N.H. Code Admin. R. He-P 301.05

Current through Register No. 24, June 13, 2024

Section He-P 301.05 - Restriction and Control Measures for Isolation and Quarantine for Specific Diseases

(a) For a case or suspect case of cutaneous and inhalation anthrax, hospitals and other institutional settings shall institute standard precautions according to He-P 301.04 for the duration of the illness.

(b) For a case or suspect case of diphtheria, isolation precautions shall be instituted as follows:

(1) For a case, suspect case or carrier of pharyngeal or cutaneous diphtheria, hospitals and other institutional settings shall maintain appropriate isolation in accordance with He-P 301.04 until 2 cultures from both throat and nose or skin lesions in cutaneous diphtheria taken not less than 24 hours apart and not less than 24 hours after cessation of antimicrobial therapy, fail to show diphtheria bacilli;

(2) Where culture is impractical, isolation may be ended after 14 days of appropriate antibiotic treatment; and

(3) For all close contacts of cases or suspect cases of pharyngeal or cutaneous diphtheria, employers shall exclude close contacts of cases or suspect cases from the following job duties until cultures prove them not to be carriers:

a. Job duties involving the handling of food;

b. Child care job duties; and

c. Direct care of hospitalized and institutionalized patients.

(c) For a case or suspect case of gonococcal ophthalmia neonatorum:

(1) Precautions shall be instituted in accordance with He-P 301.04; and

(2) The health care provider shall institute isolation of the individual for the first 24 hours after administration of effective therapy.

(d) For a case or suspect case of invasive Haemophilus influenzae infection, the health care provider shall institute appropriate isolation in accordance with He-P 301.04 for 24 hours after the start of appropriate antibiotic therapy.

(e) For a case or suspect case of hepatitis, isolation precautions shall be as follows:

(1) For persons with hepatitis A:

a. Employers shall exclude cases or suspect cases from the following job duties until one week after onset of jaundice or until hepatitis A has been ruled out:

1. Job duties involving the handling of food;

2. Child care job duties; and

3. Direct care of hospitalized and institutionalized patients; and

b. Cases or suspect cases shall be excluded from attending child care agencies until one week after the onset of jaundice or until hepatitis A has been ruled out; and

(2) For persons with hepatitis B or C, precautions shall be instituted in accordance with He-P 301.04.

(g) For a case or suspect case of measles or rubeola, the following control measures shall be instituted:

(1) The admitting official shall exclude a case or suspect case from the grounds of public and non-public schools and child care agencies for at least 4 days after appearance of the rash;

(2) Hospitals and other institutional settings shall institute appropriate isolation in accordance with He-P 301.04 from recognition of clinical illness through the fourth day of rash; and

(3) If the case or suspect case occurs in a health care facility:

a. The facility shall ensure that the following susceptible personnel receive a dose of measles vaccine:

1. All employees who cannot provide documentation of:

(i) Two doses of measles vaccine on or after their first birthday, the second dose a minimum of 28 days from the first; or

(ii) Serologic evidence of immunity to measles; and

b. The facility shall exclude susceptible personnel who have been exposed from direct patient contact from the 5th to the 21st day after exposure regardless of whether they received vaccine or immune globulin after the exposure.

(h) For a case or suspect case of meningococcemia, or infection with invasive Neisseria meningitidis, the health care provider shall institute appropriate isolation in accordance with He-P 301.04 for 24 hours after start of antibiotic therapy.

(i) For a case or suspect case of mumps, the following control methods shall be instituted:

(1) The admitting official shall exclude a case or suspect case from public and non-public schools or child care agencies for 5 days from onset of salivary gland swelling; and

(2) For a case or suspect case in hospitals or other institutional settings:

a. The health care provider shall institute appropriate isolation in accordance with He-P 301.04; and

b. The health care provider shall isolate the confirmed or suspect case in a private room for 5 days from onset of salivary gland swelling; and

(3) For all close contacts of cases or suspect cases of mumps, employers shall exclude susceptible close contacts of cases or suspect cases from the following job duties from days 12-26 post exposure:

a. Job duties involving the handling of food;

b. Child care job duties; and

c. Direct care of hospitalized and institutionalized patients.

(j) For a case or suspect case of pertussis, the following control methods shall be instituted:

(1) Confirmed or suspect cases in hospitals or other institutional settings shall be placed in appropriate isolation in accordance with He-P 301.04 by the health care provider until they have received 5 days of antibiotics;

(2) Admitting officials and employers shall exclude confirmed or suspect cases and symptomatic household contacts from the following places until they have received at least 5 days of appropriate antibiotics:

a. Public and non-public schools;

b. Child care agencies; and

c. Work places; and

(3) Health facilities shall exclude health care workers and other adults with suspect or confirmed pertussis from patient/public contact until they have received 5 days of a course of antibiotics.

(k) For confirmed or suspect cases of poliomyelitis, hospitals shall institute isolation in accordance with He-P 301.04.

