or, also, the appearance and intensive spread
of a disease in a territory where it has not previously been registered;
7) epidemiologist - a person who has a higher medical or other higher education and who
conducts epidemiological surveillance, plans, organises, co-ordinates and controls measures for
the prophylaxis and combating of infectious diseases, and who is appropriately trained for this
work;
8) epidemiological safety - the system of prophylactic, counter-epidemic, medical
treatment and organisational measures for restricting, combating the spread of infectious diseases
and preventing their possible outbreak;
9) epidemiological investigation - the work method for the detection of infectious
disease-causing agents, sources, transmission factors and means of spreading, as well as for the
organisation of prophylaxis and anti-epidemic measures;
1
Parliament of the Republic of Latvia
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
10) epidemiological observation - the regular examination of the epidemiological
situation in the focus of an epidemic during the incubation period of infectious diseases or during
the existence of the focus of the epidemic;
11) epidemiological surveillance - the uninterrupted, dynamic and complex observation
of the epidemic process of an infectious disease to determine the epidemiological situation,
forecast the exacerbation of infectious diseases and of epidemics, exertion of influence on the
epidemiological situation and evaluation of the efficiency of preventive, counter-epidemic and
medical treatment measures;
12) epizootic – an illness of animals en masse with a contagious disease;
13) immunity - the insusceptibility of an organism to infectious diseases;
14) source of infectious disease - a human or animal organism or an environmental
object in which the infectious disease-causing agents are preserved, multiply and are discharged,
or may be discharged, creating a threat of infection to humans;
15) infectious disease-causing agents - bacteria, viruses, rickettsias, spirochetes,
chlamydias, mycoplasmas, fungi, unicellular organisms, helminths, parts of micro-organisms,
toxins and other biological agents which on invading the human body may induce a disease or
the carrying of a disease-causing agent;
16) focus of an infectious disease (also, focus of an epidemic) - a place (territory)
within the boundaries of which humans may become infected by coming into contact with the
source of an infectious disease or with the carrier of an infectious disease-causing agent;
17) infectionist - an internal disease physician who specialises in the diagnosis, medical
treatment and prophylaxis of infectious diseases;
18) infected person - a person whose organism contains or discharges, or may discharge
infectious disease-causing agents into the external environment;
19) infection - the invasion of the human organism by an infectious disease-causing
agent as a result of which varying intensity infection process development forms are created;
20) isolation - a counter-epidemic measure for the segregation of infectious persons from
healthy persons, for medical treatment and for ensuring appropriate conditions in order to prevent
healthy persons from becoming infected;
21) quarantine - a special regimen for the restriction of economic activities, social
activities, operations of medical treatment institutions and other activities that is prescribed in
order to prevent the spread of dangerous and other infectious diseases outside the boundaries of
the focus of an epidemic;
22) exposed person - a person who has been in direct or indirect contact with an infected
person or who has stayed in the focus of an epidemic and who has had an opportunity to become
infected;
23) laboratory examination - the examination of human, animal or environmental
materials by various laboratory methods for direct or indirect detection of the presence of
infectious disease-causing agents;
24) medical observation - the regular examination of the health of persons subject to the
risk of infection during the incubation period of an infectious disease;
25) cause for suspicion - a conclusion based on evidence, which, on the basis of the
specialised knowledge necessary for the performance of professional duties regarding matters of
epidemiological safety, is made by epidemiologists of the Public Health Agency, State sanitary
inspectors, health care practitioners or other officials during the time of performance of duties
within their competence;
26) counter-epidemic measures – measures for stopping the spread of an infectious
disease and its liquidation (the concept “counter-epidemic” shall also be construed with this
meaning);
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
2
27) initial medical examination - the questioning and inspection of persons in order to
identify symptoms of infectious diseases;
28) prophylactic measures – measures for preventing the outbreak and spread of
infectious diseases, and for the strengthening of human and environmental health (the concepts
“prophylaxis” and “prophylactic” shall also be construed with this meaning);
29) patient - a person who has contracted an infectious disease;
30) vaccination (inoculation) – a specific prophylactic measure for the purpose of
inducing or maintaining the insusceptibility of an organism to an infectious disease by injecting a
vaccine;
31) State Immunisation Programme – a programme, in which are specified
immunisation targets, tasks, vaccination calendar and other measures to be implemented in the
State for the prevention or liquidation of such infectious diseases, as for which the form of
prophylaxis is vaccination; and
32) heightened risk object – institutions, undertakings (companies) and organisations,
whose form of activity is the provision of services to consumers and in which, due to their
activities or the operations of the equipment utilised, infectious diseases may become
widespread, if the emergence of a focus of an infectious disease is allowed.
[30 March 2000]
Section 2.
Purpose of this Law
The purpose of this Law is to regulate epidemiological safety and specify the rights and
duties of State authorities, Local Governments, and natural and legal persons in the field of
epidemiological safety, as well as to determine liability for the violation of this Law.
Section 3.
