Current through Reg. 50, No. 187; September 24, 2024
(1) Psittacosis (Ornithosis).
(a) All cases and suspected cases of
psittacosis in people or birds shall be reported to the county health
department director or administrator or their designee.
(b) Birds suspected of being infected or
having been associated with infected birds shall not be removed from any
premises until the State Health Officer or the county health department
director or administrator or their designee, has investigated the situation and
issued orders which may include quarantine, laboratory examination or
prescribed treatment according to recommendations of the National Association
of State Public Health Veterinarians, Inc., published in the Compendium of
Measures to Control Chlamydophila psittaci Infection Among
Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis), 2008, incorporated by
reference, available from the Department of Health, Division of Environmental
Health, 4052 Bald Cypress Way, Bin A-08, Tallahassee, Florida
32399-1720.
(2) Rabies
Control in Humans.
(a) Reporting of Suspected
Human Exposure to Rabies - Any person having knowledge of an incident in which
a person is bitten by or otherwise exposed to any known or suspected rabid
animal shall notify the county health department director or administrator or
their designee where the bite occurred immediately by telephone, facsimile,
electronic data transfer or other confidential means.
(b) Prevention in Humans - Persons bitten or
otherwise exposed to suspect rabid animals shall be evaluated for post-exposure
treatment by the county health department director or medical director or their
designee according to recommendations of Human Rabies Prevention - United
States, 2008, Recommendations of the Advisory Committee on Immunization
Practices (ACIP), published in the Centers for Disease Control and Prevention
Morbidity and Mortality Weekly Report, Vol. 57, No. RR-3, May 26, 2008,
incorporated by reference, available online at:
http://www.cdc.gov/mmwr/PDF/rr/rr5703.pdf.
(3) Rabies Control in Animals.
(a) The county health department director or
administrator or their designee shall promptly investigate reported bites or
exposures by suspected rabid animals.
(b) The county health department director or
administrator or their designee shall cause to be captured, confined or seized
suspected rabid animals and isolate and quarantine or humanely euthanize and
provide for laboratory examination, as outlined in the guidebook, Rabies
Prevention and Control in Florida 2008, incorporated by reference, available
at:
www.myfloridaeh.com/community/arboviral/Zoonoses/RabiesguideUpdated.pdf.
This includes animals involved in human exposure (bite and non-bite) and
animals exposed to rabid or suspected rabid animals. Other methods of
controlling rabies in domestic or wild animals shall be administered by order
of the county health department director or administrator or their designee
according to recommendations of the Florida Rabies Advisory
Committee.
(c) Upon official
request from the health agency of another state or country, the appropriate
county health department designee shall provide assistance in locating and
placing in quarantine the suspect animal as required for proper completion of
investigation of a potential rabies exposure incident.
(d) Epizootic Rabies. The State Health
Officer, or the county health department director or administrator or their
designee shall declare an area wide quarantine when prevalence of rabies so
indicates. The conditions of the quarantine shall control the movement, sale,
impoundment or required euthanasia of animals in the quarantine area as
specified by departmental policy and procedure guidelines as defined in
paragraph 64D-3.040(3)(b),
F.A.C.
(4) Shigella and
salmonella infections other than enteric disease outbreaks in child care
settings, for which see subsection
64D-3.040(5),
F.A.C., and Typhoid Fever, for which see subsection
64D-3.040(6),
F.A.C.
(a) Sensitive Situations.
1. Persons with laboratory-confirmed or
probable cases of Shigella and Salmonella infections (excluding typhoid fever)
shall be prohibited from being present in sensitive situations until they are
determined by the county health department director or administrator or their
designee no longer to be a public health hazard. Release as no longer a public
health hazard may be obtained by order of the director/administrator as
provided for in subsections
64D-3.040(3) and
(4), F.A.C., for Salmonella, or by the
infected person's submitting a minimum of two (2) stool specimens in
satisfactory condition to one of the Department's laboratories or other
clinical laboratory acceptable to the Department and meeting the following
conditions:
a. The specimens are negative for
these organisms.
b. The first
specimen shall not be obtained sooner than forty-eight (48) hours after the
cessation of any antibiotic therapy for those cases receiving
antibiotics.
c. The second and
subsequent specimen shall not be obtained sooner than at 24-hour
intervals.
