275/2010 Sb.
The DECREE
of 13 June. September 2010,
amending Decree No. 473/2008 Coll., on the system of epidemiological
vigilance for selected infections
The Ministry of health provides under section 108, paragraph. 1 of law No.
258/2000 Coll., on the protection of public health and amendment to certain
related laws, as amended by Act No. 274/2001 Coll., Act No.
320/2002 Coll., Act No. 274/2003 Coll., Act No. 392/2005 Coll., Act No.
222/2006 Coll. and Act No. 110/2007 Coll. (hereinafter the "Act") to implement section
paragraph 75A. 1 and 4 of the Act:
Article. (I)
Decree No. 473/2008 Coll., on the system of epidemiological vigilance for
selected infection, is hereby amended as follows:
1. In section 3, the current text becomes paragraph 1 and the following
paragraph 2, which reads as follows:
"(2) the scope of the data and the procedure provided for in § 1 (b). and (c))) further customizes the when
the occurrence of:
and West Nile), Appendix 15 to this Decree,
(b)) enterohemoragickými Escherichia coli (EHEC) Annex 16 to this
the Decree,
(c)), viral hepatitis and Appendix 17 to this Decree,
(d)) of viral hepatitis (B) Appendix 18 to this Decree,
e) viral hepatitis C Appendix 19 to this Decree,
f) chlamydia trachomatis Annex No. 20 of this Decree,
(g)), invasive pneumococcal disease annex 21 to this Decree,
h) detection of Campylobacter Annex No. 22 of this Ordinance,
I) Lyme disease Appendix 23 to this Decree,
j) shingles annex 24 to this Decree,
RV infections to) Annex 25 to this Decree,
l) salmonella Annex No. 26 of this Decree,
m) acquired or congenital syphilis Appendix 27 to this Decree,
n) tick-borne encephalitis annex 28 to this Decree,
about) chicken pox (varicelly) Annex No. 29 to this Ordinance. ".
2. In section 4, the number "14" is replaced by "29".
3. In annex 1, point 1.2. the word "Syphilis" following the word
"(Syphilis).
4. in annex No. 1 to the end of the text, point 1.4. the words
"Rotavirus infection".
5. in annex No. 1 to the end of the text, point 1.5.3. the words
"Lyme borreliosis
Tick-borne encephalitis ".
6. In annex 1, point 1.5.4. the following point 1.5.5.:
' 1.5.5. Other diseases
Chicken pox
Shingles ".
7. Annex 14 shall be added to annex 15 to 29 shall be added:
"Annex 15 to Decree No 473/2008 Sb.
The system of epidemiological vigilance of diseases caused by West Nile virus
fever (hereinafter referred to as "WNV")
Article. 1
The clinical definition of disease
1. The clinical picture corresponding to a feverish diseases with neurological
Symptoms range from strong headaches and muscles after aseptic
meningitis or encephalitis, with an incubation period of 2 to 6 days, in
the maximum range of 2 to 15 days after exposure, which is conditional on poštípáním
the mosquitoes, of the genus Hyalomma tick rarely přisátím, or agent of the
human to human transplants, transfusions or transplacentárně. Another
WNV transmission from person to person than blood and tissues is not
considered real.
Most of the diseases is being inaparentně, approximately 20% of cases
measure makulopapulární rash and Lymphadenopathy, disability
the central nervous system is less than 1% of the clinically manifestních
the diseases. In a typical course of the disease lasts for 2 to 7 days.
2. the Viremie achieves a peak in the time of appearance of the first symptoms, during
the following 4 to 6 days leads to the gradual reduction of the concentrations
virus on the insignificant value. It is expected that immunity after overcoming
the disease takes a life, however, he was shown a gradual decline titre
specific protective antibodies.
Article. 2
Laboratory Diagnostics
1. Demonstration of a specific antibody response (serum, likvor).
2. Detection of nucleic acid in blood or liquor.
Laboratory criteria for probable case:
1. Determining IgM antibodies to WNV in serum by ELISA test.
2. determination of IgG antibodies to WNV in serum by ELISA test.
3. determination of WNV antibodies in the serum of haemagglutination-inhibition test
HIT.
Laboratory criteria for confirmed case:
1. Demonstration of a specific antibody IgM against WNV in
the cerebrospinal fluid.
2. Isolation of WNV from blood or cerebrospinal fluid.
3. Detection of WNV nucleic acid in blood or cerebrospinal fluid.
4. positive virus neutralisation test.
When removed, the biological material (serum or likvor) shall send to the competent
medical equipment to the national reference laboratory for arboviry.
Laboratory results need to be interpreted according to the status of any
vaccination against certain diseases caused by other flaviviry, or
exclude recent infection (tickborne diseases referred
encephalitis, yellow fever, Japanese B encephalitis, dengue fever).
Article. 3
Epidemiological criteria
At least one of the following epidemiological context:
1. The transfer of the animal to man (stay, visit, or exposure
mentioned there were mosquito in an area with endemic WNV in horses and birds,
or places with extreme přemnožením mosquitoes, particularly in the context of the
flooding, exceptionally, transfer přisátím of the tick)
2. Transmission from person to person (transplantation, blood transfusion, or
transplacentárně).
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: any person meeting the clinical criteria and at least
one of the following two situations:
1. epidemiological link
2. at least one of the laboratory criteria for a probable case.
C. Confirmed: any person meeting the clinical criteria and at least one of the
laboratory criteria for a confirmed case.
Article. 5
Data collection and reporting
1. The person providing care ^ 1), that diagnoses disease WNV, by
the criteria in articles 1 to 3, reports the authority to protect public health
confirmed and probable cases of the disease or death on this
the disease. With regard to the geographical distribution of the global changes of the vector
the disease is the need to consistently detect and report data, which refer to the
relevant travel history of the affected person and information that
may be related to a possible transmission of the disease agent of interpersonal
(transplants, transfusions or transplacental transfer).
2. Locally, the competent authority shall ensure the protection of public health, immediate
the transmission of information of a confirmed case of the disease WNV all via a gravity
blood transfusion service agreed in advance of the work in the manner and at the same time
inform the Ministry of health.
3. Ministry of health shall ensure, on the basis of reports received
the way the European Commission rapid alert system (EWRS) and
through other similar systems, transmission of information on
the current epidemiological situation in the occurrence of human cases of the disease
WNV abroad, all workplaces transfusion services and authorities
public health in the Czech Republic.
Article. 6
The activity of the blood transfusion service
1. the Department shall provide services: blood transfusion
and exclusion from the donation) of whole blood and blood components for all persons,
that remained in the area with ongoing transmission of WNV to humans, and that after
a period of 28 days after leaving such areas ^ 3);
(b)) in the indicated cases, examination of selected lots full of blood and
blood components of nucleic acids in the presence of WNV.
2. Society for transfusion medicine of the Czech Medical Society of Jan
Jan Evangelista Purkyně University shall ensure the publication of information about the current epidemiological
the situation of the occurrence of human cases of WNV in abroad, according to reports
sent by way of the Ministry of health and the National Institute for
drug control on its Web site.
Article. 7
The epidemiological investigation for the suspected presence of the disease WNV
The person providing the care ^ 1), which she suspected WNV infection,
performs the collection of biological material for laboratory certificate
the etiological agent and shall ensure that the transport of the material collected in the national
reference laboratory for arboviry. National reference laboratory for
arboviry reports the results under an agreement in writing or by telephone to the person
providing care ^ 1) and to the competent authority of the Department of protiepidemickému
the protection of public health.
Article. 8
Protiepidemická measures in the outbreak of the disease WNV
1. Reporting WNV disease in accordance with article 5.
2. Ensure the collection of biological material to verify the diagnosis and its
transport to the national reference laboratory for arboviry.
3. Protiepidemická measures within the scope of articles 2, 5, 6 and 7 shall be made
in the presence of or on the basis of suspicion for all cases of WNV.
