Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 300.000 - Reportable Diseases, Surveillance, and Isolation and Quarantine Requirements › Section 300.020 - Definitions

Current through Register 1525, July 5, 2024
Airborne Precautions
. Measures
				designed to reduce the risk of transmission of infectious agents that may be
				suspended in the air in either small particle aerosols or dust particles
				(
i.e
. droplet nuclei <= 5 microns). Patients in health care
				facilities must be given a private room with special air handling and
				ventilation (negative pressure with respect to the rest of the facility), and
				an appropriate level of respiratory protection is necessary when entering the
				patient's room.
Board of Health or Local Board of
				Health
. The appropriate and legally designated health authority of
				the city, town, or other legally constituted governmental unit within the
				Commonwealth having the usual powers and duties of the board of health or
				health department of a city or town.
Carrier
. An individual who can
				tolerate an infection so as not to become ill, yet is able to transmit the
				disease-causing organism to cause infection and illness in others.
Case
or
Patient
. One who is ill, infected, injured or
				diagnosed with a reportable disease or injury.
Clinical Data
. Health observations
				collected as part of an investigation of an individual or population used to
				inform understanding of or describe a particular disease, disease event or
				illness.
Cluster
.
See
105 CMR
				300.020:
Outbreak
or
Cluster
.
Communicable
. Ability of an infection
				to be transmitted from one person or animal to another.
Contact
. A person who has been in such
				association with an infected person or animal or with a contaminated
				environment as to have had exposure capable of transmitting the infection to
				that person.
Contact Precautions
. Measures designed
				to reduce the risk of transmission of infectious agents that can be spread
				through direct contact with the patient or indirect contact with potentially
				infectious items or surfaces. Gloves and gowns are required for all patient
				contact and contact with the patient's environment; strict hand hygiene
				practices must also be applied.
Counseling
. Process by which
				individuals and groups are advised as to how to promote, maintain and/or
				restore health. Methods and procedures used in counseling must take account of
				the ways in which people develop various forms of behavior, of the factors that
				lead them to maintain or to alter their behavior, and of the ways in which
				people acquire and use knowledge.
Date of Last Exposure
. That point in
				time when exposure that would be expected to provide an opportunity for
				transmission of infection between a case or carrier and a susceptible person
				ends, or point in time when a case or carrier is no longer capable of
				transmitting illness or infection to others, whichever was more recent.
Demographic Data
. Characteristics or
				attributes of individuals used to inform understanding of particular disease,
				disease event or illness by describing the population affected. Demographic
				data includes age, gender, sexual orientation, race, ethnicity, disability,
				occupation, preferred language, and any other demographic data element as
				defined by the Department.
Department
. The Massachusetts
				Department of Public Health.
Disease
. An abnormal condition or
				functional impairment resulting from infection, metabolic abnormalities,
				physical or physiological injury or other cause, marked by subjective
				complaints, associated with a specific history, and clinical signs and
				symptoms, and/or laboratory or radiographic findings (compare 105 CMR 300.020:
Illness
).
Disease Event
. An occurrence of a
				reportable disease or laboratory evidence of infection reported to a board of
				health or the Department and entered into the disease surveillance and case
				management system, MAVEN.
Disease Surveillance and Case Management
				System
. The secure electronic system maintained by the Department
				to receive reports of disease events; collect clinical data, demographic data,
				epidemiologic data; conduct surveillance of disease; investigation, response,
				and control of diseases dangerous to the public health.
Droplet Precautions
. Measures designed
				to reduce the risk of transmission of infectious agents
via
large particle droplets that do not remain suspended in air, usually generated
				by coughing, sneezing or talking. Masks must be used, but gowns, gloves and
				special air handling are not generally needed.
Enteric Precautions
. Measures designed
				to prevent direct or indirect fecal-oral transmission of disease. Gowns must be
				worn if soiling is likely, and gloves must be worn for touching contaminated
				materials; strict hand hygiene practices must also be applied. Masks are not
				indicated.
Epidemiologic Data
. Observations
				collected as part of an investigation in an individual or population used to
				inform understanding and the distribution of a particular disease, disease
				event or illness.
Exposure
. Proximity to, and or contact
				with, a source of an infectious agent with potential for acquisition of the
				infection.
Food
. Any raw, cooked or processed
				edible substance, ice, beverage, medications, or ingredient used or intended
				for use or for sale in whole or in part for human consumption
via
the alimentary tract.
Food Handler
. Any person directly
				preparing or handling food. This could include the food handling facility
				owner, individual having supervisory or management duties, person on the
				payroll, family member, volunteer, person performing work under contractual
				agreement, or any other person working in a food handling facility.
Food Handler
also includes any person handling clean
				dishes or utensils. Any person who dispenses medications by hand, assists in
				feeding, or provides mouth care shall be considered food handlers for the
				purpose of
				105 CMR 300.000. In health
				care facilities, this includes those who set up trays for patients to eat, feed
				or assist patients in eating, give oral medications or give mouth/denture care.
				In day care facilities, schools and community residential programs, this
				includes those who prepare food for clients to eat, feed or assist clients in
				eating, or give oral medications.
