Section 410 IAC 1-2.5-130 - Salmonellosis, nontyphoidal; specific control measuresAuthority: IC 16-19-3-4; IC 16-41-2-1
Affected: IC 16-41-2; IC 16-41-9
Sec. 130.
The specific control measures for salmonellosis, nontyphoidal (infectious agent: Salmonella species) are as follows:
(1) An investigation by the local health officer shall meet the following conditions: (A) Be performed within seventy-two (72) hours.(B) Include a three (3) day food and drink consumption history prior to symptom onset with emphasis on exposure to inadequately cooked poultry and poultry products, uncooked or lightly cooked eggs or egg products, and unpasteurized milk products.(C) Determine if meal companions are additional cases.(D) If a commercial food product or restaurant is suspected, active surveillance shall be conducted to identify additional cases.(E) Determine if the case is part of an outbreak.(F) Determine if the case is a:(iii) health care worker; or(iv) daycare attendee, a school attendee, or anyone who lives at a residential institution. Medical evaluation, including adequate laboratory examination of feces of contacts, should be limited to food employees, daycare workers, health care workers, or other situations where outbreaks may occur.
(2) In addition to standard precautions, contact precautions should be used for diapered and incontinent children for the duration of illness. For others, the following guidelines apply:(A) Cases who are food employees shall be excluded from employment involving food handling until asymptomatic from vomiting and diarrhea for at least twenty-four (24) hours, then restrict until all of the following have occurred: (i) The case has been counseled about preventive measures, such as hand washing procedures, that must be followed to prevent transmission of disease.(ii) The local health officer has discussed the following topics with the employer:(AA) The employer's duty to comply with local and state rules pertaining to prevention of infectious diseases.(BB) The availability of proper hand washing facilities for all employees.(CC) The correction of any observed lapses in hygienic measures by employees.(iii) The person in charge obtains approval from the regulatory authority.(iv) One (1) of the following has been met: (AA) The local health officer has determined the case has been asymptomatic for at least twenty-four (24) hours and the food employee is free of a nontyphoidal Salmonella infection based on test results that show two (2) consecutive negative stool cultures have been collected: (aa) at least twenty-four (24) hours apart; and(bb) at least forty-eight (48) hours after cessation of antimicrobial treatment.(BB) The local health officer has determined more than thirty (30) days have passed since the food employee became asymptomatic.(CC) The local health officer has determined the case did not develop symptoms, and more than thirty (30) days have passed since the food employee was diagnosed.(B) Cases employed as daycare workers, health care workers, or in similar positions shall be excluded from employment involving direct care of children or hospitalized or institutionalized patients until all of the following have occurred: (i) The local health officer has determined the case has been asymptomatic for at least twenty-four (24) hours.(ii) The case has been counseled about preventive measures, such as hand washing procedures, that must be followed to prevent transmission of disease.(iii) The local health officer has discussed the following topics with the employer:(AA) The employer's duty to comply with local and state rules pertaining to prevention of infectious diseases.(BB) The availability of required proper hand washing facilities for employees.(CC) The correction of any observed lapses in hygienic measures by employees. (C) Cases shall be excluded from attending schools, preschools, and daycare facilities until all of the following have occurred:(i) The local health officer has determined the case has been asymptomatic for at least twenty-four (24) hours.(ii) The case or case's guardian has been counseled about preventive measures, such as hand washing procedures, that must be followed to prevent transmission of disease.(iii) The local health officer has discussed with the appropriate school, preschool, or daycare facility staff the need: (AA) for proper hand washing procedures and other infection control practices; and(BB) to comply with all local and state rules pertaining to prevention of infectious diseases. (D) If an outbreak of the infection occurs in a daycare facility or preschool, the following shall occur: (i) All attendees and staff may be required to submit stool specimens for examination.(ii) Instead of exclusion, attendees and staff may be isolated from other attendees and staff in the same facility based on symptoms, laboratory testing, and treatment. This alternative shall only be considered if the physical structure and staff organization of the facility can accommodate isolation of various attendee groups from one another. If this alternative is selected, increased emphasis on hand washing procedures and environmental cleaning is necessary.(iii) Admission of all new attendees may be suspended while the outbreak continues.(3) Concurrent disinfection of feces and soiled articles is required. Feces may be discarded in a sanitary sewer without prior disinfection. Terminal cleaning is required.(4) Reporting of disease is required to follow the "When to Report (from probable diagnosis)" time frame and salmonellosis antimicrobial susceptibility testing results are to be reported as soon as they become available.(5) Quarantine is not required.(6) Immunization is not available. Protection of contacts is not applicable.(7) The Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists set the standard clinical and laboratory case definition.Indiana State Department of Health; 410 IAC 1-2.5-130; filed 11/25/2015, 2:54 p.m.: 20151223-IR-410150039FRAReadopted filed 11/12/2021, 8:41 a.m.: 20211208-IR-410210385RFA