CHAPTER 14 Public health
14.1 Public health regulation
[14.1.1] What is public health law?
Public health law ‘provides the powers and creates the structures that assist the task of preventing disease and allowing the opportunities for longer and healthier lives’ (Reynolds, 2004: 5). It covers a vast territory, including communicable diseases, infection control, swimming pools and spas, hairdressing and beauty therapy, air conditioning, body piercing, tobacco control, epidemiological registries, immunisation, harm minimisation strategies for drug addiction, water quality and food laws.
This chapter concentrates on the laws and regulations dealing with notifiable diseases.
14.2 Notifiable diseases
[14.2.1] What diseases must be notified to health authorities?
Each state and territory has a list of notifiable diseases: see table 14.2.1. If any health professional (such as a doctor, nurse practitioner, pathologist, laboratory worker or hospital chief executive) has reasonable grounds for suspecting that a patient has contracted a notifiable disease, they must contact the health authority in that jurisdiction. Failure to do so is an offence, which may attract a large fine.
Table 14.2.1 Notifiable diseases: legislation, requirements and listed diseases
| ACT Public Health Act 1997 |
| Who must notify? |
| Who must be notified? |
| Health Services, Communicable Disease Control, Howard Florey Centenary House, 25 Mulley St Holder ACT 2611 |
| Information required |
| The notifier must complete the Report of Notifiable Disease or Related Death form and all requested information must be provided. When reporting HIV/AIDS, hepatitis B (HBV), hepatitis C (HCV) and sexually transmitted infection (STI) cases, the notifier should not provide full family name, given name and residential details. The notifier must provide the first two letters of the family name, first two letters of the given name and postcode details. The rest of the details can be submitted as per the Report of Notifiable Disease or Related Death form. See Reporting of Notifiable Conditions Code of Practice 2006 (www.health.act.gov.au/c/health?a=da&did=10010026&pid=1152509942). |
| Notifiable diseases |
| acquired immunodeficiency syndrome (AIDS); anthrax; arbovirus infections (Barmah Forest virus, dengue virus, Japanese encephalitis virus, Kunjin virus, Murray Valley encephalitis virus (notified as Australian arboencephalitis in Victoria), Ross River virus, flavivirus infection – unspecified or not otherwise classified); avian influenza (quarantinable); botulism; brucellosis; campylobacteriosis; chlamydia trachomatis; cholera (quarantinable); Creutzfeldt-Jakob disease (all forms, including classical and vCJD); cryptosporidiosis; diphtheria; donovanosis; equine morbillivirus; food poisoning (not elsewhere specified); gastrointestinal illness cluster; giardiasis; gonococcal infection; haemolytic uraemic syndrome (HUS); haemophilus influenzae serotype b (Hib) (invasive only); hepatitis A; hepatitis B; hepatitis C; hepatitis D; hepatitis E; hepatitis (infectious, not otherwise specified); human immunodeficiency virus (HIV) infection; influenza laboratory-confirmed; legionellosis; leprosy; leptospirosis; listeriosis; lyssavirus (Australian bat lyssavirus, duvenhague virus, rabies (quarantinable), European bat 1 & 2, lyssavirus unspecified); malaria; measles; meningococcal disease (invasive); mumps; paratyphoid; pertussis; plague (quarantinable); pneumococcal disease (invasive); poliomyelitis (wild type and vaccine-associated); psittacosis (ornithosis); Q fever; rubella and congenital rubella syndrome; SARS (quarantinable); salmonellosis; shigellosis; Shiga toxin-producing and Vero toxin-producing escherichia coli (STEC/VTEC); smallpox (quarantinable); syphilis; tetanus; tuberculosis; tularaemia; typhoid; varicella; viral haemorrhagic fevers (quarantinable) (lassa, marburg, ebola, unspecified or otherwise unclassified); yellow fever (quarantinable); yersiniosis |
| NSW Public Health Act 1991 |
| Who must notify? |
• medical practitioners (working outside of the hospital context) must notify the director general of category 1 and 2 conditions |
