Current through Reg. 49, No. 38; September 20, 2024
(a) Purpose. The Communicable Disease
Prevention and Control Act (Act), §81.048, requires a licensed hospital to
notify a health authority and designated infection control officer in certain
instances when an emergency response employee or volunteer may have been
exposed to a reportable disease during the course of duty from a person
delivered to the hospital under conditions that were favorable for
transmission. A hospital that gives notice of a possible exposure under this
section or a local health authority or designated infection control officer
that receives notice of a possible exposure under this section may give notice
of the possible exposure to a person other than an emergency response employee
or volunteer if the person demonstrates that the person was exposed to the
reportable disease while providing emergency care.
(b) Definitions.
(1) Designated infection control officer--The
person serving as an entity's designated infection control officer under Health
and Safety Code, § 81.012, who has a health care professional license or
specific training in infection control, acts as liaison between the entity and
the destination hospital, and monitors all follow-up treatment provided to the
affected emergency response employee or volunteer.
(2) Emergency response employee or
volunteer--An individual acting in the course and scope of employment or
service as a volunteer as emergency medical service personnel, a peace officer,
a detention officer, a county jailer, or a fire fighter, as defined under
Health and Safety Code, §
81.003.
(c) Disease and criteria which
constitute exposure. The following diseases and conditions constitute a
possible exposure to the disease for the purposes of the Act, §81.048:
(1) chickenpox; diphtheria; measles
(rubeola); novel coronavirus causing severe acute respiratory disease; novel
influenza; pertussis; pneumonic plague; smallpox; pulmonary or laryngeal
tuberculosis; and any viral hemorrhagic fever, if the worker and the patient
are in the same room, vehicle, ambulance, or other enclosed space;
(2)
Haemophilus influenzae,
invasive; meningitis; meningococcal infections, invasive; mumps; poliomyelitis;
Q fever (pneumonia); rabies; and rubella, if there has been an examination of
the throat, oral or tracheal intubation or suctioning, or mouth-to-mouth
resuscitation;
(3) acquired immune
deficiency syndrome (AIDS); anthrax; brucellosis; dengue; ehrlichiosis;
hepatitis, viral; human immunodeficiency virus (HIV) infection; malaria;
plague; syphilis; tularemia; typhus; any viral hemorrhagic fever; and yellow
fever, if there has been a needlestick or other penetrating puncture of the
skin with a used needle or other contaminated item; a splatter or aerosol into
the eye, nose, or mouth; or any significant contamination of an open wound or
non-intact skin with blood or body fluids;
(4) amebiasis; campylobacteriosis; cholera;
cryptosporidiosis; Escherichia coli O157:H7 or other Shiga
toxin-producing E. coli infection; hepatitis A; poliomyelitis;
salmonellosis, including typhoid fever; shigellosis; and
Vibrio infections, if fecal material is ingested;
(5) Methicillin-resistant
Staphylococcus aureus (MRSA) wounds, skin infections or soft
tissue infections, if there has been contact of non-intact skin to these
infections or drainage from these infections; and
(6) any other reportable disease or a disease
caused by a select agent or toxin identified or listed under
42 C.F.R. §
73.3, if there has been an exposure via the
usual mode of transmission of that disease as determined by the department or
the local health authority.
(d) Notification processes. The entity that
employs or uses the services of an emergency response employee or volunteer is
responsible for notifying the local health authorities or local health care
facilities that the entity has a designated infection control officer or
alternate designated infection control officer. The following notification
processes shall apply when possible exposures to notifiable conditions occur.
(1) If the hospital has knowledge that, on
admission to the hospital, the person transported has any of the notifiable
conditions listed in subsection (c)(1) of this section, then notice of a
possible exposure of an emergency response employee or volunteer to the disease
shall be given to the health authority for the jurisdiction where the hospital
is located and the designated infection control officer of the entity that
employs or uses the services of the emergency response employee or
volunteer.
(2) For possible
exposures to any of the diseases listed in subsection (c)(2) - (6) of this
section, the emergency response employee or volunteer or the designated
infection control officer of the employing entity shall provide a medical
professional at the hospital with notice, preferably written, of the
circumstances of the possible exposure. Once the hospital has knowledge of a
possible exposure, then notice shall be given as follows.
(A) The hospital shall report the following
information to the health authority for the jurisdiction where the hospital is
located and the designated infection control officer of the entity that employs
or uses the services of the emergency response employee or volunteer:
(i) the name of the emergency response
employee or volunteer possibly exposed;
(ii) the date of the exposure;
(iii) the circumstances of the
exposure;
(iv) whether laboratory
testing was performed for diseases potentially transmitted by such exposures;
and
(v) positive or negative test
results for these diseases.
(B) The health authority or designated
infection control officer of the entity that employs or uses the services of
the affected emergency response employee or volunteer shall determine whether
or not significant risk of disease transmission exists and report his/her
assessment of the possible exposure event to the emergency response employee or
volunteer.
(C) A person notified of
a possible exposure under this section shall maintain the confidentiality of
the information provided to him or her.
(e) Obligation to test. This section does not
create a duty for a hospital to perform a test that is not necessary for the
medical management of the person delivered to the hospital.
