SECTION 97.11. Notification of Emergency Response Employees, Volunteers, or Other Persons Providing Emergency Care of Possible Exposure to a Disease  


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  • (a) Purpose. The Communicable Disease Prevention and Control Act (Act), §81.048, requires a licensed hospital to notify a health authority and designated infection control officer in certain instances when an emergency response employee or volunteer may have been exposed to a reportable disease during the course of duty from a person delivered to the hospital under conditions that were favorable for transmission. A hospital that gives notice of a possible exposure under this section or a local health authority or designated infection control officer that receives notice of a possible exposure under this section may give notice of the possible exposure to a person other than an emergency response employee or volunteer if the person demonstrates that the person was exposed to the reportable disease while providing emergency care.

    (b) Definitions.

    (1) Designated infection control officer--The person serving as an entity's designated infection control officer under Health and Safety Code, §81.012, who has a health care professional license or specific training in infection control, acts as liaison between the entity and the destination hospital, and monitors all follow-up treatment provided to the affected emergency response employee or volunteer.

    (2) Emergency response employee or volunteer--An individual acting in the course and scope of employment or service as a volunteer as emergency medical service personnel, a peace officer, a detention officer, a county jailer, or a fire fighter, as defined under Health and Safety Code, §81.003.

    (c) Disease and criteria which constitute exposure. The following diseases and conditions constitute a possible exposure to the disease for the purposes of the Act, §81.048:

    (1) chickenpox; diphtheria; measles (rubeola); novel coronavirus causing severe acute respiratory disease; novel influenza; pertussis; pneumonic plague; smallpox; pulmonary or laryngeal tuberculosis; and any viral hemorrhagic fever, if the worker and the patient are in the same room, vehicle, ambulance, or other enclosed space;

    (2) Haemophilus influenzae, invasive; meningitis; meningococcal infections, invasive; mumps; poliomyelitis; Q fever (pneumonia); rabies; and rubella, if there has been an examination of the throat, oral or tracheal intubation or suctioning, or mouth-to-mouth resuscitation;

    (3) acquired immune deficiency syndrome (AIDS); anthrax; brucellosis; dengue; ehrlichiosis; hepatitis, viral; human immunodeficiency virus (HIV) infection; malaria; plague; syphilis; tularemia; typhus; any viral hemorrhagic fever; and yellow fever, if there has been a needlestick or other penetrating puncture of the skin with a used needle or other contaminated item; a splatter or aerosol into the eye, nose, or mouth; or any significant contamination of an open wound or non-intact skin with blood or body fluids;

    (4) amebiasis; campylobacteriosis; cholera; cryptosporidiosis; Escherichia coli O157:H7 or other Shiga toxin-producing E. coli infection; hepatitis A; poliomyelitis; salmonellosis, including typhoid fever; shigellosis; and Vibrio infections, if fecal material is ingested;

    (5) Methicillin-resistant Staphylococcus aureus (MRSA) wounds, skin infections or soft tissue infections, if there has been contact of non-intact skin to these infections or drainage from these infections; and

    (6) any other reportable disease or a disease caused by a select agent or toxin identified or listed under 42 C.F.R. §73.3, if there has been an exposure via the usual mode of transmission of that disease as determined by the department or the local health authority.

    (d) Notification processes. The entity that employs or uses the services of an emergency response employee or volunteer is responsible for notifying the local health authorities or local health care facilities that the entity has a designated infection control officer or alternate designated infection control officer. The following notification processes shall apply when possible exposures to notifiable conditions occur.

    (1) If the hospital has knowledge that, on admission to the hospital, the person transported has any of the notifiable conditions listed in subsection (c)(1) of this section, then notice of a possible exposure of an emergency response employee or volunteer to the disease shall be given to the health authority for the jurisdiction where the hospital is located and the designated infection control officer of the entity that employs or uses the services of the emergency response employee or volunteer.

    (2) For possible exposures to any of the diseases listed in subsection (c)(2) - (6) of this section, the emergency response employee or volunteer or the designated infection control officer of the employing entity shall provide a medical professional at the hospital with notice, preferably written, of the circumstances of the possible exposure. Once the hospital has knowledge of a possible exposure, then notice shall be given as follows.

    (A) The hospital shall report the following information to the health authority for the jurisdiction where the hospital is located and the designated infection control officer of the entity that employs or uses the services of the emergency response employee or volunteer:

    (i) the name of the emergency response employee or volunteer possibly exposed;

    (ii) the date of the exposure;

    (iii) the circumstances of the exposure;

    (iv) whether laboratory testing was performed for diseases potentially transmitted by such exposures; and

    (v) positive or negative test results for these diseases.

    (B) The health authority or designated infection control officer of the entity that employs or uses the services of the affected emergency response employee or volunteer shall determine whether or not significant risk of disease transmission exists and report his/her assessment of the possible exposure event to the emergency response employee or volunteer.

    (C) A person notified of a possible exposure under this section shall maintain the confidentiality of the information provided to him or her.

    (e) Obligation to test. This section does not create a duty for a hospital to perform a test that is not necessary for the medical management of the person delivered to the hospital.

Source Note: The provisions of this §97.11 adopted to be effective July 26, 1996, 21 TexReg 6622; amended to be effective December 20, 2000, 25 TexReg 12426; amended to be effective June 5, 2007, 32 TexReg 2997; amended to be effective February 28, 2011, 36 TexReg 1281; amended to be effective December 20, 2012, 37 TexReg 9777; amended to be effective June 28, 2016, 41 TexReg 4645