Epidemiological Safety
Epidemiological safety includes:
1) the control of environmental sanitary and hygiene conditions and measures for
environmental recovery;
2) the epidemiological surveillance of infectious diseases, including;
a) the registration, enumeration and analysis of the morbidity rates for infectious
diseases;
b) the laboratory examination of human, animal and environmental materials for
the observation of circulation of infectious disease-causing agents; and
c) the study of the immunity of the population;
3) the vaccination of the population;
4) the detection, enumeration, treatment and, if necessary, the isolation of patients and
infected persons;
5) the laboratory examination, medical and epidemiological observation of exposed
persons;
6) the restriction and prohibition of the occupational activities of patients and infected
persons;
7) measures for the recovery of the focus of an epidemic, as well as measures for the
discontinuance of the circulation of infectious disease-causing agents in the external
environment;
8) medical sanitary measures which are directed against the importation of dangerous
infectious disease-causing agents and against the spread of such diseases;
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
3
9) informing the inhabitants regarding the epidemiological situation and education on
issues regarding the prophylaxis of infectious diseases; and
10) the application of compulsory measures prescribed by law for failure to implement
epidemiological safety measures.
Section 4.
Financing of Epidemiological Safety
(1) Epidemiological safety measures shall be financed from State budget funds allocated to the
Ministry of Welfare pursuant to the law on the relevant annual State budget, that is, from
subsidies, from general revenues, from revenues from services charged for, and from other own
revenues, as well as from donations and gifts.
(2) In cases of epidemics, as well as in such emergency situations as threaten to cause epidemics,
the financing for additional compulsory vaccinations in accordance with Section 30, Paragraph
three of this Law, as well as for the implementation of quarantine and other measures shall be
granted from State budget funds provided for the rectifying of emergency situations in
accordance with the law on the relevant annual State budget. In such cases, the decision to grant
funding shall be taken by the Cabinet.
(3) Local Government funds, as well as funds which have been donated by other natural and
legal persons may also be used in the rectifying of epidemics and such emergency situations as
threaten to cause epidemics.
Chapter II
Competence of State and Local Government Institutions in the
Field of Epidemiological Safety
Section 5.
Competence of the Ministry of Welfare
(1) The Ministry of Welfare shall:
1) formulate and implement the State policy for the prophylaxis and combating of
infectious diseases, and ensure the co-ordination and uniformity of work in this field;
2) formulate draft regulatory enactments regarding the prophylaxis of infectious diseases
and the implementation of counter-epidemic measures;
3) co-ordinate prophylactic measures for infectious diseases, and also, the vaccination of
inhabitants and immunity research;
4) co-ordinate the formulation of the State and regional programmes for the combating
and elimination of infectious diseases;
5) in cases of emergency situations or disasters, submit to the Cabinet proposals for
preventing the threat of an outbreak of an epidemic, or for combating an existing epidemic.
6) together with the Ministry of Education and Science, co-ordinate the education of the
population in the field of the prophylaxis of infectious diseases;
7) co-ordinate activities of the services and institutions involved in the prophylaxis of
infectious diseases and counter-epidemic measures; and
8) through the agency of authorities subject to the control of the Ministry, control the
quality of medical treatment, prophylactic and counter-epidemic measures in the State.
(2) The Ministry of Welfare may partially or fully transfer the implementation of separate
matters within its competence to authorities under the supervision of or subject to the control of
the Ministry.
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
4
(3) The Ministry of Welfare and authorities under its supervision and subject to its control shall
co-operate with foreign and international health organisations in the field of exchange of
epidemiological information.
Section 6.
Competence of the State Sanitary Inspection
(1) The State Sanitary Inspection is a State administrative institution subject to the control of the
Ministry of Welfare, which shall operate in accordance with by-laws approved by the Cabinet.
(2) Within the field of epidemiological safety, the State Sanitary Inspection shall control the
implementation of the prophylactic and counter-epidemic requirements prescribed in regulatory
enactments in any object in the territory of the Republic of Latvia.
(3) Officials of the State Sanitary Inspection have the right to:
1) request from natural and legal persons, pursuant to the procedures prescribed by
regulatory enactments, information necessary for the performance of their tasks regarding
matters within the competence of the State Sanitary Inspection;
2) during the performance of official duties, visit any site in the territory of the Republic
of Latvia, irrespective of to whom it belongs, and pursuant to the procedures prescribed by
regulatory enactments perform an inspection of the relevant site or separate items, if there is
cause for suspicion that it may contain or transmit infectious disease-causing agents;
3) in accordance with the Law On the Procedures for Suspension of the Operations of
Companies, Institutions and Organisations, issue orders (take decisions) regarding the suspension
of the operations of companies, institutions and organisations; and
4) impose administrative sanctions on guilty persons for violations of regulatory
enactments.
[30 March 2000]
Section 7.
