233/2011 Sb.
DECREE
of 22 March. July 2011,
amending Decree No. 473/2008 Coll., on the system of epidemiological
vigilance for selected infections, as amended by Decree No. 275/2010 Coll.
The Ministry of health shall lay down pursuant to § 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.
274/2003 Coll., Act No. 320/2002 Coll., Act No. 392/2005 Coll., Act No.
222/2006 Coll. and Act No. 110/2007 Coll. (hereinafter the "Act") to implement section
75A para. 1 and 4 of the Act:
Article. (I)
Decree 473/2008 Coll., on the system of epidemiological vigilance for
selected infection, as amended by Decree No. 275/2010 Coll., is amended as follows:
1. In paragraph 3, at the end of paragraph 2, the period is replaced by a comma and the following
letter p) is added:
"p) viral hepatitis E Appendix 30 to this Ordinance.".
2. In section 4, the number "29" is replaced by "30".
3. in annex No. 1 to the end of the text, point 1.3. the following shall be
"Hepatitis E".
4. in annex No. 2 article. 1 at the end of the text of point 1, the words
"The incubation period of 2 to 5 days." and, in paragraph 3, the words "(2-5 days)" are deleted.
5. in annex No. 2 to the end of the text of article 2, the following sentence "the investigating
the laboratory shall send to every strain of c. diphtheriae and c. ulcerans in the national
reference laboratories for pertussis and diphtheria for further determination. ".
6. in annex No. 2 article. 5 in annex No. 3 article. 5 in annex No 6 to article. 5, in
Annex # 7 article. 5 in annex No 12 article. 5, annex No. 13 article. 5 and in the
Annex No. 14 article. 5 after the word "report", the words "the authority to protect
of public health ".
7. in annex No. 2 article. 6 and in the annex No. 4 article. 6, the words "doctor who
he pronounced "shall be replaced by" the person providing care ^ 1), which expressed the "
and at the end of the text, the following sentence "the epidemiological investigation, including
the inspection body shall ensure that the vaccination coverage of public health protection, in particular
in order to determine the source of infection and transmission path. ".
8. in annex No. 3 article. 1 at the end of the text of point 1, the words
"The incubation period of 7 to 21 days." and in the last sentence of point 5 shall be deleted.
9. in annex No. 3 article. 2, point 6, the following paragraph 7 is added:
"7. The investigating laboratory shall send to each isolated strain of b. pertussis and b.
parapertussis to verify to the national reference laboratory for pertussis and
diphtheria. ".
10. in annex 3, article 6, including the title reads as follows:
"Article. 6
Epidemiological investigation on suspicion on the occurrence of pertussis
The person providing the care ^ 1), which has expressed suspicion of disease
gag cough, shall ensure that the taking of a clinical specimen for culture or PCR
examination and makes the blood taking on serological examination and shall ensure
transport of biological material without delay to the examining laboratory;
at least 3 weeks, further blood sampling. The person providing the care ^ 1)
even the investigating laboratory reports the authority to protect public health results
According to the article. 4. The investigating laboratory shall send to each isolated strain (B).
pertussis and b. parapertussis to authenticate to the national reference laboratories
for pertussis and diphtheria. Epidemiological investigation, including control
vaccination the public health authority shall ensure, in particular, with a view to
to determine the source of infection and transmission path. ".
11. in annex No 4 article. 1 at the end of the text of point 1, the words
"The incubation period of 7 to 18 days.".
12. in annex No 4 Article 2 including the title reads as follows:
"Article. 2
Laboratory Diagnostics
1. isolation of measles virus from a clinical specimen.
2. detection of measles virus nucleic acid in a clinical specimen
taken in the acute phase of the disease.
3. the presence of specific antibodies against spalničkovému virus
characteristic for acute infection in serum or in saliva:
Detection of IgM) antibodies against measles virus in people who were not in the
the last 6 weeks vaccinated.
