Sanitation Control Basic Knowledge

Sanitation control policy in Japan

As of April 1,1999, the Japanese government implemented the Infectious Disease Act (act related to Infectious Disease Control and Healthcare for Patients) to replace the previous Infectious Disease Prevention Act. The goal was to cope with the rapidly changing landscape of infectious diseases, to implement various policies that could prevent infectious diseases, and to implement infectious disease control with regard to the patient’s human rights.

During the period from November 2002 to July 2003, SARS broke out outside Japan and spread worldwide from East Asia, mainly due to the advanced transportation and rapid communication of individuals and resources. In order to cope with the rapidly changing situation that the healthcare institutions faced, the Japanese government, on 16 October 2003, amended the Infectious Disease Act (implemented on November 5); it was combined with the Tuberculosis Prevention Act in a second amendment on 1 April 2007.
As shown above, the Japanese government has been quite proactive in coping with the ever-changing status of infectious diseases.

The Infectious Disease Act has classified infectious diseases into 7 categories; these include known infectious diseases that are divided into 5 classes based on their severity and infectiousness, the statutory infectious diseases, and the new-type infectious diseases. Healthcare institutions have different regulations based on the risk and severity of these 7 classes of infectious diseases.

Infectious disease classification

Class 1 infectious diseases:

Extremely dangerous infectious diseases based on the severity of integrated infectiousness on contact.
Target diseases: Ebola hemorrhagic fever, Crimean-Congo hemorrhagic fever, smallpox, bubonic plague, Marburg virus, Lassa fever, and South America hemorrhagic fever.

Class 2 infectious diseases:

Highly dangerous infectious diseases based on the severity of integrated infectiousness on contact.
Target diseases: Acute poliomyelitis, diphtheritis, SARS, and TB.

Class 3 infectious diseases:

Highly dangerous infectious diseases based on the severity of integrated infectiousness on contact.
Target diseases: Enterohaemorrhagic E. coli infection, cholera, bacillary dysentery, typhoid fever, and typhus.

Class 4 infectious diseases:

Infectious diseases communicable by animals or their corpses, food and drink, clothing, bedding, and other objects.
Target diseases: Hepatitis E, West Nile virus (including West Nile meningitis or encephalitis), hepatitis A, cestodiasis, yellow fever, psittacosis, Omsk hemorrhagic fever, relapsing fever, Kyasanur forest disease, Q fever, rabies, coccidioidomycosis, monkeypox, hemorrhagic fever with renal syndrome, Western equine encephalitis, mite-vector encephalitis, anthrax, scrub typhus, dengue fever, Eastern equine encephalitis, avian flu, Nipah virus, Japanese spotted fever, Japanese encephalitis, hantavirus pulmonary syndrome (HPS), Cercopithecine herpesvirus-1 (herpesvirus B), melioidosis, brucellosis, Venezuelan equine encephalitis, Hendra virus, epidemic typhus fever, Clostridium botulinum infection, malaria, tularemia or rabbit fever, Lyme disease, rabies, rift valley fever, melioidosis, Legionnaires’ disease, leptospirosis, and spotted fever rickettesiosis.

Class 5 infectious diseases:

Infectious diseases announced by the government following investigations to prevent occurrence and spread.
Notifiable diseases: Amoebiasis, viral hepatitis (except hepatitis E and A), acute encephalitis (except West Nile encephalitis and Japanese encephalitis), cryptosporidiosis, Creutzfeldt–Jakob disease (CJD), severe invasive streptococcal infection, AIDS, hexamitiasis, meningococcus meningitis, congenital rubella syndrome (CRS), syphilis, tetanus, vancomycin-resistant Staphylococcus aureus infection, and vancomycin-resistant enterococcus infection.

Focused infectious diseases: Respiratory syncytial virus, pharyngo-conjunctival fever, hemolytic streptococcal pharyngitis, transmittable gastroenteritis, chickenpox, hand, foot and mouth disease, erythema infectiosum, acute rash, bronchocephalitis, urticaria, herpangina, measles (except adult measles), epidemic mumps, influenza (except avian flu), acute hemorrhagic conjunctivitis, sexually transmitted Chlamydial disease, genital herpes, condylomata acuminate, gonorrhea, chlamydial pneumonia (except psittacosis), bacterial meningitis (except meningococcus meningitis), penicillin-resistant Streptococcus pneumoniae infection (PRSP), mycoplasma pneumonia, adult measles, aseptic meningitis, methicillin-resistant Staphylococcus aureus infections, and multidrug-resistant Pseudomonas aeruginosa infections.

Statutory infectious diseases

Known infectious diseases other than Classes 1–3 infectious diseases must be treated as Classes 1–3 infectious diseases (one year by law).

New-type infectious diseases

Infectious diseases with confirmed human-to-human transmission, accompanied by significantly novel symptoms. The class of new-type infectious diseases is determined based on their infectiousness on contact.

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