Quyết định 162/QD-BYT

DECISION

PROMULGATING THE RESPONSE PLAN FOR THE PREVENTION AND CONTROL OF ZIKA VIRUS DISEASE IN THE NEW CONTEXT OF VIETNAM

MINISTER OF HEALTH

Pursuant to the Government's Decree No. the Government's Decree No. 63/2012/ND-CP dated August 31, 2012 defining the functions, tasks, powers and organizational structure of the Ministry of Health;

Upon the request of the Director of the General Department of Preventive Medicine, affiliated to the Ministry of Health,

HEREBY DECIDES

Article 1. “The response plan for the prevention and control of Zika virus disease in the new context of Vietnam” shall be hereto appended.

Article 2. This plan shall update the plan of action for the prevention and control of Zika virus disease, referred to in the Decision No. 460/QD-BYT dated February 5, 2016, and supplement it with more activities to ensure the new plan is in line with the current situation of Zika virus disease.

Article 3. This Decision shall enter into force from the signature date.

Article 4. Chief of the Ministry’s Office, Ministry’s Chief Inspector, Directors or General Directors of Departments/Administrations affiliated to the Ministry of Health, Directors of Institutes of Hygiene and Epidemiology, Pasteur Institution, Directors of healthcare establishments affiliated to the Ministry of Health, Directors of provincial Departments of Health, Heads of Health Divisions of Ministries and sectoral administrations, and Heads of entities concerned, shall be responsible for implementing this Decision./.

RESPONSE PLAN

FOR THE PREVENTION AND CONTROL OF ZIKA VIRUS DISEASE IN THE NEW CONTEXT OF VIETNAM
(Issued together with the Decision No. 162/QD-BYT dated January 17, 2017 of the Minister of Health)

I. PROPOSITION

According to a report published by the World Health Organization (WHO) on December 29, 2016, there have been 85 countries and territories where Zika virus is spread or transmitted. In the Southeast Asia region, 9 out of 11 Zika-affected countries have been recorded, including Thailand, Philippines, Indonesia, Malaysia, Singapore, Cambodia, Laos, Myanmar and Vietnam. New cases of the Zika virus disease continue to be reported and it appears that the disease is still spread widely in Asia owing to the widespread distribution of vectors that can transmit the disease in the region, the increase in exchanges and journeys to and from affected countries and the low community immunity.

In Vietnam, there have been 191 cases positive for Zika virus in Ho Chi Minh city (169), Binh Duong (07), Khanh Hoa (06), Dong Nai (02), Ba Ria – Vung Tau (02), Dak Lak (02), Phu Yen (01), Tay Ninh (01) and Long An (01), including those cases of infants with microcephaly which are probably associated with Zika virus. These cases with such syndrome have been found sporadically in certain cities and provinces nationwide even though they did not return from affected zones. This shows that Zika virus has already existed amongst Vietnamese population. In addition, when cultural, commercial and tourist exchanges are more and more increasing, risks of infection and spread of Zika virus disease from this locality to another is very considerable and more Zika virus infection cases may be found in the future, especially in those areas where mosquitoes carrying the haemorrhagic fever and Zika virus are living.

In order to prevent and control the spread of the disease amongst community, especially pregnant women and newborns, the Ministry of Health (Emergency Operations Center – EOC) has allowed the EOC to elevate its level of warning and emergency response and has found it necessary to work out the response plan for the prevention and control of Zika virus in order to ensure its relevance, feasibility and efficiency in the new context of this epidemic.

The plan of action for the prevention and control of Zika virus disease in the new context is developed with the aim of specifying tasks included in the plan of action for prevention and control of Zika virus disease under the Decision No. 460/QD-BYT dated February 5, 2016, and will be updated or reviewed regularly and on time to ensure its relevance in the current situation of the epidemic and the progress in performing epidemic prevention and control tasks in reality.

