HIV AIDS Resource Guide/HIV-AIDS Resource Guide.iso/STAT/STATE/WISC-AD.ASC

Text File | 1993-01-14 | 20KB | 469 lines

/ * The WISCONSIN ADMINISTRATIVE CODE addresses the control of
communicable diseases and STDs. */

Chapter HSS 145

CONTROL OF COMMUNICABLE DISEASES

Subchapter I - General Provisions

HSS 145.01 Statutory authority. This chapter is promulgated under
the authority of 55. 143.02 (4), 143.05 (1), 143.06 (4), 143.07
(1) and (1m), 143.12 (6) and 990.01 (5g), Stats.



HSS 145.02 Purpose and scope. The chapter establishes a
surveillance system for the purpose of controlling the incidence
and spread of communicable diseases. This surveillance system
consists of timely and effective communicable disease reporting,
means of intervention to prevent transmission of communicable
diseases, and investigation, prevention and control of outbreaks
by local health officers and the department.



HSS 145.03 Definitions. In this chapter:

(1)  "Case" means a person determined to have a particular
communicable disease on the basis of clinical or laboratory
criteria or both.

(2)  "Communicable disease" means a disease or condition listed
in Appendix A of this chapter.

(3)  "Date of onset" means the day on which the case or suspected
case experienced the first sign or symptom of the communicable
disease.

(4)  "Department" means the department of health and social
services.

(5)  "Food handler" means a person who handles food utensils or
who prepares, processes, or serves food or beverages for people
other than members of his or her immediate household.

(6)  "Health care facility" means a hospital, a nursing home, a
home health agency, or a provider of outpatient health care.

(7)  "Individual case report form" means the form provided by the
department for the purpose of reporting communicable diseases.

(8)  "Laboratory" means any facility certified by the department
under s. 143.15, Stats., and ch. HSS 165.

(9)  "Local health officer" has the meaning prescribed in s.
143.01(1), Stats., and applies to the person who is designated as
the local health officer for the place of residence of a case or
suspected case of communicable disease.

(10) "Organized program of infection control" means written
policies and procedures for the purpose of surveillance,
investigation, control and prevention of infections in a health
care facility.

(11) "Other disease or condition having the potential to affect
the health of other persons" means a disease that can be
transmitted from one person to another but that is not reportable
under this chapter and therefore is not listed in Appendix A of
this chapter, although it is listed in Control of Communicable
Diseases in Man, 14th edition (1985), edited by Abram S.
Benenson, and published by the American Public Health
Association.

(12) "Outbreak" means the occurrence in a particular area of
communicable disease cases in excess of the expected number of
cases.

(13) "Personal care" means the service provided by one person to
another person who is not a member of his or her immediate
household for the purpose of feeding, bathing, dressing,
assisting with personal hygiene, changing diapers, changing
bedding and other services involving direct physical contact.

(14) "State epidemiologist" means the person designated by the
secretary of the department as the person in charge of
communicable disease control for the state.

(15) "Suspected case" means a person thought to have a particular
communicable disease on the basis of clinical or laboratory
criteria or both.



HSS 145.04 Reports of communicable diseases. (1) RESPONSIBILITY
FOR REPORTING. (a) Any person licensed under ch. 441 or 448,
Stats., knowing of or in attendance on a case or suspected case
shall notify the local health officer or, if required under
Appendix A of this chapter, the state epidemiologist, in the
manner prescribed in this section.

(b)  Each laboratory shall report the identification or suspected
identification of a disease- causing organism or laboratory
findings indicating the presence of a communicable disease to the
local health officer or, if required under Appendix A of this
chapter, to the state epidemiologist.

(c)  Each health care facility shall ensure that reports are made
to the local health officer or, if required under Appendix A of
this chapter, to the state epidemiologist, in the manner
specified in sub. (3). When a case is identified or suspected in
a health care facility having an organized pro-gram of infection
control, the person in charge of the infection control program
shall ensure that the case or suspected case is reported to the
local health officer or, if required under Appendix A of this
chapter, to the state epidemiologist, minimizing unnecessary
duplication.

