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Administrative Rules of Montana |
Sub-Chapter 616.28.601 MINIMAL CONTROL MEASURES (1) This subchapter contains minimal control measures to prevent the spread of disease which must be employed by a local health officer, an attending physician, or any other person caring for a person with a reportable disease.
(2) If a reportable disease is not listed in this subchapter, no minimum control measures for the disease are required. (History: Sec. 50-1-202, 50-2-116, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-116, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.601A ACQUIRED IMMUNE DEFICIENCY SYNDROME
(1) Whenever acquired immune deficiency infection occurs, blood and body fluid precautions must be used for the duration of the infection. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.602 AMEBIASIS (1) Whenever a case of amebiasis occurs:
(a) Enteric precautions are required.
(b) Feces must be disposed of by flushing down a toilet attached to a municipal or other sewage system approved by the department. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.603 ANTHRAX (1) Whenever a case of anthrax occurs:
(a) If skin lesions exist, drainage and secretion precautions must be used until lesions are bacteriologically free of anthrax bacilli.
(b) All bodily discharges must be concurrently disinfected.
(2) Strict isolation must be imposed upon each case of inhalation anthrax. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.604 BOTULISM--INFANT BOTULISM (1) Feces must be concurrently disinfected or flushed down a toilet attached to a municipal or other sewage system approved by the department.
(2) The local health officer shall make an immediate investigation of every case or suspected case of botulism in an effort to establish the diagnosis and determine the source.
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(3) In the event that a commercial food product is suspected as the source, special instructions will be given by the department. The local health officer shall prevent distribution and consumption of the suspected food. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.605 BRUCELLOSIS (1) Drainage and secretion precautions must be used.
(2) Concurrent disinfection of purulent discharges is necessary. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.605A CAMPYLOBACTER ENTERITIS (1) Enteric precautions must be observed.
(2) The local health officer may not allow an infected person to engage in a sensitive occupation as described in ARM 16.28.301 until stool specimens are clear of the organisms causing campylobacter diarrhea. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.605B CHANCROID (1) A person infected with chancroid must be directed not to engage in sexual contact until all chancroid lesions are healed. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.605C CHICKENPOX IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.605D CHLAMYDIAL GENITAL INFECTION (1) An individual with a chlamydial genital infection must be directed to undergo appropriate antibiotic therapy and to avoid sexual contact until 24 hours have passed after completion of the treatment regimen.
(2) An individual who contracts the infection must be interviewed to determine the person's sexual contacts, and those contacts must be examined and must receive the medical treatment indicated by clinical and laboratory findings. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, 50-18-107, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; AMD, 1995 MAR p. 1127, Eff. 6/30/95.)
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16.28.606 CHOLERA (1) Enteric precautions must be employed. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.606A COLORADO TICK FEVER (1) Blood and body fluid precautions must be employed.
(2) The infected person must be directed not to donate blood for four months after the date of diagnosis. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.606B CONJUNCTIVITIS EPIDEMIC IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; AMD, 1994 MAR p. 1295, Eff. 5/13/94; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.606C DIARRHEAL DISEASE OUTBREAK (1) Enteric precautions must be imposed on persons employed in sensitive occupations.
(2) Enteric precautions must be imposed until laboratory tests determine the etiologic agent involved, after which control measures must be imposed which are appropriate for that agent and set out in "Control of Communicable Diseases in Man, An Official Report of the American Public Health Association", 15th Edition, 1990.
(3) The department hereby adopts and incorporates by reference "Control of Communicable Diseases in Man, An Official Report of the American Public Health Association", 15th edition, 1990, which lists and specifies control measures for communicable diseases. A copy of "Control of Communicable Diseases in Man" may be obtained from the American Public Health Association, 1015 15th Street NW, Washington, DC 20005. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; AMD, 1994 MAR p. 1295, Eff. 5/13/94.)
16.28.606D CRYPTOSPORIDIOSIS (1) Enteric precautions must be used by a case employed in a sensitive occupation, as described in ARM 16.28.301, until 3 post-treatment stool specimens collected on 3 successive days test negative.
(2) Sources of infection must be sought, especially in the home, within the family, in food, and in water. (History: Sec. 50-1-202, MCA; IMP, Sec. 50-1-202, MCA; NEW, 1995 MAR p. 1127, Eff. 6/30/95.)
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16.28.607 DIPHTHERIA (1) For a confirmed case of diphtheria, strict isolation of an infected person must be imposed until 2 cultures, taken not less than 24 hours apart and not less than 24 hours after cessation of antimicrobial therapy, from nose and throat fail to show diphtheria bacilli, except that upon clinical recovery and when appropriate antibiotics have been used as therapy, respiratory isolation may be imposed instead of strict isolation, ending 14 days after the date administration of antibiotics commenced.