(b)) for the licence, low values of false spalničkových IgM
positives for sporadic cases of zarděnkových it is necessary to exclude possible
positivity of IgM antibodies to rubella, Parvovirus B19, EBV and
HHV6.
4. card of seroconversion or significant, multiple rise
the levels of specific IgG antibody testing a pair of spalničkových Sera
(acute and rekonvalescentního) people that were in the last 6
weeks vaccinated.
5. Pass the increase in levels of a pre-existing spalničkových IgG antibodies for
reinfekcí.
6. detection of measles virus Antigen by indirect immunofluorescence test in
Clinical specimen collected in the acute phase of the disease using
monoclonal antibodies specific for measles. To the correct
interpretation of laboratory results should take into account whether or not clinical
and epidemiological data including vaccination status. If it was in
the last 3 to 6 weeks of vaccination, it is necessary to consider the examination
the nevakcinální virus. Measles virus isolates isolated from a clinical
materials are sent to the national reference laboratory for measles,
mumps, rubella, and parvovirus B19 to further determination. ".
13. in annex No 4 article. 4, paragraph (C), after the words "case", the words ",
that has not in recent times (3 to 6 weeks) vaccinated and is ".
14. in annex No 4 article. 5 after the word "report", the words "the authority
the protection of public health "and to the end of the first sentence, the words",
which meet the criteria of "clinical and laboratory.
15. in annex No 4 article. 7 section 6 reads as follows:
"6. The person providing care ^ 1) shall ensure that the submission of normal human
immunoglobulin (NLIG) to children under 15 months of age (vaccinated), persons with
Permanent contraindications, pregnant women and persons with immunosuppression, which
have been in contact with possible, probable or confirmed case
measles, according to the summary of the product characteristics. ".
16. in annex No 4 article. 7 paragraph 7, the word "Vaccination" is replaced by
"The person providing care ^ 1) shall ensure that the vaccination".
17. in annex No 4 article. 7 paragraph 8, the words "contact with the sick"
the words "medical surveillance is carried out".
18. in annex No 4 article. 7 paragraph 9, the word "children" shall be replaced by
"Receptive children" and after the word "measles" is added after the comma.
19. in annex 5 article 1 including the title reads as follows:
"Article. 1
The clinical definition of disease
1. The clinical picture of influenza virus infection is in the form of the flu
a similar disease or in the form of acute respiratory infections. The incubation
time 1 to 4 days.
1.1. Influenza-like illness (ILI) is characterized by the following
clinical symptoms:
and sudden onset of illness), and at the same time
(b) at least one liked) symptoms, which include fever or
chills, nausea, headache, muscle pain, and at the same time
(c)), at least one of the following respiratory symptoms,
include cough, burning sensation in the throat, shortness of breath.
1.2. Acute respiratory infections (ARI) is characterized by the following
clinical symptoms:
and sudden onset of illness), and at the same time
(b)), at least one of the following respiratory symptoms,
include cough, burning sensation in the throat, shortness of breath, runny nose.
2. the period of nakažlivosti is in adults in the first to fifth day
the disease. For people in and children can be a period
nakažlivosti up to the 10th day of the disease. "
20. in annex 5 article. 6, point 1, the words "(eg. in terms of the number of
affected, in time or local context, with an unusual course) "
replaced by the words ", in particular with an unusual course in time and place
the context ".
21. in annex 5 article. 6 in point 2, the words "to be observed by the doctor,
button is clicked. EMPATHY, "shall be replaced by" the person providing care ^ 1) in cooperation with the
the locally competent public health authority ".
22. in annex 5 article. 7, point 2, the words "to be observed by the doctor.
EMPATHY "is replaced by" the person providing care ^ 1) ".
23. in annex No 6 to article. 1 at the end of the text of point 1, the words
"The incubation period of 2 to 7 days, exceptionally up to 10 days.".