II. OBJECTIVES

1. General objectives

Prepare in advance for any new Zika virus infections, ensure early detection of cases of infection with Zika virus, especially in pregnant women, women of reproductive age, and take timely actions to prevent the spread of the epidemic as well as minimize any complications resulting from this disease.

2. Specific objectives

- Objective 1: Making more preparations in advance for cases of Zika virus infection and cases of infants with microcephaly;

- Objective 2: Enhancing communications activities to raise public awareness of potential risks of Zika virus infection, especially in groups of pregnant women and women of reproductive age planning pregnancy;

- Objective 3: Carrying out the surveillance, early detection and radical elimination of the active outbreak in a community;

- Objective 4: Intensifying screening, early detection and management of pregnant women infected with Zika virus, fetuses suspected of having microcephaly and infants with microcephaly;

- Objective 5: Conducting researches into the epidemiological, virological and clinical characteristics of cases with Zika virus infection with the aim of providing scientific evidence for formulation of the effective epidemic prevention and control plan.

III. MEASURES AND TASKS

1. Direction and management tasks

- Strengthening the EOC’s activities, carrying out regular information updates and assessments of epidemic situations, seeking agreements on response measures and presiding over the performance of tasks at healthcare facilities.

- The People’s Committees of cities and provinces shall strengthen activities of local Steering Committees on epidemic prevention and control, and take initiative in implementing the plan for Zika virus epidemic prevention, control and response based on the reality of that epidemic in each locality.

- Strengthening the surveillance, assessment, inspection, direction and speeding up of epidemic prevention and control activities at each respective local jurisdiction in association with units specializing in obstetrics – pediatrics, reproductive health and health education communications.

- Involving departments, sectoral agencies, mass or socio-political organizations, press and media agencies in performing communication and dissemination activities to encourage the population to implement epidemic prevention and control measures.

- Closely cooperating with main units in implementing International Health Regulations and with international organizations in sharing information, experience and mobilizing technical support resources used in epidemic prevention, control and scientific researches.

2. Technical and professional tasks

2.1. Making more preparations in advance for cases of Zika virus infection and cases of infants with microcephaly

- Intensifying activities in the campaign “People kill mosquitoes and larvae to prevent Zika virus disease and haemorrhagic fever” in order to involve all-level regulatory authorities and socio-political organizations in the community, especially in areas where Zika virus infection cases have been found.

- Establishing and adopting procedures for diagnostic tests of microcephaly, instructions for managing and counseling cases of pregnant women infected with Zika virus, those with fetal microcephaly and infants with microcephaly.

2.2. Enhancing communications activities to raise public awareness of potential risks of Zika virus infection, especially in groups of pregnant women and women of reproductive age planning pregnancy

- Carrying out communications activities via mass media, at the grassroots level and in combination with other activities of local services and associations to mobilize the population to actively prevent mosquito bites, kill mosquitoes and larvae, and persuade pregnant women to register management of pregnancy and take periodical prenatal health checkups according to instructions given by healthcare establishments.

- Providing medical collaborators and those providing medical services at mountainous villages with training programs to propagate potential risks of Zika virus infection. Carrying out face-to-face communication and counseling for particular groups of women and marital couples, personal counseling and proactively approaching newly-wed couples, pregnant women and women of reproductive age planning pregnancy about the prophylaxis of Zika virus infection and of infants with microcephaly.

- Building, updating and correcting contents of communications products and messages with diverse language and forms (e.g. flyers, banners, posters, video clips and online posts, etc.) about the prophylaxis of Zika virus infection and infants with microcephaly to ensure that these products and messages are appropriate for each target audience, especially pregnant women and women of reproductive age planning pregnancy.

- Regularly broadcasting updated information about the epidemic situation, prevention and control measures on the Portal of the Ministry of Health, General Department of Preventive Medicine, Medical Examination and Treatment Department, Maternal and Child Health Department and affiliates of the Ministry of Health and via mass media.

2.3. Carrying out the surveillance, early detection and radical elimination of the active outbreak in a community

- Undertaking the surveillance and collection of samples tested for early detection of cases of Zika virus infection, especially pregnant women and women of reproductive age planning pregnancy, infants with microcephaly and polyradicutlitis cases.

