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S.I. No. 707/2003 - Infectious Diseases (Amendment) (No. 3) Regulations 2003

I, MicheáI Martin, Minister for Health and Children, in exercise of the powers conferred on me by sections 5 and 29 of the Health Act 1947 (No. 28 of 1947) and by section 31 of the said Act, as amended by section 34 of the Health Act 1953 (No. 26 of 1953) hereby make the following regulations:

PART 1 - PRELIMINARY AND GENERAL

1.             These Regulations may be cited as the Infectious Diseases (Amendment) (No. 3) Regulations 2003.

2.             The Regulations shall come into operation on 1 January 2004.

3.             In these Regulations -

“Principal Regulations” means the Infectious Diseases Regulations 1981 ( S.I. No. 390 of 1981 ), as amended by Infectious Diseases (Amendment Regulations 1985 ( S.I. No. 268 of 1985 ), Infectious Diseases (Amendment Regulations 1988 ( S.I. No. 288 of 1988 ), Infectious Diseases (Amendment Regulations 1996 ( S.I. No. 384 of 1996 ), Infectious Diseases (Amendment Regulations 2000 ( S.I. No. 151 of 2000 ), Infectious Diseases (Amendment Regulations 2003 ( S.I. No. 115 of 2003 ) and Infectious Diseases (Amendment) (No.2) Regulations 2003 ( S.I. No. 180 of 2003 ).

PART 2 - AMENDMENTS TO THE PRINCIPAL REGULATIONS

4.   (1)        The Schedule to the Principal Regulations as amended by the Infectious Diseases (Amendment) Regulations 1985 ( S.I. No. 268 of 1985 ), the Infectious Diseases (Amendment) Regulations 1988 ( S.I. No. 288 of 1988 ), the Infectious Diseases (Amendment) Regulations 1996 ( S.I. No. 384 of 1996 ) and the Infectious Diseases (Amendment) Regulations 2003 ( S.I. No. 115 of 2003 ) is amended by substituting the Schedule detailed hereunder for the existing Schedule.

(2)       Regulation 2 of the Principal Regulations is amended as follows by:

(i) the insertion after “ “the Minister” means the Minister for Health” of the following:

“case definition” means the set of clinical or microbiological characteristics by which a case of infectious disease is defined, which shall be maintained, updated and circulated by the National Disease Surveillance Centre;

“clinical director of a diagnostic laboratory” means (a) a consultant clinical microbiologist, consultant pathologist or other medical practitioner in charge or control of, or providing medical supervision in, a laboratory, or (b) other laboratory medical or scientific staff to whom the function of providing notification of infectious diseases has been delegated by the clinical director;

“laboratory” means an institution, or facility within an institution equipped with apparatus and reagents for the performance of diagnostic tests for human infections

“unusual cluster or changing pattern of illness” means an aggregation of health events, grouped together in time or space, that is believed or perceived to be greater than could be expected by chance”

(ii) by the substitution of the definition of the “National Disease Surveillance Centre” by the following:

“ “National Disease Surveillance Centre” means the centre of this name with an address at 25 — 27 Middle Gardiner Street, Dublin 1”.

(3)       Regulation 6 of the Principal Regulations is amended by substituting the following for the existing regulation:

“The diseases and their respective causative pathogens listed in the Schedule to these Regulations are specified to be infectious diseases and the expression “infectious disease” shall be construed as meaning any disease or causative pathogen so listed.”

(4)       Regulation 8 of the Principal Regulations is amended by substituting the following for the existing regulation:

“All the infectious diseases listed in the Schedule to these Regulations except acute anterior poliomyelitis, cholera, diphtheria, paratyphoid plague, severe acute respiratory syndrome (SARS), smallpox tuberculosis, typhoid, typhus and viral haemorrhagic fevers (Lassa Marburg, Ebola, Crimean-Congo) shall be excluded from the application of Section 38 of the Health Act 1947 as amended by Section 35 of the Health Act 1953 .”

(5)       Regulation 9 of the Principal Regulations is amended by substituting the following for the existing regulation:

“All the infectious diseases listed in the Schedule to these Regulations except acute anterior poliomyelitis, diphtheria, paratyphoid salmonellosis, shigellosis, tuberculosis, typhoid, typhus and viral haemorrhagic fevers (Lassa, Marburg, Ebola, Crimean-Congo) shall be excluded from the application of Section 44 of the Health Act 1947 as amended by Section 36 of the Health Act 1953 .”