Food Handler
does
				not include individuals in private homes preparing or serving food for
				individual family consumption.
Food Handling Facility
. Any fixed or
				mobile place, structure or vehicle, whether permanent, seasonal or temporary,
				in which food is prepared, processed, stored or held for sale, whether at
				retail or wholesale, or for service on the premises or elsewhere; or where food
				is served or provided to the public or segment of the public with or without
				charge.
Food Handling Facility
does not include
				private homes where food is prepared or served for individual family
				consumption.
Food Poisoning
. Poisoning that results
				from eating foods contaminated with toxins. These toxins may occur naturally,
				as in certain mushrooms or seafoods; they may be chemical or biologic
				contaminants; or they may be metabolic products of infectious agents that are
				present in the food.
Health Care Provider
. As defined in
				M.G.L. c. 111, § 1: "¦ any doctor of medicine, osteopathy, or
				dental science, or a registered nurse, registered pharmacist, social worker,
				doctor of chiropractic, or psychologist licensed under the provisions of M.G.L.
				c. 112, or an intern, or a resident, fellow, or medical officer licensed under
				M.G.L. c. 112, § 9, or a hospital, clinic or nursing home licensed under
				the provisions of M.G.L. c. 111 and its agents and employees, or a public
				hospital and its agents and employees;"
Health Care Worker
. One who provides
				direct care to patients or who works in a setting where such care is
				provided.
Hepatitis Syndrome, Acute
. Illness
				associated with symptoms, including but not limited to, jaundice, nausea,
				vomiting, abdominal pain, and laboratory evidence of liver damage or
				dysfunction occurring without identified cause or due to an unexpected or
				unusual cause.
Illness
. An abnormal condition or
				functional impairment resulting from infection, metabolic abnormalities,
				physical or physiological injury or other cause, marked by subjective
				complaints and clinical signs (compare 105 CMR 300.020:
Disease
).
Immunity
. Possession of protective
				antibodies or cellular components sufficient to protect from infection and/or
				illness following exposure to an infectious agent (
see
also
				105 CMR 300.020:
Resistance
).
Incidence
. A general term used to
				characterize the frequency of new occurrences of a disease, infection, or other
				event over a period of time and in relation to the population in which it
				occurs. Incidence is expressed as a rate, commonly the number of new cases
				during a prescribed time in a unit of population. For example, one may refer to
				the number of new cases of tuberculosis per 100,000 population per year.
Invasive Infection
. Infection
				involving the bloodstream or internal organs, not including infection of the
				skin or mucous membranes. Invasive infection is usually established by the
				recovery of an etiologic agent from a usually sterile body fluid or
				tissue.
Isolation
. Separation, for the period
				of communicability, of infected persons from others in such places and under
				such conditions as will prevent the direct or indirect transmission of an
				infectious agent to susceptible people or to those who may spread the agent to
				others.
Isolation
applies also to animals (compare
				105 CMR 300.020:
Quarantine
).
Laboratory
. As defined in M.G.L. c.
				111D, § 1 "¦ a facility or place, however named, the purpose of
				which is to make biological, serological, chemical, immuno-hematological,
				cytological, pathological, or other examinations of materials derived from a
				human body. This includes laboratories in hospitals and other
				facilities.
Laboratory Data
. Characteristics or
				attributes associated with biological serological, chemical,
				immune-hematological, cytological, pathological, or other examinations of
				materials.
MAVEN
. The Massachusetts Virtual
				Epidemiologic Network, the Department's infectious disease surveillance and
				case management system.
Novel Influenza A Viruses
. A strain of
				influenza A that substantially differs antigenically from circulating or
				recently circulating influenza A viruses.
Outbreak or Cluster
. The occurrence in
				a community, facility, workplace or region of cases of an illness clearly in
				excess of the number of cases usually expected. The number of cases indicating
				an outbreak or cluster will vary according to the infectious agent or the site
				conditions/hazards, size and type of population exposed, previous experience or
				lack of exposure to the disease, and time and place of occurrence. Outbreaks or
				clusters are therefore identified by significant increases in the usual
				frequency of the disease in the same area, among the specified population, at
				the same season of the year.
Personal Surveillance
. The practice of
				close medical or other supervision of contacts without restricting their
				movements in order to promote prompt recognition of infection or
				illness.
Point of Care Testing
. Testing done at
				or near the site of patient care by use of a test cleared by the federal Food
				and Drug Administration for such use.
Prophylaxis
. The administration of a
				drug or biologic agent to prevent the development of an infection or disease,
				or limit the progression of an infection.
Quarantine
. Restricting the freedom of
				movement of well persons or domestic animals who have been exposed to a
				communicable disease for a period of time relating to the usual incubation
				period of the disease, in order to prevent effective contact with those not so
				exposed (compare 105 CMR 300.020:
Isolation
).