(l) For confirmed or suspect cases of rabies, hospitals shall institute appropriate isolation in accordance with He-P 301.04.

(m) For confirmed or suspect rubella, including congenital rubella syndrome, the following control methods shall be instituted:

(1) In hospitals and institutions, patients suspected of having rubella shall be managed under appropriate isolation in accordance with He-P 301.04 and placed in a private room for 7 days after the onset of rash;

(2) Admitting officials and employers shall exclude cases or suspect cases from public and non-public schools, child care agencies and work places for 7 days after onset of rash; and

(3) Hospitals and other health care facilities shall ensure that both male and female health care personnel who may be exposed to patients with rubella are immunized unless there is evidence of previous immunity.

(n) For a case or suspected case of shigellosis, E. coli 0157, and other shiga toxin producing E. coli:

(1) Precautions shall be instituted in accordance with He-P 301.04;

(2) Employers shall exclude cases or suspect cases from the following job duties until stool cultures are free of the microorganism on 2 consecutive specimens collected not less than 24 hours apart and at least 48 hours after the last dose of antibiotics, if prescribed:

a. Job duties involving the handling of food;

b. Child care job duties; and

c. Direct care of hospitalized and institutionalized patients; and

(3) Children who are cases or suspect cases shall be excluded from child care settings until stool cultures are free of the microorganism on 2 consecutive specimens collected not less than 24 hours apart and at least 48 hours after the last does of antibiotics, if prescribed.

(o) For a case or suspected case of tuberculosis (TB), the following control methods shall be instituted:

(1) Employers and admitting officials shall exclude confirmed or suspect cases of TB from congregate settings, with the exception of patients being cared for in a healthcare facility under appropriate precautions, until TB has been ruled out or the confirmed or suspect case is deemed to be non-infectious by the department; and

(2) Health care providers shall order a drug susceptibility test on all initial M. tuberculosis cultures performed on the initial isolate in order to assure proper prescription of treatment.

(p) For a case or suspected case of typhoid fever:

(1) Precautions shall be instituted in accordance with He-P 301.04;

(2) Employers and admitting officials shall exclude cases or suspect cases with the Salmonella typhii organism from the following job duties until released from supervision by the local health authority:

a. Job duties involving the handling of food;

b. Child care job duties; and

c. Direct care of hospitalized and institutionalized patients;

(3) Children who are cases or suspect cases shall be excluded from child care settings until released from supervision by the local health authority; and

(4) The local health authority shall supervise confirmed or suspect cases until:

a. Not less than 3 consecutive cultures of feces, each taken at least 24 hours apart and at least 48 hours after last dose of any antibiotic and not earlier than one month after illness onset are negative; and

b. If any one of the cultures in a. above is positive, the culture series shall be repeated at intervals of one month during the 12-month period following illness onset until at least 3 consecutive negative cultures are obtained.

(q) For a case or suspect case of varicella disease:

(1) Admitting officials and employers shall exclude a case, suspect case, or an individual with vesicular eruption related to varicella disease, from the following places for 5 days after eruption first appears until vesicles become dry, or in immunized people without crusts, until no new lesions appear within a 24 hour period:

a. Public and non-public schools;

b. Child care agencies; and

c. Work places; and

(2) Hospitals shall maintain appropriate isolation in accordance with He-P 301.04 for 5 days after eruption first appears or until vesicles become dry or until no new onset of lesions appear within 24 hours if the lesions do not crust, i.e. form macules or papules only instead of vesicles.

(r) For any communicable disease that poses a threat to the public's health and not already described in He-P 301.05, all cases, suspect cases, and close contacts of cases or suspect cases of a communicable disease who work in sensitive occupations, such as healthcare, food service, and child care, or who are otherwise located in a congregate setting,shall be excluded or restricted from certain activities until they are no longer infectious in accordance with RSA 141-C:4 if necessary to protect the health and safety of the public from a communicable disease, and based on the best available guidance and recommendations from the Centers for Disease Control and Prevention or other established sources.

(s) Individuals described in (r) above with symptoms of acute gastrointestinal illness shall be excluded from duties involving direct patient care, childcare, or serving of food or the handling of clean dishware, utensils, or equipment until 48 hours after the resolution of symptoms or until such time the employee can provide certification from a physician that the illness is from a non-infectious cause.

N.H. Code Admin. R. He-P 301.05

#2017, eff 5-10-82; ss by #3172, eff 1-2-86; ss by #4230, eff 2-23-87; ss by #4946, eff 10-2-90; EXPIRED: 10-2-96

New. #6634, eff 11-25-97; ss by #8242, eff 12-30-04; ss by #9172, eff 6-6-08; ss by #12033, eff 11-3-16

Amended by Volume XXXVI Number 45, Filed November 10, 2016, Proposed by #12033, Effective 11/3/2016, Expires 11/3/2026.