(6)(i)    Regulation 14(1) of the Principal Regulations is amended by substituting the following for the existing paragraph:

“(1)    Subject to the provisions of Regulation 15 of these Regulations, a medical practitioner, as soon as he or she becomes aware or suspects that a person on whom he or she is in professional attendance is suffering from or is the carrier of an infectious disease, and a clinical director of a diagnostic laboratory as soon as an infectious disease is identified in that laboratory, shall —

(a) forthwith transmit a written or electronic notification to a medical officer of health, and

(b) further in the case of acute anterior poliomyelitis, anthrax botulism, cholera, diphtheria, enterohaemorrhagic escherichia coli, haemophilus influenzae disease, legionellosis meningococcal disease, paratyphoid, plague, rabies, severe acute respiratory syndrome (SARS), smallpox, tularemia typhoid, typhus, viral haemorrhagic fevers (Lassa, Marburg Ebola, Crimean-Congo), or yellow fever or where he or she is of the opinion that there is a serious outbreak of infectious disease in a locality, give immediate preliminary notification thereof to a medical officer of health.”

(6)(ii)   Regulation 14 of the Principal Regulations, as amended by the Infectious Diseases (Amendment) Regulations 1996 ( S.I. No. 384 of 1996 ), is further amended by inserting after paragraph (2)(b) the following:

“(3)(a) A medical practitioner and a clinical director of a diagnostic laboratory shall have regard to the case definitions for infectious diseases circulated by the National Disease Surveillance Centre.

(b) A medical practitioner and a clinical director of a diagnostic laboratory shall notify to the medical officer of health any unusual clusters or changing patterns of any illness, and individual cases thereof, that may be of public health concern. The medical officer of health shall in turn notify the National Disease Surveillance Centre.”

(7)       Regulation 15(2) of the Principal Regulations is amended by substituting the following for the existing paragraph:

“(2)(a) Where a medical practitioner who is a medical officer of an infectious disease hospital or infectious disease unit is required under sub-regulation (1) of this regulation to notify a case of acute anterior poliomyelitis, anthrax, botulism, cholera, diphtheria enterohaemorrhagic escherichia coli, haemophilus influenzae disease, legionellosis, meningococcal disease, paratyphoid, plague rabies, severe acute respiratory syndrome (SARS), smallpox tularemia, typhoid, typhus, viral haemorrhagic fevers (Lassa Marburg, Ebola, Crimean-Congo) or yellow fever, or where he or she is of the opinion that there is a serious outbreak of infectious disease in a locality he or she shall give immediate preliminary notification thereof to a medical officer of health.

(b) A medical practitioner and a clinical director of a diagnostic laboratory shall notify to the medical officer of health any unusual clusters or changing patterns of any illness, and individual cases thereof, within the infectious disease hospital or infectious disease unit, that may be of public health concern. The medical officer of health shall in turn notify the National Disease Surveillance Centre.”

(8)       Regulation 16 of the Principal Regulations is amended by substituting the following for the existing regulation:

“A registrar of births and deaths shall send to a medical officer of health such returns of deaths from infectious diseases as may be specified by the Minister. Every medical officer of health shall in turn forward such returns to the National Disease Surveillance Centre.”

(9)       Regulation 18 of the Principal Regulations is amended by substituting the following for the existing paragraphs:

“(1) A medical officer of health shall furnish to the Director of the National Disease Surveillance Centre by the Wednesday of each week a return of the cases of infectious diseases notified to him or her in the week ending on the previous Saturday. This return may be provided electronically.

(2) A medical officer of health shall furnish to the Minister, or to the Director of the National Disease Surveillance Centre, as soon as possible a detailed report on each case of such infectious disease as the Minister or the Director of the National Disease Surveillance Centre may specify from time to time.

(3) A standard form for the purpose of returning infectious disease shall be compiled by the National Disease Surveillance Centre and circulated by that Centre.”