| Notifiable diseases |
| In NSW there are a number of scheduled diseases which are divided into 5 categories. The disease categories have different reporting and treatment requirements. There is also a category of notifiable disease which applies to chief executives of hospitals. |
| Category 1: To be notified by medical practitioners |
| congenital malformation in a child under 1 year; cystic fibrosis in a child under 1 year; hypothyroidism in a child under 1 year; phenylketonuria in a child under 1 year; pregnancy with a child having a congenital malformation, cystic fibrosis, hypothyroidism, thalassaemia major or phenylketonuria; sudden infant death syndrome; thalassaemia major in a child under the age of 1 year |
| Category 2: To be notified by medical practitioners |
| AIDS; acute viral hepatitis; adverse event following immunisation; avian influenza in humans; CJD and vCJD; foodborne illness in two or more related cases; gastroenteritis among people of any age in an institution (eg among persons in educational or residential institutions); leprosy; measles; pertussis (whooping cough); SARS; smallpox; syphilis; tuberculosis |
| Category 3: To be notified by laboratories |
| anthrax; arboviral infections; avian influenza in humans; botulism; brucellosis; cancer; chancroid; chlamydia; cholera; congenital malformation; CJD and vCJD; cryptosporidiosis; cystic fibrosis; diphtheria; donovanosis; giardiasis; gonorrhoea; haemophilus influenzae type b; hepatitis A; hepatitis B; hepatitis C; hepatitis D (delta); hepatitis E; HIV infection; hypothyroidism; invasive pneumococcal infection; influenza; lead poisoning (as defined by a blood lead level of or above 15μg/dL); legionella infections; leptospirosis; listeriosis; lymphogranuloma venereum; lyssavirus; malaria; measles; meningococcal infections; mumps; pertussis (whooping cough); phenylketonuria; plague; poliomyelitis; pregnancy with a child having a congenital malformation, cystic fibrosis, hypothyroidism, thalassaemia major or phenylketonuria; psittacosis; Q fever; rabies; rubella; salmonella infections; SARS; shigellosis; smallpox; syphilis; thalassaemia major; tuberculosis; tularaemia; typhus (epidemic); verotoxin-producing Escherichia coli infection; viral haemorrhagic fevers; yellow fever |
| Category 4 |
| avian influenza in humans; SARS; tuberculosis; typhoid |
| Category 5 |
| AIDS; HIV |
| Notifiable conditions to be notified by chief executive of a hospital acquired immunodeficiency syndrome (AIDS); acute viral hepatitis; adverse event following immunisation; avian influenza in humans; botulism; cancer; cholera; congenital malformation in a child under the age of 1 year; CJD and vCJD; cystic fibrosis in a child under the age of 1 year; diphtheria; foodborne illness in two or more related cases; gastroenteritis among people of any age, in an institution (eg among persons in educational or residential institutions); haemolytic uraemic syndrome; haemophilus influenzae type b; hypothyroidism in a child under the age of 1 year; legionnaires’ disease; leprosy; lyssavirus; measles; meningococcal disease; paratyphoid; pertussis (whooping cough); phenylketonuria in a child under the age of 1 year; plague; poliomyelitis; pregnancy with a child having a congenital malformation, cystic fibrosis, hypothyroidism, thalassaemia major or phenylketonuria; rabies; SARS; smallpox; syphilis; tetanus; thalassaemia major in a child under the age of 1 year; tuberculosis; typhoid; typhus (epidemic); viral haemorrhagic fevers; yellow fever |
| Who must be notified? |
| The Director General of Health must be notified via the local Public Health Unit, and notification should be initiated within 24 hours of diagnosis. Notification forms and contact details are available for each area health service at www.health.nsw.gov.au/infect/notify.html. |
| Information required |
