Download Revised Communicable Disease Reporting Rule: What*s Changing

Phone Tag:
IP and Epi Communication
Charles Clark
Field Epidemiology Director
Who are we?
• Epidemiology Resource Center (ERC)
– Conduct surveillance to monitor disease trends
– Investigate communicable disease
– Maintain Communicable Disease Reporting Rule
– List of diseases available at:
http://www.in.gov/isdh/25366.htm
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Why is the HD calling me?
• Reportable disease investigation
– Demographics, H & P, testing results
• Laboratory specimens
– Forwarding to state lab
• ESSENCE follow up
• NBS Issues
• Indiana Health Alert Network (IHANs)
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IHANs
• Investigation of Seoul Virus Outbreak Associated with Homebased, Rat-breeding Facilities in Wisconsin and Illinois
• Call for Cases of Non-tuberculosis Mycobacteria Infections
Associated with hCG Injections
• Zika in the ED: How Emergency Care Staff can Take Action
• Regional Cluster of Synthetic Cannabis
• Overdoses From U-47700 Increasing In Indiana
• MDROs in Outpatient Settings
• Update: Confirmed Cases Of Mumps At Universities In Indiana
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ESSENCE
• Seasonality
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ESSENCE
• Event Detection
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When should I call the HD?
• General consultations
– Emerging infectious diseases
• Immediately reportable disease
– Upon suspicion for some diseases
• Outbreaks, unusual activity, unusual
occurrence
• Testing guidance
• PEP/treatment guidance
• NBS Issues
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Vaccine-Preventable Diseases
• Varicella
• Pertussis
– ALL cases of primary
varicella infection
(regardless of whether
lab testing was done) are
reportable (within 72
hours)
– Diagnoses of shingles
are NOT reportable
– All cases of pertussis
(regardless of lab testing)
are reportable (within 24
hours)
– CDC requires
appropriate tests (PCR or
Culture from a
nasopharyngeal swab) to
consider a case
confirmed
NOTE: VPDs should NOT be removed from a
differential just because the patient is vaccinated
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Rabies
Post-exposure Prophylaxis (PEP)
• Rabies risk in Indiana
– Bats, skunks, raccoons, and foxes are higher-risk species;
dogs and cats are lower-risk species
– Most dog and cat bites acquired in our state do not require
PEP
– Higher risk: unprovoked bite, animal apparently ill with neuro
signs, animal behaving abnormally
• Exposures of concern
– Bite
– Mucous membrane contact with animal saliva, CSF, or CNS
tissue
– Finding a bat in the same room with a sleeping person,
impaired person, developmentally disabled person, or
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unattended child
Rabies
Post-exposure Prophylaxis (PEP)
• Simply finding a bat in the house is not an indication
for PEP unless an exposure occurred
• If the animal is available, delay administration of PEP
until quarantine or testing is completed
• There is not a time limit on when PEP must be
initiated after an exposure
• Review PEP protocol with your pharmacist before
administration to avoid common mistakes
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HIPPA Exclusion
• HIPAA does not prevent disclosure of medical
or epidemiological information to public health
authorities.
• Section 1178(b) of HIPPA:
“Nothing in this part shall be construed to invalidate or
limit the authority, power, or procedures established
under any law providing for the reporting of
disease…public health surveillance, or public health
investigation or intervention.”
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IN Administrative Code
• 410 IAC 1-2.5-77(g)
“Local health departments and the Indiana state
department of health are authorized to receive
protected health information, wherever maintained,
without patient authorization for the purposes of public
health investigation, and interventions, and as otherwise
permitted by law.”
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CD Rule
• 410 IAC 1-2.3 repealed
• 410 IAC 1-2.5 enacted December 25, 2015
• 410 IAC 1-2.5-75: Reporting requirements for
physicians and hospital administrators
• 410 IAC 1-2.5-76: Laboratories; reporting requirements
• 410 IAC 1-2.5-77: Disease intervention measures;
responsibility to investigate and implement
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Overview of the CD Rule
• Definitions
• Reporting requirements for physicians,
hospitals, and laboratories
• Disease intervention measures (general and
disease specific)
– Responsibilities
– Timeliness
• References
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Important Links
• ERC Website:
http://www.in.gov/isdh/25154.htm
• CD Rule:
– http://www.in.gov/legislative/iac/T04100/A00010.P
DF
– http://www.in.gov/isdh/25366.htm
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Questions?
Charles Clark
Field Epidemiology Director
Indiana State Department of Health
317-412-2137
[email protected]
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