SCHEDULE

Diseases and their respective causative pathogens specified to be Infectious Diseases

Disease

Causative Pathogen

Acute anterior poliomyelitis

Polio virus

Acute infectious gastroenteritis

 

Ano-genital warts

 

Anthrax

Bacillus anthracis

Bacillus cereus food-borne infection/intoxication

Bacillus cereus

Bacterial meningitis (not otherwise specified)

 

Botulism

Clostridium botulinum

Brucellosis

Brucella species

Campylobacter infection

Campylobacter species

Chancroid

Haemophilus ducreyi

Chlamydia trachomatis infection (genital)

Chlamydia trachomatis

Cholera

Vibrio cholerae

Clostridium perfringens (type A) food-borne disease

Clostridium perfringens

Creutzfeldt Jakob disease

 

nv Creutzfeldt Jakob disease

 

Cryptosporidiosis

Cryptosporidium parvum

Diphtheria

Corynebacterium diphtheriae

Echinococcosis

Echinococcus species

Enterococcal bacteraemia

Enterococcus species (blood)

Enterohaemorrhagic Escherichia coli

Escherichia coli of serogroup known to be toxin-producing

Escherichia coli infection (invasive)

Escherichia coli (blood, CSF)

Giardiasis

Giardia lamblia

Gonorrhoea

Neisseria gonorrhoeae

Granuloma inguinale

 

Haemophilus influenzae disease (invasive)

Haemophilus influenzae (blood, CSF or other normally sterile site)

Hepatitis A (acute)

Hepatitis A virus

Hepatitis B (acute and chronic)

Hepatitis B virus

Hepatitis C

Hepatitis C virus

Herpes simplex (genital)

Herpes simplex virus

Influenza

Influenza A and B virus

Legionellosis

Legionella species

Leptospirosis

Leptospira species

Listeriosis

Listeria monocytogenes

Lymphogranuloma venereum

 

Malaria

Plasmodium falciparum, vivax, ovale, malariae

Measles

Measles virus

Meningococcal disease

Neisseria meningitidis

Mumps

Mumps virus

Non-specific urethritis

 

Noroviral infection

Norovirus

Paratyphoid

Salmonella paratyphi

Pertussis

Bordetella pertussis

Plague

Yersinia pestis

Q Fever

Coxiella burnetii

Rabies

Rabies virus

Rubella

Rubella virus

Salmonellosis

Salmonella enterica

Severe Acute Respiratory Syndrome (SARS)

SARS-associated coronavirus

Shigellosis

Shigella species

Smallpox

Variola virus

Staphylococcal food poisoning

Enterotoxigenic Staphylococcus aureus

Staphylococcus aureus bacteraemia

Staphylococcus aureus (blood)

Streptococcus group A infection (invasive)

Streptococcus pyogenes (blood), CSF or other normally sterile site)

Streptococcus pneumoniae infection (invasive)

Streptococcus pneumoniae (blood, CSF or other normally sterile site)

Syphilis

Treponema pallidum

Tetanus

Clostridium tetani

Toxoplasmosis

Toxoplasma gondii

Trichinosis

Trichinella species

Trichomoniasis

Trichomonas vaginalis

Tuberculosis

Mycobacterium tuberculosis complex

Tularemia

Francisella tularensis

Typhoid

Salmonella typhi

Typhus

Rickettsia prowazekii

Viral encephalitis

 

Viral meningitis

 

Viral haemorrhagic fevers

Lassa virus, Marburg virus, Ebola virus, Crimean-Congo haemorrhagic fever virus

Yellow Fever

Yellow Fever virus

Yersiniosis

Yersinia enterocolitica, Yersinia pseudotuberculosis

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Given under my Official Seal

18 December 2003

 

MICHEáL MARTIN

Minister for Health and Children

Explanatory Note

(This note is not part of the Instrument and does not purport to be a legal interpretation.)

The Schedule of Infectious Diseases is replaced. In addition to medical practitioners the clinical directors of diagnostic laboratories are now required to report infectious diseases. The list of infectious diseases for immediate preliminary notification has been updated. Unusual clusters or changing pattern of illness that may be of public health concern must also be reported. The Regulations advise that the National Disease Surveillance Centre is responsible for the maintenance, updating and circulation of case definitions in relation to infectious diseases as well as the standard form for returning infectious disease. The Regulations update the address of the National Disease Surveillance Centre.