- Eradicating outbreaks in accordance with regulations in order to prevent the epidemic from being spread to the community.

- Carrying out the surveillance of disease-transmitting vectors in order to determine prevalence, transformation and level of spread of Zika virus.

- Carrying out the event-based surveillance in order to early detect cases of Zika virus disease, infants with microcephaly and polyradicutlitis cases in order to promptly localize and eradicate the epidemic.

- Establishing and implementing epidemic surveillance procedures at obstetrics and pediatrics healthcare establishments for pregnant women suspected of Zika virus infection, pregnant women suspected of having fetal microcephaly and infants with microcephaly at areas with high risks of Zika virus.

- Updating instructions and maintaining the centralized surveillance of Zika virus disease.

- Expanding points of collection of pathology specimens and test points in certain localities to ensure they are capable enough to perform diagnostic tests to detect cases of Zika virus disease and accurately identify pathogenic factors to alleviate the overload faced by central medical establishments.

- Reviewing and updating the procedures for sampling and testing for diagnosis of cases of Zika virus infection.

2.4. Intensifying screening, early detection and management of pregnant women infected with Zika virus, fetuses suspected of having microcephaly and infants with microcephaly

- Strengthening prenatal screening and encouraging pregnant women to take periodic prenatal medical examinations, ultrasound tests and confirmatory tests, and counseling pregnant suspected of being infected with Zika virus or those with fetuses suspected of Zika virus infection to take proper actions.

- Intensifying the task of managing fetuses of pregnant women with Zika virus infection and infants with microcephaly;

- Carrying out the surveillance and monitoring of the physical, mental and motor development of infants with microcephaly related to Zika virus infection, researching and implementing measures to help infants to gain functional recovery.

2.5. Improving technical and professional competencies for medical staff

- Holding training courses in surveillance of Zika virus disease, methods of collection, storage, transportation of samples for tests and confirmatory tests of Zika virus infection.

- Organizing training programs for detecting and dealing with cases of Zika virus infection and cases of infants with microcephaly.

- Providing medical staff in charge of reproductive health care, maternal and child health care tasks at localities with training programs for enhancement of prenatal management and diagnosis for early detection of prenatal microcephaly; managing and counseling cases of pregnant women with Zika virus infection, fetuses suspected of being infected with microcephaly and infants with microcephaly.

- Creating, reviewing and updating materials on and training programs for communication and prophylaxis of Zika virus infection, surveillance and diagnosis for detection of cases of Zika virus infection, diagnosis and handling of cases of pregnant women with Zika virus infection and infants with microcephaly in order to ensure that training forms are diverse (direct or online).

3. Scientific researches

- Implementing Zika virus particle epidemiological researches in order to evaluate the origin, transformation and method of viral transmission in order to propose preventive and control measures.

- Implementing researches on epidemiological and clinical characteristics of Zika virus disease in order to offer appropriate measures, depending on the actual situation of the disease.

- Implementing researches on cases of microcephaly during pregnancy and after birth in order to evaluate basic data on microcephaly; discovering trends, causes and factors causing risks of microcephaly.

4. Financial and other resource measures

- Using funding, supplies and chemicals of relevant affiliates for epidemic prevention and control tasks; reviewing demands concerning funds, supplies or chemicals so as to appeal for additional fund allocations when necessary.

- Departments of cities and provinces shall be responsible for preparing a consolidated report on demands for supplementary funds of units in charge of performing epidemic surveillance, treatment, testing, control and communications tasks at the provincial level for submission to People’s Committees of cities and provinces to seek their approval decisions.

- Preparing plans for storage and supplementation of medicines, supplies and equipment necessary for epidemic prevention and control tasks in the event that the epidemic is widespread and long-lasting.