(d)  Any teacher, principal or nurse serving a school or day care
center knowing of a case or suspected case in the school or
center shall notify the local health officer or, if required
under Appendix A of this chapter, the state epidemiologist, in
the manner prescribed in this section.

(e)  Any person who knows or suspects that a person has a
communicable disease shall report the facts to the local health
officer or, if required under Appendix A of this chapter, to the
state epidemiologist.

(1m) QUALIFICATION OF REPORTING RESPONSIBILITY. Nothing in sub.
(1) lessens the requirement for confidentiality of test results
under s. 146.025, Stats.

(2)  CONTENT OF REPORT. (a) Each report under sub. (1) (a) to (d)
of a case or suspected case of a communicable disease to the
local health officer or the state epidemiologist shall include
the name and address of the person reporting and of the attending
physician, if any, the diagnosed or suspected disease, the name
of the ill or affected individual, that individual's address and
telephone number, age or date of birth, race and ethnicity, sex,
county of residence, date of onset of the disease, name of parent
or guardian if a minor, and other facts the department or local
health officer requires for the purposes of surveillance, control
and prevention of communicable disease.

(b)  Reports may be written or verbal. Written reports shall be
on the individual case report form provided by the department and
distributed by the local health officer or on a form containing
the information required under par. (a). Reports shall be
submitted to the local health officer or, if required under
Appendix A of this chapter, to the state epidemiologist.

(c)  Reports by laboratories of the identification or suspected
identification of a disease causing organism or laboratory
findings indicating the presence of a communicable disease shall
be made to the local health officer or, if required under
Appendix A of this chapter, to the state epidemiologist. These
reports shall include the name of the individual affected or ill,
the individual's address, telephone number, county of residence,
age or date of birth, the name of the attending physician and the
identity or suspected identity of the organism or the laboratory
findings.

(d)  All information provided under this subsection shall remain
confidential except as may be needed for the purposes of
investigation, control and prevention of communicable diseases.

(3)  URGENCY OF REPORTS. (a) A person, laboratory or health care
facility required to report under sub. (1) shall report
communicable diseases of urgent public health importance as
listed in category I of Appendix A of this chapter by telephone
to the local health officer immediately upon identification of a
case or suspected case. If the local health officer is un
available, the report shall be made immediately to the state
epidemiologist.

(b)  A person, laboratory or health care facility required to
report under sub. (1) shall report communicable diseases of less
urgent public health importance as listed in categories II and
III of Appendix A of this chapter to the local health officer or,
if required under Appendix A, to the state epidemiologist, by
individual case report form or by telephone within 72 hours of
the identification of a case or suspected case.

(c)  A person, laboratory or health care facility required to
report under sub. (1) shall report the total number of cases or
suspected cases of the other communicable diseases listed in
Appendix A to the local health officer on a weekly basis.

(4)  HANDLING OF REPORTS BY THE LOCAL HEALTH OFFICER. (a) The
local health officer shall notify the state epidemiologist
immediately by telephone of any report of cases or suspected
cases reported under sub. (3) (a).

(b)  At the close of each week, the local health officer shall
notify the state epidemiologist in writing on a form provided by
the department of all cases of reported diseases listed in
Appendix A.



HSS 145.05 Investigation and control of communicable diseases.
(1) The local health officer shall use all reasonable means to
confirm in a timely manner any case or suspected case of a
communicable disease and shall ascertain so far as possible all
sources of infection and exposures to the infection. Follow-up
and investigative information shall be completed by the local
health officer and reported to the state epidemiologist on forms
provided by the department.

(2)  Local health officers shall follow the methods of control
set out in section 9 under each communicable disease listed in
the 14th edition (1985) of Control of Communicable Diseases in
Man, edited by Abram S. Benenson, published by the American
Public Health Association, unless specified otherwise by the
state epidemiologist. Specific medical treatment shall be
prescribed by a physician.

(3)  Any person licensed under ch. 441 or 448, Stats., attending
a person with a communicable disease shall instruct the person in
the applicable methods of control contained in Control of
Communicable Diseases in Man, 14th edition (1985), edited by
Abram S. Benenson, published by the American Public Health
Association, unless specified otherwise by the state
epidemiologist, and shall cooperate with the local health officer
and the department in their investigation and control procedures.

