(a) Purpose. The Communicable Disease Prevention and
Control Act (Act), §81.048, requires a licensed hospital to notify
a health authority and designated infection control officer in certain
instances when an emergency response employee or volunteer may have
been exposed to a reportable disease during the course of duty from
a person delivered to the hospital under conditions that were favorable
for transmission. A hospital that gives notice of a possible exposure
under this section or a local health authority or designated infection
control officer that receives notice of a possible exposure under
this section may give notice of the possible exposure to a person
other than an emergency response employee or volunteer if the person
demonstrates that the person was exposed to the reportable disease
while providing emergency care.
(b) Definitions.
(1) Designated infection control officer--The person
serving as an entity's designated infection control officer under
Health and Safety Code, §81.012, who has a health care professional
license or specific training in infection control, acts as liaison
between the entity and the destination hospital, and monitors all
follow-up treatment provided to the affected emergency response employee
or volunteer.
(2) Emergency response employee or volunteer--An individual
acting in the course and scope of employment or service as a volunteer
as emergency medical service personnel, a peace officer, a detention
officer, a county jailer, or a fire fighter, as defined under Health
and Safety Code, §81.003.
(c) Disease and criteria which constitute exposure.
The following diseases and conditions constitute a possible exposure
to the disease for the purposes of the Act, §81.048:
(1) chickenpox; diphtheria; measles (rubeola); novel
coronavirus causing severe acute respiratory disease; novel influenza;
pertussis; pneumonic plague; smallpox; pulmonary or laryngeal tuberculosis;
and any viral hemorrhagic fever, if the worker and the patient are
in the same room, vehicle, ambulance, or other enclosed space;
(2) Haemophilus influenzae, invasive;
meningitis; meningococcal infections, invasive; mumps; poliomyelitis;
Q fever (pneumonia); rabies; and rubella, if there has been an examination
of the throat, oral or tracheal intubation or suctioning, or mouth-to-mouth
resuscitation;
(3) acquired immune deficiency syndrome (AIDS); anthrax;
brucellosis; dengue; ehrlichiosis; hepatitis, viral; human immunodeficiency
virus (HIV) infection; malaria; plague; syphilis; tularemia; typhus;
any viral hemorrhagic fever; and yellow fever, if there has been a
needlestick or other penetrating puncture of the skin with a used
needle or other contaminated item; a splatter or aerosol into the
eye, nose, or mouth; or any significant contamination of an open wound
or non-intact skin with blood or body fluids;
(4) amebiasis; campylobacteriosis; cholera; cryptosporidiosis; Escherichia coli O157:H7 or other Shiga
toxin-producing E. coli infection;
hepatitis A; poliomyelitis; salmonellosis, including typhoid fever;
shigellosis; and Vibrio infections,
if fecal material is ingested;
(5) Methicillin-resistant Staphylococcus
aureus (MRSA) wounds, skin infections or soft tissue infections,
if there has been contact of non-intact skin to these infections or
drainage from these infections; and
(6) any other reportable disease or a disease caused
by a select agent or toxin identified or listed under 42 C.F.R. §73.3,
if there has been an exposure via the usual mode of transmission of
that disease as determined by the department or the local health authority.
(d) Notification processes. The entity that employs
or uses the services of an emergency response employee or volunteer
is responsible for notifying the local health authorities or local
health care facilities that the entity has a designated infection
control officer or alternate designated infection control officer.
The following notification processes shall apply when possible exposures
to notifiable conditions occur.
(1) If the hospital has knowledge that, on admission
to the hospital, the person transported has any of the notifiable
conditions listed in subsection (c)(1) of this section, then notice
of a possible exposure of an emergency response employee or volunteer
to the disease shall be given to the health authority for the jurisdiction
where the hospital is located and the designated infection control
officer of the entity that employs or uses the services of the emergency
response employee or volunteer.
(2) For possible exposures to any of the diseases listed
in subsection (c)(2) - (6) of this section, the emergency response
employee or volunteer or the designated infection control officer
of the employing entity shall provide a medical professional at the
hospital with notice, preferably written, of the circumstances of
the possible exposure. Once the hospital has knowledge of a possible
exposure, then notice shall be given as follows.
(A) The hospital shall report the following information
to the health authority for the jurisdiction where the hospital is
located and the designated infection control officer of the entity
that employs or uses the services of the emergency response employee
or volunteer:
(i) the name of the emergency response employee or
volunteer possibly exposed;
(ii) the date of the exposure;
(iii) the circumstances of the exposure;
(iv) whether laboratory testing was performed for diseases
potentially transmitted by such exposures; and
(v) positive or negative test results for these diseases.
(B) The health authority or designated infection control
officer of the entity that employs or uses the services of the affected
emergency response employee or volunteer shall determine whether or
not significant risk of disease transmission exists and report his/her
assessment of the possible exposure event to the emergency response
employee or volunteer.
(C) A person notified of a possible exposure under
this section shall maintain the confidentiality of the information
provided to him or her.
(e) Obligation to test. This section does not create
a duty for a hospital to perform a test that is not necessary for
the medical management of the person delivered to the hospital.
|
Source Note: The provisions of this §97.11 adopted to be effective July 26, 1996, 21 TexReg 6622; amended to be effective December 20, 2000, 25 TexReg 12426; amended to be effective June 5, 2007, 32 TexReg 2997; amended to be effective February 28, 2011, 36 TexReg 1281; amended to be effective December 20, 2012, 37 TexReg 9777; amended to be effective June 28, 2016, 41 TexReg 4645 |