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DHS 145.03(18) (18) "Organized program of infection control" means written and implemented policies and procedures for the purpose of surveillance, investigation, control and prevention of infections in a health care facility.
DHS 145.03(19) (19) "Other disease or condition having the potential to affect the health of other persons" means a disease that can be transmitted from one person to another but that is not listed in Appendix A of this chapter and therefore is not reportable under this chapter, although it is listed in Control of Communicable Diseases Manual, 18th edition (2004), edited David L Heymann, and published by the American Public Health Association, unless specified otherwise by the state epidemiologist.
DHS 145.03 Note Note: The handbook, Control of Communicable Diseases Manual, 18th edition (2004), edited by David L. Heymann, is on file in the Department's Division of Public Health and the Legislative Reference Bureau, and is available for purchase from the American Public Health Association, Publications Sales, PO Box 933019, Atlanta, GA 31193-3019.
DHS 145.03(20) (20) "Outbreak" means an unusual aggregation of health events that are grouped together in a short time period and limited geographic area.
DHS 145.03(21) (21) "Personal care" means the service provided by one person to another person who is not a member of his or her immediate household for the purpose of feeding, bathing, dressing, assisting with personal hygiene, changing diapers, changing bedding and other services involving direct physical contact.
DHS 145.03(22) (22) "Physician" means an individual possessing the degree of doctor of medicine or doctor of osteopathy or an equivalent degree as determined by the medical examining board, and holding a license granted by the board under s. 448.01 (5), Stats.
DHS 145.03(23) (23) "Public building" means any privately or publicly owned building which is open to the public.
DHS 145.03(24) (24) "Public health intervention" means an action designed to promote and protect the health of the public.
DHS 145.03(25) (25) "State epidemiologist" means the person appointed by the state health officer under s. 250.02 (1), Stats., to be the person in charge of communicable disease control for the state who serves also as chief medical officer for the acute and communicable disease program area.
DHS 145.03(26) (26) "Surveillance" means the systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpretation of these data and the dissemination of consolidated and processed information to those who need to know.
DHS 145.03(27) (27) "Suspected case" means a person thought to have a particular communicable disease on the basis of clinical or laboratory criteria or both.
DHS 145.03 History History: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (2) and (11), Register, February, 1989, No. 398, eff. 3-1-89; correction in (8) and (9) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; r. and recr. Register, March, 2000, No. 531, eff. 4-1-00; CR 07-090: am. (19) and (20) Register February 2008 No. 626, eff. 3-1-08; correction in (9) made under s. 13.92 (4) (b) 6., Stats., Register January 2009 No. 637.
DHS 145.04 DHS 145.04 Reports of communicable diseases.
DHS 145.04(1)(1) Responsibility for reporting.
DHS 145.04(1)(a)(a) Any person licensed under ch. 441 or 448, Stats., knowing of or in attendance on a case or suspected case shall notify the local health officer or, if required under Appendix A of this chapter, the state epidemiologist, in the manner prescribed in this section.
DHS 145.04(1)(b) (b) Each laboratory shall report the identification or suspected identification of a disease-causing organism or laboratory findings indicating the presence of a communicable disease to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist.
DHS 145.04(1)(bg) (bg) Each laboratory shall forward a specimen to the state laboratory of hygiene, or another laboratory designated by the state epidemiologist, for confirmatory or investigation purposes if requested by the state epidemiologist.
DHS 145.04(1)(br) (br) Each laboratory shall report a negative test result to the local health officer to justify release from isolation or quarantine if requested by the state epidemiologist or the local health officer.
DHS 145.04(1)(c) (c) Each health care facility shall ensure that reports are made to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist, in the manner specified in sub. (3). When a case is identified or suspected in a health care facility having an organized program of infection control, the person in charge of the infection control program shall ensure that the case or suspected case is reported to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist, minimizing unnecessary duplication.
DHS 145.04(1)(cm) (cm) Each health care facility shall report a negative test result to the local health officer to justify release from isolation or quarantine if requested by the state epidemiologist or the local health officer.
DHS 145.04(1)(d) (d) Any teacher, principal or nurse serving a school or day care center knowing of a case or suspected case in the school or center shall notify the local health officer or, if required under Appendix A of this chapter, the state epidemiologist, in the manner prescribed in this section.
DHS 145.04(1)(e) (e) Any person who knows or suspects that a person has a communicable disease shall report the facts to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist.
DHS 145.04(1)(g) (g) Nothing in this subsection lessens the requirement for confidentiality of HIV test results under s. 252.15, Stats.
DHS 145.04(2) (2)Content of report.