(4)  The department in cooperation with the local health officer
shall institute special disease surveillances, follow-up reports
and control measures consistent with contemporary epidemiologic
practice in order to study and control any apparent outbreak or
unusual occurrence of communicable diseases.



HSS 145.06 Special disease control measures. (1) SCHOOLS. Any
teacher, principal or nurse serving the school may send home, for
the purpose of diagnosis and treatment, any pupil suspected of
having a communicable disease or of having any other disease or
condition having the potential to affect the health of other
students and staff including but not limited to pediculosis and
scabies. The teacher or principal authorizing the action shall
ensure that the parents of the child and nurse serving the school
of the child are informed of the action.

(2)  PERSONAL CARE. Home health agency personnel providing per
sonal care in the home and persons providing personal care in
health care facilities, day care centers and other comparable
facilities shall refrain from providing care while they are able
to transmit a communicable disease through the provision of that
care, in accord with the methods of communicable disease control
contained in Control of Communicable Diseases in Man, 14th
edition (1985), edited by Abram S. Benenson, and published by the
American Public Health Association, unless specified otherwise by
the state epidemiologist.

(3)  FOOD HANDLERS. Food handlers shall refrain from handling
food while they have a disease in a form that is communicable by
food handling, in accord with the methods of communicable disease
control contained in Control of Communicable Diseases in Man,
14th edition (1985), edited by Abram S. Benenson, and published
by the American Public Health Association, unless specified
otherwise by the state epidemiologist.

(4)  PREVENTION OF OPHTHALMIA NEONATORUM. The attending physician
or midwife shall place 2 drops of a one percent solution of
silver nitrate, or 2 drops of an ophthalmic solution containing
one percent tetracycline or 0.5% erythromycin, or a one
centimeter strip of an ophthalmic ointment containing one percent
tetracycline or 0.5% erythromycin, in each eye of a newborn child
as soon as possible after delivery but not later than one hour
after delivery. No more than one newborn child may be treated
from an individual container.



Subchapter III - Sexually Transmitted Disease

HSS 145.12 Definitions. In this subchapter:

(1)  "Commitment" means the process by which a court of record or
ders the confinement of a person to a place providing care.

(2)  "Contact" means a person who had sexual intercourse with a
case during a period of time which covers both the maximum
incubation period for the disease and the time during which the
case showed symptoms of the disease, or could have either
infected the case or been infected by the case.

(3)  "Sexually transmitted diseases" mean syphilis, gonorrhea,
chancroid, granuloma inguinale, lymphogranuloma venereum, genital
herpes infection (first clinical episode only), nongonococcal
urethritis, chlamydia trachomatis, other nongonococcal
cervicitis, and sexually transmitted pelvic inflammatory disease.

(4)  "Source" means the person epidemiologic evidence indicates
to be the origin of infection.

(5)  "Suspect" means a person who meets the criteria in s. HSS
145.16.



HSS 145.13 Case reporting. Any administrator of a health care
institution, state correctional institution or local facility
subject to ch. DOC 350, who has knowledge of a case of a sexually
transmitted disease shall report the case by name and address to
the local health officer. Where the services of an attending
physician are available in an institution, the physician shall
report as described ins. HSS 145.04 (1) (a). The administrator
shall ensure that this reporting requirement is fulfilled.



HSS 145.14 Reporting of cases delinquent in treatment. Whenever
any person with a sexually transmitted disease fails to return to
the physician who has treated that person within the time
directed, the physician shall report the person, by name and
address, to the local health officer and the department, as
delinquent in treatment.



HSS 145.15 Determination of sources and contacts. Physicians ac
cepting cases for treatment shall determine the probable source
of infection and any other contacts, and shall attempt to
diagnose and treat those persons, or shall request that the local
health officer or the department do so.