_______________
3) Annex 2 of Decree No 143/2008 Coll., on the establishment of closer to the requirements of
to ensure the quality and safety of human blood and its components
(Decree on human blood).
Annex No. 16 of Decree No. 473/2008 Sb.
The system of epidemiological vigilance of infection induced by enterohemoragickými
Escherichia coli (hereinafter referred to as EHEC)
Article. 1
The clinical definition of disease
1. The clinical picture of EHEC infection, corresponding to it is diarrhea, often
bloody, and abdominal cramping, usually without or only with low temperature
temperature (lower than 38 ° c). The disease may be complicated by
haemolytic-uraemic syndrome (HUS, dg. (D) 36.8). In the pathogenesis of EHEC
infections are the main role of Shiga toxins (for the verotoxin): Shiga toxin 1
(Stx1) and Shiga toxin 2 (Stx2).
2. The incubation period of the disease is 2 to 8 days. It depends on the size of the
the infectious dose, which is very low (O157: H7 strains is 10-100
the bacteria), on age and on the susceptibility of the individual. The highest risk group
the sick are children under 5 years of age and persons aged over 60 years.
3. The disease lasts for lighter cases 5 to 6 days, in the case of system
complications of the disease (HUS) disease takes up a number of weeks.
Article. 2
Laboratory Diagnostics
1. Isolation and serotyping of Escherichia coli strains (sklíčková agglutination
O, H antigens).
2. card (Verotoxinů), Shiga (Latex Agglutination, ELISA, and others).
3. Detection of genes coding for the production of Shiga toxins 1 and 2 and their
subtypizace.
4. The identification of other factors of virulence of strains: detection of genes coding for EHEC
adhezin intimin (eae) and EHEC hemolysin (hlyA EHEC-) PCR method.
5. Confirmation of, and H antigens by genetic methods.
6. The method of restriction analysis (PFGE) to the genetic findings of identical
strains in the epidemiological context.
7. Immunological determination of antibodies to lipopolysaccharide (LPS) in the serum
sick methods, passive haemagglutination immunoblotting, ELISA.
The examination shall be carried out on a sample of stool early in the disease,
otherwise, the probability of finding the etiological agents in the material quickly
decreases. In the case of failure of the classic culture is in selected
laboratories (national reference laboratory for Escherichia coli and
shigely) should use imunomagnetické method for the separation of the catchment of the tribe
EHEC from stools, which for this examination must be held
a temperature of minus 70 ° C.
Article. 3
Epidemiological criteria
At least one of these epidemiological context:
1. Transmission from person to person
2. Exposure to a common source
3. Transmission from animal to human
4. Exposure through contaminated food or drinking water
5. Exposure to environmental resources
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: a case with clinical symptoms that has
epidemiological link, or laboratory confirmed isolate without
the clinical signs of the disease.
C. Confirmed: a clinically relevant case that is laboratory
confirmed the isolation of EHEC strain.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses of the disease, by EHEC
the criteria in articles 1 to 3, reports the authority to protect public health
a probable or confirmed case of the illness or death of the EHEC on this
the disease.
Article. 6
Epidemiological investigation on the incidence of EHEC
1. The person providing care ^ 1), which expressed the suspicion of disease
EHEC, shall ensure the collection of faeces and its immediate transportation to the investigating
microbiological laboratories. Microbiological laboratory will report the results of
the person providing care ^ 1) and to the competent Department of the protiepidemickému
authority to protect public health. EHEC strains when the detection zone is suspektních,
in particular, serogroup O157, O26, O103, O111 and O145, the laboratory immediately
sends the tribes to the national reference laboratory for Escherichia coli and
shigely of the State Health Institute. The national reference laboratory
performs the confirmation of the tribes, the detection of Shiga toxins and other factors
the virulence of the EHEC and reports the results of a dentist or physician, to the competent
protiepidemickému the Department authority to protect public health and
the microbiological laboratory.
2. the competent authority of the protiepidemické Department of public health
ensure that in all cases the epidemiological investigation. The investigation is focused
primarily on a detailed search for the source of the disease, the way of transmission of the disease and
After the other cases in the outbreak, clinical form of the disease and
any deaths, to verify the proper implementation of the biological
the material on the laboratory demonstration of etiology, possibly on the active
ensure the subscriptions of biological material. This investigation must be launched
immediately after the card for the first case of infection with EHEC (index case).
Article. 7
Protiepidemická measures in the outbreak disease EHEC
1. Reporting diseases of EHEC in accordance with article 5.
2. Ensure the collection of biological material in laboratory tests.
3. Isolation of the patient, in more severe cases required hospitalization, according to the
other legislation ^ 4).
4. Active search all contacts and microbiological examination
their sample of stool, with the requirement of the serotyping of Escherichia coli. U
the tribes of sérotypově identical to the originator of the disease to ensure the examination
production of Shiga toxins.
5. Medical surveillance for a period of 8 days from the occurrence of the last case
the disease.
6. The consistent observance of sanitary measures in food production,
including compliance with the production technology and good manufacturing practice.
7. cooperation with the authorities of the State Veterinary Administration and State agricultural and
food inspection when tracing the vehicle of infection.
_______________
4 § 64 (a)). and Act No.) 258/2000 Coll., on the protection of public health and the
change some of the related laws.
Annex No. 17 of Decree No 473/2008 Sb.
The system of epidemiological vigilance of viral hepatitis and (hereinafter referred to as "VHA")
Article. 1
The clinical definition of disease
1. The clinical picture corresponding to the VHA: a gradual development of symptoms, especially
fatigue, abdominal pain, loss of appetite, intermittent nausea and
vomiting, together with the symptom of fever or jaundice, or increased
levels of serum aminotransferázy.
2. the period of the nakažlivosti: in the stool is a virus present in 1 to 2 weeks before
at the beginning of the disease, and 1 to 3 weeks after the beginning of the disease,
described period up to 6 months. In the blood is a virus present in the second
half of the incubation period and at the beginning of the disease.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. Detection of specific IgM antibody against the VHA.
2. Detection of nucleic acid in serum, plasma VHA, or in the stool.
3. Detection of the Antigen VHA in the stool.
Article. 3
Epidemiological criteria
At least one of these epidemiological context:
1. Transmission from person to person
2. Exposure to a common source
3. Exposure through contaminated food or drinking water
4. Exposure to environmental resources
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: any person meeting the clinical criteria with
epidemiological context.
C. Confirmed: any person meeting the clinical and the laboratory criteria.
Article. 5
Data collection and reporting
The person providing the care ^ 1), which diagnoses diseases of VHA, reports
public health authority confirmed case of the disease and death
This disease.
Article. 6
Epidemiological investigation of suspected presence of VHA
The person providing the care ^ 1), which she suspected disease of the VHA,
performs the collection of biological material for laboratory disease card
and ensure its transport into investigating the lab. The epidemiological
investigation authority shall ensure the protection of public health, in particular in order to determine the
the source of infection and transmission path.
Article. 7
Protiepidemická measures in the outbreak disease VHA
1. Reporting diseases VHA referred to in article 5.
2. Ensure the donations and transportation of biological material to the patient and
contacts to verify the diagnosis in a competent laboratory. 3. Insulation
sick from the disease, or the suspect, according to the Department of infectious diseases
other legal ^ 2).
4. in the case of persons who have been in contact with the sick, medical surveillance is carried out
in 50 days from the last contact.
5. Reception of new persons to the groups of preschool children is disabled in
the time of the medical surveillance for the presence of the VHA as assessed locally
the competent authority to protect public health.
6. the persons in contact with the VHA executing activities of the epidemiologically
serious, are excluded from these activities, the imposition of increased medical
surveillance for a period of 50 days from the last contact with the sick.
7. The restrictions referred to in paragraph 4, 5 and 6 shall not apply to persons
has been proven, the presence of total antibodies, and at the same time the negativity on the
specific IgM antibodies against the virus of VHA and the person shown to be properly
vaccinated against VHA.
