NAC441A.550. Haemophilus influenzae type b.

     1. The health authority shall investigate each report of a case having an invasive disease caused by Haemophilus influenzae type b, which includes bacteremia, meningitis, epiglottitis, septic arthritis, cellulitis, pericarditis, endocarditis, osteomyelitis and pneumonia, to:

     (a) Confirm the diagnosis;

     (b) Determine the extent of any outbreak;

     (c) Determine if the case is a child attending a child care facility; and

     (d) Identify any contacts and determine the need for antimicrobial prophylaxis of any contacts.

     2. The health authority shall recommend to a health care provider providing services to a case having a disease caused by invasive Haemophilus influenzae type b that the following preventive measures be taken:

     (a) If the case is in a medical facility and upon discharge will return to a child care facility or a household where there will be a contact who is less than 4 years of age, the case be prescribed a course of prophylactic antimicrobial therapy before being discharged, unless medically contraindicated.

     (b) If the case resides in a household where there is a contact who is less than 4 years of age, antimicrobial prophylaxis be prescribed for all contacts in the household, unless medically contraindicated, as soon as possible after diagnosis of the case.

     3. A person diagnosed as having a disease caused by invasive Haemophilus influenzae type b shall not attend a child care facility or a private or public school while the disease is in a communicable form.

     4. If a case having a disease caused by invasive Haemophilus influenzae type b is in a medical facility, the medical facility shall provide care to the case in accordance with respiratory isolation or other appropriate disease specific precautions.

     5. If a case having a disease caused by invasive Haemophilus influenzae type b is in a child care facility or a medical facility where there is a contact who is less than 2 years of age, the child care facility or medical facility shall provide written notice to the parents or legal guardians of all children in the same classroom or care unit as the case, regardless of whether the children have received an immunization against Haemophilus influenzae type b. The notice must inform the parent:

     (a) That the child has been exposed to a disease caused by invasive Haemophilus influenzae type b;

     (b) To seek medical advice promptly if the child develops symptoms suggestive of a disease caused by invasive Haemophilus influenzae type b; and

     (c) That initiation of antimicrobial prophylaxis is required, unless medically contraindicated, for the child as a condition of readmission to the child care facility or medical facility.

     6. If a case having a disease caused by invasive Haemophilus influenzae type b is in a child care facility or a medical facility where there is a contact who is less than 2 years of age, each employee of the child care facility or medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated.

     7. If a case having a disease caused by invasive Haemophilus influenzae type b is in a child care facility or a medical facility where there is no contact who is less than 2 years of age, and two persons have been diagnosed as having a disease caused by invasive Haemophilus influenzae type b within 60 days, each child and member of the staff in the child care facility or medical facility shall complete a course of antimicrobial prophylaxis, unless medically contraindicated, regardless of whether the child or member of the staff has received an immunization against Haemophilus influenzae type b.

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