24. in annex No 6 to article. 2, point 5, the last sentence is replaced by the phrase "subscription
on the cultivation of the examination shall be carried out before deployment of antibiotic
therapy. ".
25. in annex No 6 to article. 6, the words "doctor who uttered" are replaced by
the words "the person providing care ^ 1), which has expressed" and at the end of the text
the words "that isolates forwarded to the national reference laboratories
For meningococcal disease for further determination. The national reference
antibiotics laboratory ensures monitoring of antibiotic resistance.
The epidemiological investigation authority shall ensure protection of public health, in particular,
to identify the source of infection. "
26. in annex No 6 to article. 7 paragraph 6, the words "immediately launches a protective
chemotherapy "is replaced by" initiate the person providing care ^ 1)
protective chemotherapy ".
27. in annex # 7 at the end of the text of article 1, the words "the incubation
duration of 2 to 4 days. ".
28. in annex # 7 article. 2 the final part of the provision reads as follows:
"Due to the fact that the above clinical syndromes can be
caused by a number of other aetiological agents, is a laboratory certificate
the etiology of h. influenzae, up to the level of the species h. influenzae and types
necessary. H. influenzae strains isolated from clinical material
It is normally sterile, or body fluids obtained from
clinical manifestations of referred to in article 1, are to be sent to the national reference
laboratory for hemofilové disease for further determination. The national reference
laboratory for detecting antibiotic resistance to antibiotics. Subscriptions
biological material on the culture of the examination must be done before
Deploying ATB therapy. ".
29. in annex # 7 article. 6, the words "doctor who uttered" are replaced by
the words "the person providing care ^ 1), which has expressed" and at the end of the text
the words "which shall transmit to the national reference laboratory isolates
for hemofilové disease for further determination. The national reference laboratory
for antibiotics ensures monitoring of antibiotic resistance.
Epidemiological investigation, including control of proočkovannosti authority shall ensure
protection of public health, in particular in order to determine the source of infection. ".
30. in annex # 7 article. 7, the following paragraph 5 is added:
"5. The children's preschools are not accepted susceptible children to
diseases caused by h. influenzae for maximum incubation period from
disposal of sick child. ".
31. in annex 8, article 6, including the title reads as follows:
"Article. 6
Epidemiological investigation on suspicion on HIV/AIDS
The person providing the care ^ 1), which expressed the suspected disease
HIV/AIDS, performs the blood taking to investigate the presence of antibodies.
The epidemiological inquiry shall ensure that the person providing the care ^ 1) or authority
protection of public health, in particular in order to determine the source of infection and the path
transfer. ".
32. Annex 8 article. 7, the following paragraph 3 is added:
"3. If the person providing the care ^ 1) provide for the examination of persons with poranily
a used needle, according to the table below.
------------------------------------------------ ------------------------------------------------
EXAMINATION of The 72 hours after the injury every 90 days after injury For 180 days after injury
------------------------------------------------ ------------------------------------------------
Viral hepatitis (B) Yes * Yes Yes
Viral hepatitis C Yes Yes Yes
HIV Yes Yes No
------------------------------------------------ ------------------------------------------------
* For injured people with proven protective titer of anti HBs antibodies after vaccination
or enjoy a further investigation of disease markers VHB exits.
A negative result HBsAg, anti-HCV markers and anti HIV in
potential source, if known, the tracking of the injured person
exits. Part of the examination is also the detection of subjective issues and
the clinical symptoms that may be related to viral disease
hepatitis and laboratory examination of the activities of the aminotransferases. Event
always be recorded in the medical record of the person injured. ".
33. in annex No 9 to article. 1, point 1, the words "the symptoms and/or" shall be deleted.