(2) All household contacts must be placed under quarantine until their nose and throat cultures are negative.
(3) All carriers must be treated unless medically contraindicated.
(4) A contact in a sensitive occupation must be excluded from work until s/he is determined not to be a carrier.
(5) The local health officer must initiate surveillance for susceptible contacts and must recommend immediate immunization to any such contact found. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.607A ESCHERICHIA COLI 0157:H7 ENTERITIS
(1) Enteric precautions must be observed.
(2) The local health officer may not allow an infected person to engage in a sensitive occupation as described in ARM 16.28.301 until stool specimens are culture-negative for escherichia coli 0157:H7 enteritis. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1994 MAR p. 1295, Eff. 5/13/94.)
16.28.608 ENCEPHALITIS (1) The local health officer must search for undetected cases of encephalitis and, in the cases where the encephalitis is mosquito-borne, for vector mosquitoes, as well. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.608A GASTROENTERITIS EPIDEMIC (1) Enteric precautions must be employed until laboratory tests indicate what organism is responsible for the infection, after which control measures must be taken which are specific for the organism in question. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.609 GIARDIASIS (1) Enteric precautions must be used by a case employed in a sensitive occupation until three post-treatment stool specimens collected on 3 successive days are negative.
(2) Sources of infection must be sought, especially in
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the home, within the family, in food, and in water. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.609A GONOCOCCAL INFECTION (1) A person who contracts genital gonococcal infection must be directed to undergo appropriate antibiotic therapy and to avoid sexual contact until 24 hours have passed after completion of the treatment regimen.
(2) An individual who contracts the infection must be interviewed to determine the person's sexual contacts, and those contacts must be examined and must receive the medical treatment indicated by clinical and laboratory findings. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, 50-18-107, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; AMD, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.610 GONOCOCCAL OPHTHALMIA NEONATORUM IS REPEALED (History: Sec. 50-1-202, 50-2-118 MCA; IMP, Sec. 50-1-202, 50-2-118 MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.610A GRANULOMA INGUINALE (1) Contact with lesions must be avoided until after the lesions are healed.
(2) Examination and epidemiological treatment of sexual contacts is recommended. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.610B HAEMOPHILUS INFLUENZA B INVASIVE DISEASE
(1) Contacts must be identified in order to determine if chemoprophylaxis is advisable. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.610C HANSEN'S DISEASE (LEPROSY) (1) For a case of Hansen's disease, modified isolation must be imposed if the infected person is infectious. The degree of isolation must be determined by the local health officer, who must be advised by a physician specially qualified to manage this disease. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.610D HANTAVIRUS PULMONARY SYNDROME (1) The local health officer must conduct studies to determine the source of the infection. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1994 MAR p. 1295, Eff. 5/13/94.)
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16.28.610E HEMOLYTIC UREMIC SYNDROME (1) Enteric precautions must be observed.
(2) The local health officer may not allow an infected person to engage in a sensitive occupation, as described in ARM 16.28.301, until stool specimens are culture-negative for escherichia coli 0157:H7 enteritis. (History: Sec. 50-1-202, MCA; IMP, Sec. 50-1-202, MCA; NEW, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.611 HEPATITIS TYPE A (1) For a case of type A hepatitis, enteric precautions must be imposed until 5 days after the onset of jaundice.
(2) An infected person may not engage in a sensitive occupation during the infectious period. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.612 HEPATITIS TYPE B (1) For a case of type B hepatitis:
(a) Blood and body fluid precautions must be imposed until it is determined that viremia no longer exists.
(b) Contacts must be identified and advised how to prevent acquisition of the disease, given the nature of their relationship to the case. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.612A HEPATITIS, NON-A NON-B (1) For a case of non-A non-B hepatitis, the control standards set out in ARM 16.28.612 for hepatitis, type B, must be followed. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.612B HEPATITIS, TYPE UNSPECIFIED IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.612C INFLUENZA (1) Individuals who are at high risk for disease must be isolated, to the extent possible, from acutely ill or incubatory influenza cases. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.613 LASSA FEVER IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
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16.28.614 LEGIONELLOSIS (1) Drainage and secretion precautions must be observed for each case of legionellosis until that person is treated and his/her discharges are found to be no longer infectious. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.615 LEPROSY (HANSEN'S DISEASE) IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.616 LEPTOSPIROSIS IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.616A LISTERIOSIS EPIDEMIC (1) Surveillance of contacts must be conducted and identification of the disease source attempted. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.616B LYME DISEASE (1) The local health officer must conduct studies to determine the source of the infection. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.616C LYMPHOGRANULOMA VENEREUM (1) A person who contracts lymphogranuloma venereum must be instructed to avoid sexual contact until after the lesions heal.