DHS 145.04(2)(a)(a) Each report under sub. (1) (a) to (d) of a case or suspected case of a communicable disease to the local health officer or the state epidemiologist shall include the name and address of the person reporting and of the attending physician, if any, the diagnosed or suspected disease, the name of the ill or affected individual, that individual's address and telephone number, age or date of birth, race and ethnicity, sex, county of residence, date of onset of the disease, name of parent or guardian if a minor, and other facts the department or local health officer requires for the purposes of surveillance, control and prevention of communicable disease.
DHS 145.04(2)(b) (b) Reports may be written, verbal, or by electronic transmission. Written reports shall be on the individual case report form provided by the department and distributed by the local health officer or on a form containing the information required under par. (a). Reports shall be submitted to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist.
DHS 145.04(2)(c) (c) Reports by laboratories of the identification or suspected identification of a disease-causing organism or laboratory findings indicating the presence of a communicable disease shall be made to the local health officer or, if required under Appendix A of this chapter, to the state epidemiologist. These reports shall include the name of the individual affected or ill, the individual's address, telephone number, county of residence, age or date of birth, the name of the attending physician and the identity or suspected identity of the organism or the laboratory findings.
DHS 145.04(2)(d) (d) All information provided under this subsection shall remain confidential except as may be needed for the purposes of investigation, control and prevention of communicable diseases.
DHS 145.04(3) (3)Urgency of reports.
DHS 145.04(3)(a)(a) A person, laboratory or health care facility required to report under sub. (1) shall report communicable diseases of urgent public health importance as listed in category I of Appendix A of this chapter to the local health officer immediately upon identification of a case or suspected case. If the local health officer is unavailable, the report shall be made immediately to the state epidemiologist.
DHS 145.04(3)(b) (b) A person, laboratory or health care facility required to report under sub. (1) shall report communicable diseases of less urgent public health importance as listed in categories II and III of Appendix A of this chapter to the local health officer or, if required under Appendix A, to the state epidemiologist, by individual case report form or by telephone within 72 hours of the identification of a case or suspected case.
DHS 145.04(4) (4)Handling of reports by the local health officer.
DHS 145.04(4)(a)(a) The local health officer shall notify the state epidemiologist immediately of any cases or suspected cases reported under sub. (3) (a).
DHS 145.04(4)(b) (b) At the close of each week, the local health officer shall notify the state epidemiologist in writing on a form provided by the department of all cases of reported diseases listed in Appendix A.
DHS 145.04(4)(c) (c) Local health departments serving jurisdictions within the same county may, in conjunction with the department, establish a combined reporting system to expedite the reporting process.
DHS 145.04 History History: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (1), (2) (a) to (c), (3) (a) and (b), cr. (1m), Register, February, 1989, No. 398, eff. 3-1-89; correction in (1m) made under s. 13.93 (2m) (b) 7., Stats., Register, August, 1995, No. 476; renum. and am. (1m) to be (1) (g), am. (3) (a), (4) (a) and cr. (4) (c), Register, March, 2000, No. 531, eff. 4-1-00; CR 07-090: cr. (1) (bg), (br) and (cm), am. (2) (b), r. (3) (c) Register February 2008 No. 626, eff. 3-1-08.
DHS 145.05 DHS 145.05 Investigation and control of communicable diseases.
DHS 145.05(1)(1) The local health officer shall use all reasonable means to confirm in a timely manner any case or suspected case of a communicable disease and shall ascertain so far as possible all sources of infection and exposures to the infection. Follow-up and investigative information shall be completed by the local health officer and reported to the state epidemiologist on forms provided by the department.
DHS 145.05(2) (2) Local health officers shall follow the methods of control set out in section 9 under each communicable disease listed in the 18th edition (2004) of Control of Communicable Diseases Manual, edited by David L. Heymann, published by the American Public Health Association, unless specified otherwise by the state epidemiologist. Specific medical treatment shall be prescribed by a physician or an advanced practice nurse prescriber.
DHS 145.05(3) (3) Any person licensed under ch. 441 or 448, Stats., attending a person with a communicable disease shall instruct the person in the applicable methods of control contained in Control of Communicable Diseases Manual, 18th edition (2004), edited by David L. Heymann, published by the American Public Health Association, unless specified otherwise by the state epidemiologist, and shall cooperate with the local health officer and the department in their investigation and control procedures.
DHS 145.05(4) (4) The department in cooperation with the local health officer shall institute special disease surveillances, follow-up reports and control measures consistent with contemporary epidemiologic practice in order to study and control any apparent outbreak or unusual occurrence of communicable diseases.
DHS 145.05 Note Note: The handbook, Control of Communicable Diseases Manual, 18th edition (2004), edited by David L. Heymann, is on file in the Department's Division of Public Health and the Legislative Reference Bureau, and is available for purchase from the American Public Health Association, Publications Sales, PO Box 933019, Atlanta, GA 31193-3019.