HSS 145.16 Criteria for determination of suspects. Any person
falling into one or more of the following categories is
designated as a suspect:

(1)  Persons identified as sexual contacts of a sexually
transmitted disease case;

(2)  Persons having positive laboratory or clinical findings of
sexually transmitted disease; and

(3)  Persons in whom epidemiologic evidence indicates a sexually
transmitted disease may exist.



HSS 115.17 Examination of suspects. Local health officers shall
require the examination of suspects. The examination shall
include a physical examination and appropriate laboratory and
clinical tests.



HSS 145.18 Commitment of suspects. If, following the order of a
local health officer or the department, a suspect refuses or
neglects examination or treatment, a local health officer or the
department shall file a petition with a court to have the person
committed to a health care facility for examination, treatment or
observation.



HSS 145.19 Treatment of minors. A physician may treat a minor
with a sexually transmitted disease or examine and diagnose a
minor for the presence of the disease without obtaining the
consent of the minor's parents or guardian. The physician shall
incur no civil liability solely by reason of the lack of consent
of the minor's parent or guardian, as stated in s. 143.07 (1m),
Stats.



HSS 145.20 Treatment guidelines. Nationally recognized
guidelines, including the "Sexually Transmitted Disease Treatment
Guidelines 1982," published by the U.S. Department of Health and
Human Services, shall be considered in the treatment of sexually
transmitted diseases. Specific medical treatment shall be
prescribed by a physician.



APPENDIX A: COMMUNICABLE DISEASES

CATEGORY I:

The following diseases are of urgent public health importance and
shall be reported by telephone to the local health officer
immediately upon identification of a case or suspected case. See
s. HSS 145.04 (3) (a).

Anthrax                             Pertussis (whooping cough)
Botulism                            Plague
Botulism ,infant                    Poliomyelitis
Cholera                             Rabies (human)
Diphtheria                          Rubella
Food-borne or water-borne outbreaks Rubella (congenital syndrome)
Hepatitis, viral Type A             Tuberculosis
Measles                             Yellow fever



CATEGORY II:

The following diseases are of less urgent public health
importance and shall be reported to the local health officer by
individual case report form or by telephone within 72 hours of
the identification of a case or suspected case. Sees. HSS 145.04
(3(b).

Acquired Immune Deficiency         Sexually transmitted diseases
Syndrome (AIDS)                      Chancroid
Amebiasis                            Chlamydia trachomatis
Blastomycosis                        Genital herpes infection
Brucellosis                         (first clinical episode only)
Campylobacter enteritis              Gonorrhea
Encephalitis, viral (specify etiology)  Granuloma inguinale
Giardiasis                           Lymphogranuloma venereum
Hepatitis, viral                     Nongonococcal cervicitis
Types B, non-A non-B, or unspecified     Nongonococcal urethritis
Histoplasmosis                       Sexually transmitted
Kawasaki disease                      pelvic inflammatory disease
Legionnaires' disease                Syphilis
Leprosy                            Shigellosis
Leptospirosis
Lyme disease                      Tetanus
Malaria                           Toxic-shock syndrome
Meningitis, aseptic (specify      Toxic substance related disease
etiology)                            Infant methemoglobinemia
Meningitis, bacterial (specify       Lead intoxication (specify
etiology)                               Pb levels)
Meningococcal disease                Other metal poisonings
Mumps                                Other organic chemical
Nontuberculous mycobacterial            poisonings
disease (specify etiology)           Pesticide poisoning
Psittacosis                        Toxoplasmosis
Q fever                            Trichinosis
Reye's syndrome                    Tularemia
Rheumatic fever (newly diagnosed)  Typhoid fever
Rocky mountain spotted fever       Typhus fever

Salmonellosis                      Yersiniosis
Suspected outbreaks of other acute or occupationally-related
diseases



CATEGORY III:

The following disease shall be reported to the state
epidemiologist by individual case report form or by telephone
within 72 hours of the identification of a case or suspected
case. See s. 146.025 (7) (b), Stats., and s. HSS 145.04 (3) (b).

Human immunodeficiency virus (HIV) infection



CATEGORY IV:

The total numbers of cases or suspected cases of the following
communicable disease shall be reported to the local health
officer on a weekly basis. See s. HSS 145.04 (3) (c).

Chickenpox