8. the competent authority shall prescribe the scope of the protection of public health and the way
imunoprofylaxe and in emergency situations, after the approval of the main
Chief public health officer of the CZECH REPUBLIC, provides emergency vaccination in the community. On the basis of the
the decision of the locally competent authority to protect public health on the
medical surveillance or surveillance of health, ensure increased person
^ 1) providing care for persons in direct contact with the VHA vaccination against the VHA.
9. for donors of blood and other biological material shall be treated in accordance with
other legislation ^ 5).
_______________
5) Law No. 296/2008 Coll., on ensuring the quality and safety of human
tissues and cells intended for human applications and of changed related
laws (law on human tissues and cells), as amended
regulations.
Act No. 285/2002 Coll., on the donation, subscriptions and transplantation of tissues and
authorities and on amendments to certain acts (the Transplant Act), as amended by
amended.
Decree No 143/2008 Coll., on the establishment of closer to the requirements for ensuring the
the quality and safety of human blood and its components (the Decree on the human
the blood).
Annex No. 18 of Decree No. 473/2008 Sb.
The system of epidemiological vigilance of acute viral hepatitis B (hereinafter referred to as
"VHB")
Article. 1
The clinical definition of disease
1. The clinical picture: progressive development of the corresponding VHB symptoms, especially
fatigue, abdominal pain, loss of appetite, intermittent nausea and
vomiting, together with the symptom of fever or jaundice, or increased
levels of serum aminotransferázy.
2. The period of nakažlivosti: all HBsAg-positive persons
potentially infectious.
Article. 2
Laboratory Diagnostics
Detection of specific IgM antibody against the Antigen nukleokapsidovému
(core) VHB.
Article. 3
Epidemiological criteria
Epidemiological link with the transmission from human to human, in particular
the transfer of blood, sexual contact or vertical transmission.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: any person meeting the clinical criteria with
epidemiological context.
C. Confirmed: any person meeting the clinical and the laboratory criteria.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses of the disease acute VHB,
reported to the public health authority confirmed case of the disease and
deaths from this disease.
Article. 6
Epidemiological investigation on incidence of acute VHB
The person providing the care ^ 1), which expressed the suspicion of disease
acute VHB, the biological material for laboratory
the aetiology of the card and shall ensure their transport into investigating the lab.
The epidemiological investigation authority shall ensure the protection of public health, in particular
in order to determine the source of infection and transmission path.
Article. 7
Protiepidemická measures in the outbreak of the disease acute VHB
1. Reports of the disease acute VHB pursuant to article 5.
2. Ensure the donations and transportation of biological material to the patient and
contacts to verify the diagnosis in a competent laboratory.
3. Isolation of sick or suspect of the disease on the infectious Department
According to another legal regulation ^ 2).
4. in the case of natural persons, which have been in contact with the sick, shall be carried out
medical surveillance of a duration of 180 days from the last contact.
5. for donors of blood and other biological material shall be treated in accordance with
other legislation. ^ 5)
6. The restrictions referred to in paragraphs 3 and 4 shall not apply to persons with
arguably the island disease and persons, VHB which was
demonstrated by the presence of antibodies against HBV surface antigen in the
the protection quantities (at least 10 IU/l).
Annex No. 19 of Decree No. 473/2008 Sb.
The system of epidemiological vigilance of viral hepatitis C ("HCV")
Article. 1
The clinical definition of disease
It is not important for the purposes of the system of epidemiological vigilance.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. The presence of specific antibodies against HCV confirmed
different test on another principle of test for the determination of antibodies.
2. Detection of HCV nucleic acid in serum or plasma.
3. Detection of the Antigen (core) of hepatitis C virus in serum or plasma.
Article. 3
Epidemiological criteria
Cannot be used.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
B. Probable: cannot be used.
C. Confirmed: any person meeting the laboratory criteria.
Article. 5
Data collection and reporting
The person providing the care ^ 1), that the diagnosis of HCV disease, reports the
public health authority confirmed case of the disease and death
This disease.
Article. 6
Epidemiological investigation on the incidence of viral hepatitis C
The person providing the care ^ 1), which she suspected disease of HCV,
performs biological material for laboratory certificate
of the disease and shall ensure their transport into investigating the lab.
The epidemiological investigation authority shall ensure the protection of public health, in particular
in order to determine the source of infection and transmission path.
Article. 7
Protiepidemická measures in the outbreak of the disease of HCV
1. Reporting of HCV disease in accordance with article 5.
2. Ensure the donations and transportation of biological material of the patient to
verification of the diagnosis in a competent laboratory.
3. Patients with diagnosed acute HCV are isolated at the infectious
the wards. Health care is also provided by the clinical picture
the sick man.
4. in the case of persons who have been in contact with the sick, medical surveillance is carried out
in the length of 150 days from the last contact.
5. for donors of blood and other biological material shall be treated in accordance with
other legislation ^ 5).
Annex No. 20 of Decree No 473/2008 Sb.
The system of epidemiological vigilance of Chlamydia trachomatis infection
Article. 1
The clinical definition of disease
1. The clinical picture matching chlamydial infection, other than
lymphogranuloma venereum (hereinafter referred to as "LGV"), for children and adults-
inflammatory disease characterized by at least one of the following
symptoms: acute urethritis, epididymitida, salpingitida, acute
endometritis, cervitida, proctitis. The incubation period of 7 to 14 days
possibly longer.
2. The clinical picture matching chlamydial infection, other than the LGV, with
the newborn is characterized by at least one of the following expressions:
conjunctivitis, pneumonia.
3. The clinical picture corresponding to the LGV: zánětlivě ulcerative infection
characterized by at least one of the following symptoms: urethritis,
genital ulcers, inguinal Lymphadenopathy, cervitida, proctitis.
4. The period of nakažlivosti can be very long and is not limited to
the presence of clinical signs of infection. The sick can be a source of infection
even without the subjective and objective difficulties.
Article. 2
Laboratory Diagnostics
Chlamydia trachomatis infection, other than the LGV, at least one of the
the following licence:
1. isolation of Chlamydia trachomatis from urogenital tract from the sample,
the anal area, or of the conjunctiva
2. demonstration of Chlamydia trachomatis direct fluorescent antibody in clinical
sample
3. detection of Chlamydia trachomatis nucleic acid in a clinical specimen
Infection of Chlamydia trachomatis-LGV, at least one of the following
the ways of the card:
1. isolation of Chlamydia trachomatis from urogenital tract from the sample,
the anal area, or of the conjunctiva
2. detection of Chlamydia trachomatis nucleic acid in a clinical specimen
3. in the case of positive results, in accordance with point 1. or 2. at the same time
identification of sérovaru (genovaru) L1, L2 or L3
Article. 3
Epidemiological criteria
Epidemiological link-people to people transmission sexual contact or
vertical transmission.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: Clinically relevant case with an epidemiological
context.
C. Confirmed: a clinically relevant case confirmed in the laboratory.
Article. 5
Data collection and reporting
1. The person providing care ^ 1), diagnoses of the disease caused by
Chlamydia trachomatis (LGV, LGV, other than), reports the protection authority
of public health confirmed and probable cases of the disease and death
on this disease.
2. Cumulative data reported to the lab once a month locally
competent authorities to protect public health, according to format:
and the number of all examinations of structured according to:
i. gender
II. age
III. diagnosis
IV. the expertise of the doctor
(b) the number of all positive findings, structured according to the:
i. gender
II. age
III. diagnosis
IV. the expertise of the doctor
in a kind of biological material. (a swab of the cervix, urine, etc.)
vi. methods of the licence (including the name of the manufacturer of the test)
Article. 6
The epidemiological investigation for suspected infection of Chlamydia trachomatis
The person providing the care ^ 1), which she suspected infection
Chlamydia trachomatis, ensure biological material to
Laboratory of disease, its transport card to the investigating
the lab, also carried out a targeted examination for all contact and the competent
After treating patients with diagnosed infections.