| The notifier must complete the doctor/hospital notification form, either by telephone or in writing. HIV/AIDS is reported on the AIDS notification form. Laboratories must notify scheduled medical conditions and provide information specified in the laboratory notification form, either by telephone or in writing. HIV/AIDS is notifiable only by laboratories carrying out confirmatory testing, direct to Communicable Diseases Branch . When reporting category 5 conditions (HIV/AIDS) identifying information cannot be used, unless by consent or by order of the District Court. The director general may seek a court order to disclose the identity of the patient when it is necessary in order to safeguard the health of the public. |
| The notification policy is contained in Policy Directive PD2006_014, Notification of Infectious Diseases under the Public Health Act 1991 www.health.nsw.gov.au/policies/pd/2006/pdf/PD2006_014.pdf. |
| NT Notifiable Diseases Act 1981 |
| Who must notify? |
• Medical practitioners must report to the Centre for Disease Control if they diagnose a notifiable disease or they suspect a person has a notifiable disease. |
| Notifiable diseases to be notified by medical practitioners |
| AIDS; acute post-streptococcal glomerulonephritis; adverse vaccine reactions; anthrax; Australian bat lyssavirus; avian influenza; botulism; chancroid; chicken pox; cholera; congenital rubella syndrome; congenital syphilis; Creutzfeldt-Jakob disease; dengue virus infection; diphtheria; donovanosis; food or water borne disease (in 2 or more related cases); gastroenteritis involving 1 or more related cases in an institution or food handler; gonococcal conjunctivitis; haemolytic uraemic syndrome (HUS); haemophilus influenzae type b (invasive); hepatitis B; hepatitis C; hepatitis not otherwise specified; hepatitis (acute viral); HTLV 1 (adult T cell leukaemia/lymphoma, tropical spastic paraparesis); Japanese encephalitis; Kunjin virus infection; leprosy; lymphogranuloma venereum (LGV); lyssavirus not otherwise specified; malaria; measles; meningococcal infection; mumps; Murray Valley encephalitis; non-tuberculous mycobacterial disease; pertussis; plague; poliomyelitis; rabies; rheumatic fever; rubella; SARS; smallpox; syphilis; tetanus; thrombotic thrombocytopenic purpura (TTP); tuberculosis; tularaemia; typhoid; typhus (all forms); varicella infection unspecified; viral haemorrhagic fevers (Crimean-Congo fever, ebola virus disease, Lassa fever, Marburg virus disease); yellow fever; zoster (shingles) |
| Notifiable diseases to be notified by laboratories |
| adult T-cell leukaemia/lymphoma; amoebiasis; anthrax; arbovirus infection; Australian bat lyssavirus; avian influenza; Barmah Forest virus; botulism hydatid infection; brucellosis influenza shigellosis; campylobacteriosis; chancroid; chicken pox; chlamydial conjunctivitis; chlamydial infection; cholera; cryptosporidiosis; dengue virus infection; diphtheria; donovanosis; gonococcal conjunctivitis; gonococcal infection; gonococcal neonatal ophthalmia; haemophilus influenzae non-type b (invasive); haemophilus influenzae type b (invasive); hepatitis A; hepatitis B; hepatitis C; hepatitis D; hepatitis E; HIV; HTLV-1; Japanese encephalitis; Kunjin virus; legionnellosis; leprosy; leptospirosis; listeriosis; lymphogranuloma venereum (lgv); lyssavirus not otherwise specified; malaria; measles; melioidosis; meningococcal infection; mumps; Murray Valley encephalitis; non-tuberculous mycobacterial disease; ornithosis (psittacosis); pertussis; plague; pneumococcal disease; poliomyelitis; Q fever; rabies; Ross River virus infection; rotavirus; rubella; salmonellosis (including paratyphoid); SARS; Shiga-like toxin (verocytotoxin) producing E. coli infection; smallpox; syphilis; tetanus; trichomoniasis; tuberculosis; tularaemia; typhoid; typhus (all forms); varicella infection unspecified; vibrio food poisoning; viral haemorrhagic fevers (Crimean-Congo fever, ebola virus disease, Lassa fever, Marburg virus disease); yellow fever; yersiniosis; zoster (shingles) |
| Who must be notified? |
| The Centre for Disease Control. Notification forms and contact details are available for each area health service at www.nt.gov.au/health/cdc/cdc.shtml. |
| Information required: |
