IMA supports timely notification of notifiable diseases

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.