Statement of Principles
concerning
 
LEPTOSPIROSIS
No. 95 of 2014
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning leptospirosis No. 95 of 2014.
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 51 of 2004 concerning leptospirosis; and
(b)        determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about leptospirosis and death from leptospirosis.
(b)                           For the purposes of this Statement of Principles, "leptospirosis" means a clinical illness caused by infection with a bacterium from the genus Leptospira.  This condition is characterised by an initial flu-like illness, followed in some cases by a more severe illness involving renal failure, jaundice, bleeding and multi-organ inflammation (Weil’s disease).
(c)                Leptospirosis attracts ICD-10-AM code A27.
 
(d)       In the application of this Statement of Principles, the definition of "leptospirosis" is that given at paragraph 3(b) above.
Basis for determining the factors
4.         On the sound medical-scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that leptospirosis and death from leptospirosis can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA).
Factors that must be related to service
5.         Subject to clause 7, at least one of the factors set out in clause 6 must be related to the relevant service rendered by the person.
Factors
6.         The factor that must exist before it can be said that, on the balance of probabilities, leptospirosis or death from leptospirosis is connected with the circumstances of a person’s relevant service is:
(a)               being exposed to a pathogenic bacterium from the genus Leptospira between two and 30 days before the clinical onset of leptospirosis; or
(b)               inability to obtain appropriate clinical management for leptospirosis.
Factors that apply only to material contribution or aggravation
7.         Paragraph 6(b) applies only to material contribution to, or aggravation of, leptospirosis where the person’s leptospirosis was suffered or contracted before or during (but not arising out of) the person’s relevant service.
Inclusion of Statements of Principles
8.                  In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.
Other definitions
9.                  For the purposes of this Statement of Principles:
"being exposed to a pathogenic bacterium" means:
(a)                having direct contact with an animal infected with a pathogenic bacterium;
(b)               having direct contact with soil, water or vegetation contaminated with a pathogenic bacterium;
(c)                having direct contact with urine, blood or tissue contaminated with a pathogenic bacterium;
(d)               ingesting food or water contaminated with a pathogenic bacterium; or
(e)                inhaling aerosols contaminated with a pathogenic bacterium;
"death from leptospirosis" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s leptospirosis;
"direct contact" means physical contact where no protective or impermeable barrier is used;
"ICD-10-AM code" means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), Eighth Edition, effective date of 1 July 2013, copyrighted by the Independent Hospital Pricing Authority, and having ISBN 978-1-74128-213-9;
"relevant service" means:
(a)        eligible war service (other than operational service) under the VEA;
(b)        defence service (other than hazardous service and British nuclear test defence service) under the VEA; or
(c)        peacetime service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a)                pneumonia;
(b)               respiratory failure;
(c)                cardiac arrest;
(d)               circulatory failure; or
(e)                cessation of brain function.
Application
10.       This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
Date of effect
11.       This Instrument takes effect from 17 November 2014.
Dated this   seventeenth   day of   October   2014
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON