NAC441A.510. Diphtheria.

     1. The health authority shall investigate each report of a case having diphtheria or suspected case considered to have diphtheria to determine if the isolated organism is a toxigenic strain of Corynebacterium diphtheriae, to determine the extent of any outbreak, to identify any carriers or contacts and to identify the source of the infection.

     2. If a case having oropharyngeal toxigenic diphtheria or a suspected case considered to have oropharyngeal toxigenic diphtheria is in a medical facility, the medical facility shall provide care to the case or suspected case in accordance with procedures of strict isolation and other appropriate disease specific precautions. The health authority having jurisdiction where the medical facility is located may waive the requirement of isolation if two specimens from the nose and two specimens from the throat, taken from the case or suspected case at least 24 hours apart and at least 24 hours after cessation of antibiotic therapy, fail to show toxigenic Corynebacterium diphtheriae organisms upon testing by a medical laboratory.

     3. If a case having cutaneous toxigenic diphtheria or a suspected case considered to have cutaneous toxigenic diphtheria is in a medical facility, the medical facility shall require contact isolation of the case or suspected case or provide care to the case or suspected case in accordance with the appropriate disease specific precautions. The health authority having jurisdiction where the medical facility is located may waive the requirement of isolation after two specimens from the wound of the case or suspected case fail to show toxigenic Corynebacterium diphtheriae organisms upon testing by a medical laboratory.

     4. The health authority shall offer immunization against diphtheria to any contacts of a case, suspected case or carrier of diphtheria.

     5. A contact of a case, suspected case or carrier of diphtheria shall not work in a sensitive occupation unless it has been determined that the contact is not a carrier by a health care provider by means of testing a nasopharyngeal specimen or a specimen from another site suspected to be infected. The health authority may waive this restriction.

     (Added to NAC by Bd. of Health, eff. 1-24-92)