34. in annex No 9 to article. 2 the opening sentence of the provisions of the fourth supplement
the sentence "in the case of the isolated strains of Mycobacterium tuberculosis, the results are
the tests of sensitivity of the antimycobacterial drugs konfirmovány in the national reference
laboratory for Mycobacteria. To exclude or confirm
multidrug-resistant or extensively drug-resistant tuberculosis are carried out
mykobakteriologické laboratory isolation of m. tuberculosis, and tests
the sensitivity and the strains isolated from the section of the material, or in tribes
isolated from clinical samples of the material people, which in the course of
the implementation of laboratory tests have died. "
35. in annex No 9 to article. 4 point 1 shall read:
"1. Classification according to infectivity.
1.1. A case with an infectious form of TB disease:
1.1.1. the person with TB, negative in sputum or in another material bacilli
the m. tuberculosis complex, proven and particularly culture-and culture-
microscopically.
1.2. the case having reason to suspect the disease infectious form of TB:
1.2.1. the person with the findings give active pulmonary TB (XRD findings
histology, etc.), for which the results of the culture of sputum or other
the material is not yet closed, or
1.2.2. the person with the findings give active pulmonary TB, for which
material for bacteriological examination has not been obtained, or
1.2.3. the person with the findings give only active extrapulmonary TB,
that is a reason to suspect the Elimination of tuberculosis bacilli in
bodily excretions of sekretech or to the outside environment.
1.3. Case with unproven infection rate is:
1.3.1. the person with the findings give active pulmonary TB with closed
mykobakteriologickým examination with negative results.
1.4. The case with unlikely infection rate is:
1.4.1. the person with the findings give only active extrapulmonary TB, in addition to
the situation referred to in point 1.1. and 1.2.3. ".
36. in annex No 9 to article. 4, paragraph 2.1. the words "tracheo-bronchial
branch "be replaced by" tracheo-bronchial tree ".
37. in annex No 9 to article. 4, paragraph 2.3. the word "branch" be replaced by
the "tree".
39. in annex No 9 to article. 6, point 1, the words "doctor who uttered"
replaced by the words "the person providing care ^ 1), which has expressed" and at the end of
the text, the following sentence "shall ensure that epidemiological inquiries in particular with
to determine the source of infection and transmission path. In cases of infectious forms of
TB disease, especially with a range of positive, microscopically outbreak
exceeding the family contacts, working closely in the epidemiological
the investigation with the authority to protect public health. ".
40. Annex # 10 reads as follows:
' The annex to Decree No 10 No 473/2008 Sb.
The system of epidemiological vigilance of legionellosis
Article. 1
The clinical definition of legionellosis
1. Legionnaires ' disease-acute lower respiratory tract disease with
symptoms of pneumonia diagnosed clinically, to reduce the rate,
in the laboratory. The incubation period of 2 to 10 days.
2. Pontiac fever-acute legionelová infection without involvement of the lower
respiratory tract infections. The incubation period of 1 to 2 days.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. A direct demonstration of the Antigen in the urine.
2. card of specific antibodies in the serum.
3. direct detection of the Microbe in the respiratory sekretech.
4. selective Cultivation soils.
5. Typing of strains sent to the national reference laboratory for
Legionnaires Disease by using sequencing.
Article. 3
Epidemiological criteria
Exposure to the same common tank as the confirmed case.
Article. 4
The classification of a case of disease
A. possible: not applicable.
B. Probable: above the clinical definition of disease,
epidemiological criteria and at least one of the following laboratory
criteria:
1. a fourfold or greater rise in antibody to l. pneumophila
other serological groups than an sg. 1 or other types of certified
indirect fluorescence or mikroaglutinací;
2. high titre of antibodies against l. pneumophila sg. 1 or more
serological groups or species;
3. card of specific agents in the respiratory sekretech and lung tissue
using direct fluorescence with monoclonal antibodies;
4. card of Legionella in the biological material of molecular biological
accredited methods (PCR).
(C). confirmed: meets the above definition of clinical disease and
one or more of the following laboratory criteria:
1. isolation of Legionella from bronchoalveolar washings, sputum, pleural
fluid, the lung tissue, blood or other biological material;
2. a fourfold or greater rise in antibody titres against specific
Legionella pneumophila sg. 1 confirmed the indirect fluorescent,
mikroaglutinací or ELISA test;
3. card of specific antigen in the urine by a validated diagnostic
Kit.
