Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 90 - REGULATIONS FOR DISEASE REPORTING AND CONTROL › Part I - Definitions › Section 12VAC5-90-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms when used in this chapter
					 shall have the following meanings unless the context clearly indicates
					 otherwise:
"Affected area" means any part or the whole of the
					 Commonwealth, that has been identified as where persons reside, or may be
					 located, who are known to have been exposed to or infected with, or who are
					 reasonably suspected to have been exposed to or infected with, a communicable
					 disease of public health threat. "Affected area" shall include cities,
					 counties, towns, and subsections of such areas, public and private property,
					 buildings, and other structures.
"Arboviral infection" means a viral illness that is
					 transmitted by a mosquito, tick, or other arthropod. This includes chikungunya
					 (CHIK), dengue, eastern equine encephalitis (EEE), LaCrosse encephalitis (LAC),
					 also known as California encephalitis, St. Louis encephalitis (SLE), West Nile
					 virus (WNV), and Zika virus (Zika) infection.
"Board" means the State Board of Health.
"Cancer" means all carcinomas, sarcomas, melanomas,
					 leukemias, and lymphomas excluding localized basal and squamous cell carcinomas
					 of the skin, except for lesions of the mucous membranes.
"CDC" means the Centers for Disease Control and Prevention
					 of the U.S. Department of Health and Human Services.
"Child care center" means a child day center, child day
					 program, family day home, family day system, or registered family day home as
					 defined by §
										63.2-100 of the Code
					 of Virginia, or a similar place providing day care of children by such other
					 name as may be applied.
"Clinic" means any facility, freestanding or associated
					 with a hospital, that provides preventive, diagnostic, therapeutic,
					 rehabilitative, or palliative care or services to outpatients.
"Commissioner" means the State Health Commissioner or his
					 duly designated officer or agent, unless stated in a provision of this chapter
					 that it applies to the State Health Commissioner in his sole discretion.
"Communicable disease" means an illness due to an
					 infectious agent or its toxic products that is transmitted, directly or
					 indirectly, to a susceptible host from an infected person, animal, or arthropod
					 or through the agency of an intermediate host or a vector or through the
					 inanimate environment.
"Communicable disease of public health significance" means
					 an illness caused by a specific or suspected infectious agent that may be
					 transmitted directly or indirectly from one individual to another. This
					 includes infections caused by human immunodeficiency viruses, bloodborne
					 pathogens, and tubercle bacillus. The State Health Commissioner may determine
					 that diseases caused by other pathogens constitute communicable diseases of
					 public health significance.
"Communicable disease of public health threat" means an
					 illness of public health significance, as determined by the State Health
					 Commissioner in accordance with this chapter, caused by a specific or suspected
					 infectious agent that may be reasonably expected or is known to be readily
					 transmitted directly or indirectly from one individual to another and has been
					 found to create a risk of death or significant injury or impairment; this
					 definition shall not, however, be construed to include human immunodeficiency
					 viruses or the tubercle bacilli, unless used as a bioterrorism weapon.
"Companion animal" means, consistent with the provisions of
					 §
										3.2-6500 of the Code
					 of Virginia, any domestic or feral dog, domestic or feral cat, nonhuman
					 primate, guinea pig, hamster, rabbit not raised for human food or fiber, exotic
					 or native animal, reptile, exotic or native bird, or any feral animal or any
					 animal under the care, custody, or ownership of a person or any animal that is
					 bought, sold, traded, or bartered by any person. Agricultural animals, game
					 species, or any animals regulated under federal law as research animals shall
					 not be considered companion animals for the purpose of this chapter.
"Condition" means any adverse health event, such as a
					 disease, an infection, a syndrome, or as indicated by a procedure (including
					 the results of a physical exam, laboratory test, or imaging interpretation)
					 suggesting that an exposure of public health importance has occurred.
"Contact" means a person or animal known to have been in
					 such association with an infected person or animal as to have had an
					 opportunity of acquiring the infection.
"Contact services" means a broad array of services that are
					 offered to persons with infectious diseases and their contacts. Contact
					 services include contact tracing, providing information about current
					 infections, developing risk reduction plans to reduce the chances of future
					 infections, and connecting to appropriate medical care and other
					 services.
"Contact tracing" means the process by which an infected
					 person or health department employee notifies others that they may have been
					 exposed to the infected person in a manner known to transmit the infectious
					 agent in question.