IV. IMPLEMENTATION ORGANIZATION

1. General Department of Preventive Medicine

- Regularly preparing update and consolidated reports on domestic and international epidemic situations for submission to the Leadership of the Ministry of Health, the Government and other relevant affiliates.

- Assisting the Minister of Health in directing affiliated healthcare units nationwide to carry out the surveillance and response to prevention and control of Zika virus disease in the light of epidemic situations and issuing epidemic emergency declarations to the extent that declaration conditions regulated by the Prime Minister have been fully satisfied.

- Formulating, updating and issuing professional instructions for public surveillance and prophylaxis of Zika virus disease so as to ensure uniform implementation of these instructions throughout the country.

- Directing Institutes of Hygiene and Epidemiology/ Pasteur Institution and relevant affiliates to perform diagnostic tests, identify and actively implement surveillance and prophylaxis activities.

- Establishing commissions charged with directing, inspecting and supervising epidemic prevention and control tasks at localities.

- Playing pivotal roles in implementing International Health Regulations and sharing information with international organizations and other countries.

2. Maternal and Child Health Department

- Directing obstetrics - pediatrics and reproductive health medical establishments to strengthen the implementation of prophylactic methods applied to pregnant women and women of reproductive age planning pregnancy.

- Intensifying the tasks of managing fetuses, early detection and handling of cases of pregnant women with Zika virus infection and infants born to mothers with Zika virus infection.

- Updating and supplementing provisional instructions for care, management and handling of pregnant women and fetuses suspected of having microcephaly and infants with microcephaly suspiciously caused by Zika virus in the current context of that epidemic in Vietnam.

- Directing organization of communications campaigns for Zika virus prevention and control to persuade mothers and pregnant women to take medical examinations at obstetrics – pediatrics medical establishments.

- Building and issuing instructions for the surveillance of prenatal and postnatal microcephaly.

3. Medical Examination and Treatment Administration

- Assisting the Minister of Health in directing and administering receipt and treatment of cases of Zika virus infection; directly pushing all of healthcare establishments at the central level through the local level to implement this Decision.

- Formulating, updating and issuing professional instructions for diagnosis and handling of cases of Zika virus disease, infants with microcephaly or polyradicutlitis cases and ensure they are implemented uniformly throughout the country.

- Directing healthcare establishments to manage, monitor and diagnose suspicious cases of Zika virus infection, especially cases of pregnant women in the first trimester of pregnancy or fetuses suspected of having microcephaly, infants with microcephaly or cases of polyradicutlitis syndrome.

- Directing leading hospitals to perform tests to identify factors causing postnatal microcephaly.

4. Health Environment Management Agency

- Launching the patriotic hygiene campaign to promote the people’s health and the larvae killing campaign.

- Directing and guiding localities to duly implement the environmental hygiene campaign for epidemic prevention and control purposes.

5. Communication, Emulation and Rewarding Agency

- Presiding over and cooperating with communications units in propaganda and education of prevention and control of Zika virus disease.

- Playing pivotal roles in providing information about epidemic situations and prevention and control measures for press agencies.

- Building communication messages appropriate for target audiences facing risks, especially pregnant women, women of reproductive age planning pregnancy and posting these messages on their website as materials used in communication and training activities at localities.

6. Planning – Finance Department

- Taking the initiative in advising the leadership of the Ministry of Health on allocating funds, using and coordinating resources from the national reserve, the State budget and domestic and foreign organizations for the prevention and control of Zika virus disease, including the prophylaxis, impossible failure alike, detection and handling of pregnant women infected with Zika virus and infants born to mothers infected with Zika virus.

- Guiding units and localities to implement regimes and policies for its officers involved in the prevention and control of the epidemic.

7. International Cooperation Department

- Playing pivotal roles in contacting and mobilizing support from foreign organizations for the prevention and control of Zika virus epidemic.

- Cooperating with competent authorities affiliated to the Ministry of Foreign Affairs in collecting information about situations of the epidemic, prevention and control measures from Vietnam’s overseas diplomatic missions.

