NAC441A.690. Shigellosis.

     1. The health authority shall investigate each report of a case having shigellosis to confirm the diagnosis, to determine the extent of any outbreak, to identify any carriers of the infection, to identify any contacts, to identify the source of the infection, to determine if the case is employed in a sensitive occupation or is a child attending a child care facility and to determine if there is a contact residing in the same household as the case who is employed in a sensitive occupation.

     2. A person excreting Shigella spp. shall not work in a sensitive occupation unless authorized to do so by the health authority. The health authority may authorize a person excreting Shigella spp. to work in a sensitive occupation if:

     (a) At least two fecal specimens collected from the person, at least 24 hours apart and at least 48 hours after cessation of antimicrobial therapy, fail to show Shigella spp. organisms upon testing by a medical laboratory;

     (b) The person has received an appropriate course of antimicrobial therapy and is asymptomatic; or

     (c) The person has been asymptomatic for at least 4 weeks.

     3. A contact residing in the same household as a case having shigellosis shall not work in a sensitive occupation unless authorized to do so by the health authority. The health authority may authorize the contact to work in a sensitive occupation if the contact:

     (a) Has submitted at least two fecal specimens for examination by a medical laboratory; or

     (b) Is asymptomatic and there is no indication of poor personal hygiene.

Ê If a fecal specimen submitted for examination pursuant to paragraph (a) shows Shigella spp. organisms, the contact shall be considered a case subject to the provisions of this section.

     4. The health authority shall instruct a case having shigellosis or a carrier of Shigella spp. of the need and proper method of hand washing after defecation.

     5. An infant or child excreting Shigella spp. shall not attend a child care facility or school until asymptomatic. The health authority shall instruct a child care facility where an infant or child who is excreting Shigella spp. is attending of the need and proper method of hand washing and other practices for the control of infection which prevent the transmission of shigellosis.

     6. If a case having shigellosis is in a medical facility, the medical facility shall provide care to the case in accordance with enteric precautions or other appropriate disease specific precautions.

     (Added to NAC by Bd. of Health, eff. 1-24-92; A by R087-08, 1-13-2011)