Report of a Disease
. A notice
				submitted pursuant to reporting requirements in
				105 CMR 300.000 that shall
				include contact information for the clinician responsible for reporting the
				disease and full personal demographic, clinical, epidemiologic and laboratory
				information on the case, to the appropriate authority of the occurrence of a
				specified disease in people or animals, directly by telephone, in writing, by
				facsimile, or by electronic means. Content of reports to the Department shall
				be defined on a disease by disease basis. Also
see
105
				CMR 300.170 for laboratory reports.
Resistance
. The sum total of body
				mechanisms which interpose barriers to the progress of invasion or
				multiplication of infectious agents or to damage by their toxic
				products.
(1) Immunity is that resistance usually associated with
				possessing antibodies or cells having a specific activity against the etiologic
				agent of an infectious disease. Passive immunity is attained either naturally
				by maternal transfer or artificially by introducing specific protective
				antibodies. Passive immunity is of brief duration. Active immunity is attained
				by infection, with or without symptoms, or by introducing certain fractions or
				products of the infectious agent or the agent itself in a killed, modified or
				variant form.
(2) Natural resistance is the ability to resist disease
				independently of antibodies or a specific cellular response. It commonly rests
				in anatomic, cellular or physiologic characteristics of the host. It may be
				genetic or acquired, permanent or temporary.
Respiratory Hygiene/Cough Etiquette
.
				Measures to prevent the transmission of all respiratory infections, that
				includes covering of the nose/mouth when coughing or sneezing, use and safe
				disposal of tissues and hand hygiene.
Risk
. The probability of an individual
				developing a given disease or experiencing a change in health status over a
				specific period of time.
Self-monitoring
. The practice of an
				individual observing their own clinical presentation to promote prompt
				recognition of infection or illness. This may include documentation of the
				observation by public health authorities.
Spinal Cord Injury
. The occurrence of
				an acute traumatic lesion of neural elements in the spinal canal (spinal cord
				or
cauda equina
) resulting in temporary or permanent sensory
				deficit, motor deficit, or bowel or bladder dysfunction.
Standard Precautions
. Refers to
				consistent and prudent preventive measures to be used at all times regardless
				of patient's infection status. The Department adopts, by reference, as standard
				precautions for infection control, the
2007 Guideline for Isolation
				Precautions: Preventing Transmission of Infectious Agents in Healthcare
				Settings
, published by the U.S. Centers for Disease Control and
				Prevention and its Healthcare Infection Control Practices Advisory
				Committee.
Surveillance of Disease
. Monitoring
				the occurrence and spread of disease and indications of such occurrence and
				spread.
Susceptible
. A person or animal not
				possessing resistance to a pathogenic agent. Such a person or animal is liable
				to contract a disease if or when significantly exposed to such agent.
Suspect Case
. A person or animal with
				clinical and/or laboratory evidence suggestive of the existence of a disease or
				condition dangerous to the public health, but prior to the confirmation of such
				a diagnosis.
Traumatic Amputation
. An unintentional
				severing of some or all of a body part.
Traumatic Brain Injury
. An occurrence
				of injury to the head, arising from blunt or penetrating trauma or from
				acceleration-deceleration forces, with one or more of the following conditions
				attributed to the injury: decreased level of consciousness, amnesia, skull
				fracture, or objective evidence of a neurological or neuropsychological
				abnormality or diagnosed intracranial lesion.
Tuberculosis
.
(1)
Active Tuberculosis
. A disease
				that is caused by
Mycobacterium tuberculosis
or other members
				of the
Mycobacterium tuberculosis
complex family in any part
				of the body and that is in active state as determined by either:
(a) a positive diagnostic test for tuberculosis on any human
				specimen and the person has not completed the appropriate prescribed course of
				medication for active tuberculosis disease;
(b) radiographic, current clinical, or laboratory evidence
				sufficient to support a clinical diagnosis of tuberculosis for which treatment
				is indicated.
(2)
Tuberculosis Infection (also known as Latent
				Tuberculosis Infection)
. Condition in which living
tubercle bacilli
are present in an individual, without
				producing clinically active disease. Infected individuals usually have a
				positive tuberculin skin test or laboratory test for tuberculosis infection
				(such as an interferon release assay or IGRA), but are not infectious.
Unusual Disease
. A disease, by any
				indication, occurring for the first time, or rarely, in a geographic area or
				circumstance, or associated with signs and symptoms not otherwise expected to
				occur based on the known or presumed etiology of the disease.
Unusual Illness
. An illness, by any
				indication, occurring for the first time, or rarely in a geographic area or
				circumstance, or an illness associated with signs and symptoms not otherwise
				expected to occur based on the known or presumed etiology of the
				illness.
Work-related Disease
. A disease or
				condition which is believed to be caused or aggravated by conditions in the
				individual's workplace.
Work-related Serious Traumatic Injury to a Person
				Younger than 18 Years Old
. An injury to a person younger than 18
				years old which:
(1) results in death, hospitalization, or, in the judgment of
				the treating physician, results in significant scarring or disfigurement,
				permanent disability, significant loss of consciousness, or loss of a body part
				or bodily function; or which
(2) the physician determines is less significant but is of the
				same or similar nature to injuries previously sustained at the same place of
				employment.
Zoonotic
. Infectious disease of
				animals that can be transmitted to humans.