Instrument No.15 of 2001
Revocation and Determination
of
Statement of Principles
concerning
DENGUE FEVER
ICD-10-AM CODES: A90, A91
Veterans’ Entitlements Act 1986
1. The Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act):
(a) revokes Instrument No.139 of 1995; and
(b) determines in its place the following Statement of Principles.
Kind of injury, disease or death
2. (a) This Statement of Principles is about dengue fever and death from dengue fever.
(b) For the purposes of this Statement of Principles, “dengue fever” means a clinical illness due to:
(i) a viral infection due to dengue viruses types 1, 2, 3, or 4, or
(ii) dengue haemorrhagic fever,
attracting ICD-10-AM code A90 or A91.
Basis for determining the factors
3. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that dengue fever and death from dengue fever can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.
Factors that must be related to service
4. Subject to clause 6, at least one of the factors set out in clause 5 must be related to any relevant service rendered by the person.
Factors
5. The factors that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting dengue fever or death from dengue fever with the circumstances of a person’s relevant service are:
(a) being infected with dengue viruses types 1, 2, 3, or 4 within the 14 days immediately before the clinical onset of dengue fever; or
(b) for dengue haemorrhagic fever only, being infected with dengue viruses types 1, 2, 3, or 4 within the 20 years immediately before the clinical onset of dengue fever; or
(c) inability to obtain appropriate clinical management for dengue fever.
Factors that apply only to material contribution or aggravation
6. Paragraph 5(c) applies only to material contribution to, or aggravation of, dengue fever where the person’s dengue fever was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.
Inclusion of Statements of Principles
7. In this Statement of Principles if a relevant factor applies and that factor includes an injury or disease in respect of which there is a Statement of Principles then the factors in that last mentioned Statement of Principles apply in accordance with the terms of that Statement of Principles.
Other definitions
8. For the purposes of this Statement of Principles:
“death from dengue fever” in relation to a person includes death from a terminal event or condition that was contributed to by the person’s dengue fever;
“dengue haemorrhagic fever” means a complication of infection with dengue virus that is characterised by high fever, and haemorrhagic phenomena. The pathophysiological changes underlying the condition are an increased vascular permeability and disordered haemostasis;
“ICD-10-AM code” means a number assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, 10th revision, Australian Modification (ICD-10-AM), Second Edition, effective date of 1 July 2000, copyrighted by the National Centre for Classification in Health, Sydney, NSW, and having ISBN 1 86487 271 3;
“relevant service” means:
(a) operational service; or
(b) peacekeeping service; or
(c) hazardous service;
“terminal event” means the proximate or ultimate cause of death and includes:
(a) pneumonia;
(b) respiratory failure;
(c) cardiac arrest;
(d) circulatory failure; or
(e) cessation of brain function.
Application
9. This Instrument applies to all matters to which section 120A of the Act applied.
Dated this Twenty-second day of February 2001
The Common Seal of the )
Repatriation Medical Authority )
was affixed to this instrument )
in the presence of: )
KEN DONALD
CHAIRMAN