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Statement of Principles concerning hepatitis E No. 31 of 2007

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Statement of Principles
concerning
 
HEPATITIS E
No. 31 of 2007
 
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 hepatitis E No. 31 of 2007.
 
Determination
2.                  The Repatriation Medical Authority under subsection 196B(2) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)       revokes Instrument No. 46 of 1994 concerning hepatitis E; and
(b)       determines in its place this Statement of Principles.
 
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about hepatitis E and death from hepatitis E.
(b)              For the purposes of this Statement of Principles, "hepatitis E" means infection with hepatitis E virus generally leading to inflammation of the liver.  This definition excludes immunological evidence of past subclinical infections (infection without clinical symptoms).
(c)              Hepatitis E attracts ICD-10-AM code B17.2.
(d)              In the application of this Statement of Principles, the definition of "hepatitis E" is that given at paragraph 3(b) above.
 
Basis for determining the factors
4.         The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that hepatitis E and death from hepatitis E can be related to relevant service rendered by veterans, members of Peacekeeping Forces, 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 as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting hepatitis E or death from hepatitis E with the circumstances of a person’s relevant service is:
 
(a)               being exposed to the hepatitis E virus between 15 and 80 days before the clinical onset of hepatitis E; or
 
(b)              being pregnant at the time of the clinical worsening of hepatitis E; or
 
(c)              inability to obtain appropriate clinical management for hepatitis E.
 
Factors that apply only to material contribution or aggravation
7.         Paragraphs 6(b) to 6(c) apply only to material contribution to, or aggravation of, hepatitis E where the person’s hepatitis E 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 the hepatitis E virus" means:
(a)               consuming food or water or using eating utensils contaminated with hepatitis E virus;
(b)              being in a house or workplace with a person having hepatitis E;
(c)              receiving a transfusion of blood or blood products contaminated with hepatitis E virus;
(d)              having skin penetration by an instrument contaminated with hepatitis E virus; or
(e)              exposure to human or animal faecal material containing hepatitis E virus;
 
"death from hepatitis E" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s hepatitis E;
 
"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), Fifth Edition, effective date of 1 July 2006, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 772 3;
 
"relevant service" means:
(a)     operational service under the VEA;
(b)     peacekeeping service under the VEA;
(c)          hazardous service under the VEA;
(d)          warlike service under the MRCA; or
(e)          non-warlike 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 120A of the VEA or section 338 of the MRCA applies.
 
Date of effect
11.       This Instrument takes effect from 7 March 2007.
 
Dated this   twenty-second    day of   February   2007
 
 
The Common Seal of the                              )
Repatriation Medical Authority                   )
was affixed to this instrument                      )
in the presence of:                                        )
 
KEN DONALD
CHAIRPERSON