DHS 145.05 History History: Cr. Register, April, 1984, No. 340, eff. 5-1-84; am. (2) and (3), Register, February, 1989, No. 398, eff. 3-1-89; am. (2) and (3), Register, March, 2000, No. 531, eff. 4-1-00; CR 03-033: am. (2) and (3) Register Register December 2003 No. 576, eff. 1-1-04; CR 07-090: am. (2) and (3) Register February 2008 No. 626, eff. 3-1-08.
DHS 145.06 DHS 145.06 General statement of powers for control of communicable disease.
DHS 145.06(1) (1) Applicability. The general powers under this section apply to all communicable diseases listed in Appendix A of this chapter and any other infectious disease which the chief medical officer deems poses a threat to the citizens of the state.
DHS 145.06(2) (2)Persons whose substantiated condition poses a threat to others. A person may be considered to have a contagious medical condition which poses a threat to others if that person has been medically diagnosed as having any communicable disease and exhibits any of the following:
DHS 145.06(2)(a) (a) A behavior which has been demonstrated epidemiologically to transmit the disease to others or which evidences a careless disregard for the transmission of the disease to others.
DHS 145.06(2)(b) (b) Past behavior that evidences a substantial likelihood that the person will transmit the disease to others or statements of the person that are credible indicators of the person's intent to transmit the disease to others.
DHS 145.06(2)(c) (c) Refusal to complete a medically directed regimen of examination and treatment necessary to render the disease noncontagious.
DHS 145.06(2)(d) (d) A demonstrated inability to complete a medically directed regimen of examination and treatment necessary to render the disease noncontagious, as evidenced by any of the following:
DHS 145.06(2)(d)1. 1. A diminished capacity by reason of use of mood-altering chemicals, including alcohol.
DHS 145.06(2)(d)2. 2. A diagnosis as having significantly below average intellectual functioning.
DHS 145.06(2)(d)3. 3. An organic disorder of the brain or a psychiatric disorder of thought, mood, perception, orientation or memory.
DHS 145.06(2)(d)4. 4. Being a minor, or having a guardian appointed under ch. 54, Stats., following documentation by a court that the person is incompetent.
DHS 145.06(2)(e) (e) Misrepresentation by the person of substantial facts regarding the person's medical history or behavior, which can be demonstrated epidemiologically to increase the threat of transmission of disease.
DHS 145.06(2)(f) (f) Any other willful act or pattern of acts or omission or course of conduct by the person which can be demonstrated epidemiologically to increase the threat of transmission of disease to others.
DHS 145.06(3) (3)Persons whose suspected condition poses a threat to others. A person may be suspected of harboring a contagious medical condition which poses a threat to others if that person exhibits any of the factors noted in sub. (2) and, in addition, demonstrates any of the following without medical evidence which refutes it:
DHS 145.06(3)(a) (a) Has been linked epidemiologically to exposure to a known case of communicable disease.
DHS 145.06(3)(b) (b) Has clinical laboratory findings indicative of a communicable disease.
DHS 145.06(3)(c) (c) Exhibits symptoms that are medically consistent with the presence of a communicable disease.
DHS 145.06(4) (4)Authority to control communicable diseases. When it comes to the attention of an official empowered under s. 250.02 (1), 250.04 (1) or 252.02 (4) and (6), Stats., or under s. 252.03 (1) and (2), Stats., that a person is known to have or is suspected of having a contagious medical condition which poses a threat to others, the official may direct that person to comply with any of the following, singly or in combination, as appropriate:
DHS 145.06(4)(a) (a) Participate in a designated program of education or counseling.
DHS 145.06(4)(b) (b) Participate in a defined program of treatment for the known or suspected condition.
DHS 145.06(4)(c) (c) Undergo examination and tests necessary to identify a disease, monitor its status or evaluate the effects of treatment on it.
DHS 145.06(4)(d) (d) Notify or appear before designated health officials for verification of status, testing or direct observation of treatment.
DHS 145.06(4)(e) (e) Cease and desist in conduct or employment which constitutes a threat to others.
DHS 145.06(4)(f) (f) Reside part-time or full-time in an isolated or segregated setting which decreases the danger of transmission of the communicable disease.
DHS 145.06(4)(g) (g) Be placed in an appropriate institutional treatment facility until the person has become noninfectious.
DHS 145.06(5) (5)Failure to comply with directive. When a person fails to comply with a directive under sub. (4), the official who issued the directive may petition a court of record to order the person to comply. In petitioning a court under this subsection, the petitioner shall ensure all of the following:
DHS 145.06(5)(a) (a) That the petition is supported by clear and convincing evidence of the allegation.
DHS 145.06(5)(b) (b) That the respondent has been given the directive in writing, including the evidence that supports the allegation, and has been afforded the opportunity to seek counsel.
