Procedures for the Implementation of Public Health Measures

Issued pursuant to
Section 36.², Paragraph two of the Epidemiological Safety Law

I. General Provisions

1. This Regulation prescribes the procedures for the implementation of public health measures to prevent or reduce threat to the public health.

2. Within the meaning of this Regulation, the State Emergency Medical Service of Latvia is:

2.1. the provider of emergency medical assistance;

2.2. a national Focal Point for the International Health Regulations (hereinafter - Focal Point).

3. The public health measures in accordance with Article 22 of the International Health Regulations shall be provided by the following competent authorities:

3.1. the Centre for Disease Prevention and Control;

3.2. the State Emergency Medical Service of Latvia;

3.3. the Health Inspectorate;

3.4. the State Environmental Service;

3.5. the Food and Veterinary Service;

3.6. the limited liability company "Rīgas Austrumu klīniskā universitātes slimnīca".

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II. Reporting and Transfer of Information

4. The Centre for Disease Prevention and Control, the Health Inspectorate, the State Environmental Service and the Food and Veterinary Service shall notify the Focal Point upon receipt of a report or discovery of a respective case that may cause a public health threat of international significance.

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5. Upon receipt of a report on public health threat, the Focal Point shall:

5.1. in co-operation with the competent authority that submitted the respective report, assess the obtained information in accordance with Annex 2 to the International Health Regulations;

5.2. notify the Ministry of Health regarding a case that may cause a public health threat of international significance in the country;

5.3. notify the International Health Regulations Focal Point of the World Health Organization (hereinafter - WHO Focal Point) within 24 hours after assessment of the health protection information regarding a case that may cause a public health threat of international significance, and the health measures carried out in the country in response to this event;

5.4. continue to provide the WHO Focal Point with such detailed information in the field of health care as available on the notified event, stating the type of cases of discovering and diagnosing a disease, the number of cases and death cases, conditions affecting the spread of the disease and the health measures carried out;

5.5. if necessary, request assistance from the WHO Focal Point to evaluate the epidemiologic evidence obtained through epidemiological investigation of the reported case, and a public health risk;

5.6. if necessary, notify the WHO Focal Point regarding the problems related to responding to the potential public health threat of international significance.

6. If there is evidence in the territory of the country (irrespective of the origin or source of information) regarding any unexpected or unusual case that affects public health and may cause a public health threat of international significance, the Focal Point shall notify the WHO Focal Point thereof.

7. Where possible, the Focal Point shall inform the WHO Focal Point within 24 hours regarding receiving evidence on such public health threats identified outside the national territory that may cause international disease spread and manifests as human cases (imported or exported), vectors which carry infection or contamination (imported or exported) or goods that are contaminated (imported or exported).

8. The Focal Point shall receive the current information from the WHO Focal Point and transfer it to:

8.1. the Centre for Disease Prevention and Control - information regarding cases of infectious diseases and diseases of unclear etiology, which can lead to public health threat of international significance;

8.2. the Health Inspectorate - information regarding public health threat;

8.3. the Food and Veterinary Service - information regarding contamination of food products and outbreaks of such infectious diseases, which affect both humans and animals;

8.4. the State Fire and Rescue Service - information regarding spread or risk of spread of toxic or radioactive substances in the environment;

8.5. the State Environmental Service - information regarding spread or risk of spread of toxic or radioactive substances in the environment, as well as radiation-induced acute harm to health if there is a public health threat of international significance;

8.6. the State Border Guard, if, due to the cases of disease or a threat of its spread, the World Health Organisation has determined a specific geographical location or area where specific health measures are imposed;

8.7. the Consumer Rights Protection Centre - information regarding non-conformity of goods and services with the safety and harmlessness requirements;

8.8. the Ministry of Foreign Affairs and the Ministry of Transport - information regarding potential public health threat of international significance;

8.9. the State Agency of Medicines, if a public health threat of international significance is caused by medicines.

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9. Within 24 hours after receiving a notification of a potential public health threat of international significance, the Centre for Disease Prevention and Control, the Health Inspectorate, the State Environmental Service, the Food and Veterinary Service, the State Fire and Rescue Service, the State Agency of Medicines, the Ministry of Foreign Affairs and the Ministry of Transport shall inform the Focal Point regarding the measures taken.

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III. Preventive Measures

10. The Centre for Disease Prevention and Control shall provide epidemiological surveillance of infectious diseases, public health risk identification and assessment in relation to possible spread of infectious diseases and biological agents.

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11. Upon request of a master, owner, operator of a ship or a ship agent, the Health Inspectorate shall carry out the following in the ports referred to in Paragraph 13 of this Regulation:

11.1. carry out inspections of ships if the Ship Sanitation Control Exemption Certificate or Ship Sanitation Control Certificate has expired;

11.2. issue a Ship Sanitation Control Exemption Certificate or Ship Sanitation Control Certificate in accordance with Annex 3 to the International Health Regulations for a time period of up to six months.