"Coronavirus infection, severe" means suspected or
					 confirmed infection with severe acute respiratory syndrome (SARS)-associated
					 coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS)-associated
					 coronavirus (MERS-CoV), or another coronavirus causing a severe acute
					 illness.
"Decontamination" means the use of physical or chemical
					 means to remove, inactivate, or destroy hazardous substances or organisms from
					 a person, surface, or item to the point that such substances or organisms are
					 no longer capable of causing adverse health effects and the surface or item is
					 rendered safe for handling, use, or disposal.
"Department" means the State Department of Health, also
					 referred to as the Virginia Department of Health or VDH.
"Designee" or "designated officer or agent" means any
					 person, or group of persons, designated by the State Health Commissioner to act
					 on behalf of the commissioner or the board.
"Ehrlichiosis/Anaplasmosis" means human infections caused
					 by Ehrlichia chaffeensis (formerly included in the category "human monocytic
					 ehrlichiosis" or "HME"), Ehrlichia ewingii, or Anaplasma phagocytophilum
					 (formerly included in the category "human granulocytic ehrlichiosis" or
					 "HGE").
"Epidemic" means the occurrence in a community or region of
					 cases of an illness clearly in excess of normal expectancy.
"Essential needs" means basic human needs for sustenance
					 including food, water, clothing, and health care (e.g., medications, therapies,
					 testing, and durable medical equipment).
"Exceptional circumstances" means the presence, as
					 determined by the commissioner in his sole discretion, of one or more factors
					 that may affect the ability of the department to effectively control a
					 communicable disease of public health threat. Factors to be considered include
					 (i) characteristics or suspected characteristics of the disease-causing
					 organism or suspected disease-causing organism such as virulence, routes of
					 transmission, minimum infectious dose, rapidity of disease spread, the
					 potential for extensive disease spread, and the existence and availability of
					 demonstrated effective treatment; (ii) known or suspected risk factors for
					 infection; (iii) the potential magnitude of the effect of the disease on the
					 health and welfare of the public; and (iv) the extent of voluntary compliance
					 with public health recommendations. The determination of exceptional
					 circumstances by the commissioner may take into account the experience or
					 results of investigation in Virginia, another state, or another country.
"Foodborne outbreak" means two or more cases of a similar
					 illness acquired through the consumption of food contaminated with chemicals or
					 an infectious agent or its toxic products. Such illnesses include heavy metal
					 intoxication, staphylococcal food poisoning, botulism, salmonellosis,
					 shigellosis, Clostridium perfringens food poisoning, hepatitis A, and Shiga
					 toxin-producing Escherichia coli infection.
"Healthcare-associated infection" (also known as nosocomial
					 infection) means a localized or systemic condition resulting from an adverse
					 reaction to the presence of an infectious agent or its toxin that (i) occurs in
					 a patient in a health care facility (e.g., a medical care facility or
					 outpatient clinic), and (ii) was not found to be present or incubating at the
					 time of admission unless the infection was related to a previous admission to
					 the same setting.
"Immunization" means a procedure that increases the
					 protective response of an individual's immune system to specified
					 pathogens.
"Independent pathology laboratory" means a nonhospital or a
					 hospital laboratory performing surgical pathology, including fine needle
					 aspiration biopsy and bone marrow specimen examination services, that reports
					 the results of such tests directly to physician offices without reporting to a
					 hospital or accessioning the information into a hospital tumor registry.
"Individual" means a person or companion animal. When the
					 context requires it, "person or persons" shall be deemed to include any
					 individual.
"Infection" means the entry and multiplication or
					 persistence of a disease-causing organism (prion, virus, bacteria, fungus,
					 parasite, or ectoparasite) in the body of an individual. An infection may be
					 inapparent (i.e., without recognizable signs or symptoms but identifiable by
					 laboratory means) or manifest (clinically apparent).
"Influenza A, novel virus" means infection of a human with
					 an influenza A virus subtype that is different from currently circulating human
					 influenza H1 and H3 viruses. Novel subtypes include H2, H5, H7, and H9 subtypes
					 or influenza H1 and H3 subtypes originating from a nonhuman species or from
					 genetic reassortment of human and animal influenza viruses.
"Invasive" means the organism is affecting a normally
					 sterile site, including blood or cerebrospinal fluid.
"Investigation" means an inquiry into the incidence,
					 prevalence, extent, source, mode of transmission, causation of, and other
					 information pertinent to a disease occurrence.
