Regulations Regarding Influenza Counter-epidemic Measures

Issued pursuant to
Section 14, Paragraph one, Clause 5 of
the Epidemiological Safety Law

1. This Regulation prescribes the counter-epidemic measures which shall be carried out by a health care practitioner, if influenza has been determined to a patient or there are causes for suspicion regarding infection with influenza.

2. The influenza counter-epidemic measures shall include the following:

2.1. reporting on the cases of contracting influenza;

2.2. epidemiological investigation of the cases of contracting influenza;

2.3. specimen collection from patients in the cases specified in Paragraph 4 of this Regulation;

2.4. influenza surveillance (systematic epidemiological data (indicator)) data collection, compilation and analysis regarding respiratory infections, including the spread and severity of influenza, as well as the circulation of viruses causing the abovementioned infection during the influenza season - during the time period from week 40 of the current year until week 20 of the following year, as well as during the pandemic declared the World Health Organisation (Phase 6) or in case of pandemic threats (Phases 4 and 5));

2.5. measures in the particular territory, place or object in conformity with the epidemiological situation, including in the cases specified in Paragraph 5 of this Regulation.

[8 September 2009; 9 August 2011]

3. If professionally substantiated suspicions have arisen to a health care practitioner during the inter-seasonal period for influenza regarding a group illness with influenza (five or more epidemiologically related cases of acute illness with the following symptoms: a sudden onset of the disease, a rapid rise of temperature above 38°C, muscle pain, headache, cough, sore throat), he or she shall notify within 24 hours by telephone or electronically the epidemiologist of the respective regional branch of the Centre for Disease Prevention and Control.

[8 September 2009; 10 April 2012]

4. A health care practitioner shall ensure specimen collection from a patient and their delivery to the laboratory for the virological diagnosis of influenza and surveillance of influenza virus circulation in the following cases:

4.1. there are professionally substantiated suspicions regarding a group illness with influenza during the inter-seasonal period for influenza;

4.2. a hospitalised patient has a severe course of acute upper respiratory infection;

4.3. influenza occurs with complications to a person who has been vaccinated against influenza with a vaccine recommended by the World Health Organisation for a specific epidemiological season;

4.4. the death of a patient with acute upper respiratory infection symptoms has occurred;

4.5. a person with the acute upper respiratory infection symptoms referred to in Paragraph 3 of this Regulation, in case of influenza pandemic threats, within seven days prior to contracting the disease:

4.5.1. has stayed in a territory in which influenza caused by a virus recognised by the World Health Organisation as the possible pandemic agent is spreading among people;

4.5.2. has been in contact with a person who is potentially infected with an influenza virus recognised by the World Health Organisation as the possible pandemic agent.

[8 September 2011; 9 August 2011]

4.¹ A health care practitioner shall inform the Centre for Disease Prevention and Control regarding each case of death, if it has occurred in a patient who has been diagnosed with influenza or there are causes for suspicion regarding infection with influenza virus, within 24 hours by telephone and within 48 hours in writing, sending a notification form by fax, by mail, by courier or completed electronically in accordance with Annex 2 to this Regulation.

[9 August 2011; 10 April 2012]

5. The medical treatment institution shall develop an action plan for the work during the time period of an influenza epidemic and it shall be implemented in the case of an influenza epidemic (the abovementioned plan may be included in the existing plan of a hygienic and counter-epidemic regime of the institution). The following issues shall be included in the plan:

5.1. individual influenza prophylaxis of the employees of the medical treatment institution (personnel vaccination, use of the specific antivirals and use of personal protective equipment);

5.2. working mode of the medical treatment institution, including the measures limiting influenza;

5.3. tactics of medical treatment and care of influenza patients;

5.4. ensuring of reserve medical treatment personnel and the involvement of additional resources;

5.5. redeployment of beds of the medical treatment institution during the time period of an influenza epidemic;

5.6. medical treatment institution's personnel training on how to act during an influenza epidemic;

5.7. education of the patients and their family members in the issues of influenza prophylaxis.

6. The epidemiologists of the respective regional branches of the Centre for Disease Prevention and Control shall:

6.1. determine the medical treatment institutions (health care practitioners), involved in the influenza surveillance, including the primary health care institutions, inpatient institutions, as well as educational institutions (the institutions involved in influenza surveillance shall service not less than 5-10% of the population of the administrative territory);

6.2. inform the persons involved in the influenza surveillance regarding the requirements of the selection and the procedures for the provision of data.

[8 September 2009; 10 April 2012]

6.¹ The heads of the institutions referred to in Sub-paragraph 6.1 of this Regulation shall ensure the participation of the institution in the influenza surveillance.