(2) An individual who contracts the disease must be interviewed to determine who his/her contacts are, and those contacts should be examined and receive the medical treatment indicated by clinical and laboratory findings. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.617 MALARIA (1) A case of malaria should, to the extent possible, stay within a mosquito-proof area. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.618 MEASLES--RUBEOLA (1) A local health officer or the department shall impose modified isolation consisting of respiratory isolation of a measles case and quarantine of susceptible contacts whenever a suspected or confirmed case of
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measles occurs. If isolation and quarantine are imposed, the local health officer shall provide the notice required by ARM 16.28.308 and 16.28.309 and make immunizations available. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.619 MENINGITIS--BACTERIAL OR VIRAL (1) A case of aseptic or viral meningitis must be kept in strict isolation during febrile illness or until the existence of bacterial meningitis is ruled out.
(2) Whenever a case of meningococcal meningitis, meningococcemia, or bacterial meningitis occurs:
(a) modified isolation consisting of respiratory isolation, blood and body fluid precautions, and drainage and secretion precautions must be imposed upon the case until 24 hours have passed since the initiation of antibiotic chemotherapy; and
(b) the local health officer must impose surveillance upon the case's household and other intimate contacts for a minimum of 10 days after the diagnosis of the case. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.620 MENINGOCOCCAL MENINGITIS--MENINGOCOCCEMIA IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.621 MUMPS (1) For a case of mumps, the following measures must be imposed:
(a) drainage and secretion precautions until the fever and swelling of the salivary glands have disappeared; and
(b) respiratory isolation for 9 days after the onset of swelling. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.621A OPHTHALMIA NEONATORUM (1) Whenever a case of ophthalmia neonatorum is confirmed:
(a) drainage and secretion precautions must be imposed until 24 hours after administration of an antibiotic; and
(b) concurrent disinfection of discharges is necessary.
(2) Precautions which must be followed by any birth attendant to prevent ophthalmia neonatorum are contained in ARM 16.24.215. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
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16.28.622 ORNITHOSIS (PSITTACOSIS) (1) Respiratory precautions must be imposed upon a case of ornithosis as long as the fever lasts.
(2) The local health officer must inquire whether a bird epidemiologically linked to a case of ornithosis was obtained from an aviary, and, if so, determine the location of the aviary and report it to the Montana state veterinarian, department of livestock. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.623 PERTUSSIS (WHOOPING COUGH) (1) Modified isolation consisting of respiratory isolation must be imposed upon a case of pertussis for 7 days after the start of antibiotic therapy, or 21 days after the date of onset of symptoms if no antibiotic therapy is given.
(2) Children exposed to pertussis who have no history of adequate immunization must be quarantined.
(3) Surveillance for susceptible contacts must be initiated and immediate immunizations recommended to identified susceptible contacts. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.624 PLAGUE (1) Whenever a case of pneumonic plague exists:
(a) strict isolation must be imposed for no less than 3 days following commencement of antibiotic therapy to which the infected person responds; and
(b) those who have been in household or face-to-face contact with the case must be placed on chemoprophylaxis and kept under surveillance for 7 days, or, if they refuse chemoprophylaxis, be kept in strict isolation with careful surveillance for 7 days.
(2) Whenever a case of bubonic plague exists, drainage and secretion precautions must be imposed until antibiotic therapy has been terminated and the lesions are bacteriologically negative for plague bacilli.
(3) Concurrent disinfection of discharges and bodily fluids must be done in all plague cases.
(4) An investigation must be conducted to identify vectors and reservoirs whenever a case of bubonic plague exists. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.625 POLIOMYELITIS (1) For a case of poliomyelitis, modified isolation consisting of enteric precautions must be imposed for 7 days from the onset of illness, or for the
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duration of fever, if longer.
(2) Surveillance for susceptible contacts must be initiated and immunization recommended to them immediately. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.625A Q-FEVER (QUERY FEVER) (1) Respiratory precautions must be used.