"Isolation" means the physical separation, including
					 confinement or restriction of movement, of an individual who is infected with,
					 or is reasonably suspected to be infected with, a communicable disease in order
					 to prevent or limit the transmission of the communicable disease to uninfected
					 and unexposed individuals.
"Isolation, complete" means the full-time confinement or
					 restriction of movement of an individual infected with, or reasonably suspected
					 to be infected with, a communicable disease in order to prevent or limit the
					 transmission of the communicable disease to uninfected and unexposed
					 individuals.
"Isolation, modified" means a selective, partial limitation
					 of freedom of movement or actions of an individual infected with, or reasonably
					 suspected to be infected with, a communicable disease. Modified isolation is
					 designed to meet particular situations and includes the exclusion of children
					 from school, the prohibition or restriction from engaging in a particular
					 occupation or using public or mass transportation, or requirements for the use
					 of devices or procedures intended to limit disease transmission.
"Isolation, protective" means the physical separation of a
					 susceptible individual not infected with, or not reasonably suspected to be
					 infected with, a communicable disease from an environment where transmission is
					 occurring, or is reasonably suspected to be occurring, in order to prevent the
					 individual from acquiring the communicable disease.
"Laboratory" means a clinical laboratory that examines
					 materials derived from the human body for the purpose of providing information
					 on the diagnosis, prevention, or treatment of disease.
"Laboratory director" means any person in charge of
					 supervising a laboratory conducting business in the Commonwealth of
					 Virginia.
"Law-enforcement agency" means any sheriff's office, police
					 department, adult or youth correctional officer, or other agency or department
					 that employs persons who have law-enforcement authority that is under the
					 direction and control of the Commonwealth or any local governing body.
					 "Law-enforcement agency" shall include, by order of the Governor, the Virginia
					 National Guard.
"Least restrictive" means the minimal limitation of the
					 freedom of movement and communication of an individual while under an order of
					 isolation or an order of quarantine that also effectively protects unexposed
					 and susceptible individuals from disease transmission.
"Medical care facility" means any hospital or nursing home
					 licensed in the Commonwealth, or any hospital operated by or contracted to
					 operate by an entity of the United States government or the Commonwealth of
					 Virginia.
"Midwife" means any person who is licensed as a nurse
					 midwife by the Virginia Boards of Nursing and Medicine or who is licensed by
					 the Board of Medicine as a certified professional midwife.
"National Healthcare Safety Network" or "NHSN" means a
					 surveillance system created by the CDC for accumulating, exchanging, and
					 integrating relevant information on infectious adverse events associated with
					 health care delivery.
"Nucleic acid detection" means laboratory testing of a
					 clinical specimen to determine the presence of deoxyribonucleic acid (DNA) or
					 ribonucleic acid (RNA) specific for an infectious agent using any method,
					 including hybridization, sequencing, or amplification such as polymerase chain
					 reaction.
"Nurse" means any person licensed as a professional nurse
					 or as a licensed practical nurse by the Virginia Board of Nursing.
"Occupational outbreak" means a cluster of illness or
					 disease that is indicative of a work-related exposure. Such conditions include
					 silicosis, asbestosis, byssinosis, pneumoconiosis, and tuberculosis.
"Outbreak" means the occurrence of more cases of a disease
					 than expected.
"Period of communicability" means the time during which the
					 etiologic agent may be transferred directly or indirectly from an infected
					 person to another person, or from an infected animal to a person.
"Physician" means any person licensed to practice medicine
					 or osteopathy by the Virginia Board of Medicine.
"Quarantine" means the physical separation, including
					 confinement or restriction of movement, of an individual who is present within
					 an affected area or who is known to have been exposed, or may reasonably be
					 suspected to have been exposed, to a communicable disease and who do not yet
					 show signs or symptoms of infection with the communicable disease in order to
					 prevent or limit the transmission of the communicable disease of public health
					 threat to unexposed and uninfected individuals.
"Quarantine, complete" means the full-time confinement or
					 restriction of movement of an individual who does not have signs or symptoms of
					 infection but may have been exposed, or may reasonably be suspected to have
					 been exposed, to a communicable disease of public health threat in order to
					 prevent the transmission of the communicable disease of public health threat to
					 uninfected individuals.
"Quarantine, modified" means a selective, partial
					 limitation of freedom of movement or actions of an individual who does not have
					 signs or symptoms of the infection but has been exposed to, or is reasonably
					 suspected to have been exposed to, a communicable disease of public health
					 threat. Modified quarantine may be designed to meet particular situations and
					 includes limiting movement to the home, work, or one or more other locations,
					 the prohibition or restriction from using public or mass transportation, or
					 requirements for the use of devices or procedures intended to limit disease
					 transmission.