Competence of the Public Health Agency
(1) The Public Health Agency (hereinafter - the Public Health Agency) shall:
1) plan and co-ordinate measures for the prophylaxis and combating of infectious
diseases;
2) formulate draft regulatory enactments and submit these for evaluation by the Ministry
of Welfare;
3) participate in the formulation of drafts of State programmes for the prophylaxis and
combating of infectious diseases;
4) ensure epidemiological surveillance and collect, accumulate and analyse statistical data
concerning:
a) human morbidity with infectious diseases (registration and enumeration of
patients and infected persons);
b) the results of laboratory examination of patients, infected persons and contact
exposed persons;
c) circulation of infectious disease-causing agents in water and other
environmental sites, food products, as well as among animals; and
d) the vaccination and immunity of the inhabitants;
5) supervise the epidemiological surveillance of units and subordinate units of the
National Armed Forces;
6) co-ordinate the implementation of the State Immunisation Programme, plan the
vaccination of the inhabitants, and organise and perform research on the specific immunity of the
inhabitants for the evaluation of the effectiveness of this programme;
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
5
7) inform and consult interested authorities and inhabitants through the agency of the
mass media, distribute special informative materials concerning the prophylaxis and combating
of infectious diseases, as well as concerning the epidemiological situation in the State, and warn
of epidemics in foreign states;
8) perform epidemiological investigations, organise the laboratory examination of
environmental sites and exposed persons, organise prophylactic and counter-epidemic measures
in the focus of infectious diseases;
9) organise sanitary medical measures for the prevention of the importation of infectious
disease-causing agents and the spread of such diseases, and emergency counter-epidemic
measures in cases of disaster and in other emergency situations;
10) on behalf of the Ministry of Welfare, co-operate with foreign and international
epidemiological surveillance authorities, ensure mutual exchange of epidemiological
information, and participate in the implementation of international programmes for combating of
infectious diseases; and
11) inform the State Sanitary Inspection of violations of this Law and other regulatory
enactments regarding epidemiological safety.
(2) In the performance of epidemiological surveillance or epidemiological investigations,
epidemiologists of the Public Health Agency have the right to:
1) request from natural and legal persons, pursuant to the procedures prescribed by
regulatory enactments, information necessary for the performance of their tasks; and
2) during the performance of official duties, visit any object in the territory of the
Republic of Latvia, irrespective of to whom it belongs, and pursuant to the procedures prescribed
by regulatory enactments carry out an inspection of the relevant site or separate items, if there is
cause for suspicion that it may contain or transmit infectious disease-causing agents.
[30 March 2000]
Section 8.
Competence of Local Government
(1) Local Governments pursuant to the procedures and in the cases prescribed by regulatory
enactments may take decisions on measures for the prevention of epidemics and the rectification
of their consequences.
(2) In cases when there is a threat that infectious diseases may spread (except dangerous
infectious diseases), on a recommendation from the head of a local division of the Public Health
Agency or the head of a local division of the State Sanitary Inspection, Local Governments are
entitled to take decisions regarding the specification of quarantine measures in educational,
medical treatment and social welfare institutions, as well as the conduct of public measures or the
restriction or prohibition of the use of places for swimming.
[30 March 2000]
Chapter III
Epidemiological Surveillance and Epidemiological Information
Section 9.
Epidemiological Surveillance
(1) The Ministry of Welfare shall determine the procedures pursuant to which epidemiological
surveillance is performed.
(2) Epidemiological surveillance shall be financed from the State budget. Local Governments
and other natural and legal persons may also participate in its financing.
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
6
Section 10.
Registration of Infectious Diseases
The Cabinet shall determine the procedures pursuant to which cases of infectious
diseases, and cases of human and animal infection and cases of the determination of infectious
disease-causing agents are registered.
Section 11.
Epidemiological Surveillance Statistics
(1) The statistical data on epidemiological surveillance shall be collected, registered and
compiled pursuant to the Official Statistics Law.
(2) Statistical activities regarding epidemiological surveillance shall be financed from the State
budget.
Section 12.
Information concerning the Spread of Infectious Diseases and the
Epidemiological Situation in Latvia
(1) Natural and legal persons, pursuant to the procedures prescribed by regulatory enactments,
are entitled to receive from competent State authorities information regarding the spread of
infectious diseases and the epidemiological situation in Latvia.
(2) Official information concerning the epidemiological situation in Latvia shall be prepared by
the Ministry of Welfare or another authority authorised by it.
Section 13.
Obligation not to Disclose Information in Cases of Infectious Diseases
Information concerning persons who have infectious diseases, persons in respect of
whom there is professionally determined causes for suspicion that they have become infected
with infectious diseases, as well as concerning decedents whose death was caused by infectious
diseases shall be confidential and utilised only in relation to the performance of medical
treatment, prophylaxis and counter-epidemic measures to the extent necessary to implement such
measures. Health care practitioners, the epidemiologists of the Public Health Agency (hereinafter
also - epidemiologists) and State sanitary inspectors, pursuant to the procedures prescribed by
regulatory enactments, shall provide such information only to:
1) other health care practitioners and institutions;
2) authorities which register infectious diseases, perform epidemiological surveillance of
them and organise counter-epidemic measures; and
3) the courts, police or prosecutorial institutions pursuant to a written request from them.
