Reactive arthritis
Meaning of reactive arthritis: For the purposes of this Statement of Principles, reactive arthritis: (a) means an immune-mediated arthritis of more than four weeks' duration; and (b) is usually associated with evidence of a preceding extra-articular infection; and (c) excludes: (i) acute rheumatic fever; (ii) arthritis associated with viruses which are known to cause arthritis as part of the usual spectrum of clinical manifestations (for example, Ross River virus infection, Barmah Forest virus, rubella virus, parvovirus B19); (iii) leptospirosis; (iv) Lyme disease; (v) post-streptococcal reactive arthritis; and (vi) septic arthritis.
Reasonable Hypothesis (RH) — Statement of Principles No. 75 of 2018
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting reactive arthritis or death from reactive arthritis with the circumstances of a person's relevant service:
- (1)having an infection as specified within the three months before the clinical onset of reactive arthritis;
Note: infection as specified is defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus at the time of the clinical onset of reactive arthritis;
- (3)being vaccinated with hepatitis B vaccine within the 30 days before the clinical onset of reactive arthritis;
- (4)having intravesical BCG therapy for malignant neoplasm of the bladder or intradermal BCG therapy for a malignant neoplasm within the 30 days before the clinical onset of reactive arthritis;
Note: BCG therapy is defined in the Schedule 1 - Dictionary.
- (5)having active mycobacterial disease within the 30 days before the clinical onset of reactive arthritis;
Note: active mycobacterial disease is defined in the Schedule 1 - Dictionary.
- (6)having intestinal bypass surgery within the one year before the clinical onset of reactive arthritis;
- (7)inability to obtain appropriate clinical management for reactive arthritis;
Aggravation-only factors: the factors in subsection 9(7) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 76 of 2018
7 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, reactive arthritis or death from reactive arthritis is connected with the circumstances of a person's relevant service:
- (1)having an infection as specified within the three months before the clinical onset of reactive arthritis;
Note: infection as specified is defined in the Schedule 1 - Dictionary.
- (2)having infection with human immunodeficiency virus at the time of the clinical onset of reactive arthritis;
- (3)being vaccinated with hepatitis B vaccine within the 30 days before the clinical onset of reactive arthritis;
- (4)having intravesical BCG therapy for malignant neoplasm of the bladder or intradermal BCG therapy for a malignant neoplasm within the 30 days before the clinical onset of reactive arthritis;
Note: BCG therapy is defined in the Schedule 1 - Dictionary.
- (5)having active mycobacterial disease within the 30 days before the clinical onset of reactive arthritis;
Note: active mycobacterial disease is defined in the Schedule 1 - Dictionary.
- (6)having intestinal bypass surgery within the one year before the clinical onset of reactive arthritis;
- (7)inability to obtain appropriate clinical management for reactive arthritis;
Aggravation-only factors: the factors in subsection 9(7) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