12. In order to receive a Ship Sanitation Control Exemption Certificate or Ship Sanitation Control Certificate in accordance with Article 39 of the International Health Regulations, the following documents shall be submitted to the Health Inspectorate:

12.1. an application regarding issuance of the Ship Sanitation Control Exemption Certificate or Ship Sanitation Control Certificate;

12.2. the Maritime Declaration of Health in accordance with Annex 8 to the International Health Regulations.

13. Administration of the limited liability company "Aviosabiedrība "Liepāja"", limited liability company "Ventspils lidosta" and state stock company "Starptautiskā lidosta "Rīga"" (hereinafter - airport), the management of the Free Port of Riga, the Special Economic Zone Port of Liepāja and the Free Port of Ventspils (hereinafter - port) and the administration of the state stock company "Latvijas dzelzceļš" shall, at the border crossing points established within its area, which are determined as border crossing points in laws and regulations:

13.1. provide core capacity in accordance with Annex 1, Section B of the International Health Regulations;

13.2. in co-operation with the competent authorities involved develop a plan for the prevention of unexpected public health threat situations, indicate the coordinator and co-ordinate the plan with the Focal Point;

13.3. appoint an official responsible for providing information to the competent authority concerned, if a person onboard a vehicle on international route develops the symptoms of the disease referred to in Paragraph 14 of this Regulation or there is evidence of a public health threat in the vehicle;

13.4. ensure appropriate actions in case of emergency public health threat complying with the instructions of the Focal Point or the competent authority referred to in Paragraph 3 of this Regulation.

IV. Response Measures

14. If a person onboard a vehicle on international route develops any of the disease symptoms - rash, fever, chills, yellowing of skin, mucous membranes or whites of the eyes, swollen glands, diarrhea, vomiting, bleeding, cough - and there is a suspicion of having fallen ill with a dangerous infectious disease or evidence of any public health threats have been detected, before entering the territory of Latvia:

14.1. the bus driver and passenger train operator shall immediately report the case of disease to the State Emergency Medical Service of Latvia. Upon arrival at a border crossing point, the bus driver and passenger train operator shall immediately inform the State Border Guard regarding the case of disease;

14.2. the master, owner, operator of the ship, or a ship agent and aircraft captain shall immediately report the case of disease to the airport administration or port management at the respective border crossing point.

15. The official responsible for providing information and appointed by the airport administration or port management shall immediately report the case of disease to the State Emergency Medical Service of Latvia.

16. If the border crossing point (port, airport) of the ship or aircraft is not referred to in Paragraph 13 of this Regulation and there is a person with the symptoms of disease referred to in Paragraph 14 of this Regulation onboard the vehicle, the master, owner, operator of the ship, or a ship agent and the aircraft captain shall immediately report the case of disease to the State Emergency Medical Service of Latvia and the State Border Guard.

17. In the cases referred to in Paragraph 14 of this Regulation, the Centre for Disease Prevention and Control shall:

17.1. commence the epidemiological investigation of the case and assess the obtained information in accordance with Annex 2 to the International Health Regulations;

17.2. request from the aircraft captain or his representative the Health Part of the Aircraft General Declaration in accordance with Annex 9 to the International Health Regulations;

17.3. request from the master, owner, operator of the ship or a ship agent the Maritime Declaration of Health in accordance with Annex 8 of the International Health Regulations;

17.4. if necessary, request that the vehicle and the premises affected be isolated to prevent the spread of disease;

17.5. ensure the performance of disinfection, disinsection and deratting in accordance with the laws and regulations on disinfection, disinsection and deratting;

17.6. report the respective case to the Focal Point;

17.7. upon request by the State Border Guard, provide the necessary information regarding the person who, in relation to the suspicion of being ill with a dangerous infectious disease, has been taken from a vehicle at the border crossing point and hospitalised at the limited liability company "Rīgas Austrumu klīniskā universitātes slimnīca" (the referred-to person need not undergo border check due to objective reasons).

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18. If an infectious disease agent has been found in relation to the transportation of animals, the Food and Veterinary Service shall ensure disinfection of the luggage, cargo or vehicle accordingly.

19. The State Fire and Rescue Service shall ensure decontamination to the persons who have been in contact with toxic, radioactive and biological agents (including contact with a patient who is reasonably believed to carry a dangerous disease).

Prime Minister,
Minister for Regional Development
and Local Government V. Dombrovskis

Minister for Health J.Bārzdiņš

Translation © 2014 Valsts valodas centrs (State Language Centre)