Current through Register Vol. 48, No. 38, September 20, 2024
a) Control of Case
1) Food Handlers or Persons in Sensitive
Occupations, Not Including Health Care Workers. Cases with cholera shall not
work as food handlers or in sensitive occupations until diarrhea has ceased for
at least 48 hours and three consecutive negative stool specimens are obtained.
Specimens shall be obtained following clinical recovery of the patient, at
least 24 hours apart and not sooner than 48 hours after the last dose of
antimicrobials, if administered. Specimens shall be submitted within one week
after notification.
2) Health Care
Workers or Those Who Work in Occupations Requiring Standard Precautions. Local
health departments may require specimens from health care workers or those who
work in occupations requiring standard precautions if there is reason to
believe that specimen testing is necessary (e.g., the nature of the work,
including feeding patients, assisting patients with eating, providing or
preparing meals for patients, denture or oral care, hygienic practices of the
worker, dispensing or administering oral medications, or as part of an
investigation of a cluster). Specimens shall be obtained following clinical
recovery of the patient, at least 24 hours apart and not sooner than 48 hours
after the last dose of antimicrobials, if administered. Specimens shall begin
to be submitted within one week after notification, or the individual shall be
restricted from patient care. When specimen submission is required, health care
workers who feed patients or assist patients with eating, meals, provide
denture or oral care or dispense or administer oral medications, shall be
restricted from these duties until three negative stool specimens are obtained
or the public health authority determines that monitoring is no longer
warranted.
3) Persons shall be
excluded from school or child care facilities until vomiting and diarrhea has
resolved for at least 24 hours without the use of antidiarrheal
medication.
b) Control
of Contacts
Contacts should be asked about symptoms during the period of
household exposure and for five days after last exposure.
1) Contacts Who Have Not Had Diarrhea During
the Previous Four Weeks
A) Food Handlers or
Persons in Sensitive Occupations, Not Including Health Care Workers
i) There are no work restrictions while
submitting release specimens for contacts who are employed as food handlers or
in sensitive occupations and who have had no symptoms of cholera infection
during the previous four weeks.
ii)
Contacts to cases of cholera who are employed as food handlers or in sensitive
occupations shall submit three consecutive negative stool specimens obtained at
least 24 hours apart and not sooner than 48 hours after the last dose of
antimicrobials, if administered. These contacts shall be restricted from their
occupations if they do not begin submitting release specimens within one week
after notification. Release specimens shall be submitted at least once per week
until three consecutive negative specimens are obtained, or the individual
shall be restricted from working.
iii) If any of the three release specimens is
positive for toxigenic Vibrio cholera O1 or O139, contacts shall be considered
cases and shall be required to comply with restrictions on returning to work in
subsection (a)(2).
B)
Health Care Workers
Local health authorities may require specimens from health
care workers or those who work in occupations requiring standard precautions if
there is reason to believe that specimen testing is necessary (e.g., the nature
of the work, including feeding patients, assisting patients with eating,
providing or preparing meals for patients, denture or oral care, hygienic
practices of the worker, dispensing or administering oral medications, or as
part of an investigation of a cluster). Specimens shall be obtained at least 24
hours apart. Specimens shall begin to be submitted within one week after
notification, or the individual shall be restricted from patient care.
2) Contacts Who
Currently Have, or Have Had, Diarrhea During the Previous Four Weeks
A) Food Handlers or Persons in Sensitive
Occupations, Not Including Health Care Workers
i) All contacts to cases of cholera employed
as food handlers or in sensitive occupations, and who currently have diarrhea
or have had diarrhea during the previous four weeks, shall not work in their
occupations until diarrhea has ceased for at least 48 hours and they have
submitted three consecutive negative stool specimens. Specimens shall be
obtained following clinical recovery of the patient, at least 24 hours apart
and not sooner than 48 hours after the last dose of antimicrobials, if
administered. Specimens shall begin to be submitted within one week after
notification.
ii) If any of the
three release specimens is positive for toxigenic Vibrio cholerae, contacts
shall be considered cases and shall comply with subsection (a)(1).
B) Health Care Workers
Local health authorities may require specimens from health
care workers or those who work in occupations requiring standard precautions if
there is reason to believe specimen testing is necessary (e.g., the nature of
the work, including feeding patients, assisting patients with eating, providing
or preparing meals for patients, denture or oral care, hygienic practices of
the worker, dispensing or administering oral medications, or as part of an
investigation of a cluster). Specimens shall be obtained following clinical
recovery of the patient, at least 24 hours apart and not sooner than 48 hours
after the last dose of antimicrobials, if administered. Specimens shall begin
to be submitted within one week after notification, or the individual shall be
restricted from patient care. When specimen submission is required, health care
workers who feed patients or assist patients with eating or meals, provide
denture or oral care, or dispense or administer oral medications shall be
restricted from these duties until three negative stool specimens are obtained,
or the public health authority determines that monitoring is no longer
warranted.
c) Sale of Food, Milk, etc. (See Section
690.30(b).)
d) Laboratory Reporting
1) Laboratories shall report to the local
health authority all patients who have a positive result on any laboratory test
indicative of and specific for detecting Vibrio cholerae infection.
2) Laboratories shall forward clinical
materials suspected to be positive for Vibrio cholerae to the Department's
laboratory in accordance with the Department's specimen submission criteria,
which can be accessed at:
https://dph.illinois.gov/topics-services/lab-testing-services/general-requirements.html.
3) Laboratories shall report and submit to
the Department's laboratory any food or environmental Vibrio cholerae isolates
resulting from an outbreak investigation.
