Tuberculosis is a notifiable disease under the NSW Public Health Act 1991. Under the provisions of the Public Health Act doctors, hospital chief executives (or general managers) and pathology laboratories are required to notify people with presumptive and/or confirmed TB.
Notifications can be made to the local Public Health Unit by telephone or mail, using specific notification forms available at Disease Notification. Notification forms must not be forwarded by facsimile unless patient confidentiality can be assured.
Notifications should be made by the person who identifies the disease as soon as is practicable. Ideally, notification should be made by telephone to the local Public Health Unit within 1 working day of a provisional diagnosis of TB. The Public Health Unit will then report the case to the local Chest Clinic by phone for follow up and investigation.
Public health orders
There are occasions where a person with TB disease is either non-compliant with treatment or fails to act in a way that minimises the potential for transmission to others. Where the person has pulmonary TB and is assessed as being infectious the risk to the public must be considered.
It is essential that individualised, ongoing education and support is provided to all persons with TB to improve compliance with diagnosis, treatment and screening. A Public Health Order is only issued after other strategies to establish and maintain compliance with care or treatment are exhausted and it is assessed that there is a risk to the health of the public.
TB is classified as a Category 4 medical condition under the Public Health Act 1991. As a Category 4 medical condition a Public Health Order may be made under Part 3, Division 6 of the Public Health Act 1991 by an authorised Medical Practitioner if s/he is satisfied on reasonable grounds that the person is:
- suffering from TB, and
- is behaving in a way that is endangering, or is likely to endanger, the health of the public because the person is suffering from the disease.
A Public Health Order must require the person to whom it applies to do any one or more of the following:
- refrain from a specified conduct
- undergo specified treatment
- undergo counselling by a specified person or by one or more persons belonging to a specified class of persons
- submit to the supervision of a specified person or one or more persons belonging to a specified class of persons
- undergo specified treatment and be detained at a specified place while undergoing the treatment.
An order must indicate:
- the circumstances purporting to justify making the order,
- the length of time it is to remain in force (up to 28 days).
Where the circumstances justify continuing the order past 28 days, then an application may be made to the District Court to extend the order for up to a further six months.
It is an offence to contravene an order and the person may be apprehended by the police for such a contravention.
It is also an offence to improperly release a person being detained under an order.
An appeal to the District Court may be made against the order.
Where a quarantine officer is satisfied that a person, being a non-citizen, is suffering from active pulmonary TB, under section 35AA, subsection (1), of the Quarantine Act 1908, s/he may order the person to undergo a medical examination to ascertain their infectivity status.
If a person fails to comply with this order, the quarantine officer may place the person in quarantine.
Where a quarantine officer is of the opinion that a person, being a non-citizen, is, or is likely to be, suffering from active pulmonary TB, under section 35AA, subsection (4), of the Quarantine Act 1908, s/he may order the person into quarantine.
These orders must be in writing, and served on the person.