Current through Register Vol. 48, No. 38, September 20, 2024
This Section establishes routine measures for the control of
notifiable diseases, conditions and outbreaks by the Department or local health
authorities and health care providers, and establishes progressive initiatives
to ensure that appropriate measures are implemented to control the spread and
occurrence of notifiable diseases, conditions and outbreaks. This Section does
not apply to infectious or non-infectious diseases and conditions for which
reporting requirements are specified elsewhere in the Illinois Administrative
Code, such as sexually transmissible infections, which are regulated under the
Control of Sexually Transmissible Infections Code, the HIV/AIDS Confidentiality
and Testing Code, and the Perinatal HIV Prevention Code.
a) Investigation
1)
The Department of Public Health
shall investigate the causes of contagious, or
dangerously contagious, or infectious diseases,
especially when existing in epidemic form, and take means to restrict and
suppress the same, and whenever such disease becomes, or threatens to become,
epidemic in any locality and the local board of health or local authorities
neglect or refuse to enforce efficient measures for its restriction or
suppression or to act with sufficient promptness or efficiency, or whenever the
local board of health or local authorities neglect or refuse to promptly
enforce efficient measures for the restriction or suppression of dangerously
contagious or infectious diseases, the Department of Public Health may enforce
such measures as it deems necessary to protect the public health, and all
necessary expenses so incurred shall be paid by the locality for which services
are rendered. (Section 2(a) of the Act)
2) The Department shall make
investigations and inquiries with respect to the causes of disease,
health conditions, and death; investigate the effect of environment,
including conditions of employment and other conditions that may affect health;
and to make other investigations that it may deem necessary for the
preservation and improvement of health. (Section 510 of the Public
Health Powers and Duties Law)
3)
Each case or cluster of a notifiable disease or condition shall be investigated
to determine the source, where feasible. Findings of the investigation shall be
reported as specified under the Section of this Part applicable to each
specific disease.
4) The Department
or local health authority may investigate the occurrence of cases, suspect
cases, or carriers of diseases or conditions or unusual disease or condition
occurrences in a public or private place for the purposes of verifying the
existence of a disease or condition; ascertaining the source of the disease or
condition-causing agent; identifying unreported cases; locating and evaluating
contacts of cases and suspect cases; identifying those at risk of disease or
the condition; determining necessary control measures, including isolation and
quarantine; and informing the public if necessary.
5) When the Director determines that a
certain disease or condition warrants investigation, the Director may declare
the disease or condition to be the subject of a medical investigation and
require hospitals, physicians, health care facilities, etc., to submit
information, data and reports, and allow review and examination of medical
records as necessary for the purpose of the investigation. No practitioner or
person shall be liable in any action at law for permitting examination and
review. The data obtained shall be held confidential in accordance with the
Communicable Disease Report Act.
6)
When two or more cases of a suspected or notifiable disease or condition,
including, but not limited to confirmed health care associated infection or
colonization, or single case with public health significance occur in any
business, organization, institution, health care facility, school, child care
center or provider, residential facility, or private home, the business owner,
the person in charge of the establishment or the event, or the homeowner shall
cooperate with public health authorities in the investigation of cases, suspect
cases, outbreaks and suspect outbreaks. This includes, but is not limited to,
release of utilization information about a product used to mitigate spread,
including therapeutics; shopper card records; credit card receipts; food
preparation methods; menus; environmental specimens; food specimens; clinical
specimens, invoices, employee work schedules and work logs, including logs of
employee illness or absences; lists of customers, attendees, residents or
patients; travel/transportation logs; utilization information about a product
used to mitigate spread, including therapeutics, vaccinations or prophylactics;
and the name and other pertinent information about employees, guests, members
or residents diagnosed with a communicable disease or condition, including
infection or colonization as the information relates to the investigation. When
outbreaks of infectious disease occur in any business, organization,
institution, health care facility or private home, employees of the location
under investigation may be considered to be contacts to cases and be required
to submit release specimens by the local health authority.
7) When two or more cases of a notifiable
communicable disease or condition occur in association with a common source,
the investigation should include a search for additional cases.
8) All reports of an outbreak shall be
entered in the Department's ORS by the local health jurisdiction within 24
hours of receipt of the report. Within 30 days of the end of the outbreak
investigation, the final information shall be entered in the Department's ORS.
Supplemental questionnaires may be used during the outbreak investigation,
including, but not limited to use of REDCap or other online systems.
9) Under circumstances with highly infectious
diseases or other disease or conditions causing extreme harm, including, but
not limited to, high risk or high occurrence of death or complication, and when
normal attempts to make contact have failed, the Department, local health
authority, or law enforcement may obtain and review any cell phone, computer,
mobile device or other communication device, from a case for the purpose of the
investigation, including, but not limited to, the identification of possible
contacts or possible exposures, for the purpose of preventing or controlling
disease or the condition.
10) State
and local law enforcement authority shall share information with the Department
or local health department as requested by either the Department or the local
health authority for the treatment, response to, control of, investigation of,
or prevention of a notifiable disease, condition or outbreak.
11) The Department or local health authority
may conduct sentinel surveillance for an infectious disease, condition or
syndrome if the Department or local health authority determines that sentinel
surveillance will provide adequate data for the purpose of preventing or
controlling disease or the condition or achieving other significant public
health purposes in a defined geographic area or the entire State. The
Department or local health authority shall select, after consultation with the
sites, sentinel surveillance sites that have epidemiological significance for
the disease, condition or syndrome under investigation. A disease, condition or
syndrome may be removed from sentinel surveillance if the Department or local
health authority determines that the surveillance is no longer necessary. The
Department or local health authority shall provide a description, in writing,
to sentinel surveillance sites of a specific, planned mechanism for
surveillance of the disease, condition or syndrome and, as necessary,
submission of clinical materials from cases and suspect cases.