Chapter IV
Rights and Duties of Health Care Practitioners in Cases of Infectious Diseases
Section 14.
Rights and Obligations of Health Care Practitioners in Cases of Infectious
Diseases
(1) If health care practitioners have established that a patient has an infectious disease, or if there
is cause for suspicion that a patient has become infected, health care practitioners shall have an
obligation to:
1) organise without delay the medical examination and medical treatment of the patient;
2) organise the necessary laboratory examination to clarify the diagnosis;
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
7
3) request information from the patient, which is necessary for the organisation of
counter-epidemic measures, and also information regarding exposed persons and possible
sources of the infectious disease;
4) register the case of the infectious disease pursuant to the procedures prescribed by the
Cabinet; and
5) perform counter-epidemic measures prescribed by the Cabinet or the Ministry of
Welfare.
(2) Except in cases provided for by other regulatory enactments, health care practitioners shall
not have the right to refuse to perform an initial medical examination of a patient and to take
material for laboratory examination, if they have professionally determined that there is cause for
suspicion that the patient has become infected with an infectious disease and may spread it.
(3) Health care practitioners shall have a duty to provide emergency medical assistance to a
patient until an infectionist or other appropriately trained health care practitioners take over the
medical treatment of the patient.
(4) Persons who have become sick with a dangerous infectious disease may be treated by
infectionists or other health care practitioners in conformity with their specialisation, inviting if
necessary, other specialists as consultants.
(5) Health care practitioners shall notify the Public Health Agency without delay if a patient or a
person under medical observation does not follow the instructions of health care practitioners and
without authorisation ceases medical treatment, thereby posing a threat of the spread of an
infectious disease.
Chapter V
Counter-epidemic Measures
Section 15.
Conditions for Implementation of Counter-epidemic Measures
Counter-epidemic measures pursuant to the procedures prescribed by the Ministry of
Welfare shall be implemented, if the following have been determined:
1) the focus of an infectious disease, or circumstances under which such a focus may
develop, or if there is professionally determined cause for suspicion that such focus or
circumstances already exist; or
2) a patient or an infected person, or a person regarding whom there is professionally
determined cause for suspicion that he or she has become infected with an infectious disease, or a
case of death caused by an infectious disease.
Section 16.
Organisation of Counter-epidemic Measures
(1) If the conditions set out in Section 15 of this Law have been determined, an epidemiologist
shall have a duty, pursuant to the procedures prescribed by the Ministry of Welfare, to organise,
manage and co-ordinate counter-epidemic measures while the focus of an epidemic or the threat
of the spread of an infection exist, and also to specify and control the scope and terms of
laboratory examinations, procedures regarding the taking of materials, the duration of medical
observation in respect of exposed persons and persons regarding whom there is professionally
determined cause for suspicion that they have become infected with an infectious disease.
(2) [30 March 2000]
(3) Before an epidemiologist has become involved in the organisation of counter-epidemic
measures, as well as in cases if, pursuant to procedures specified by the Ministry of Welfare,
such involvement is not mandatory, health care practitioners shall have a duty to organise
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
8
emergency counter-epidemic measures and, at the request of an epidemiologist or a State sanitary
inspector, provide information on such measures and other information necessary to ensure
epidemiological surveillance.
(4) A State sanitary inspector has the right, by his or her order, to modify, revoke or supplement
the instructions of health care practitioners or an epidemiologist in respect of counter-epidemic
measures.
[30 March 2000]
Section 17.
Informing of Persons
(1) Health care practitioners and epidemiologists have a duty to inform a patient or an infected
person (or persons who provide care for them), as well as exposed persons or persons who are
subject to medical observation, regarding the means of the spread of the infectious disease and
the individual prophylactic measures. In cases specified by the Ministry of Welfare, the relevant
instructions shall also be recorded in medical documents and issued in writing to the persons
being informed.
(2) In cases of dangerous infectious diseases, pursuant to the request of health care practitioners
or an epidemiologist, a person who has been provided information or instructions in accordance
with Paragraph one of this Section shall certify with his or her signature that he or she:
1) has been informed of the means of spread of the infectious disease and clinical
manifestations of the disease, and the necessary prophylactic measures;
2) undertakes to observe the prescribed regimen; and
3) has been warned regarding the consequences of the violation of the mentioned
instructions and this Law.
Section 18.
Rights of Persons
(1) Persons, who have symptoms of an infectious disease or who suspect that they are infected,
pursuant to the procedures prescribed by regulatory enactments, have the right to:
1) a medical examination, consultations for the making of a diagnosis of an infectious
disease, and also anonymous medical and laboratory examinations, if public health is not
threatened by a flare up of such infectious disease or by an epidemic;
2) a confidential laboratory examination, medical treatment and consultations in matters
of health; and
3) the implementation of the necessary counter-epidemic measures at the dwelling-place,
place of work or of residence of such persons.