Article. 7
Protiepidemická measures in the outbreak of Chlamydia trachomatis
1. The reporting of disease caused by Chlamydia trachomatis in accordance with article 5.
2. the Protiepidemická consist in the proper execution of the depistážního
the investigation and examination of all contacts of the patient in accordance with other legal
^ Regulation 6).
3. inspection, examination of a patient after 6 weeks after completion of therapy and
examination on other serious sexually transmitted diseases (syphilis, gonorrhoea,
HIV/AIDS).
4. Medical procedures the patient for 3 months with the subsequent examination and
disposal of records on the basis of the negative control examination ^ 7).
5. For donors of reproductive cells are treated in accordance with other legal
Code ^ 8).
_______________
6) of the Ministry of health of the Czech Socialist Republic.
30/1968 Journal of the MINISTRY OF HEALTH of the CSR on measures against sexual diseases, as amended by
Decree No 225/1996 Coll. (reg. p. 51/1968 Coll.).
7) Decree No. 386/2007 Coll., laying down the illness, for which
provide dispensary care, the time between inspections and dispenzárních
designation of specialization dispenzarizujícího a doctor.
8) Annex 5 of Regulation No. 422/2008 Coll., on the establishment of closer to the requirements of
to ensure the quality and safety of human tissues and cells intended for
use in humans.
Annex No. 21 of the Decree No 473/2008 Sb.
The system of epidemiological vigilance of invasive pneumococcal disease
Article. 1
The clinical definition of disease
The clinical picture of the disease, corresponding to the invasive meningitis,
septicemia, bacteremia, pneumonia. The pneumonia is required to pass the originator
in the blood, serum, or section of the material.
Article. 2
Laboratory Diagnostics
1. Culture of Streptococcus pneumoniae card from clinical material
that is normally sterile (cerebrospinální mok, blood,
sectional material) for clinical manifestations in accordance with article 1.
2. Bezkultivační card Antigen of Streptococcus pneumoniae LaTeX
agglutination of clinical material, which is normally
sterile (cerebrospinální mok, blood, sectional material) for clinical
speeches referred to in article 1.
3. Bezkultivační card Streptococcus pneumoniae DNA methods
Molecular Microbiology of the clinical material, which is for
normal conditions of sterile (cerebrospinální mok, blood, sectional
material) for clinical manifestations in accordance with article 1.
Due to the fact that the above clinical syndromes can be
caused by a number of other etiologických agents, laboratory confirmation of
the etiology of Streptococcus pneumoniae necessary. Isolates Of Streptococcus
pneumoniae from invasive pneumokokového diseases submitted by
microbiological laboratories to the national reference laboratory for
streptococci and enterococci of the State Health Institute in Prague. National
reference laboratory for antibiotics determines resistance to
chemoterapeutikům. Subscription to culture tests must be done before
deployment of antibiotic therapy.
Article. 3
Epidemiological criteria
Are not defined.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
B. Probable: cannot be used.
C.: the case of confirmed laboratory Confirmed the result of the positive
culture or nucleic acid detection testing Streptococcus
pneumonia or Antigen detection of Streptococcus pneumoniae from above
Clinical material referred to in article 2.
Article. 5
Data collection and reporting
The person providing the care ^ 1) diagnose invasive disease
caused by Streptococcus pneumoniae reports the authority to protect public health
confirmed case of the disease and deaths from this disease.
Article. 6
Epidemiological investigation on suspicion on invasive pneumococcal
disease
The person providing the care ^ 1), which expressed the suspicion of invasive
pneumococcal disease, the collection of biological material on
laboratory and etiology of the licence shall ensure that its transport to the investigating
the lab and discovers that he was sick of the vaccinated against pneumokokům and what
vaccine. Detailed epidemiological investigation authority shall ensure the protection of the
public health.
Article. 7
Protiepidemická measures in the outbreak of invasive pneumokokového
disease
1. Reporting of invasive pneumokokového diseases referred to in article 5.
2. Ensure the collection of biological material from the patient and his departure
in the laboratory the laboratory examination.
3. Isolation of the patient. The procedure for the isolation of another legal
prescription ^ 4).
Annex No. 22 of Decree No 473/2008 Sb.
The system of epidemiological vigilance of detection of Campylobacter
Article. 1
The clinical definition of disease
1. The clinical picture corresponding to the kampylobakterióze, it is a fever,
diarrhea, abdominal pain.
2. The period is nakažlivosti all the time and a few days after disease
its their. After infection occurs often, usually to the nosičství
does not exceed a period of 6 weeks.
Article. 2
Laboratory Diagnostics
1. Laboratory Diagnostics kampylobakterióz is a direct card
the bacterium Campylobacter species in biological material by the
selectively diagnostic soils and identify fenotypovými or
genotypovými methods.
2. For epidemiological purposes, it is necessary to carry out the generic destination
isolated kampylobakterů.
Biological material supplied to the examination usually involves a rectal swab of
or stool, less often sectional material, joint punktát, blood and
For more. Sampling shall be carried out using the probang test of the tampon with transport
medium.
Article. 3
Epidemiological criteria
At least one of these epidemiological context:
1. Transmission from person to person
2. Transmission from animal to human
3. Exposure to a common source
4. Exposure through contaminated food or drinking water
5. Exposure to environmental resources
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
B. Probable:
1. A case that meets the clinical case definition and has
an epidemiological link to a confirmed case.
2. the laboratory confirmed Case with unknown clinical criteria.
3. laboratory confirmed Case without clinical criteria
C. Confirmed: a case that meets the clinical case definition and is
laboratory confirmed.
Article. 5
Data collection and reporting
The person providing the care ^ 1), that the diagnosis of the disease
kampylobakteriózou, reported to the public health authority of the likely
or confirmed case of the disease or death to this disease.
Article. 6
Epidemiological investigation of suspected presence of detection of Campylobacter
1. The person providing care ^ 1), which expressed the suspicion of disease
kampylobakteriózou, the collection of biological material on culture
examination and the removed material shall send without delay to the microbiological
the laboratory. Microbiological laboratory reports the results according to the agreement
in writing or by telephone to the person providing care ^ 1) and to the competent
protiepidemickému the Department authority to protect public health.
2. the competent authority of the protiepidemické Department of public health
ensure that the epidemiological investigation confirmed cases of the disease
kampylobakteriózou. The investigation consists in the active search for contacts,
is preschool children and persons performing the activities of the epidemiologically
serious, in the early implementation of the collection of biological material on
Laboratory demonstration of the agent of the disease and determine the source of infection and the path
transmission.
3. In cases of suspected of having the disease, the bulk of cases with atypical
progress or death on kampylobakteriózu shall ensure the protection of the authorities
of public health in collaboration with the microbiological laboratories send
the tribes of kampylobakterů to typing into the State Health Institute.
Article. 7
Protiepidemická measures in the outbreak detection of Campylobacter
1. Reports of the disease kampylobakteriózou in accordance with article 5.
2. Ensure the collection of biological material in laboratory tests.
3. Isolation of the patient, in more severe cases, hospitalization, according to another
the law ^ 4).
4. Active search of the persons who have consumed food and vytypovanou
Search contacts for preschool children and persons performing activities
epidemiologically significant, which is done by microbiological examination
rektálního swab or stool.
5. Medical surveillance for the contacts for a period of 5 days from the occurrence of the last
the case of the disease in children's pre-school establishments.
6. the search and subsequent disqualification, where appropriate, the adjustment of the working
conditions for persons pursuing activities of epidemiologically significant that
exclusive kampylobaktery or for which there has been a disease of people living
in a common household, until three consecutive kultivačně
the negative results of the examination of the stool according to the assessment of the locally
the competent authority to protect public health.
7. Children from families, from care centres or other collectives, where the disease
kampylobakteriózou occurred, can the experience if they are in
good clinical condition, have diarrhea, and after the assessment of the conditions of the device
the locally competent authority to protect public health.
8. In communities and households to perform focal and ongoing
disinfecting, disinfecting hands, social equipment, objects, surfaces,
dishes and more.