DHS 145.06(5)(c) (c) That the remedy proposed is the least restrictive on the respondent which would serve to correct the situation and to protect the public's health.
DHS 145.06(6) (6)Hazards to health. Officials empowered under ss. 250.02 (1), 250.04 (1) and 252.02 (4) and (6), Stats., or under s. 252.03 (1) and (2), Stats., may direct persons who own or supervise real or physical property or animals and their environs, which present a threat of transmission of any communicable disease under sub. (1), to do what is reasonable and necessary to abate the threat of transmission. Persons failing or refusing to comply with a directive shall come under the provisions of sub. (5) and this subsection.
DHS 145.06 History History: Cr. Register, March, 2000, No. 531, eff. 4-1-00; correction in (2) (d) 4. made under s. 13.92 (4) (b) 7., Stats., Register February 2008 No. 626.
DHS 145.07 DHS 145.07 Special disease control measures.
DHS 145.07(1)(1) Schools and day care centers. Any teacher, principal, director or nurse serving a school or day care center may send home, for the purpose of diagnosis and treatment, any pupil suspected of having a communicable disease or of having any other disease or condition having the potential to affect the health of other students and staff including but not limited to pediculosis and scabies. The teacher, principal, director or nurse authorizing the action shall ensure that the parent, guardian or other person legally responsible for the child or other adult with whom the child resides and the nurse serving the child's school or day care center are immediately informed of the action. A teacher who sends a pupil home shall also notify the principal or director of the action.
DHS 145.07(2) (2)Personal care. Home health agency personnel providing personal care in the home and persons providing personal care in health care facilities, day care centers and other comparable facilities shall refrain from providing care while they are able to transmit a communicable disease through the provision of that care, in accord with the methods of communicable disease control contained in Centers for Disease Control and Prevention, "Guideline for Infection Control in Health Care Personnel, 1998," unless specified otherwise by the state epidemiologist.
DHS 145.07 Note Note: The publication, Centers for Disease Control and Prevention, "Guideline for Infection Control in Health Care Personnel, 1998," is on file in the Department's Division of Public Health and the Legislative Reference Bureau, and is available for purchase from the National Technical Information Service (NTIS), U.S. Dept. of Commerce, 5285 Port Royal Road, Springfield, VA 22161, (703) 486-4650.
DHS 145.07(3) (3)Food handlers. Food handlers shall refrain from handling food while they have a disease in a form that is communicable by food handling, in accord with the methods of communicable disease control contained in Control of Communicable Diseases Manual, 16th edition (1995), edited by Abram S. Benenson, and published by the American Public Health Association, unless specified otherwise by the state epidemiologist.
DHS 145.07 Note Note: The handbook, Control of Communicable Disease Manual, 16th edition (1995), edited by Abram S. Benenson, is on file in the Department's Division of Public Health and the Legislative Reference Bureau, and is available for purchase from the American Public Health Association, 1015 Fifteenth St., NW, Washington D.C. 20005.
DHS 145.07(4) (4)Prevention of ophthalmia neonatorum. The attending physician or midwife shall ensure placement of 2 drops of a one percent solution of silver nitrate, or a 1-2 centimeter ribbon of an ophthalmic ointment containing 0.5% erythromycin or one percent tetracycline, in each eye of a newborn child as soon as possible after delivery but not later than one hour after delivery. No more than one newborn child may be treated from an individual container.
DHS 145.07 History History: Cr. Register, April, 1984, No. 340, eff. 5-1-84; r. and recr. (4), Register, November, 1984, No. 347, eff. 12-1-84; am. (1) to (3), Register, February, 1989, No. 398, eff. 3-1-89; renum. from HFS 145.06 and am., Register, March, 2000, No. 531, eff. 4-1-00.
subch. II of ch. DHS 145 Subchapter II — Tuberculosis
DHS 145.08 DHS 145.08 Definitions. In this subchapter:
DHS 145.08(1) (1) "Case management" means the creation and implementation of an individualized treatment plan for a person with tuberculosis infection or disease that ensures that the person receives appropriate treatment and support services in a timely, effective, and coordinated manner.
DHS 145.08(2) (2) "Confinement" means the restriction of a person with tuberculosis to a specified place in order to prevent the transmission of the disease to others, to prevent the development of drug-resistant organisms or to ensure that the person receives a complete course of treatment.
DHS 145.08(3) (3) "Contact" means a person who shares air with a person who has infectious tuberculosis.
DHS 145.08(4) (4) "Contact investigation" means the process of identifying, examining, evaluating and treating a person at risk of infection with Mycobacterium tuberculosis due to recent exposure to infectious tuberculosis or suspected tuberculosis.
DHS 145.08(5) (5) "Directly observed therapy" means the ingestion of prescribed anti-tuberculosis medication that is observed by a health care worker or other responsible person acting under the authority of the local health department.
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