More legionelóz for the purposes of the national classification system
epidemiological vigilance:
a. Nosocomial legionellosis-patient infected in a healthcare
device.
(b) travel of legionellosis-patient when one day, or
few days stay at a hotel or other devices of mass accommodation
The CZECH REPUBLIC or abroad, where he stayed from 2 to 10 days before the appearance of
clinical symptoms of the disease.
c. Professional legionellosis infection that occurred in the performance of work.
d. Community of legionellosis infection from other reservoirs.
e. Other.
Article. 5
Data collection and reporting
The person providing the care ^ 1), which diagnoses Legionnaires Disease, disease
immediately reports the authority to protect public health, disease and death
This disease.
Article. 6
Epidemiological investigation on suspicion on the incidence of legionellosis
The person providing the care ^ 1), which has expressed suspicion of disease
Legionnaires Disease, performs biological material (bronchoalveolar
lavage, sputum or pleural effusion, urine, blood, or other body
the liquid in the event of the death of part of the bearing of the affected lung tissue) to the
laboratory licence etiology and ensure their transportation to the
investigating the lab. Vykultivované tribes, or removed
biological material, shall be forwarded to the national reference laboratory of the laboratory
for identification and typing of Legionella or processing.
The epidemiological investigation authority shall ensure the protection of public health, in particular
in order to determine the reservoir of infection and transmission path.
Article. 7
Protiepidemická measures in the outbreak disease Legionnaires Disease
1. reporting diseases of Legionnaires Disease in accordance with article 5.
2. Ensure the collection of biological material to verify the diagnosis, his
transport to the laboratory.
3. Epidemiological investigation on the outbreak of the disease, including the definition of other
the affected people, the screening of travel history, sampling water from the
technical equipment, design, technical review. ".
41. in annex # 11 article. 1, point 2.3. the word "domestic" is replaced by
"neimportovaný (home)".
42. In annex 11 to the end of the text of article 2, the following sentence "Isolates
poliovirus isolated from clinical materials are sent to the national
reference laboratories for enteroviruses to the further determination. ".
43. in annex # 11 article. 4 the last sentence, the words "or" domestic ""
shall be deleted.
44. in annex # 11 article. 5 after the word "report", the words "the authority
the protection of public health "and at the end of the text, the following sentence" within the
the system of epidemiological vigilance of poliomyelitis are reported and shall investigate
also, cases of acute palsy with only 15 years of age. ".
45. in annex No. 11 article 6, including the title reads as follows:
"Article. 6
Epidemiological investigation on suspicion on the occurrence of poliomyelitis
The person providing the care ^ 1), which has expressed suspicion of disease
poliomyelitis, performs the sampling of the stool and transmit a subscription to
National reference laboratories for enteroviruses. The investigating laboratory
isolated strain of poliovirus will send to the regional reference laboratory for
enteroviruses in the World Health Organization for Europe.
Epidemiological investigation, including control of vaccination shall ensure that the authority
the protection of public health, in particular in order to determine the source of infection and the path
transfer. ".
46. in annex # 11 article. 7 section 6 reads as follows:
"6. Medical surveillance for a period of 35 days from the last contact with a confirmed
the case of paralytic poliomyelitis. For persons carrying out activities
severe epidemiological health surveillance increased, is mandated for a period of 6
weeks after the last contact with a confirmed case of paralytic
poliomyelitis. ".
47. in annex No 12 article. 1 at the end of the text of point 1, the words
"The incubation period of 3 to 21 days.".
48. in annex 12 to the end of the text of article 2, the following sentence
"The investigating laboratory shall send to each isolated strain of c. tetani in National
reference laboratories for tetanus. ".