"Reportable disease" means an illness due to a specific
					 toxic substance, occupational exposure, or infectious agent, that affects a
					 susceptible individual, either directly, as from an infected animal or person,
					 or indirectly through an intermediate host, vector, or the environment, as
					 determined by the board.
"School" means
(i) any public school from kindergarten through grade 12
					 operated under the authority of any locality within the Commonwealth;
(ii) any private or religious school that offers
					 instruction at any level or grade from kindergarten through grade 12;
					 and
(iii) any private or religious nursery school or preschool,
					 or any private or religious child care center required to be licensed by the
					 Commonwealth.
"Serology" means the testing of blood, serum, or other body
					 fluids for the presence of antibodies or other markers of an infection or
					 disease process.
"Surveillance" means the ongoing systematic collection,
					 analysis, and interpretation of outcome-specific data for use in the planning,
					 implementation, and evaluation of public health practice. A surveillance system
					 includes the functional capacity for data analysis as well as the timely
					 dissemination of these data to persons who can undertake effective prevention
					 and control activities.
"Susceptible individual" means a person or animal who is
					 vulnerable to or potentially able to contract a disease or condition. Factors
					 that affect an individual's susceptibility include physical characteristics,
					 genetics, previous or chronic exposures, chronic conditions or infections,
					 immunization history, or use of medications.
"Toxic substance" means any substance, including any raw
					 materials, intermediate products, catalysts, final products, or byproducts of
					 any manufacturing operation conducted in a commercial establishment, that has
					 the capacity, through its physical, chemical or biological properties, to pose
					 a substantial risk of death or impairment either immediately or over time, to
					 the normal functions of humans, aquatic organisms, or any other animal but not
					 including any pharmaceutical preparation that deliberately or inadvertently is
					 consumed in such a way as to result in a drug overdose.
"Tubercle bacilli" means disease-causing organisms
					 belonging to the Mycobacterium tuberculosis complex and includes Mycobacterium
					 tuberculosis, Mycobacterium africanum, Mycobacterium bovis, Mycobacterium
					 canetti, Mycobacterium microti, Mycobacterium caprae, or other members as may
					 be established by the commissioner.
"Tuberculosis, active disease" (also "active tuberculosis
					 disease" and "active TB disease"), as defined by §
										32.1-49.1 of the Code
					 of Virginia, means a communicable disease caused by an airborne microorganism
					 and characterized by the presence of either (i) a specimen of sputum or other
					 bodily fluid or tissue that has been found to contain tubercle bacilli as
					 evidenced by culture or nucleic acid amplification, including preliminary
					 identification by rapid methodologies; (ii) a specimen of sputum or other
					 bodily fluid or tissue that is suspected to contain tubercle bacilli as
					 evidenced by smear, and where sufficient clinical and radiographic evidence of
					 active tuberculosis disease is present as determined by a physician licensed to
					 practice medicine in Virginia; or (iii) sufficient clinical and radiographic
					 evidence of active tuberculosis disease as determined by the commissioner is
					 present, but a specimen of sputum or other bodily fluid or tissue containing,
					 or suspected of containing, tubercle bacilli is unobtainable.
"Tuberculosis infection " means a positive result from a
					 test for tuberculosis infection without clinical or other evidence of active
					 tuberculosis disease.
"Vaccinia, disease or adverse event" means vaccinia
					 infection or serious or unexpected events in persons who received the smallpox
					 vaccine or their contacts, including bacterial infections, eczema vaccinatum,
					 erythema multiforme, generalized vaccinia, progressive vaccinia, inadvertent
					 inoculation, post-vaccinial encephalopathy or encephalomyelitis, ocular
					 vaccinia, and fetal vaccinia.
"Waterborne outbreak" means two or more cases of a similar
					 illness acquired through the ingestion of or other exposure to water
					 contaminated with chemicals or an infectious agent or its toxic products. Such
					 illnesses include giardiasis, viral gastroenteritis, cryptosporidiosis,
					 hepatitis A, cholera, and shigellosis. A single case of laboratory-confirmed
					 primary amebic meningoencephalitis or of waterborne chemical poisoning is
					 considered an outbreak.
Statutory Authority: §§
												32.1-12,
						32.1-35,
						and
						32.1-42
						of the Code of Virginia.