Section 690.360  Cholera (Toxigenic Vibrio cholerae O1 or O139) (Reportable by telephone, facsimile, or electronically as soon as possible, within 24 hours)

a)         Control of Case

1)         Food Handlers or Persons in Sensitive Occupations, Not Including Health Care Workers.  Cases with cholera shall not work as food handlers or in sensitive occupations until diarrhea has ceased for at least 48 hours and three consecutive negative stool specimens are obtained.  Specimens shall be obtained following clinical recovery of the patient, at least 24 hours apart and not sooner than 48 hours after the last dose of antimicrobials, if administered.  Specimens shall be submitted within one week after notification.

2)         Health Care Workers or Those Who Work in Occupations Requiring Standard Precautions.  Local health departments may require specimens from health care workers or those who work in occupations requiring standard precautions if there is reason to believe that specimen testing is necessary (e.g., the nature of the work, including feeding patients, assisting patients with eating, providing or preparing meals for patients, denture or oral care, hygienic practices of the worker, dispensing or administering oral medications, or as part of an investigation of a cluster). Specimens shall be obtained following clinical recovery of the patient, at least 24 hours apart and not sooner than 48 hours after the last dose of antimicrobials, if administered. Specimens shall begin to be submitted within one week after notification, or the individual shall be restricted from patient care. When specimen submission is required, health care workers who feed patients or assist patients with eating, meals, provide denture or oral care or dispense or administer oral medications, shall be restricted from these duties until three negative stool specimens are obtained or the public health authority determines that monitoring is no longer warranted.

3)         Persons shall be excluded from school or child care facilities until vomiting and diarrhea has resolved for at least 24 hours without the use of antidiarrheal medication.

b)         Control of Contacts

Contacts should be asked about symptoms during the period of household exposure and for five days after last exposure.

1)         Contacts Who Have Not Had Diarrhea During the Previous Four Weeks

A)        Food Handlers or Persons in Sensitive Occupations, Not Including Health Care Workers

i)          There are no work restrictions while submitting release specimens for contacts who are employed as food handlers or in sensitive occupations and who have had no symptoms of cholera infection during the previous four weeks.

ii)         Contacts to cases of cholera who are employed as food handlers or in sensitive occupations shall submit three consecutive negative stool specimens obtained at least 24 hours apart and not sooner than 48 hours after the last dose of antimicrobials, if administered.  These contacts shall be restricted from their occupations if they do not begin submitting release specimens within one week after notification. Release specimens shall be submitted at least once per week until three consecutive negative specimens are obtained, or the individual shall be restricted from working.

iii)        If any of the three release specimens is positive for toxigenic Vibrio cholera O1 or O139, contacts shall be considered cases and shall be required to comply with restrictions on returning to work in subsection (a)(2).

B)        Health Care Workers

Local health authorities may require specimens from health care workers or those who work in occupations requiring standard precautions if there is reason to believe that specimen testing is necessary (e.g., the nature of the work, including feeding patients, assisting patients with eating, providing or preparing meals for patients, denture or oral care, hygienic practices of the worker, dispensing or administering oral medications, or as part of an investigation of a cluster). Specimens shall be obtained at least 24 hours apart.  Specimens shall begin to be submitted within one week after notification, or the individual shall be restricted from patient care.

2)         Contacts Who Currently Have, or Have Had, Diarrhea During the Previous Four Weeks

A)        Food Handlers or Persons in Sensitive Occupations, Not Including Health Care Workers

i)          All contacts to cases of cholera employed as food handlers or in sensitive occupations, and who currently have diarrhea or have had diarrhea during the previous four weeks, shall not work in their occupations until diarrhea has ceased for at least 48 hours and they have submitted three consecutive negative stool specimens.  Specimens shall be obtained following clinical recovery of the patient, at least 24 hours apart and not sooner than 48 hours after the last dose of antimicrobials, if administered.  Specimens shall begin to be submitted within one week after notification.

ii)         If any of the three release specimens is positive for toxigenic Vibrio cholerae, contacts shall be considered cases and shall comply with subsection (a)(1).

B)        Health Care Workers

Local health authorities may require specimens from health care workers or those who work in occupations requiring standard precautions if there is reason to believe specimen testing is necessary (e.g., the nature of the work, including feeding patients, assisting patients with eating, providing or preparing meals for patients, denture or oral care, hygienic practices of the worker, dispensing or administering oral medications, or as part of an investigation of a cluster). Specimens shall be obtained following clinical recovery of the patient, at least 24 hours apart and not sooner than 48 hours after the last dose of antimicrobials, if administered.  Specimens shall begin to be submitted within one week after notification, or the individual shall be restricted from patient care. When specimen submission is required, health care workers who feed patients or assist patients with eating or meals, provide denture or oral care, or dispense or administer oral medications shall be restricted from these duties until three negative stool specimens are obtained, or the public health authority determines that monitoring is no longer warranted.

c)         Sale of Food, Milk, etc. (See Section 690.30(b).)

d)         Laboratory Reporting

1)         Laboratories shall report to the local health authority all patients who have a positive result on any laboratory test indicative of and specific for detecting Vibrio cholerae infection.

2)         Laboratories shall forward clinical materials suspected to be positive for Vibrio cholerae to the Department's laboratory in accordance with the Department's specimen submission criteria, which can be accessed at: https://dph.illinois.gov/topics-services/lab-testing-services/general-requirements.html.

3)         Laboratories shall report and submit to the Department's laboratory any food or environmental Vibrio cholerae isolates resulting from an outbreak investigation.

(Source:  Amended at 48 Ill. Reg. 4098, effective February 27, 2024)