9. In households with the appearance of detection of Campylobacter and domestic holdings
animals, especially dogs, cats or birds, can make
stool sampling for animals.
10. The consistent observance of sanitary measures in food production,
in the preparation and handling of food, the observance of good manufacturing and
public health practice.
11. cooperation with the authorities of the State Veterinary Administration and State agricultural and
food inspection when tracing the vehicle of infection.
Annex No. 23 of Decree No 473/2008 Sb.
The system of epidemiological vigilance of Lyme disease
Article. 1
The clinical definition of disease
Clinical diagnosis of Lyme disease is determined on the basis of criteria
for the three stages of the disease:
1. Early borreliosis is characterized by localized skin manifestations
marked as erythema migrans.
2. Early disseminated borreliosis is characterized by the presence of
agent in the tissue of the skin (borreliový lymfocytom), musculoskeletal,
nerve and heart, myalgia, arthralgia, (recurrent arthritis, disability
brain nerve N II, III-VI, VII, VIII, meningomyeloradikuloneuritidy
"Garin-Bujadoux-Bannwarth's syndrome", aseptic meningitis,
carditis).
3. The late chronic borreliosis, which arises after a few months to
years after infection, is characterized by impairment of the nervous system
(chronic encefalomyelopatie, chronic polyneuritidy, depression and more
Psychic manifestations), joints (Lyme arthritis) and skin (inflammatory or
atrophic akrodermatitida).
Article. 2
Laboratory Diagnostics
1. Demonstration of IgM and IgG-class antibodies against borreliím in serum
or in the cerebrospinal fluid and synovial fluid with enzyme
immuno-analysis (ELISA) in doubtful cases clinically konfirmované method
of immunoblot (Western blots).
2. Cultivation demonstration of Borrelia burgdorferi sensu lato from a clinical
the material.
3. Bezkultivační detection of antigens or genome card and plasmidové
nucleic acid (DNA) Borrelia, possibly in combination with direct
microscopic card.
For the initiation of treatment in the acute phase referred to in article 1, paragraph 1, is not a license
the antibodies needed.
Article. 3
Epidemiological criteria
At least one of the following epidemiological context during the
last 4 weeks before the appearance of the first symptoms of the disease:
1. Certified by the tick bite.
2. Stay in the area of the occurrence of the ticks.
3. Risk of manipulation with the tick, in particular the removal of the tick, when
There is direct contact of the skin of the patient.
Article. 4
The classification of a case of disease
And Possible: a case that meets the clinical definition of the disease.
(B). likely: a case that meets the clinical definition of the image and is
in the epidemiological connection with a confirmed přisátím.
C. Confirmed: a case that meets the clinical definition of image and was
confirmed the result of the laboratory examination.
Article. 5
Data collection and reporting
The person providing the care ^ 1) diagnose Lyme disease
Lyme disease, according to the criteria in articles 1 to 3, reports the protection authority
public health and the probable confirmed case of illness or death
on this disease.
Article. 6
Epidemiological investigation on suspicion of the presence of Lyme disease
1. The person providing care ^ 1), which expressed the suspicion of disease
Lyme Lyme disease, shall ensure the collection of biological material on
laboratory license and its transport to the etiology of the investigating
the lab.
2. the authority shall ensure the protection of public health, epidemiological investigation,
which, outside of the standard observed fact, records the clinical form of
the disease, if any, deaths, and looks for the probable location of the disease.
Article. 7
Protiepidemická measures against the spread of Lyme disease
1. Reporting of Lyme disease Lyme disease in accordance with article 5.
2. the Protiepidemické Department authority to protect public health in the region
its scope of records of outbreaks of Lyme disease and recommends
their compliance with the precautionary measures visitors to
reduce the risk of infestation by ticks.
3. Persons after an borrelióze is not recommended for blood donation and
blood derivatives or bone marrow for a period of 2 years.
4. The State Health Institute in cooperation with the Czech hydrometeorologickým
the Institute forecast activities carried out during the season of ticks, which is as
an indicative figure for citizens located on the website of the Ministry of
health, the National Health Institute and the protection of the public authorities
health.
Annex No. 24 of Decree No 473/2008 Sb.
The system of epidemiological vigilance of shingles
Article. 1
The clinical definition of disease
1. The clinical picture of shingles is characterized by unilateral
sowing makulopapulózního Exanthema in the range of 1 to 3, dermatomů,
most commonly in the lumbar or thorakální area. Sowing can prevent
severe pain at the site of the future sowing. The most common complications
postherpetic neuralgia are disease, especially in patients over 50
years. Other possible complications are neurological (cerebellitis,
meningoencephalitis and, myelitis, intracranial vaskulitis) or eye
(keratitis, iridocyklitis, retinitis) or bacterial superinfection
skin and soft tissue. In immunocompromised persons at risk system
disease (generalized form).
2. The period of nakažlivosti sowing begins and ends with Exanthema if they are already
all efflorescence in the stage of the crusts. Infectivity is localized
form 5 times lower than for chicken pox. Infectious is swine vesicular
the fluid, the generalized form and secretions from the upper respiratory tract.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. Detection of varicella zoster virus nucleic acid in a clinical specimen
(peripheral blood, vesicular fluid, cerebrospinal fluid, a smear of lesions)
2. Isolation of varicella zoster virus on tissue cultures of smear or
vesicular fluid
3. Demonstration of viral antigen by the method of direct immunofluorescence in a smear of
efflorescence
4. Pass the virus electron microscope in a clinical specimen
5. The rise of specific antibodies against the virus varicella zoster.
The presence of IgM antibodies may be obscured by their occurrence in the
subclinical reactivation of the virus, and cross reactivity with IgM
antibodies against other herpetickým viruses, in particular herpes simplex
virus. It is therefore their isolated detection of one sample to be
be regarded as inadequate. Cases it is necessary to verify a significant
increases in the levels of total IgG antibody or. To the correct interpretation of the
the results of the serological examination it is necessary to take into account the clinical,
laboratory and epidemiological data.
Article. 3
Epidemiological criteria
The disease occurs only in people who have suffered chicken pox (can also be
Sub-clinical evidence), or have been vaccinated with a live vaccine against chicken
the smallpox vaccine.
Article. 4
The classification of a case of disease
And Possible: a case with atypical clinical course or a recurring track
Herpes without laboratory testing.
(B). likely: a case that meets the clinical definition of the disease.
C. Confirmed: a case that meets the clinical definition of image and was
confirmed the result of the laboratory examination.
Article. 5
Data collection and reporting
The person providing the care ^ 1), that diagnoses disease belt
haze, reports the authority to protect public health and committed
cases of illness, complications and deaths from this disease.
Article. 6
Epidemiological investigation on the incidence of shingles
The person providing the care ^ 1), which expressed the suspicion of disease
shingles, in its sole discretion for clinically cases of dispute
performs biological material for laboratory licence etiology
and ensure its transport into investigating the lab.
Article. 7
Protiepidemická measures in the outbreak of shingles
1. Reporting to the shingles disease in accordance with article 5.
2. Ensure the collection of biological material from the patient to verify the
diagnosis in clinical cases of dispute and ensure the transport of
biological material to the appropriate laboratories.
3. Isolation of the patient it takes until they are all in the efflorescence
stage of the crusts. The procedure for the isolation of another legal regulation ^ 4).
4. Active search resources and contacts.
5. The epidemiological investigation on the outbreak of the disease. The person
providing care ^ 1), which she suspected disease of the conveyor
haze, give special attention to persons, pregnant and imunosuprimovaným
that still have not undergone the chicken pox, or were not properly vaccinated.
6. For the submission of hyperimunního of human immunoglobulin is necessary to evaluate
the severity of the exposure. Generalized shingles is as infectious as a
chickenpox and therefore should be hyperimunní human globulin administered
72 hours after contact with the infection to persons heavily pregnant or
imunosuprimovaným, which in the past have not undergone, or the chicken pox
have not been vaccinated with two doses of the vaccine. Only if it is promeškán
the interval of 72 hours from the contact with the disease, the alternative is to feed
the full therapeutic doses of antivirals to the seventh day from the contact with the
infections.