8. Institutes of Hygiene and Epidemiology/ Pasteur Institute/ Institute of Malariology, Parasitology and Entomology

- Guiding the provinces and cities in charge of surveillance, prevention and control of Zika virus epidemic, control of outbreaks, and assisting in the surveillance of vectors and the handling of Zika outbreaks by localities.

- Performing confirmatory tests for Zika virus infection, carrying out the assessment and forecasting of epidemic situations in order to keep up with and transfer testing techniques.

- Establishing commissions directly supporting, guiding and overseeing epidemic prevention and control activities at localities where cases of Zika virus disease appear.

- Organizing professional and technical training in the surveillance, prevention and control of Zika virus disease.

- Playing pivotal roles in implementing scientific researches related to epidemiology, ecological characteristics, virology and immunology of Zika virus.

9. Central-level general hospitals

- Organizing the collection of samples for confirmatory tests for Zika virus disease, diagnostic tests for pathogenic factors, managing cases of Zika virus infection and participating in researches on clinical Zika virus cases.

- Providing medical treatment staff with training in the diagnosis, care and treatment of Zika virus disease.

- Taking initiative in cooperating with preventive medicine units in reporting cases of Zika virus infection in a sufficient, accurate and timely manner in accordance with regulations in force.

- Overseeing and collecting samples tested to find pathogenic factors and researching cases of infants with microcephaly or polyradicutlitis.

10. Central-level obstetrics and Pediatrics hospitals

- Carrying out and directing other medical establishments at the same level to promote the monitoring of fetuses, diagnosis and counseling of pregnant women infected with Zika virus or with fetuses suspected of having microcephaly and infants with microcephaly.

- Organizing training for obstetrics and gynecology staff members in preventing women of reproductive age from Zika virus infection, early detection of cases of pregnant women suspected of being infected with Zika virus, prenatal diagnosis for early detection of prenatal microcephaly, monitoring and handling of cases of pregnant women with Zika virus infection, fetuses suspected of having microcephaly and infants with microcephaly.

- Cooperating with the preventive medicine establishments in carrying out communication activities to raise public awareness of the prophylaxis and early detection of Zika virus infection for pregnant women and women of reproductive age planning pregnancy.

- Overseeing and collecting samples tested to find pathogenic factors and researching cases of infants with microcephaly or polyradicutlitis.

11. National Center for Health Communication and Education

- Cooperating with the Communication, Emulation and Rewarding Agency to create communication messages, materials and training documents on health communication and education with a view to promoting diverse forms (direct, online, etc.).

- Directing the Centers for Health Communication and Education in provinces and cities to carry out communication and training activities to meet requirements of Zika virus prevention and control tasks, especially paying attention to the contents of prevention of infection with respect to women of reproductive age, pregnant women and those persons that need to be tested for Zika virus infection.

12. Departments of Health in cities and provinces

- Advising People's Committees of provinces and cities to intensify the killing of insects, mosquito larvae, mosquitoes, prevention and control of Zika virus disease within localities, making epidemic emergency declarations when fully meeting requirements concerning epidemic emergency declaration in accordance with the Prime Minister’s regulations; strengthening the operation of the Steering Committee for epidemic prevention and control at all levels, the direction of their affiliates to closely cooperate in and uniformly implement epidemic prevention and control measures under the guidance of the Ministry of Health.

- Directing the medical units within provinces and cities to develop and implement plans for Zika virus disease prevention and control from the beginning of the year; preparing a general report on funding demands of medical units for submission to the provincial/municipal People's Committees for their approval in order to take the initiative in supervising, detecting and effectively preventing and controlling the epidemic.

- Inspecting and evaluating efficiency of epidemic prevention and control activities by units within cities and provinces.

Above is the response plan for prevention and control of Zika virus epidemic in the new context with the aim of promoting direction and uniform administration to ensure appropriacy, feasibility and effectiveness of planned activities. The Ministry of Health requests its affiliates and relevant units to imperatively implement this Decision and ensure the quality of Zika virus disease prevention and control activities.