2. Persons who
are contacts to probable or confirmed cases of shigella and salmonella
infections (excluding typhoid fever).
a. Who
have symptoms of an enteric illness or who have had such symptoms during the
past two (2) weeks shall be presumed to be infected and shall be managed as a
case as outlined in subparagraph
64D-3.040(4)(a)
1., F.A.C., or
b. Persons who are
contacts to probable or confirmed cases of Shigella and Salmonella infections
(excluding typhoid fever) and who do not have symptoms of an enteric illness or
who have not had those symptoms during the past two (2) weeks may be permitted
to continue in their sensitive situation at the discretion of the county health
department director or administrator or their designee.
3. Persons infected with Salmonella
(excluding typhoid fever) without symptoms may attend schools or child care
settings at the discretion of the county health department director or
administrator or their designee, provided adequate sanitary facilities and
hygienic practices exist.
(b) Non-sensitive Situations.
Cases, Contacts, and Carriers of Salmonella or Shigella who
are not in non-sensitive situations should be counseled regarding disease
transmission, food preparation and hand washing practices. Follow-up or release
based on stool culture results is not required.
(5) Enteric disease outbreaks in child care
settings [for typhoid fever, see subsection
64D-3.040(6),
F.A.C.]. In the event of an outbreak in a child care setting of one of these
diseases, the county health department director or administrator or their
designee shall implement control procedures as defined in "Guidelines for
Control of Outbreaks of Enteric Disease in Child Care Settings, " dated March
2000, incorporated by reference, available online at:
www.doh.state.fl.us/disease%5Fctrl/epi/surv/enteric.pdf.
(6) Typhoid Fever.
(a) Cases: Enteric isolation procedures are
required for all cases during the acute stages of illness. The patient shall be
under the supervision of the county health department director or administrator
or their designee until bacteriologic cultures are obtained from feces and are
negative in no less than three consecutive specimens taken at least 24 hours
apart and not earlier than 1 month after onset of illness, provided the patient
has been off antibiotic therapy for a period of 1 week. If any one specimen of
this series yields typhoid organisms, then at least an additional three
negative consecutive specimens of feces taken at least 24 hours apart are
required for release of the case.
(b) Household contacts of a typhoid case who
may be excreting S. typhi as determined by the county health department
director or administrator or their designee and who are involved in food
processing, food preparation or food service for public consumption or in any
occupation bringing them in contact with children, ill persons, or the elderly
or are present in other sensitive situations, as defined in subsection
64D-3.028(22),
F.A.C., are prohibited from returning to such occupation or situation until no
less than three specimens of feces taken at least 24 hours apart are negative
for typhoid organisms. In addition, other appropriate tests may be required at
the discretion of the county health department director or administrator or
their designee.
(7)
Perinatal Hepatitis B.
(a) Infants born to
HBsAg-positive mothers shall receive hepatitis B immune globulin and hepatitis
B vaccine once physiologically stable, preferably within 12 hours of birth, and
complete the hepatitis B vaccine series according to the recommended vaccine
schedule. Testing infants for HBsAg and antibody to hepatitis B surface antigen
(anti-HBs) six (6) months after the completion of the hepatitis B vaccine
series is recommended to monitor the success or failure of therapy.
(b) Household members, sexual and
needle-sharing partners of HBsAg-positive prenatal/postpartum hepatitis B women
should be tested to determine susceptibility to the hepatitis B virus, and, if
susceptible should receive the hepatitis B vaccine series.
(8) Vibrio Infections. All food service
establishments serving raw oysters shall display, either on menus or on table
placards, the following notice: "Consumer Information: There is risk associated
with consuming raw oysters. If you have chronic illness of the liver, stomach
or blood or have immune disorders, you are at greater risk of serious illness
from raw oysters, and should eat oysters fully cooked. If unsure of your risk,
consult a physician."
Rulemaking Authority
381.0011, 381.003(2),
381.006(16), 384.25(2), 384.33 FS. Law Implemented 381.0011,
381.003(1),
381.0031,
384.25,
384.27
FS.
New 11-20-06, Amended
11-24-08.