TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER k: COMMUNICABLE DISEASE CONTROL AND IMMUNIZATIONS
PART 690 CONTROL OF COMMUNICABLE DISEASES CODE
SECTION 690.640 SHIGELLOSIS (REPORTABLE BY MAIL, TELEPHONE, FACSIMILE OR ELECTRONICALLY AS SOON AS POSSIBLE, WITHIN SEVEN DAYS)


 

Section 690.640  Shigellosis (Reportable by mail, telephone, facsimile or electronically as soon as possible, within seven days)

 

a)         Control of Case

 

1)         Standard precautions shall be followed.  Contact precautions shall be followed for diapered or incontinent persons or during institutional outbreaks until diarrhea is absent for 24 hours.

 

2)         Food Handlers or Persons in Sensitive Occupations, Not Including Health Care Workers

Cases with shigellosis shall not work as food handlers or in sensitive occupations until diarrhea has ceased for at least 24 hours and two 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 begin to be submitted within one week after notification.

 

3)         Health Care Workers

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 or oral care, hygienic practices of the worker, 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.

             

b)         Control of Contacts

 

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 Shigella infection during the previous four weeks.

 

ii)         Contacts to cases of shigellosis who are employed as food handlers or in sensitive occupations shall submit two 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 two consecutive negative specimens are obtained or the individual shall be restricted from working.

 

iii)        If either of the two release specimens is positive for Shigella, contacts shall be considered cases and shall comply with subsection (a)(2).

 

B)        Health Care Workers

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 or oral care, hygienic practices of the worker, 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 shigellosis 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 24 hours and they have submitted two 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 either of the two release specimens is positive for Shigella, contacts shall be considered cases and shall comply with subsection (a)(2).

 

B)        Health Care Workers

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 or oral care, hygienic practices of the worker, 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.

 

c)         Sale of Food, Milk, etc. (See Section 690.30(b).)

 

d)         Laboratory Reporting

 

1)         Laboratories shall report to the local health authority patients from whom Shigella has been isolated or patients who have a positive result on any laboratory test indicative of and specific for detecting Shigella infection.

 

2)         Laboratories shall forward clinical materials positive for Shigella to the Department's laboratory.

 

3)         Laboratories shall report and submit to the Department's laboratory any Shigella-positive food or environmental samples resulting from an outbreak investigation.

 

(Source:  Amended at 38 Ill. Reg. 5533, effective February 11, 2014)