(2) Persons have the right to request and receive from health care practitioners or epidemiologists
a certificate, which sets out:
1) the medical treatment and counter-epidemic measures implemented in respect of them;
2) the counter-epidemic measures which have been implemented in respect of property
and possessions of such persons; and
3) the reasons for the implementation of the mentioned measures and the methods and
procedures used.
[30 March 2000]
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
9
Section 19.
Initial Medical Examination, Laboratory Examination and Medical
Observation of Exposed Persons
(1) The procedures regarding the initial medical and laboratory examination of exposed persons
shall be determined by the Ministry of Welfare.
(2) Exposed persons under medical observation may not be isolated and their freedom of
movement may not be restricted. Health care practitioners or an epidemiologist may require the
person to attend a specified medical treatment institution within a specified time period.
(3) If an exposed person under medical observation changes his or her dwelling-place, he or she
shall have an obligation to inform the medical treatment institution, which is performing the
medical observation, of such. Information regarding such person shall be transferred to the
relevant medical treatment institution at the future dwelling-place of such person to continue the
medical observation.
(4) An exposed person under medical examination who has received the warning mentioned in
Section 17, Paragraph two of this Law has an obligation to, without delay, notify health care
practitioners indicated in the warning or to turn to such health care practitioners, if any symptoms
of an infectious disease appear in relation to him or her.
Section 20.
Mandatory Medical and Laboratory Examination, Isolation and Treatment
(1) The Cabinet shall approve a list of infectious diseases and determine the procedures by which
persons who have become infected with any of the diseases listed, or concerning whom there is
professionally determined cause for suspicion that they have become infected, or separate
population groups, shall be subject to mandatory medical and laboratory examination, isolation
or treatment.
(2) Isolation shall be carried out at the dwelling-place of the person or at a medical treatment
institution.
Section 21.
Conditions for Isolation in a Medical Treatment Institution
(1) A person who has become infected with an infectious disease, or concerning whom there is
professionally determined cause for suspicion that he or she has become infected, may be
isolated in a medical treatment institution only if:
1) such infectious disease is included in the list mentioned in Section 20, Paragraph two
of this Law; and
2) the isolation is necessary to prevent the infection of human beings with the infectious
disease and if other counter-epidemic measures are unable to stop the spread of such disease
because:
a) the person does not subject himself or herself to the instructions of health care
practitioners or an epidemiologist in respect of his or her treatment and the observance of
the prescribed regimen;
b) the person is not capable of complying with the instructions of health care
practitioners or an epidemiologist fully and within the specified time; or
c) during the course of the treatment it is impossible to ensure the necessary
circumstances at the dwelling-place of the person in order to prevent the infection of
other persons.
(2) Isolation in a medical treatment institution shall be discontinued, if the person observes the
prescribed regimen and complies with the instructions of health care practitioners and an
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
10
epidemiologist, as well as when the other circumstances mentioned in this Section no longer
exist.
(3) A patient shall be isolated temporarily until all infectious disease-causing agents are
discharged, except in cases when health care practitioners determine otherwise.
(4) A person, who has become infected with any infectious disease mentioned in Section 20,
Paragraph one of this Law, or concerning whom there is professionally determined cause for
suspicion that he or she has become infected, may be isolated in accordance with the conditions
mentioned in Paragraph one of this Section, for the performance of medical and laboratory
examinations for the time that is necessary for the performance of such examination. Isolation in
such cases shall be terminated as soon as the results of the laboratory examination confirming
that the isolated person is not infectious have been received.
Section 22.
Forcible Isolation in a Medical Treatment Institution, Medical and
Laboratory Examination
(1) If the conditions mentioned in Section 21, Paragraph one of this Law exist, but an infected
person avoids isolation, he or she shall be forcibly isolated.
(2) A decision to forcibly isolate a person pursuant to the procedures prescribed by the Cabinet,
pursuant to the request of health care practitioners or an epidemiologist, shall be taken by the
chief State sanitary inspector or his or her deputies. The implementation of such decision shall be
controlled by State sanitary inspectors. With respect to persons who are in places of
imprisonment or isolation cells for short-term detention which are subject to the control of the
Ministry of the Interior, a decision on forcible isolation shall be taken by the head of the Sanitary
Epidemiological Service of the Ministry of the Interior.
(3) State sanitary inspectors have the right to issue an order, regarding the mandatory medical
and laboratory examination of persons, mentioned in Section 19, Paragraph one of this Law.
(4) If a person refuses to comply with the decision of the chief State sanitary inspector or his or
her deputy regarding his or her isolation in a medical treatment institution and the performance
of medical and laboratory examinations, such person shall be forcibly conveyed to the mentioned
institution by a police officer in the presence of health care practitioners, an epidemiologist, or a
State sanitary inspector. If necessary, the police shall provide guards at the place of isolation.
Police officers shall observe the necessary individual epidemiological protection requirements,
which are determined by health care practitioners, an epidemiologist or a State sanitary inspector.
Section 23.
