Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 20 - Division of Community and Public Health › Chapter 20 - Communicable Diseases › Section 19 CSR 20-20.040 - Measures to Determine the Prevalence and Prevent the Spread of Diseases which are Infectious, Contagious, Communicable, or Dangerous in their Nature

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment changes the title and disease
				  categories to be in accordance with the disease categories listed in section
				  192.020,
				  RSMo and listed and updated in
				  19 CSR
				  20-20.020 and updates the department of health to
				  department. This amendment also sets forth additional methods to determine the
				  prevalence and to prevent the spread of diseases which are infectious,
				  contagious, communicable, or dangerous in their nature within Missouri
				  including notification of the public and potentially exposed individuals and
				  the issuance of orders.
(1)
				The director shall use the legal means necessary to control, investigate, or
				both, any disease or condition listed in
				19 CSR
				20-20.020 which is a threat to the public
				health.
(2) It shall be the duty of
				the local health authority, the director of the department , or the director's
				designated representative on receiving a report of a disease which is
				infectious, contagious, communicable, or dangerous in its nature as included in
				19 CSR
				20-20.020 to-
(A)
				Inspect any premises that they have reasonable grounds to believe are in a
				condition conducive to the spread of the disease;
(B) Confer with the physician, laboratory or
				person making the report;
(C)
				Collect for laboratory analysis any samples or specimens that may be necessary
				to confirm the diagnosis or presence of the disease or biological, chemical, or
				physical agents and to determine the source of the infection, epidemic, or
				exposure. Health program representatives and other personnel employed by the
				department , after training and certification to perform venipuncture, and
				after specific authorization from a physician, are authorized to perform
				venipuncture utilizing procedures within the scope of the training they have
				been given. The content and scope of this training shall be established by the
				department . Training shall be provided by a physician or his/her designee and
				the certificate shall be signed by the physician. Nothing in this rule shall
				limit the authority of local public health departments to establish their own
				training policies, with or without certification, or to limit their voluntary
				participation in the certification program developed by the department , nor
				shall it apply to venipuncture for other purposes;
(D) Make a complete epidemiological,
				environmental or occupational industrial hygiene investigation and record of
				the findings on a communicable disease or exposure report form;
(E) Establish and maintain quarantine,
				isolation or other measures as required;
(F) Provide the opportunity to be immunized
				to all contacts of persons suffering from those diseases for which there is a
				reliable and approved means of immunization;
(G) Establish appropriate control measures
				which may include isolation, quarantine, disinfection, immunization, closure of
				establishment, notification to potentially exposed individuals to make them
				aware of the risk or potential risk of the disease and such information
				required to avoid or appropriately respond to the exposure, notification to the
				public of the risk or potential risk of the disease and such information
				required to avoid or appropriately respond to the exposure, the creation and
				enforcement of adequate orders to prevent the spread of the disease and other
				measures considered by the department and/or local health authority as
				appropriate disease control measures based upon the disease, the patient's
				circumstances, the type of facility available, and any other available
				information related to the patient and the disease or infection;
(H) Establish, as the local health authority,
				whenever a case of unrecognized illness is reported or otherwise brought to the
				attention of the local health authority or the department and investigation
				presents symptoms of a communicable disease, but sufficient time has not
				elapsed to render a positive diagnosis, after consultation with the director or
				his/her designated representative, the control measures applicable in actual
				cases of the suspected communicable disease, until a positive diagnosis can be
				established. If a disease proves to be noncommunicable, the temporary control
				measures shall be terminated at once;
(I) Assume direct responsibility as director
				of health to make necessary investigation and immediately institute appropriate
				control measures necessary for the protection of the public health in
				occurrence of outbreaks or unusual clusters of illness involving more than one
				(1) county or a general regional area; and
(J) Investigate, as the local health
				authority, the disease within the local jurisdiction with assistance from the
				director of the department or his/her designated representative when any
				outbreak or unusual occurrence of a reportable disease is identified through
				reports required by 19 CSR 20-20.020. If, in the
				judgment of the director, the disease outbreak or unusual occurrence
				constitutes a medical emergency, the director may assume direct responsibility
				for the investigation.