7. Post-exposure vaccination is possible in susceptible individuals to the disease
chickenpox, which have not expired 3 days ago from contact with
the sick.
8. in the case of susceptible persons who were in contact with the disease, the medical
supervision, if indicated, take for the maximum incubation period, it
is 21dní. If such person was filed hyperimunní human globulin,
period will be extended to 40 days.
9. Children who are susceptible to the disease and have been in contact with the belt
haze, are due to low infectivity accepted into the collective
devices without restriction.
Annex 25 to the Decree No 473/2008 Sb.
The system of epidemiological vigilance of RV infection
Article. 1
The clinical definition of disease
1. The clinical picture corresponding to acute gastroenteritidě, vomiting,
diarrhea, fever. The disease suddenly begins vomiting with high frequency.
During the 24 hours adds watery diarrhea with a large volume and frequency
produced by the mill. Manifestní disease is usually accompanied by
fever, sometimes only a slight rise in temperature. The most serious of course
the disease is usually in children under 5 years of age and for persons over 65 years of age with rapid
dehydration and hypernatrémií. The incubation period of 24 to 72 hours.
2. The period of nakažlivosti can be long, especially in immunodeficient
persons.
Article. 2
Laboratory Diagnostics
1. Standard laboratory test for the diagnosis of rotavirus infection is
pass the Antigen (Antigen) rotaviruses. Currently, the most commonly
use the imunochromatografické rapid tests, Latex Agglutination and
ELISA. For laboratory examination is taken, or native stool
a swab from the rectum. The highest záchytnost is in the first 3 days of illness.
2. Elektronmikroskopický is the ID of the agent.
3. Detection of nucleic acids.
4. card-specific antibody responses against rotavirus infections in
persons who have not been vaccinated during the previous 8 weeks. To
serological examination shall be taken 2 blood samples in 2 weekly
interval. The first sample was taken as soon as possible in the acute stage.
A prerequisite for the serological diagnosis of the current examination of the first and
the second serum sample. Confirmation of current disease is proven
a significant rise of the seroconversion of antibody or levels of negativity
the positivity. Any level of antibodies in a single sample is not
proof of ongoing disease. acutely
Due to the fact that the above mentioned clinical symptoms can be
caused by a number of other etiologických agents, laboratory confirmation of
rotaviruses are necessary.
Article. 3
Epidemiological criteria
Are not fixed.
Article. 4
The classification of a case of disease
And Possible: a case that meets the clinical case definition.
(B). likely: a case that meets the clinical case definition and
has epidemiological link to a confirmed case.
C. Confirmed: a case that meets the clinical definition of image and was
confirmed by laboratory testing.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses of the disease caused by
rotavirus, reported to the authority, the protection of public health or likely to
confirmed case of the disease or death to this disease.
Article. 6
The epidemiological investigation for the suspected presence of a disease induced by a
rotavirus
The person providing the care ^ 1), which expressed the suspicion of disease
caused by rotavirus, shall ensure the collection of native stool, or a swab from the
rectal and ensure the transport of biological material without delay to the
investigating the lab. The epidemiological investigation authority shall ensure the protection of the
public health.
Article. 7
Protiepidemická measures in the outbreak of diseases induced by rotavirus
1. the Department of public health protection for all reported illnesses
epidemiological investigation on the outbreak of the disease, the search for the source of the disease and
other contacts, including authentication data, whether the sick person has been
the past have been vaccinated against rotavirus infections.
2. The procedure for the isolation of another legal regulation ^ 4).
3. A child under the age of 5 years, after having proven disease laboratory
caused by rotavirus can be accepted in daycare, nursery school,
school facilities for institutional upbringing or protective custody,
Special children's facilities, social welfare facilities and similar
equipment (hereinafter referred to as "the collective device"), provided that it does not
the clinical symptoms of rotavirus infection, however, for the first 10 days of the
the beginning of the disease.
4. the person carrying out the activities of the epidemiologically significant held
laboratory proof of disease caused by rotavirus can these activities
to carry out, provided that it does not have clinical symptoms of rotavirus infection
However, as soon as possible after 10 days from the beginning of the disease.
5. Medical surveillance for a period of 3 days from the last contact with the sick for
children under 5 years of age of the equipment and lessons
their legal representatives about the need to contact a doctor of
the symptoms of the disease, including increased temperatures.
6. The increased medical supervision for a period of 3 days from the last contact with the
sick for natural persons engaged in activities of an epidemiological
serious.
7. When rotavirus hospital infection or suspected its incidence
the person providing care without delay to ensure that the implementation of protiepidemických
the measures.
Annex No 26 Decree No 473/2008 Sb.
The system of epidemiological vigilance of salmonella
Article. 1
The clinical definition of disease
1. The clinical picture matching salmonella – has, this is a fever, diarrhea,
abdominal pain, nausea and sometimes vomiting. The originator of the disease can
cause also extraintestinální infection (infection among
the intestinal tract).
2. in the course of the disease lasts case fatality ratio, which is extremely variable, ranging from
a few days to several weeks. Chronic nosičství lasting longer than
one year are rare. Administration of antibiotics does not affect excretion of salmonella.
Article. 2
Laboratory Diagnostics
1. the laboratory diagnosis of salmonella is in direct card salmonella
in biological material by selectively diagnostic soils and
identification of the fenotypovými or genotypovými methods.
2. For epidemiological purposes is necessary serotyping.
3. in the case of significant phage typing of serotypes is carried out, where appropriate, other
analysis on the level of the genotype.
4. indirect diagnosis provides antibodies to O, H and, where applicable, Vi
the Antigen.
Biological material for examination according to the type of disease: rectal swab of
stool serum, urine, bile, pus, articular punktát, sectional material and
For more.
Article. 3
Epidemiological criteria
At least one of these epidemiological context:
1. Transmission from person to person
2. Exposure to a common source
3. Transmission from animal to human
4. Exposure through contaminated food or drinking water
5. Exposure to environmental resources
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: a case that meets the clinical case definition and
has epidemiological link or a laboratory confirmed isolate without
clinical information.
C. Confirmed: a case that meets the clinical case definition and is
laboratory confirmed.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses the disease salmonellosis,
According to the criteria in articles 1 to 3, reports the authority to protect public health
probable and confirmed case of the disease or death on this
the disease.
Article. 6
Epidemiological investigation on suspicion of the presence of salmonella
1. The person providing care ^ 1), which expressed the suspicion of disease
salmonellosis, the collection of biological material on culture
examination and the removed material shall send without delay to the microbiological
the laboratory. Microbiological laboratory will produce results under the agreement
in writing or by telephone to the person providing care ^ 1) and to the competent
protiepidemickému the Department authority to protect public health.
2. the competent authority of the protiepidemické Department of public health
ensure that the epidemiological investigation of all confirmed cases of the disease
and in the case of the occurrence of epidemického in all cases of suspected
the disease salmonellosis. The investigation is in the early implementation of the sampling
biological material in laboratory demonstration of etiology, in the active
to search for contacts which also carries out microbiological
examination, and in determining the source of infection and transmission paths.
Article. 7
Protiepidemická measures in the outbreak of salmonella
1. Reports of the disease salmonellosis in accordance with article 5.
2. Ensure the collection of biological material in laboratory tests.
3. The procedure for the isolation of another legal regulation ^ 4).
4. Active search of the persons who have consumed vytypovanou diet,
in particular, preschool children and the persons performing the activities of the epidemiologically
serious, which carries out microbiological examinations rektálního
spawning. The circuit of the investigated persons shall designate the locally competent authority protection
public health.
5. Medical surveillance for a period of 4 days from the occurrence of the last case
diseases in children's pre-school establishments.
6. the search and subsequent disqualification, where appropriate, the adjustment of the working
conditions for persons pursuing activities of epidemiologically significant that
eliminate salmonella, or for which there has been a disease of people living in
common household, until three consecutive kultivačně
the negative results of the examination of the stool.