| All information required by the doctor/hospital report of clinically notifiable conditions. Identifying information should be omitted for patients with HIV/AIDS. See www.nt.gov.au/health/docs/notification_form_2006.pdf. |
| Qld Public Health Act 2005 |
| Who must notify? |
• a person in charge of a hospital where a doctor indicates that a patient has a clinical or preliminary diagnosis of a notifiable condition |
| Notifiable conditions |
| AIDS; acute flaccid paralysis; acute rheumatic fever; acute viral hepatitis; adverse event following vaccination; anthrax; arbovirus infections (alphavirus infections, including Barmah Forest, getah, Ross River and sindbis viruses); bunyavirus infections (including gan gan, mapputta, termeil and trubanaman viruses), flavivirus infections (including alfuy, Edge Hill, Japanese encephalitis, kokobera, Kunjin, Murray Valley encephalitis, Stratford and other unspecified flaviviruses; excluding dengue fever and yellow fever); any other arbovirus infections (excluding dengue fever and yellow fever); atypical mycobacterial infection; avian influenza; botulism; brucellosis; campylobacteriosis; chancroid; chlamydia trachomatis infection (anogenital and non-anogenital); chlamydia trachomatis infection (lymphogranuloma venereum); cholera; ciguatera intoxication; Creutzfeldt-Jakob disease; Cryptococcosis; Cryptosporidiosis; dengue fever; diphtheria; donovanosis; echinococcosis (hydatid disease); equine morbillivirus (hendra virus) infection; food-borne or waterborne illness in 2 or more cases; food-borne or waterborne illness in food handler; gonococcal infection; haemolytic uraemic syndrome (HUS); haemophilus; influenza type b infection (invasive); Hansen’s disease (leprosy); hepatitis A; hepatitis B; hepatitis C; hepatitis D; hepatitis E; hepatitis (other); human immunodeficiency virus infection (HIV); influenza; invasive group A streptococcal infection; lead exposure; legionellosis; leptospirosis; listeriosis; lyssavirus (Australian bat lyssavirus) including potential exposure; lyssavirus (rabies); lyssavirus (unspecified); malaria; measles; melioidosis; meningococcal infection (invasive); mumps; ornithosis (psittacosis); paratyphoid; pertussis; plague; pneumococcal disease (invasive); poliomyelitis; Q fever; rotavirus infection; rubella, including congenital rubella; salmonellosis; SARS; shiga toxin and vero toxin producing escherichia coli infection (SLTEC/VTEC); shigellosis; smallpox; syphilis, including congenital syphilis; tetanus; tuberculosis; tularaemia; typhoid; varicella-zoster virus infection (chickenpox, shingles or unspecified); viral haemorrhagic fevers (Crimean-Congo, Ebola, Lassa fever and Marburg viruses); yellow fever; yersiniosis |
| Who must be notified? |
| The chief executive of Qld Health, via local Population Health Centres. Contact details can be found at www.health.qld.gov.au/phs/Documents/cdu/notif_conditions_rpt.pdf. |
| For HIV/AIDS reports must be sent to AIDS Medical Unit, PO Box 15239, Brisbane City East Qld 4002. |
| For tuberculosis, reports must be sent to Queensland Tuberculosis Control Centre, Locked Bag 66 Coorparoo DC Qld 4151. |
| Information required |
| The notification forms can be found at www.health.qld.gov.au/phs/Documents/cdu/notif_conditions_rpt.pdf. The notifier may choose to give anonymised information, but the chief executive has the power to ask for further information, including the full name of the patient and other identifying information. |
| SA Public & Environmental Health Act 1987 |
| Who must notify? |
• medical practitioners who suspect that a patient is suffering from or has died from a notifiable disease |
| Notifiable diseases |