49. in annex No 12 article. 6, the words "doctor who uttered" are replaced by
the words "the person providing care ^ 1), which has expressed" and at the end of the text
the following sentence "the epidemiological investigation, including control of vaccination coverage
authority shall ensure the protection of public health, in particular in order to determine the path of the
transfer. ".
50. in annex No. 13 article. 1 at the end of the text of point 1, the words
"The incubation period is 14 to 21 days." and in paragraph 2 (B), the word
"jaundice" is replaced by the word "jaundice".
51. in annex No. 13 article 2 including the title reads as follows:
"Article. 2
Laboratory Diagnostics
1. criteria for confirmed case of rubella:
rubella virus isolation and in people who have not been in the last 6 weeks
vaccinated, 1 week before and 1 week after the appearance of the rash.
Material for direct card virus of rubella are best swabs from the throat,
otherwise, the samples of blood, urine and cerebrospinal fluid swabs from the nose.
Samples must be taken as soon as possible.
b. Detection of rubella virus nucleic acid in a clinical nevakcinálního
the sample, taken in the acute phase of the disease.
(c) seroconversion or significant. card, několinásobného levels
zarděnkových-specific IgG antibody testing serum pairs
or saliva in people who have not been vaccinated in the past 6 weeks. Licence
the increase in levels of already existing IgG antibodies at zarděnkových
reinfekcí.
2. the criteria for probable case of rubella:
Detection of IgM antibodies to rubella virus in people who were not in the
the last 6 weeks vaccinated. In case of suspected rubella in
pregnancy must be further confirmation of the positive test results on IgM
(eg. specific IgG avidity test antibodies against rubella virus
the demonstration of low avidity of).
3. criteria for congenital zarděnkový syndrome (COP):
and rubella virus isolation from a clinical specimen.
b. detection of rubella nucleic acid.
c. the presence of specific IgM antibodies against rubella virus.
d. IgG antibody persistence against the virus of rubella between the sixth and
the twelfth month of age (at least 2 samples with similar concentrations of
IgG antibodies against rubella virus).
Rubella virus isolates isolated from clinical materials are sent to
National reference laboratory for measles, mumps, rubella, and
Parvovirus B19 to further determination. ".
52. in annex No. 13 article. 6, the words "doctor who uttered" are replaced by
the words "the person providing care ^ 1), which has expressed" and at the end of the text
the following sentence "the epidemiological investigation, including control of vaccination coverage
authority shall ensure the protection of public health. ".
53. in annex No. 14 article. 1 at the end of the text of point 1, the words
"The incubation period of 16 to 18 days.".
54. in annex No. 14 article 2 including the title reads as follows:
"Article. 2
Laboratory Diagnostics
1. direct card nevakcinálního mumps virus strain isolation from a clinical
the sample, taken in the acute phase of the disease.
2. Detection of nucleic acid nevakcinálního mumps virus strain in the
a clinical specimen, collected in the acute phase of the disease.
3. detection of IgM antibodies against mumps virus in people who were not in the
the last 6 weeks vaccinated.
4. card of seroconversion or significant, multiple rise
the levels of specific IgG antibody testing a pair of parotitických
samples serum or saliva of the people that were in the last 6 weeks
vaccinated.
5. Pass the increase in levels of already existing parotitických IgG antibodies
at reinfekcí.
6. detection of mumps virus strain nevakcinálního Antigen (DFA) by using the
parotitických-specific monoclonal antibodies in clinical
the sample, taken in the acute phase of the disease.
To correct the interpretation of laboratory results should be taken into account
also the clinical and epidemiological data, including vaccination status. ".
55. in annex No. 14 article. 6, the words "doctor who uttered" are replaced by
the words "the person providing care ^ 1), which has expressed".
56. in annex # 15 article. 1, point 1 shall be replaced by the word "maculopapular"
the word "rash".