Hygienic and Counter-epidemic Regimen in Medical Treatment Institutions
(1) The basic requirements for a hygienic and counter-epidemic regimen in medical treatment
institutions, in order not to allow the spread of infectious diseases, shall be determined by the
Ministry of Welfare.
(2) An isolated person in a medical treatment institution shall be ensured an opportunity to
communicate with other persons, if this does not create a threat of the spread of an infectious
disease.
(3) An isolated person may only leave the territory of the medical treatment institution or its part
which is intended for the isolation of the person, as well as transfer articles to other persons with
the permission of health care practitioners, if such isolated person does not create a threat of
infection to other persons. Health care practitioners have the right to organise the disinfection of
the articles transferred by the isolated person.
[30 march 2000]
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
11
Section 24.
Obligations and Rights of Natural and Legal Persons during the Time of
Epidemiological Investigation, Surveillance and Control
(1) Natural and legal persons may not interfere with an epidemiologist or a State sanitary
inspector in the performance of an epidemiological investigation, surveillance or control.
(2) Natural and legal persons have an obligation to provide an epidemiologist and a State sanitary
inspector with necessary information.
(3) Natural and legal persons have the right to receive information regarding the basis, course
and results of the epidemiological investigation and observation from those performing an
epidemiological investigation.
Section 25.
Taking of Environmental Samples for Laboratory Examination
(1) The Public Health Agency, in performing an epidemiological investigation, as well as during
epidemiological observation, but the State Sanitary Inspection, in performing control in the field
of epidemiological safety, are entitled to take samples for laboratory examination of any
environmental objects, items and food products. The samples shall be taken, documented and
transported, observing the procedures prescribed by the Ministry of Welfare.
(2) The owner, possessor or their authorised person shall have the right to organise an
independent control examination of a sample in an accredited or otherwise equivalently
evaluated laboratory. In such case, the expenses relating to the taking of samples shall be covered
by the owner or the possessor.
Section 26.
Obligation of Persons to Subject Themselves to Epidemiological
Examination, Medical and Laboratory Examination and Medical
Observation
If in respect of a particular person there is determined cause for suspicion that he or she
has been under the circumstances mentioned in Section 15 of this Law or has become infected
with any infectious disease, such person has an obligation to:
1) subject himself or herself to the medical and laboratory examination and medical
observation recommended by health care practitioners and an epidemiologist, as well as to give
the necessary materials for laboratory examination;
2) provide health care practitioners and an epidemiologist pursuant to their request with:
a) information regarding sources of the infectious disease and regarding the
possible time, place and circumstances of becoming infected;
b) information regarding a person or persons whom he or she may have infected;
and
c) other information which is of importance for the organisation and
implementation of counter-epidemic measures; and
3) comply with the request of an epidemiologist and a State sanitary inspector to
examine the hygiene conditions of his or her dwelling-place and to submit information regarding
the changes of his or her dwelling-place or place of residence pursuant to the procedures in
regulatory enactments regulating counter-epidemic measures.
Section 27.
Disinfection, Deratization and Disinsectization
(1) If it is determined or there is professionally determined cause for suspicion that items or food
products contain some infectious disease-causing agents and are considered to be dangerous in
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
12
respect of the spread of infectious disease-causing agents, as well as where there are rodents or
harmful arthropods on the premises, disinfection, deratization or disinsectization measures shall
be performed pursuant to the procedures prescribed by the Cabinet. The Cabinet shall also
determine the procedures for financing of such measures, and the requirements regarding the
qualifications of officials and employees who shall implement the mentioned measures.
(2) Pursuant to a decision by an official of the State Sanitary Inspection, the items or food
products mentioned in Paragraph one of this Section shall be destroyed if:
1) the relevant disinfection methods do not guarantee the safety of the items in respect of
the spread of infectious diseases even after their treatment; or
2) the disinfection costs exceed the value of the item. If it is necessary to destroy
property, the value of which exceeds 500 lati, the opinion of a commission established by the
Ministry of Welfare is required.
(3) The utilisation of items or premises subject to disinfection, deratization or disinsectization is
prohibited until the end of these procedures, if:
1) the person who implements these measures does not give other directions; or
2) it is not otherwise provided by the regulatory enactments, which regulate the
procedures regarding the implementation of such measures.
Section 28.
Prophylaxis and Combating of Such Infectious Diseases as to which both
Animals and Humans are Susceptible
If it is determined that an animal has an infectious disease to which humans are also
susceptible, or that there is professionally determined cause for suspicion that the agents causing
such disease may be found in the organism of an animal or the external environment, and there
exists a realistic possibility that humans may also become infected with such disease, the
necessary counter-epidemic measures shall be organised and implemented by the Public Health
Agency, but the counter-epizootic measures – by the State Veterinary Service – mutually coordinating their activities.
[30 March 2000]
Section 29.