(2) Bodily fluid discharges must be concurrently disinfected. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.626 RABIES--HUMAN (1) For a case of human rabies, strict isolation must be imposed for the duration of the illness. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.626A RABIES EXPOSURE (1) The following actions must be reported to the local health officer if they are committed by an animal other than a rabbit, hare, or rodent whose species can be infected with rabies and that is not satisfactorily vaccinated against rabies as specified in ARM 32.3.1205:
(a) biting of a human being;
(b) contamination of a mucous membrane, scratch, abrasion, or open wound of a human by the saliva or other potentially infectious material from an animal that exhibits:
(i) paralysis or partial paralysis of the limbs;
(ii) marked excitation, muscle spasms, difficulty swallowing, apprehensiveness, delirium, or convulsions; or
(iii) unusual aggressive or unnatural behavior toward a person, animal, or inanimate object.
(2) The local health officer shall investigate each report of possible rabies exposure and gather, at a minimum, information about the circumstances of the possible rabies exposure; nature of the exposure; name, age, and address of the exposed individual; vaccination status of the animal in question; treatment of the exposed person; and eventual outcome for both animal and person involved.
(3) As soon as possible after receiving a report of possible rabies exposure, the local health officer must inform the exposed person or the individual responsible for that person if s/he is a minor whether or not treatment is necessary to prevent rabies.
(4) Whenever the circumstances described in (1) occur, the local health officer must either isolate the animal in question for at least 10 days for observation at a pound, veterinary facility, or other adequate facility, or, if the symp-
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toms described in (1)(b)(i), (ii), and (iii) above exist, order the animal killed and the head sent to the department of livestock's diagnostic laboratory at Bozeman for rabies analysis. The local health officer may also order an animal killed subsequent to isolation, and the brain analyzed.
(5) Additional rabies reporting and control requirements are contained in ARM 32.3.1201 through 32.3.1207, rules of the department of livestock.
(6) The department hereby adopts and incorporates by reference ARM 32.3.1205, which contains the standards for proper vaccination against rabies. A copy of ARM 32.3.1205 may be obtained from the Department of Livestock, Animal Health Division, Scott Hart Building, Capitol Station, Helena, Montana 59620 (phone 406-444-2043). History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.627 RELAPSING FEVER--TICK-BORNE--LOUSE-BORNE IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.628 ROCKY MOUNTAIN SPOTTED FEVER (1) Ticks removed from a case must be destroyed by chemical or physical means which entirely dispose of the tick while avoiding skin contact. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.628A RUBELLA (1) Whenever necessary to protect a susceptible pregnant woman or to control an epidemic, isolation must be imposed on a case of rubella for 4 days after the onset of rash. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.629 RUBELLA--CONGENITAL (1) Modified isolation consisting of respiratory isolation must be imposed on any person with congenital rubella during the time they are hospitalized.
(2) Any susceptible contact of the person with congenital rubella must be identified, to the extent possible, and encouraged to undergo rubella immunization if not already immune. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.630 SALMONELLOSIS (OTHER THAN TYPHOID FEVER)
(1) For purposes of this rule, "Salmonellosis" is any illness in which organisms of the genus Salmonella, with the
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exception of the typhoid bacillus, have been isolated from feces, blood, urine, or pathological material from a person.
(2) Whenever a case of Salmonellosis exists:
(a) enteric precautions must be imposed upon the case for the duration of the illness;
(b) the case must not be allowed to engage in a sensitive occupation until 2 successive specimens of feces have been determined by a laboratory to be negative for Salmonella organisms, the first specimen of which is collected at least 48 hours after cessation of the therapy and the second not less than 24 hours thereafter; and
(c) stool cultures must be made for any family contacts of a case who are themselves involved in a sensitive occupation; if the culture is positive for Salmonella, the contact is subject to the requirements of (a) and (b) above. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.631 SHIGELLOSIS (1) For a case of shigellosis enteric precautions must be imposed for the duration of the illness.
(2) A local health officer must not allow an infected person to engage in a sensitive occupation until 2 successive specimens of feces taken at an interval of not less than 24 hours apart, beginning no earlier than 48 hours after cessation of specific therapy, have been determined to be free of Shigella organisms. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.632 SMALLPOX (INCLUDING VACCINIA) IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.632A STAPHYLOCOCCAL EPIDEMIC IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.632B STREPTOCOCCAL EPIDEMIC IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16-1262 6/30/95 ADMINISTRATIVE RULES OF MONTANA COMMUNICABLE DISEASE CONTROL 16.28.632D
16.28.632C SYPHILIS (1) A person with a case of infectious syphilis must be instructed to refrain from activities in which body fluids are shared (such as sexual intercourse) until 48 hours after effective treatment has been commenced and must either receive treatment or be isolated until s/he does.