57. in annex # 15 article. 6 including the title reads as follows:
"Article. 6
Operation of the blood transfusion service
Blood transfusion service will ensure your device:
and the exclusion of the donation) of whole blood and blood components for all people,
that have been located in an area with ongoing transmission of WNV to humans, and that after
for 28 days after leaving such areas ^ 3);
(b)) in the indicated cases, examination of blood samples and
blood components for the presence of WNV nucleic acid. ".
58. in annex No. 16 article. 3, point 5, shall be repealed.
59. in annex No. 16 article. 7, point 5 shall be deleted.
Items 6 and 7 are renumbered as 5 and 6.
60. in annex No. 16 article. 7 paragraph 5, after the words "food production"
the words "in cooperation with the authorities of the State Veterinary Administration.
61. in annex No. 17 article. 1 at the end of the text of point 1, the words
"The incubation period of 15 to 50 days.".
62. in annex No. 17 article. 1, point 2, the words ", described
period of up to 6 months "shall be deleted.
63. in annex No. 17 article. 3, point 4 is deleted.
64. in annex No. 17 article. 7 paragraph 5, after the words "early childhood" inserted
the words "and of the school".
65. in annex No 6 to article. 1 point 1, after the word "abdomen," the words
"pain," and at the end of the text of point 1, the words "the incubation
time of 45 to 180 days. ".
66. in annex No 6 to article. 7 sections 7 and 8 are added:
"7. the Healthcare worker who was the exposure of the patient's blood
injured, or if there is serious contamination of skin and mucous membranes and that
at the same time, it has not been vaccinated or was incompletely vaccinated, or were aware of the
the inability of anti HBs antibody formation, is applied 1 dose
specific hyperimunního globulin against VHB, in accordance with the summary
the product information.
8. The person providing care ^ 1) provide for the examination of persons with poranily
a used needle, according to the table below.
------------------------------------------------ ---------------------------------------------------
EXAMINATION of The 72 hours after the injury every 90 days after injury For 180 days after injury
------------------------------------------------ ---------------------------------------------------
Viral hepatitis (B) Yes * Yes Yes
Viral hepatitis C Yes Yes Yes
HIV Yes Yes No
------------------------------------------------ ---------------------------------------------------
* For injured people with proven protective titer of anti HBs antibodies after vaccination
or enjoy a further investigation of disease markers VHB exits.
A negative result HBsAg, anti-HCV markers and anti HIV in
potential source, if known, the tracking of the injured person
exits.
Part of the examination is also the finding of subjective issues and clinical
symptoms that may be associated with viral hepatitis and
laboratory examination of the activity of transaminases. The event is always
be recorded in the medical documentation of the injured person. ".
67. in annex # 19 article. 1 at the end of the text, the words "the incubation
the period 14 to 180 days. ".
68. in annex # 19 article. 7, the following paragraph 6 is added:
"6. The person providing care ^ 1) provide for the examination of persons with poranily
a used needle, according to the table below.
------------------------------------------------ ---------------------------------------------------
EXAMINATION of The 72 hours after the injury every 90 days after injury For 180 days after injury
------------------------------------------------ ---------------------------------------------------
Viral hepatitis (B) Yes * Yes Yes
Viral hepatitis C Yes Yes Yes
HIV Yes Yes No
------------------------------------------------ ---------------------------------------------------
* For injured people with proven protective titer of anti HBs antibodies after vaccination
or enjoy a further investigation of disease markers VHB exits.
A negative result HBsAg, anti-HCV markers and anti HIV in
potential source, if known, the tracking of the injured person
exits.
Part of the examination is also the finding of subjective issues and clinical
symptoms that may be associated with viral hepatitis and
laboratory examination of the activity of transaminases. The event is always
be recorded in the medical documentation of the injured person. ".
69. in annex # 21 article. 1 at the end of the text, the words "the incubation
time according to the clinical picture of 1 to 4 days. ".
70. In annex 22 to article. 1 at the end of the text of point 1, the words
"The incubation period 1 to 10 days.".