Actions with the Body of a Deceased Human in Cases of Infectious Diseases
The procedures by which the body of a deceased human is brought into the State or taken
out of it, conveyed, stored, buried or cremated, as well as the procedures by which a mandatory
pathologic-anatomical investigation is performed after the death of a patient to refine a diagnosis
shall be determined by the Cabinet.
Chapter VI
Vaccination and Work with Infectious Disease-causing Agents
Section 30.
General Provisions for Vaccination
(1) The Cabinet shall determine against which infectious diseases the vaccination of persons
shall be compulsory, as well as the procedures for such vaccination and the cohort of persons to
be vaccinated. Expenses, which are associated with such vaccination shall be covered from the
State budget. Expenditures, which are associated with vaccinations provided for in the State
Immunisation Programme, shall be covered from funds provided for this purpose in the annual
State budget.
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
13
(2) For persons who are engaged in work which is associated with a heightened risk of infection,
as well as schoolchildren and students who during their period of education or practice are in
contact with or may come into contact with infectious disease-causing agents, vaccination is
mandatory.
(3) If an epidemic has commenced or there is a threat of such, additional compulsory vaccination
may be proclaimed pursuant to the procedures prescribed by the Cabinet.
(4) Vaccinations which are not provided for in Paragraphs one and two of this Section shall be
voluntary, individual and all expenditures relating to such shall be covered by the person to be
vaccinated, or his or her employer, or other natural or legal persons. The Cabinet shall determine
relief for certain groups in the population for the payment of the expenditures involved in
vaccination.
[30 March 2000]
Section 31.
Conditions for Vaccinations
(1) Only such vaccines may be used for vaccination which are included in the Drug Register of
Latvia, or the distribution of which is permitted in accordance with regulatory enactments.
(2) Persons who are engaged in the storage and conveyance of vaccines shall be liable for the
observance of the procedures prescribed by the Ministry of Welfare regarding the preservation of
the safety, harmlessness and quality of vaccines.
(3) Vaccinations may only be carried out by certified health care practitioners.
(4) The registration of the vaccinations performed, pursuant to the procedures determined by the
Ministry of Welfare. A record shall be made on an inoculation card in respect of the vaccinations
performed.
(5) The Cabinet shall determine the mandatory minimal security requirements for the conduct of
vaccinations.
[30 March 2000]
Section 32.
Complications Caused by Vaccinations
(1) Health care practitioners who have determined complications caused by vaccination have a
duty to provide notification of this without delay in accordance with the procedures prescribed by
the Ministry of Welfare.
(2) Complications caused by vaccination shall be investigated by epidemiologists of the Public
Health Agency, but the actions of the health care practitioners shall be evaluated by the Quality
Control Inspection for Expert Examination in Health Care and Work Disability of the Ministry of
Welfare.
Section 33.
Work with Infectious Disease-causing Agents
(1) Work with infectious disease-causing agents may only be performed by scientific institutions
or institutions accredited for the performance of such work or equivalently evaluated institutions.
(2) The following shall be considered work with infectious disease-causing agents:
1) experiments with infectious disease-causing agents capable of multiplying;
2) microbiological and serological examination to determine infectious diseases;
3) liquidation of infectious disease-causing agents;
4) conveyance, storage and exchange of infectious disease-causing agents capable of
multiplying; and
5) preparation of serums and vaccines.
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
14
Chapter VII
Conditions for Occupational Activities to Guarantee Epidemiological Safety
Section 34.
Mandatory Health Examination
Persons who are engaged in work, which is associated with a possible risk to the health of
other persons, shall be subject to a mandatory initial (prior to commencing employment) and to
periodic health examinations. Cabinet shall determine the referred to list and the periodicity of
the health examinations.
[30 March 2000]
Section 35. Restrictions on Occupational Activities
The Cabinet shall approve the list of the infectious diseases with which persons who have
become ill, or with which persons who have become infected, or persons in respect of whom
there is professionally determined cause for suspicion that they have become infected with such
infectious disease, may not be employed in:
1) undertakings (companies), institutions and organisations the type of activity of which
includes the production, processing or distribution of food products or drinking water, if such
persons are in direct or indirect contact with foods or drinking water;
2) undertakings (companies), institutions and organisations the type of activity of which
includes the provision of services to consumers (hairdressing salons, cosmetology salons, saunas,
swimming-pools, and others); or
3) medical treatment institutions, educational institutions, residential institutions for
children or extracurricular institutions.
Chapter VIII
Quarantine and other Medical Sanitary Measures
Section 36.
Quarantine in the Case of Dangerous Infectious Diseases
(1) If there is a threat of the spread of dangerous infectious diseases in the territory of Latvia,
pursuant to the recommendation of the Minister for Welfare, the Prime Minister shall proclaim a
quarantine and determine a quarantine regimen by an order. The quarantine regimen in a certain
site (buildings, production facilities, and the like) shall be determined by an order of the Minister
of Welfare, but in particular sites of the National Armed Forces, by the Commander of the
National Armed Forces after co-ordination with the Minister of Welfare.