(2) A person with syphilis must be interviewed to identify the following types of contacts, depending upon the disease stage in question:
(a) for primary syphilis, all sexual contacts during the 3 months prior to the onset of symptoms;
(b) for secondary syphilis, all sexual contacts during the 6 months preceding diagnosis;
(c) for early latent syphilis, those sexual contacts during the year preceding diagnosis, if the time that primary and secondary lesions appeared cannot be established;
(d) for late latent syphilis, marital partners and children of infected mothers;
(e) for congenital syphilis, all members of the immediate family of the case.
(3) All identified contacts of confirmed cases of early syphilis must be examined to determine if they have syphilis, directed to refrain from activities in which body fluids are shared, and, if they consent, immediately be given appropriate treatment. Laboratory specimens must be taken during the examination. (History: Sec. 50-1-202, 50-2-118, 50-18-105, MCA; IMP, Sec. 50-1-202, 50-2-118, 50-18-102, 50-18-107, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.632D STREPTOCOCCUS PNEUMONIAE INVASIVE DISEASE, DRUG RESISTANT (1) Whenever a case of drug resistant streptococcus pneumonia invasive disease is identified, the following measures must be imposed:
(a) contact isolation for the duration of acute illness; and
(b) concurrent disinfection of discharges from nose and throat.
(2) Surveillance for susceptible contacts must be initiated and immediate immunizations recommended to those identified as high risk for pneumococcal disease, including persons aged 2 years or older with sickle cell disease; functional or anatomic asplenia; nephrotic syndrome or chronic renal failure; immunosuppression, including HIV infection; organ transplantation or cytoreducation therapy; other chronic illnesses; and all persons aged 65 years or older.
(3) Contacts at high risk for whom immunization is not advised or not deemed effective must be evaluated for chemoprophylaxis.
(4) Epidemics or clusters of cases may warrant more liberal use of the pneumococcal vaccine or chemoprophylaxis
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after consultation with the department.
(5) In the case of meningitis, compliance with ARM 16.28.619 is also required. (History: Sec. 50-1-202, MCA; IMP, Sec. 50-1-202, MCA; NEW, 1995 MAR p. 1127, Eff. 6/30/95.)
16.28.633 TETANUS IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; REP, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.634 TRICHINOSIS (1) Any person, other than the case, who may have eaten the infected food must be identified and put under surveillance by the local health officer. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.634A TUBERCULOSIS (1) Tuberculosis control measures are contained in subchapter 10 of this chapter. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.635 TULAREMIA (1) Drainage and secretion precautions must be followed whenever open lesions exist or lacrimal sacs are draining (i.e. tears are produced). (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.636 TYPHOID FEVER (1) The provisions of this rule apply to all forms of typhoid fever.
(2) Enteric precautions must be imposed until specific therapy for the fever has been completed and no fewer than 3 successive specimens of feces have been found negative for typhoid organisms, the first of which is taken one month after therapy is discontinued and followed by the other 2 at no less than 1-week intervals.
(3) The local health officer may not allow an infected person to engage in a sensitive occupation until modified isolation has been terminated in accordance with (2) of this rule. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.637 TYPHUS FEVER (LOUSE-BORNE) IS REPEALED (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87; REP, 1995 MAR p. 1127, Eff. 6/30/95.)
16-1264 6/30/95 ADMINISTRATIVE RULES OF MONTANA COMMUNICABLE DISEASE CONTROL 16.28.638B
16.28.638 YELLOW FEVER (1) Blood and body fluid precautions must be followed. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1980 MAR p. 1579, Eff. 6/13/80; AMD, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.638A YERSINIOSIS (1) Modified isolation consisting of enteric precautions must be imposed. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87.)
16.28.638B ILLNESS IN TRAVELER FROM FOREIGN COUNTRY
(1) Isolation and quarantine must be imposed until the etiologic agent of the disease is determined, at which point control measures must be imposed which are prescribed for that etiologic agent in "Control of Communicable Diseases in Man, An Official Report of the American Public Health Association", 15th edition, 1990.
(2) The department hereby adopts and incorporates by reference "Control of Communicable Diseases in Man, An Official Report of the American Public Health Association", 15th edition, 1990, which lists and specifies control measures for communicable diseases. A copy of "Control of Communicable Diseases in Man" may be obtained from the American Public Health Association, 1015 15th Street NW, Washington, DC 20005. (History: Sec. 50-1-202, 50-2-118, MCA; IMP, Sec. 50-1-202, 50-2-118, MCA; NEW, 1987 MAR p. 2147, Eff. 11/28/87; AMD, 1994 MAR p. 1295, Eff. 5/13/94.)
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