A notifiable disease is any disease that is to be reported to
government authorities as required by the law. India has a double burden
of NCDs and communicable diseases, despite the disease epidemiology
transitioning to noncommunicable diseases because communicable diseases
continue to be prevalent in the country and be major public health
concerns.
Every now and then, dengue makes it appearance, taking on an epidemic
form. Last year, the national capital faced an unprecedented high number
of Chikungunya cases. Cases of Bird flu have been reported. China is in
the midst of an ongoing avian influenza A epidemic. With blurring of
international boundaries and increasing travel, there is a threat of
global spread of any infectious disease. The recent Zika virus infection
outbreak in Mexico was declared a public health emergency of
international concern. Zika is still spreading.
Doctors alone can no longer be responsible for Public health.
Prevention and control of outbreaks also requires commitment on the part
of Policy makers, administrators and all stakeholders.
Notification of disease is a step in this endeavor. Notification of a
disease is an important source of epidemiological information. It allows
mapping of affected areas, the epicentre in particular and take
preventive steps to control the spread. Notification strengthens public
health surveillance systems.
Regulation 5.2 of the MCI Code of Ethics Regulations, 2002 require a
physician to notify the constituted public health authorities of every
case of communicable disease under his care.
“5.2 Public and Community Health: Physicians, especially those engaged
in public health work, should enlighten the public concerning quarantine
regulations and measures for the prevention of epidemic and
communicable diseases. At all times the physician should notify the
constituted public health authorities of every case of communicable
disease under his care, in accordance with the laws, rules and
regulations of the health authorities. When an epidemic occurs a
physician should not abandon his duty for fear of contracting the
disease himself.”
Indian Penal Code 269 says “Any negligent act likely to spread
infection of disease dangerous to life is punished with imprisonment of
either description for a term which may extend to six months, or with
fine, or with both” and IPC 270 says “Malignant act likely to spread
infection of disease dangerous to life with imprisonment of either
description for a term which may extend to two years, or with fine, or
with both.”
While a doctor is expected to maintain privacy and confidentiality and
not disclose the secrets of a patient that have been learnt in the
exercise of his / her profession, exceptions to this in a court of law
under orders of the Presiding Judge, in circumstances where there is
serious and identified risk to a specific person and/or the community
and in case of notifiable diseases (Regulation 7.14). In case of
communicable / notifiable diseases, concerned public health authorities
should be informed immediately.
List of Notifiable Diseases
1. Cerebrospinal fever 12. Tuberculosis
2. Chickenpox 13. Infectious Hepatitis (Hepatitis A, B, C, D & E)
3. Diphtheria 14. Epidemic Influenza (Including Swine Flu (H1N1), Bird
Flu & Seasonal Influenza)
4. Leprosy 15. Whooping cough
5. Cholera 16. Viral encephalitis
6. Measles 17. Hemorrhagic fever (Including Dengue)
7. Plague 18. Malaria
8. Rabies 19. Tetanus
9. Scarlet fever 20. Poliomyelitis
10. Smallpox* 21. AIDS
11. Typhoid/Enteric fever 22. Chikungunya
23. Any other disease which the Government may from time to time by
notification declare to be a notified disease for the purpose of this
part either generally throughout the state or in such part or parts
thereof as may be specified in the notification.
*Small Pox globally eradicated in the year 1980, but continues to be a
notifiable disease.
Not notifying diseases like TB, dengue or Chikungunya is a violation of
the above regulations including local municipal acts.
The Indian Medical Association (IMA) supports proper and timely
notification of a notifiable disease. But, it also wants cancer, Zika
virus disease and microcephaly to be included in the notifiable list.
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