## Overview

## Outline of the Act on Prevention of Infectious Diseases and Medical Care for Patients Suffering Infectious Diseases

(Approved on September 28, 1998 and enforced on April 1, 1999)

## Preventive administrative measures against outbreak and spread of infectious diseases

• Development and establishment of the surveillance system for infectious diseases

• Promotion of comprehensive nationwide and prefectural measures

(in order to facilitate cooperation of related parties, basic guidelines to prevent infectious diseases are formulated and announced by the government, and the prevention plans by the prefectural governments)

• Formulation of guidelines to prevent specific infectious diseases, including influenza, sexually transmitted diseases, AIDS, tuberculosis, and measles (the government formulates and announces guidelines to investigate causes, prevent outbreak and spread, provide medical care services, promote research and development, and obtain international cooperation for the diseases that require comprehensive preventive measures in particular)

## Types of infectious diseases and medical care system

Type of infectious disease	Key measures	Medical care system	Medical fee payment
New infectious diseases	Hospitalization	Designated medical institutions for specific infectious disease (several in number nationwide designated by the government)	Publicly funded in full (no insurance applied)
Type 1 (Plague, Ebola hemorrhagic fever, South American haemorrhagic fever, etc.)	Designated medical institutions for Type 1 infectious disease [1 hospital in each prefecture designated by prefectural governors]	Medical insurance applied with public funds (for hospitalization)
Type 2 (Avian influenza (H5N1), tuberculosis, SARS, etc.)	Designated medical institutions for Type 2 infectious disease [1 hospital in each secondary medical service area designated by prefectural governors]
Type 3 (Cholera, Enterohemorrhagic Escherichia coli infection, etc.)	Work restriction in certain jobs	General medical institutions	Medical insurance applied (partial cost sharing)
Type 4 (Avian influenza (excluding H5N1), West Nile fever, etc.)	Sterilization and other objective measures
HospitalizationType 5 (Influenza (excluding avian influenza and novel influenza infection, etc.), AIDS, viral hepatitis (excluding hepatitis E and hepatitis A), etc.)	Identification of the situation with infection and information provision
Novel influenza, etc.	Hospitalization	Designated medical institutions for specific/Type 1/Type 2 infectious disease	Medical insurance applied with public funds (for hospitalization)

* Infectious diseases other than Type 1, 2, or 3 infectious diseases requiring emergency measures are designated as "designated infectious diseases" in Cabinet Order and are treated the same as Type 1, 2, and 3 infectious diseases for a limited period of 1 year in principle.

## Development of hospitalization procedures respecting patients' human rights

• Work restriction and hospitalization according to the type of infectious disease

• Introduction of a system to recommend hospitalization based on patients' decisions

• Hospitalization up to 72 hours by orders of prefectural governors (directors of health centers)

• Hospitalization for every 10 days (30 days for tuberculosis) with hearing opinions from the council for infectious disease examination established in health centers

• Reporting of complaints on conditions of hospitalization to prefectural governors

• Provision of special cases to make decisions within 5 days against the request for administrative appeal from the patients who are hospitalized for more than 30 days

• In the event of emergency, the government on its own responsibility shall provide necessary guidance to prefectural governments on hospitalization of patients

## Development of measures, including sufficient sterilization to prevent infectious diseases from spreading

• Sterilization to prevent Type 1, 2, 3, and 4 infectious diseases and novel influenza from spreading

• Restricting entry to buildings to prevent Type 1 infectious diseases from spreading

• In the event of emergency, the government on its own responsibility shall provide necessary guidance to prefectural governments on sterilization and other measures