Definition of Infectious Disease
Let’s begin with the definition of infectious disease.
New Infectious Disease: It is evident that the disease is transmitted from a person to person and has extremely high risks from a comprehensive point of view including the infectiousness and the seriousness of symptoms in case of its contraction. Measures specified for infectious diseases- Type I shall be taken.
Infectious Disease- Type I: Infectious disease that has extremely high risks from a comprehensive point of view including the infectiousness and the seriousness of symptoms in case of its contraction. Hospitalization is needed in principle.
Infectious Disease- Type II: Infectious disease that has high risks from a comprehensive point of view including the infectiousness and the serious ness of symptoms in case of its contraction. Hospitalization is needed according to the situation.
Infectious Disease- Type III: Infectious disease that does not have particularly high risks from a comprehensive point of view including the infectiousness and the seriousness of symptoms in case of its contraction, but could break out massively in groups of particular jobs.
Infectious disease- Type IV: Infectious disease that is not transmitted from a person to person, but through a media such as animals and foods. Sterilization and disposure are needed according to the situation.
Infectious disease- Type V: Infectious disease whose outbreak and expansion should be prevented by the government through researches on its outbreak and the provision and disclosure of necessary information based upon the results to the public and medical professionals.
Designated Infectious Disease: Of the already-known infectious diseases, one that does not belong to any of the Types I to III but requires measures specified for Types I to III. (Designated by the government ordinance. The period is limited to one year.)
New infectious disease is just as explained on the top. The next disease type, Type I, includes very dangerous diseases like Ebola hemorrhagic fever, and hospitalization is needed in principle. Type III includes O157 virus. It is a disease that the government prohibits you from working in a kitchen if you catch it. Designated Infectious Disease is explained at last, but this is the one that includes bird flu. When a new-type flu breaks out, the government will designate the flu based on the Infectious Disease Law as soon as the virus is determined.
Classification of Infectious Disease
The law classifies infectious diseases based on the classification above. Type I is the most dangerous infectious disease that includes, Ebola hemorrhagic fever, Crimea-Congo hemorrhagic fever, pest, Marburg disease, Lassa fever, severe acute respiratory syndrome (only when the agent is SARS coronavirus), smallpox.
Type II is the second most dangerous infectious diseases after Type I that includes, acute anterior poliomyelitis, cholera, bacterial dysentery, diphtheria, typhoid, paratyphoid, etc. The former Infectious Diseases Prevention Act forced hospitalization to patients of these dysentery or cholera, but the new law allows them to be hospitalized only when the situation is severe. (About 10% of all cases.)
Type III is O157; Type IV includes West Nile fever, yellow fever, parrot disease, relapsing fever, Q fever, rabies, hemorrhagic fever with renal syndrome, anthrax, dengue fever, Japanese spotted fever, Japanese encephalitis, spotted typhus, malaria, bird flu, etc.
Type V includes, amebic dysentery, viral hepatitis, Creutzfeldt-Jakob disease, Acquired immunodeficiency syndrome (AIDS), congenital rubella syndrome (CRS), syphilis, tetanus, influenza (except bird flu), chickenpox, pertussis, rubella, measles, etc. Regular influenza is also included in Type V.
Features of Infectious Disease Law
Under the former Infectious Diseases Prevention Act, infected patients were forced to be isolated without exception. On the other hand, the new Infection Disease Law sets the principle that the chief of healthcare center warns the patient and hospitalize after getting consent of the patient. However, if the patient does not follow the warning, the healthcare center can force hospitalization for 72 hours. After the 72 hours, it can extend the duration of hospitalization in every 10 days. It is supposed to establish an exploratory conference in every healthcare center. The new law includes a policy to protect the human rights of the compulsorily-detained patients, by establishing a third-party, the exploratory conference, and letting it discuss whether the forced hospitalization is reasonable and not invading the patient’s human rights.
The government is trying to change itself into a “pre-responsive government,” which can prevent outbreak or spread of infectious disease by reinforcing the system of surveillance in order to grasp the domestic and international situation of infectious diseases. The new Infectious Disease Law shows many signs of progress:
1. The law respects the human rights. Hospitalization is taken only with the patient’s consent in principle. Forced hospitalization will become exceptional.
2. The law declares that the government and the local communities should actively disclose the information. This is from a lesson we learnt from the HIV-tainted-blood scandal.
It is important not to think about isolating infected patients from the society, but to check the use of the law in order to prevent a spread of the disease while protecting the human rights of the patients.