[8 September 2009]

7. The health care practitioners involved in influenza surveillance shall provide data regarding cases of influenza (Annex 1) to the epidemiologist of the respective regional branch of the Centre for Disease Prevention and Control once per week within the time frame specified in Sub-paragraph 2.4 of this Regulation.

[8 September 2009; 9 August 2011; 10 April 2012]

7.¹ The limited liability company "Riga East University Hospital" shall ensure:

7.¹ 1. specimen investigation for determining the presence of the influenza virus and specific antibodies;

7.¹ 2. isolation of the influenza virus in a cell culture;

7.¹ 3. characterisation (typology) of the isolates of the influenza virus;

7.¹ 4. sending of the isolates of the influenza virus to the regional reference centre of the World Health Organisation;

7.¹ 5. provision of data regarding circulation of pathogens of influenza and other acute upper respiratory virus infections to the Centre for Disease Prevention and Control.

[10 April 2012]

8. The Centre for Disease Prevention and Control shall ensure:

8.1. the collection of influenza surveillance data, epidemiological analysis of operational data and informing of public;

8.2. the provision of data regarding the circulation of the influenza virus and the influenza surveillance to the World Health Organisation and to the influenza epidemiological surveillance institutions of the European Union in conformity with the delegation of the European Centre for Disease Prevention and Control.

[10 April 2012]

8.¹ The Centre for Disease Prevention and Control, on the basis of the influenza surveillance data, shall notify regarding the beginning of influenza epidemic in the state on the website of the Centre, if the number of patients to whom influenza has been determined or there are causes for suspicion regarding infection with influenza and who have sought medical assistance, exceeds 100 patients per 100 000 inhabitants within a week in at least one of the territories involved in the influenza surveillance, and regarding the end of influenza epidemic in the state, if this indicator does not exceed 100 patients per 100 000 inhabitants in the time period of at least two weeks in none of the territories involved in the influenza surveillance.

[9 August 2011; 10 April 2012]

9. [8 September 2009]

10. [8 September 2009]

11. [8 September 2009]

12. The Centre for Disease Prevention and Control shall ensure exchange of epidemiological information with the influenza epidemiological surveillance institutions of the European Union, referred to in Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community and Commission Decision 2009/363/EC of 30 April 2009 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (notified under document number C(2009) 3517).

[8 September 2009; 10 April 2012]

Prime Minister A. Kalvītis

Minister for Health G. Bērziņš

Annex 1
Cabinet Regulation No. 948
21 November 2006

[8 September 2009; 9 August 2011]

Influenza Surveillance Indicators

Notes.

1. The medical treatment institution shall complete the corresponding section of the form - the outpatient medical treatment institution shall complete Section A, the inpatient medical treatment institution - Section B.

2. Details of the document "signature", "date" and "Place for a seal" shall not be completed, if the electronic document has been prepared in accordance with the laws and regulations regarding drawing up of electronic documents.

Place for a seal

Annex 2
Cabinet Regulation No. 948
21 November 2006

[9 August 2011]

Notification Regarding Death of the Patient who has been Diagnosed with Influenza Determined or There are Causes for Suspicion Regarding Infection with Influenza Virus

Name of the medical treatment institution
Code

(given name, surname, telephone number of the doctor)

2.

Personal identity number

-

3.	Sex:
		female
		male

4.	Age  (years); for children up 2 years of age   (months)
5.	Actual place of residence
6.	Declared place of residence

7.	Date of symptom onset	.   .     .
		(dd/mm/yyyy)

8.	Seeking of medical assistance in relation to influenza	.   .     .
		(dd/mm/yyyy)

8.1.	the patient sought assistance:
		with family doctor
		with emergency medical assistance
		in inpatient institution

9.	Date of hospital admission	.   .     .
		(dd/mm/yyyy)

10.	Date of death	.   .     .
		(dd/mm/yyyy)

11.	Date of specimen collection for laboratory investigation	.   .     .
		(dd/mm/yyyy)

12.	Concomitant diseases:
		no
		not known
		yes (specify):

	cardiovascular diseases
	respiratory tract diseases
	diabetes
	oncological diseases
	immunosuppresion
	chronic liver, kidney diseases
	nervous system diseases
	pregnancy (weeks)
	obesity
	other

13.	Risk factors:
		smoking
		alcohol consumption
		physical or mental overload

14.	Antiviral use:
		yes
		no
		not known
14.1.	name of the antiviral

14.2.	date when the antivirals were commenced	.   .     .
		(dd/mm/yyyy)

15.	Vaccination status:
		vaccinated against influenza for the current season
		not vaccinated
		not known

Note. * Details of the document "signature", "date" and "seal" shall not be completed, if the electronic document has been prepared in accordance with the laws and regulations regarding drawing up of electronic documents.

Translation © 2015 Valsts valodas centrs (State Language Centre)