7. The child after having a laboratory confirmed salmonellosis is a disease
can be taken into the collective device to one negative
the culture of stool examination, or if the child is in a good clinical
on the basis of an assessment of the status of the locally competent authority to protect public
health.
8. Children from families, from care centres or other collectives, where the disease
salmonellosis incidence, the collective experience, if they are in good
clinical status, have diarrhea, and after the assessment of the conditions of the equipment locally
the competent authority to protect public health.
9. In communities and households to perform focal and ongoing
disinfecting, disinfecting hands, social equipment, objects, surfaces,
dishes and more.
10. The consistent observance of sanitary measures in food production,
in particular in the processing, storage and transport of raw materials and the risk
food production technology and compliance with good manufacturing practice.
11. cooperation with the authorities of the State Veterinary Administration and State agricultural and
food inspection when tracing the vehicle of infection.
Annex No. 27 of Decree No. 473/2008 Sb.
The system of epidemiological vigilance of acquired or congenital syphilis
Article. 1
The clinical definition of disease
1. Obtained primary syphilis-it is ulcerative disease
characterized by the presence of one, a few, usually
nebolestivých, erozivních to ulcerativních lesions (chancres) in the genital,
perineal or anal area in the mouth, on the mucosa of the pharynx, or
anywhere else outside of the genital area.
2. the Obtained secondary syphilis-a person with at least one of these
symptoms: diffuse maculopapular rash involving the palms and often
massage, total Lymphadenopathy, kondyloma latum, exantém, diffuse
alopecia.
3. Obtained early latent syphilis-a person with symptoms of primary or
secondary syphilis in history in the previous 24 months that meets the
laboratory criteria (specific tests).
4. the Obtained late latent syphilis over 24 months-person meeting
laboratory criteria (specific tests).
5. Congenital syphilis early-child up to 2 years of age that meet at least one of the
the following symptoms: hepatosplenomegaly, mukokutánní lesions,
kondyloma latum, persistent rhinitis, jaundice, pseudoparalýza
caused by periostitidou and osteochondritidou, the disability Central
the nervous system, anemia, malnutrition, nephrotic syndrome.
6. Congenital syphilis late-person over 2 years of age with clinical manifestations
the relevant late congenital syphilis, and meeting the laboratory criteria
(specific tests).
7. Period of nakažlivosti is limited to the presence of clinical symptoms in
the time of contact or in the preceding 24 months (transfer of blood or of the
the mother to the fetus).
Article. 2
Laboratory Diagnostics
A. confirmed case-at least one of the following findings:
1. Demonstration of Treponema pallidum subspecies pallidum microscopic
examination in the dark field microscopy in the exudate of lesions in tissue, umbilical cord, in
the placenta or effluent from the nose
2. Demonstration of Treponema pallidum subspecies pallidum direct
fluorescent in the exudate of lesions in tissue, umbilical cord, in
the placenta or effluent from the nose
3. PCR license Treponema pallidum subspecies pallidum in the exudate from the lesions,
in the tissue of the umbilical cord, the placenta, or the effluent from the nose
4. the Detection of specific antibodies against Treponema pallidum subspecies
pallidum by screening test (eg. TPHA, TP-PA, EIA, etc.) and
at the same time the detection of specific antibodies against Treponema pallidum
subspecies pallidum IgM class
5. in the case of congenital syphilis detection of specific IgM antibody against
Treponema pallidum subspecies pallidum and non-specific detection
antibodies in the test (for example, netreponemovém. VDRL, RPR)
B. probable case-at least one of the following findings:
1. Detection of specific antibodies against Treponema subspecies pallium
pallidum by screening test (eg. TPHA, TP-PA, EIA, etc.) and
at the same time a confirmation of specific antibodies against Treponema pallidum
subspecies pallidum IgG class methodically independent test (FTA-ABS
Western blot IgG, IgG)
2. in the case of congenital syphilis detection of non-specific antibodies against Treponema
pallidum subspecies pallidum in the netreponemovém test (eg. VDRL, RPR)
liquoru
3. in the case of congenital syphilis detection of specific antibodies against Treponema
pallium subspecies pallidum by screening test (eg. TPHA,
TP-PA, EIA, etc.) and at the same time a confirmation of specific antibodies against
Treponema pallidum subspecies pallidum IgG class methodically
independent test (FTA-ABS western blot IgG, IgG) for mothers
4. in the case of congenital syphilis detection of non-specific antibodies against Treponema
pallidum subspecies pallidum in the netreponemovém test (eg. VDRL, RPR)
in the four times higher than in the mother's titer
Article. 3
Epidemiological criteria
Epidemiological link-people to people transmission sexual contact or
vertical transmission.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
(B). likely: Clinically relevant case with an epidemiological
context and laboratory tests corresponding to the probable
case.
C. Confirmed: a clinically relevant case confirmed in the laboratory.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses of the disease acquired or
congenital syphilis, reported to the public health authority confirmed
probable case of the disease and death to this disease by
the criteria in article 1 to 3.
Article. 6
Epidemiological investigation on suspicion of the presence of syphilis
1. The person providing the care, which she suspected infection
Treponema pallidum subspecies pallidum, shall ensure that the biological
material for laboratory etiology and its transport card into the
investigating the lab.
2. The clinician dermatovenerologického workplace depistážní
the service, according to the place of residence of the patient with proven infections, performs
targeted screening for all relevant contacts and after appropriate checks
treating patients with diagnosed infections.
Article. 7
Protiepidemická measures
1. The reporting of disease caused by Treponema pallidum subspecies pallidum
by článkku 5.
2. the Protiepidemická consist in the proper execution of the depistážního
the investigation and examination of all relevant contacts of the patient by another
^ Law 6).
3. for syphilis I and II. the stage must always be ordered isolation and treatment on
venerologickém Department and natural persons are obliged to undergo treatment
According to another legal regulation ^ 2).
4. for donors of blood and other biological material shall be treated in accordance with
other legislation ^ 5).
Annex No. 28 of Decree No. 473/2008 Sb.
The system of epidemiological vigilance of tick-borne encephalitis
Article. 1
The clinical definition of disease
The clinical picture of the disease can be carried out in two stages.
1. The first symptoms typically appear after an incubation period of 7 to 14 days (3 to
28 days) after exposure, which is conditional on an infected tick, přisátím
or stay in the area of the occurrence of the ticks, or risk handling
a tick, or the consumption of unpasteurized milk, cheese, yogurt, or
other products, especially from goats ' and sheep's milk, during the last 4
weeks before the appearance of the first symptoms of the disease. In the first period
a period of 2 to 7 days has the disease chřipkovitý nature, it is increased
temperature, fatigue, weakness, pain in the joints and muscles, a headache.
abortivní likvorovým-, with a negative finding. The first phase may
sometimes miss.
2. After a couple of the aftermath of the first symptoms (approximately 4 to 10 days)
may be the second phase of the disease, which is hit by the Central
nervous system. According to the severity and clinical image in this second
stage of the form meningitickou (inflammation of the brain membrane), or the
meningoencefalitickou (with disabilities of gray and white matter of the brain) or
meningo-encefalomyelitickou (with disabilities leading spinal Horn) or the
the form of the bulbocervikální (with segments of the cervical spine and the extended
the spinal cord).
Article. 2
Laboratory Diagnostics
1. Determining IgM antibodies in serum or liquor using ELISA or NIF
(indirect fluorescent antibody).
2. Demonstration of seroconversion or signifikantního the rise of the levels of antibodies
the classes IgG, or total antibodies using ELISA or COMPLEMENT FIXATION, NIF.
Patients newly vaccinated against tick-borne encephalitis, yellow
fever, Japanese encephalitis, and for persons who have returned from endemic
the areas of these viruses, dengue fever, and West Nile virus, it is necessary to
serological results confirm the virus neutralization test.
Article. 3
Epidemiological criteria
With regard to the classification of diseases in the case of article 4 could not be
epidemiological criteria apply.