| AIDS; anthrax; arbovirus infection; avian influenza infection in humans; brucellosis; campylobacter infection; chlamydia infection; cholera; Creutzfeldt-Jakob disease; cryptosporidiosis; diphtheria; donovanosis; food poisoning; gonococcal infection; haemolytic-uraemic syndrome (HUS); haemophilus influenzae infection; HIV infection; hydatid disease; infection caused by escherichia coli capable of producing Shiga toxin; invasive pneumococcal disease; legionellosis; leptospirosis; listeriosis; lyssavirus infection; malaria; measles; meningococcal infection; mumps; mycobacterial infection; pandemic influenza; pertussis; plague; poliomyelitis; Q fever; rabies; rubella; salmonella infection; SARS; shigella infection; smallpox; syphilis; tetanus; tularaemia; variant Creutzfeldt-Jakob disease; varicella-zoster infection; viral haemorrhagic fever; viral hepatitis; yellow fever; yersinia infection |
| Who must be notified? |
| The Communicable Disease Control Branch, Reply Paid 6, PO Box 6 Rundle Mall Adelaide SA 5000 |
| Information required |
| The notification forms can be found at www.dh.sa.gov.au/pehs/PDF-files/notifiable-disease-form.pdf. For HIV, AIDS, AIDS-related death, hepatitis B or C, and sexually transmitted infections a separate form is forwarded automatically to the doctor upon a positive laboratory result. |
| Tas Public Health Act 1997; HIV/AIDS Preventative Measures Act 1993 |
| Who must notify? |
• registered medical practitioners who believe on reasonable grounds that a patient has a notifiable disease |
| Notifiable conditions |
| anthrax; arbovirus (Ross River virus, Barmah Forest virus, dengue); arbovirus (Japanese encephalitis, Murray Valley encephalitis, Kunjin virus, other); botulism; brucellosis; campylobacteriosis; chancroid; chlamydia trachomatis; cholera; Creutzfeldt-Jakob disease (all variants); cryptosporidiosis; diphtheria; donovanosis; gastroenteritis in an institution (residential, educational or child care facility); giardia infection; gonococcal infection; haemolytic uraemic syndrome (HUS); haemophilus influenzae type b infection (invasive only); hepatitis A; hepatitis B (acute case); hepatitis B (carrier); hepatitis C; hepatitis D; hepatitis E; hepatitis other (details to be specified ); HIV infection; diagnosis of an AIDS-defining illness; hydatid infection; influenza infection; influenza infection (avian influenza); lead (demonstration of blood level in excess of 15 μg/dL/ (0.72 μmol/L) in any person not known to be occupationally exposed to lead); legionellosis; leprosy; leptospirosis; listeriosis; lymphogranuloma venereum; lyssavirus (including Australian bat lyssavirus and others); malaria; measles; meningococcal infection; mumps; ornithosis (psittacosis); paratyphoidosis; pertussis; plague; pneumococcal infection (invasive disease); poliomyelitis; Q fever; rabies; rickettsial infection (including Flinders Island spotted fever and others); rubella (including congenital rubella); salmonellosis; SARS; Shiga toxin producing E.coli (both VTEC and STEC); shigellosis; smallpox; suspected cases of food or water borne illness; syphilis (including congenital syphilis); taeniasis; tetanus; tuberculosis; tularaemia; typhoid; typhus; vancomycin resistant enterococci (VRE); varicella; vibrio infection; viral haemorrhagic fever; yellow fever; yersinia infection |
| Who must be notified? |
| The Director of Public Health, Public & Environmental Health Service, Department of Health & Human Services, GPO Box 125 Hobart Tas 7001 |
| Information required |
| The patient details required for notification are outlined in the Guidelines for Notification of Notifiable Diseases, Human Pathogenic Organisms and Contaminants 2006 ( www.dhhs.tas.gov.au/agency/pro/publichealthlegislation/documents/notifiable_diseases_guidelines_24_jan%20_06.pdf). For sexual transmissible diseases notification must be identified by the first 2 letters of the given name and the first 2 letters of the surname of the patient. The full name of the patient must not be provided unless it is requested by the director. Only the postcode and suburb of the area in which the patient lives must be provided. The full address of the patient must not be provided unless it is requested by the director. |
| Vic Health (Infectious Diseases) Regulations 2001 |
| Who must notify? |
• medical practitioners who become aware that a patient shows evidence of, or has died with, or is a carrier of a notifiable disease
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