Section 690.1000  General Procedures for the Control of Communicable Diseases

The purpose of this Subpart is to establish routine measures for the control of communicable diseases by the Department or local health authorities and health care providers.  This Subpart establishes progressive initiatives to ensure that disease-appropriate measures are implemented to control the spread of communicable diseases.  These procedures are intended for use in homes and similar situations. This Subpart does not apply to Sexually Transmissible Diseases.  Sexually Transmissible Diseases are regulated under 77 Ill. Adm. Code 693.

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)         Each case or cluster of a reportable communicable disease 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.

3)         The Department or local health authority may investigate the occurrence of cases, suspected cases, or carriers of reportable diseases or unusual disease occurrences in a public or private place for the purposes of verifying the existence of disease; ascertaining the source of the disease-causing agent; identifying unreported cases; locating and evaluating contacts of cases and suspected cases; identifying those at risk of disease; determining necessary control measures, including isolation and quarantine; and informing the public if necessary.

4)         When the Director determines that a certain disease or condition that is known or suspected to be communicable or infectious warrants study, 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 such information, data and reports, and allow review and examination of medical records as are necessary for the purpose of the specific study.  No such practitioner or person shall be liable in any action at law for permitting such examination and review. The data so obtained shall be held confidential in accordance with the Communicable Disease Report Act [745 ILCS 45].

5)         When cases of reportable infectious disease occur in any business, organization, institution or private home, the business owner, the person in charge of the establishment, or the homeowner shall cooperate with public health authorities in the investigation, including, but not limited to, release of food preparation methods, menus, customer lists, environmental specimens, food specimens, clinical specimens and the name and other pertinent information about employees or guests diagnosed with a communicable disease as the information relates to an infectious disease investigation.

6)         When two or more cases of a reportable communicable disease occur in association with a common source, the investigation should include a search for additional cases.

7)         The Department may conduct sentinel surveillance for an infectious disease or syndrome, other than those diseases or syndromes for which general reporting is required under this Part, if the Department determines that sentinel surveillance will provide adequate data for the purpose of preventing or controlling disease or achieving other significant public health purposes.  The Department shall select, after consultation with the sites, sentinel surveillance sites that have epidemiological significance for the disease or syndrome under investigation.  A disease or syndrome may be removed from sentinel surveillance if the Department determines that the surveillance is no longer necessary.  The Department shall provide a description, in writing, to sentinel surveillance sites of a specific, planned mechanism for surveillance of the disease or syndrome and/or submission of clinical materials from cases and suspect cases.

8)         Investigations of outbreaks shall be summarized in a final report and submitted to the Department.  The most current summary form shall be used, and a narrative report may also be requested.

9)         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; to investigate causes; to identify other cases related to the outbreak or the reported dangerously contagious or infectious disease in a region, community, or workplace; to conduct epidemiologic studies; to determine whether a patient with a reportable dangerously contagious or infectious disease has received adequate treatment to render the patient non-infectious or whether a person exposed to a case has received prophylaxis, 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 to collect pertinent and relevant information about the causes of or risk factors for the reportable 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 locating information about persons, travelers, passengers, or transportation crews with a similar or common potential exposure to the infectious agent as a reported case; such 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 dangerously contagious or infectious disease 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 reportable dangerously contagious or infectious disease;

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 reportable dangerously contagious or infectious disease.  Investigations shall be conducted during regular business hours, if possible, and with such notice as is possible under the circumstances.

b)         Control of Food Products.  Whenever a case, a carrier, or a suspected 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 as deemed necessary by the Department or the local health authority to prevent the transmission of communicable diseases.

1)         Cholera

2)         Cryptosporidiosis

3)         Diphtheria

4)         E. coli infections (Shiga toxin-producing E. coli, Enterotoxigenic E. coli, Enteropathogenic E. coli and Enteroinvasive E. coli)

5)         Foodborne or waterborne illness

6)         Giardiasis

7)         Hepatitis A

8)         Norovirus

9)         Salmonellosis

10)       Shigellosis

11)       Smallpox

12)       Staphylococcal skin infections

13)       Streptococcal infections

14)       Typhoid fever

15)       Yersiniosis

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 of the school, facility or college/university.

2)         Persons suspected of being infected with a reportable infectious disease for which isolation is required, or persons with diarrhea believed to be infectious in nature, shall be refused admittance to the school or child care facility while acute symptoms are present.

3)         School, child care facility, and college/university authorities shall handle contacts of infectious disease cases in the manner prescribed in this Part, or as recommended by the local health authority.

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 laboratory.  The number of specimens needed for release, as detailed under specific diseases, is the minimum and may be increased when deemed necessary by the Department.

2)         The local health authority may require testing of foodhandlers for specific pathogens, including, but not limited to, Norovirus, as deemed necessary in response to an outbreak.

(Source:  Amended at 32 Ill. Reg. 3777, effective March 3, 2008)