71. In annex 22 to article. 3, point 5, shall be repealed.
72. In annex 22 to article. 6 point 3, the words ' by typing into the State
the Health Institute "shall be replaced by the words" towards the further determination of the Department of
Laboratory of hygiene of nutrition and food safety, the State health
the Institute in Brno ".
73. in annex No. 23 article. 1 at the end of the text of point 1, the words
"The incubation period of 3 to 32 days, early stage can be inaparentní.".
74. in annex No. 23 article. 7 point 3 is added:
"3. persons with active disease Lyme disease are deleted from donation
blood and its components, and the donation of tissues and cells for a period of 6 months after the
retreatment. To exclude people with a chronic illness decides the doctor. ".
75. in annex # 24 article. 1 at the end of the text of point 1, the words
"The incubation period of 10 to 21 days.".
76. in annex No 26 article. 1 at the end of the text of point 1, the words
"The incubation period from 6 to 72 hours".
77. in annex No 26 article. 3, point 5, shall be repealed.
78. in annex No. 27 article. 1 at the end of the text of point 1, the words
"The incubation period of 10 days to 3 months.".
79. in annex No. 27 article. 2, point (B) (i)(a) 1, the word "pallium" is replaced by
the word "pallidum."
80. in annex # 29 article. 1 the sixth sentence of paragraph 1, the word "pulmonary"
replaced by the word "pulmonary" and at the end of the text following point
"The incubation period of 10 to 21 days.".
81. in annex # 29 article. 5, the words "probable and confirmed case"
shall be deleted.
82. After annex No. 29, the following Annex No. 30, which read as follows:
' Annex # 30 to # 473/2008 Sb.
The system of epidemiological vigilance of viral hepatitis E (hereinafter referred to as "VHE")
Article. 1
The clinical definition of disease
1. The clinical picture is similar to that of viral hepatitis A; the gradual
the development of symptoms, especially fatigue, abdominal pain, loss of appetite,
the occasional nausea and vomiting, jaundice, increased level of
aminotransferases, dark urine, pain in the joints. Infection tends to have higher mortality
especially in pregnant women in the third trimester of pregnancy. The incubation period is
15 to 60 days.
2. the period of nakažlivosti is not known. The virus is demonstrable in the stool has already
at the end of the incubation period and the excretion of the virus persists for 2 to 3 weeks.
Article. 2
Laboratory Diagnostics
At least one of the following criteria:
1. Detection of specific IgM antibody VHE.
2. card of the viral RNA in the VHE stool or blood.
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. Stay in the area with an abundance of VHE, with a predominance of interhumánního transfer.
Article. 4
The classification of a case of disease
A. possible: not applicable.
B. the likely: any person meeting the clinical criteria
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 disease VHE, reports
authority to protect public health and the death of a confirmed case of the disease on the
This disease including a suspicion of the disease.
Article. 6
Epidemiological investigation on suspicion on the occurrence of the VHE
The person providing the care ^ 1), which has expressed suspicion of the disease the VHE
performs biological material for laboratory subscriptions card
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 in the VHE
1. reporting diseases VHE 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 on infectious diseases of the Department
under another law ^ 2).
4. in the case of persons who have been in contact with the sick, medical surveillance is carried out
of 60 days from the last contact.
5. Reception of new people into groups of children of pre-school and school age is
disabled at the time the medical supervision for the occurrence of the VHE according
assessment of the locally competent authority to protect public health.
6. Persons in contact with the executing activity severe epidemiological VHE
are excluded from these activities, the imposition of increased medical surveillance
for a period of 60 days from the last contact with the sick.
7. for donors of blood and other biological material shall follow the procedure referred to in
other legislation ^ 5).
8. cooperation with the authorities of the State Veterinary Administration. ".
Article. (II)
The effectiveness of the
This Decree shall enter into force on the fifteenth day following the date of its publication.
Minister:
doc. MUDr. Heger, CSc., r.