12) An individual or entity, including a
health information exchange, may carry out activities such as sentinel
surveillance under a grant, contract or cooperative agreement with the
Department. The authorized individual or entity functions as a public health
authority for the purposes of the activity.
13) Investigations conducted by the
Department or local health authority may include, but are not limited to:
A) Review of pertinent, relevant medical
records by authorized personnel, if necessary to confirm the diagnosis;
investigation of causes; identification of other cases related to the outbreak
or the reported disease (including colonization) or condition in a region,
community, or workplace; to conduct epidemiologic studies; to determine whether
a patient with a notifiable disease or condition has received adequate
treatment to render the patient non-infectious, whether a person exposed to a
case has received vaccination or prophylaxis, if appropriate, or infection or
environmental control measures have been implemented, if appropriate. Review of
records may occur without patient consent and shall be conducted at times and
with such notice as is possible under the circumstances;
B) Performing interviews with the case, or
persons knowledgeable about the case, and collecting pertinent and relevant
information about the causes of or risk factors for the notifiable disease or
condition;
C) Medical examination
and testing of persons, with their explicit consent;
D) Obtaining, from public or private
businesses or institutions, the identities of and location and contact
information about persons, travelers, passengers or transportation crews with a
similar or common potential exposure to the infectious agent as a reported
case; exposure may be current or have occurred in the past;
E) Interviewing or administering
questionnaire surveys confidentially to any resident of any community, or any
agent, owner, operator, employer, employee, or client of a public or private
business or institution, who is epidemiologically associated either with the
outbreak or with the reported disease or condition case or has had a similar
exposure as a reported case;
F)
Collecting environmental samples of substances or measurements of physical
agents that may be related to the cause of an outbreak or notifiable disease or
condition;
G) Taking photographs
related to the purpose of the investigation. If the photographs are taken in a
business, the employer shall have the opportunity to review the photographs
taken or obtained for the purpose of identifying those that contain or might
reveal a trade secret; and
H)
Entering a place of employment for the purpose of conducting investigations of
those processes, conditions, structures, machines, apparatus, devices,
equipment, records, and materials within the place of employment that are
relevant, pertinent, and necessary to the investigation of the outbreak or
notifiable dangerously contagious or infectious disease. Investigations shall
be conducted during regular business hours, if possible, and with as much
notice as possible under the circumstances.
b) Control of Food Products
Whenever a case, a carrier, or a suspect case or carrier of
the following diseases exists in a home or establishment where food is produced
that is likely to be consumed raw or handled after pasteurization and before
final packaging, the sale, exchange, removal or distribution of the food items
from the home or establishment may be prohibited by the Department or the local
health authority as necessary to prevent the transmission of communicable
diseases or conditions. These include, but are not limited to, the following
diseases:
1)
Campylobacteriosis
2)
Cholera
3)
Cryptosporidiosis
4)
Diphtheria
5) E. coli infections
(Shiga toxin-producing E. coli)
6)
Foodborne or waterborne illness
7)
Hepatitis A
8) Norovirus
9) Salmonellosis
10) Shigellosis
11) Smallpox
12) Staphylococcal skin infections
13) Streptococcal infections
14) Typhoid fever
c) Schools, Child Care Facilities, and
Colleges/Universities
1) Except in an
emergency, the occurrence of a case of a communicable disease in a school,
child care facility or college/university should not be considered a reason for
closing the school, facility or college/university.
2) Persons suspected of being infected with a
notifiable infectious disease for which isolation is required, or persons with
diarrhea or vomiting believed to be infectious in nature, shall be refused
admittance to the school or child care facility until fever-free and diarrhea
and vomiting free for 24 hours without use of fever reducing, antidiarrheal, or
antiemetic medications and other medications.
3) School, child care facility, and
college/university authorities shall handle contacts of infectious disease
cases as prescribed in this Part, or as recommended by the local health
authority.
4) When outbreaks of
disease occur in any child care facility, staff and attendees of the facility
may be considered to be contacts to cases and may be required by the local
health authority to submit specimens for testing.
5) Identifiable information on a student or
staff, such as name and contact information (including current address and
phone), seating charts on busses and in the classroom, and rosters for
extracurricular activities, shall be reported to the Department or local public
health authority for any notifiable disease or condition within the timeframes
specified in this Part.
d) Release of Specimens
1) Whenever this Part requires the submission
of laboratory specimens for release from imposed restrictions, the results of
the examinations will not be accepted unless the specimens have been examined
in the Department's laboratory or an acceptable medical laboratory. The number
of specimens needed for release, as detailed under specific diseases, is the
minimum and may be increased by the Department as necessary. Improper storage
or transportation of a specimen or inadequate growth of the culture suggestive
of recent antibiotic usage can result in disapproval of the submitted specimen
by the Department's laboratory or an acceptable medical laboratory and result
in the need for an additional specimen to be collected.
2) The local health authority may require
testing of food handlers for specific pathogens, including, but not limited to,
E. coli, Salmonella and Norovirus, as necessary in response to an
outbreak.
3) A local health
authority may disclose and require to a food service business owner or the
owner's designee that an employee with a disease that can be transmitted
through food cannot return to work until the local health authority lets the
business owner know that the employee can return to work.