Article. 4
The classification of a case of disease
A. Possible: cannot be used.
B. Probable: cannot be used.
C. Confirmed: a case that meets the clinical case definition and is
laboratory confirmed.
Article. 5
Data collection and reporting
The person providing the care ^ 1), tick-borne disease diagnoses
encephalitis, reported to the public health authority confirmed case
illness or death to this disease according to the criteria of articles 1 to
3.
Article. 6
Epidemiological investigation on the incidence of tick-borne encephalitis
The person providing the care ^ 1), which she suspected tick-borne
encephalitis, the collection of biological material for laboratory
card and will transport the etiology into investigating the lab.
The investigating laboratory shall report the results under an agreement in writing or
by phone the person providing care ^ 1) and to the competent protiepidemickému
the Department authority to protect public health. Protiepidemické Department
public health protection authority shall ensure that an epidemiological investigation,
which, inter alia, determine the facts relating to the vaccination records and
the clinical form of the disease and possibly death to this disease.
Determine the circumstances of the attack, especially when the patient may be a tick
date akvirace and accurate determination of the place where the akviraci occurred.
Determines whether the sick had refrained from eating cooked or raw milk
products from it.
Article. 7
Protiepidemická measures
1. Protiepidemické the Department authority to protect public health in the region
its scope of records of outbreaks of encephalitis and
It is recommended that visitors respect their preventive measures
to reduce the risk of infestation by ticks.
2. the Department of public health in collaboration with health institutions and
The State Health Institute provides disability awareness-raising actions increasing
the awareness of the population about the non-specific preventive measures,
especially about the possibility of vaccination against tick-borne encephalitis, particularly when
repeated or prolonged stay in outbreaks of encephalitis.
Involved in national events, the occurrence of the ticks in the natural map
environment and their promořenost with infectious agents that are transmitted.
3. In the case of detection of possible foodborne transmission protection authority
public health measures and ensure that the prohibition of protiepidemická consumption
suspektního vehicle, how milk and unpasteurised products from
This milk, an active search for all exposed persons and
ensure their clinical and serological testing for tick-borne
encephalitis.
4. in cooperation with veterinarians and the national reference laboratory for
arboviry Health Institute Ostrava shall ensure the examination suspektních
the source of animals, their milk for the presence of virus, tick-borne
encephalitis, and their serum for the presence of antibodies to tick-borne
encephalitis and examination of possible rezervoárových of the animals.
5. The State Health Institute in Prague in cooperation with the Czech
hydrometeorologickým the Institute carries out activities during the season forecast
ticks, which is as an indicative figure for citizens located on the Web
the website of the Ministry of health, the National Health Institute and the
authorities to protect public health.
The annex to Decree No 29 No 473/2008 Sb.
The system of epidemiological vigilance of chicken pox
Article. 1
The clinical definition of disease
1. The clinical picture can be characterized by the gradual sowing svědivého
makulopapulózního Exanthema, increased temperature or fever. Sowing
begins on the trunk and the head, including the hairy part, gradually spread to the
the limb. The planting season usually takes place in several waves, therefore, tend to be
in parallel, the presence of all developmental stages Exanthema (macula, papule,
vezikula, pustula, crust). A more severe course of the disease in adults has
(long febrilie, a massive eruption of eflorescencí). Complications of the disease
There is a risk, in particular in children under 1 year of life of adults over 20 years old, for
people of pregnant and imunosuprimovaných.
Neurological complications (encephalitis, myelitis, cerebellitis) or
pulmonary (varicellová pneumonia, secondary bacterial pneumonia)
or bacterial superinfection of skin and soft tissues and bleeding.
Systemic disease at risk for persons and imunosuprimovaných in newborns, for
the mothers of sowing of chicken pox occurred 5 days before and 2 days after
childbirth. Varicella zoster virus is considered to be teratogenic and
primoinfekci in the 28th week of pregnancy before the threat of the so-called.
varicellového kongenitálního syndrome.
2. The period of nakažlivosti begins 2 days before sowing Exanthema and ends,
If you are already all efflorescence in the stage of the crusts.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. Detection of varicella zoster virus nucleic acid in a clinical specimen
(peripheral blood, vesicular fluid, cerebrospinal fluid)
2. Isolation of varicella zoster virus on tissue cultures
3. Demonstration of viral antigen by the method of direct immunofluorescence in a smear of
efflorescence
4. Pass the virus electron microscope in a clinical specimen
5. The rise of specific antibodies against the virus varicella zoster.
The presence of IgM antibodies may be obscured by their occurrence in the
the reactivation of the virus, and cross reactivity with antibodies of IgM
other herpetickým viruses, in particular, the herpes simplex virus. Therefore, it is
their isolated detection of one sample to be considered
the lack of a pass. Cases is necessary to verify a significant increase in the level of
of the total, or IgG antibodies. To the correct interpretation of the results
serological examinations should take into account the clinical, laboratory and
epidemiological data.
Article. 3
Epidemiological criteria
Epidemiological link-people to people transmission of the disease. Disease
is direct contact with a sick person, and a person
the vaccination. The virus is contained in the vesicular fluid eflorescencí in the
broken without my elephant even when shingles and in secretions from the upper tract
respiratory. The indirect transfer of objects contaminated by
secretions of the respiratory tract or skin lesions, exceptionally content
transmission occurs and transplacentárně.
Article. 4
The classification of a case of disease
And: the case with Possible. the typical clinical course without laboratory
examination.
(B). likely: a case that meets the clinical definition of disease and
in connection with other cases of the epidemic.
C. Confirmed: a case that meets the clinical case definition and is
laboratory confirmed.
Article. 5
Data collection and reporting
The person providing the care ^ 1), diagnoses of the disease on the
chickenpox, reports the authority to protect public health and the likely
confirmed case of the disease, hospitalization, and death from the complications of this
the disease also indicate vaccination carried out.
Article. 6
Epidemiological investigation on the incidence of chicken pox
The person providing the care ^ 1), which expressed the suspicion of disease
chickenpox, at its sole discretion for clinically disputed
cases, the biological material for laboratory certificate
etiology and ensure its transport into investigating the lab.
Article. 7
Protiepidemická measures in the outbreak of chicken pox
1. Reporting of chickenpox disease in accordance with article 5.
2. Ensure the collection of biological material from the patient to verify the
diagnosis in clinical cases of dispute and ensure the transport of
biological material to the appropriate laboratories.
3. Isolation of the patient it takes until they are all in the efflorescence
stage of the crusts. The procedure for the isolation of another legal regulation ^ 4).
4. Active search resources and contacts are normally does not.
5. The epidemiological investigation on the outbreak of the disease is normally not performed. The person
providing care ^ 1), which has expressed suspicion of the disease on the
chickenpox, give special attention to persons and pregnant
imunosuprimovaným that chickenpox still without or not
properly vaccinated.
6. Submission of the hyperimunního of human immunoglobulin in 72 hours from the contact
with infections or imunosuprimovaným persons heavily pregnant, which in
past idle without nešotvice or were not properly vaccinated. If
promeškán interval is 72 hours from contact with patients, alternative
It is the submission of the full therapeutic doses of antivirals to the seventh day from the
contact with the infection. Furthermore, human immunoglobulin hyperimunní served
newborns whose mothers took place to the sowing of chicken pox 5 days
before and 2 days after birth, and nedonošencům, born before the twenty-eighth
gestational week, who have been in contact with chickenpox.
7. Post-exposure vaccination is possible in susceptible individuals to the disease
chickenpox, which have not expired 3 days ago from contact with
the sick.
8. in the case of susceptible persons who were in contact with the disease, the medical
supervision, if indicated, take for the maximum incubation period, it
is 21dní. If such person was filed hyperimunní human
immunoglobulin, the period shall be extended to 40 days. ".
Article. (II)
The effectiveness of the
This Decree shall take effect on the 15th day after the date of its publication.
Minister:
doc. MUDr. Heger, CSc., r.