(2) Quarantine shall include:
1) restrictions on the crossing of the boundaries of the declared quarantine territory;
2) necessary counter-epidemic measures regarding persons and means of transport
leaving the quarantine territory and the cargo to be taken out, as well as, if necessary, counterepizootic measures;
3) restrictions on public events and economic activity in the declared quarantine territory;
and
4) other counter-epidemic measures mentioned in this Law and other regulatory
enactments.
(3) A commission chaired by the Prime Minister or his or her authorised representative shall be
established to co-ordinate the quarantine measures. If the quarantine has been determined by the
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
15
Minister of Welfare, he or she shall also establish an appropriate commission and determine its
chairperson.
(4) Quarantine shall be proclaimed through the agency of the mass media. The mass media have
a duty to provide the necessary information at the specified time and in the specified amount.
(5) The Ministry of Welfare shall without delay inform the World Health Organisation of cases
when quarantine has been determined by an order of the Cabinet.
(6) The implementation of quarantine measures shall be financed from the State budget.
[30 March 2000]
Section 36.1
Quarantine in the Case of Other Infectious Diseases
Quarantine measures to prevent the spread of other infectious diseases in medical
treatment, social welfare and education institutions shall be determined by the Head of the
relevant institution on the basis of a recommendation of a health care practitioner or an
epidemiologist, or in accordance with a decision of a local government.
[30 March 2000]
Section 37.
Medical Sanitary Measures
(1) Medical sanitary measures are measures implemented by State institutions to prevent or
reduce the threat of the importation or spread of dangerous infectious diseases in the territory of
the State.
(2) The procedures regarding implementation of medical sanitary measures shall be determined
by the Cabinet.
Chapter IX
Final Provisions
Section 38.
Control of Biological Materials to Be Used in Medicine, Cosmetics and
Perfumery and Laboratory Examination of Donors
(1) Donor materials, serums, and other human and animal biological materials which contain
infectious disease-causing agents or in respect of which there is determined cause for suspicion
regarding such, may not be used in medicine, cosmetics and perfumery.
(2) Donors of blood, tissue, organs, sperm and other biological substrata shall be subject to
mandatory laboratory examination pursuant to the procedures prescribed by the Ministry of
Welfare.
(3) The procedures for laboratory examination and control of the quality of biological materials,
as well as the utilisation of the relevant information shall be determined by the Ministry of
Welfare.
Section 38.1
Hygiene Requirements
To ensure prophylaxis of infectious diseases, the Cabinet shall determine the hygiene
requirements for heightened risk objects. It is the duty of the Head of such objects to ensure the
observance of the hygiene requirements.
[30 March 2000]
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
16
Section 39.
International Tourism and Health of Travellers
In organising tours, the undertakings (companies), institutions and organisations, which
operate in the field of international tourism and perform the carriage of passengers shall fully and
objectively inform clients regarding:
1) the health risk factors in the territories which they wish to visit, as well as the threat of
infectious diseases and individual measures, including vaccination; and
2) the possibility of receiving medical assistance and consultations both before and during
the tour.
Section 40.
Police Assistance
Pursuant to a request from officials of the State Sanitary Inspection, police institutions
shall render assistance to health care practitioners, as well as epidemiologists of the Public
Health Agency and State sanitary inspectors, in order to ensure:
1) unimpeded epidemiological investigation;
2) forcible isolation of persons and their guarding; and
3) epidemiological safety in accordance with the procedures prescribed by this Law.
Section 41.
Liability for Violations of this Law
(1) Persons shall be subject to liability for violations of this Law in accordance with the liability
prescribed by law.
(2) The subjecting of persons to disciplinary, administrative or criminal liability shall not release
such persons from the obligation to compensate losses caused as a result of violation of this Law.
Transitional Provisions
1. Until the establishment of the Public Health Agency, its functions shall be performed by the
National Environmental Health Centre and territorial environmental health centres in the territory
under their supervision in accordance with their by-laws.
2. The following Cabinet Regulations, which were issued in accordance with Section 14, Clause
3 of the Structure of Cabinet Law, shall remain in force until 1 January 2001:
1) 19 May 1998 Cabinet Regulation No. 183, Regulations On Hygiene Requirements in
Hospitals;
2) 9 June 1998 Cabinet Regulations No. 216, Regulations On Hygiene Requirements in
Pre-school Educational Institutions; and
3) 13 July 1999 Cabinet Regulations No. 255, Regulations On Hygiene Requirements in
General Education Schools.
[30 March 2000]
This Law has been adopted by the Saeima on 11 December 1997.
President
G.Ulmanis
Riga, 30 December 1997
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
17
Transitional Provisions Regarding Amendments
to the Epidemiological Safety Law
Transitional Provision
(regarding amending Law of 30 March 2000)
With the coming into force of this Law, Cabinet Regulation No. 9, Amendments to the
Epidemiological Safety Law, issued in accordance with Article 81 of the Constitution of the
Republic of Latvia, is repealed.
Translation © 2000 Tulkoðanas un terminoloìijas centrs (Translation and Terminology Centre)
18