Law and infectious diseases

1. Law and infectiousdiseases Marta Rorat PhD, MD

2. The Act of 5 December 2008 on preventing and fighting infections and infectious diseases in humans • THE ACT DEFINES

3. The Act of 5 December 2008 on preventing and fighting infections and infectious diseases in humans Chapter 1 Generalprovisions (purpose of the Act, the legal definitions,to whomand to what itapplies, programmes, obligations)Chapter 2Sanitary-epidemiologicalanalysis, investigation(who, when andwhere is obliged to perform tests, verification, temporaryremoval from work)Chapter 3 Infectionsassociated with providinghealthcare servicesChapter 4 VaccinationsChapter 5 Other actionsto prevent infections and infectious diseasesChapter 6Proceeding in case of suspicion or recognitionof infection or infectious disease,and in case of deathdue to infectionChapter 7 Public administration in prevention and control of infections and infectious diseasesChapter 8 Rules of proceedingin case of epidemiologythreatand epidemic outbreakChapter 9 Legal penaltiesAppendix The list of infections and infectious diseases

4. An obligation toundergo „mandatory vaccinations” • People residing on the territory of Poland for less than 3 months are exempt from the obligation to be vaccinated • Beforeavaccination physicalexaminationhas to be performed • The doctorissues a certificateconfirming no contraindications to vaccination, including the date and exacttime • The certificate is valid for 24 hours • Long-term postponement of obligatoryvaccinationrequires specialistconsultation

5. Doctors, nurses, midwives,school hygienist qualifyingpatients to bevaccinated • Runningmedicaldocumentationismandatory • Obligatoryvaccinationhas to be reported to SanitaryInspector • Vaccineadversereaction(or suspicion)has to be reportedwithin 24 hours

6. Childrenunder 6 years of agehave to be assisted by theirparentsor a legalguardian Childerover 6 might be examinedwithoutpresence of parentsor a legalguardian, afterobtainingtheirwrittenconsent and beinggivenaninformationabouttheirhealth status

7. A doctorisobliged to inform the person aboutmandatory as well as recommendedvaccines • Healthcareprovidershave to send the reportsaboutperformedvaccinations to SanitaryInspector • SanitaryInspectorcalls for vaccinationand indicatesconsequences of failure to comply with the obligation • In case of furtheravoiding the obligation a provincegovernor (wojewoda) isbeinginformed and startsadministrativeproceeding • Possiblepunishment: a fine (recoveryprocedure)

8. 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.

9. If a patientissuspected of aninfection orinfectious disease he must be informed by doctor, nurseormidwifeaboutways of transmission and protectionoptions. In case of STD (sexualtransmiteddisease) alsoaboutnecessity of doctor’svisit of hissexualpartners. It mustbe assigned by a patient in medicalrecords.

10. A doctor, who suspects or recognises aninfection, infectious disease or death due to infection/ infectious disease, is obliged immediately (in less than 24 hours) to report such event to SanitaryInspector. In case of patients admitted to the hospital, the obligation iswithin the hospital managerduties.

11. 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

12. Healthcare centre managers and individuals providing healthcare services are obliged to engage activelyin actions aimed at preventing the spread of infections and infectious diseases The actions mentioned aboveshould include in particular: assessment of the risk of hospital acquired infections monitoring the risk factors and hospital acquired infections establishing, implementation and supervision of procedures preventing the occurrence of hospital acquired infections introduction of individual and group protection, aimed at preventing the transfer of contagious biological agentsto otherpeople conducting laboratory tests and analysisof local epidemiologicsituation internalcontrol

13. Hospitalacquiredinfections • 1) obligation to run the medicalrecorddocumentation • 2) obligation to implement system of prevention and fightinghospitalacquiredinfection: • establishing and supervisingactivity of Group and Committee of HospitalAcquiredInfections; • riskassessment and monitoring hospitalacquiredinfections and alarm factors • procedures to ensureprevention of hospitalacquiredinfections, patients’ isolation, 24/7 test performing (includingmicrobiological), antibiotictherapycontrol • monitoring and registeringhospitalacquiredinfectionsand alarm factors • infections and outbreaksarereported to SanitaryInspector

14. Fines 1) for vaccinatinghaving no formalqualification 2) for lackorimproperrunning of medicalrecords on vaccination 3) for not informing the patient/legalguardianaboutmandatoryorrecommendedvaccines 4) for not informing a patient/legalguardianaboutsafetymeasureswhichpreventinfectiontransmitingfrom one person to anotherorobligation to performsanitary-epidemiologicaltests 5) for not informinganinfected person of the obligation to visit a doctor by his/hersexualpartners 6) lack of AEFI reporting 7) for not reportingsuspicionorrecognitionof aninfection, infectiousdisaese, deathbecause of infection/infectiousdisease 8) for not implementing and not applyingproceduresprotectingfrom infections and infectiousdiseases 9) for not followinghygienic-sanitaryprocedures

15. 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.