410 IAC 1-2.5-129 Rubella (German measles); specific control measures

Sec. 129. The specific control measures for rubella (German measles) (infectious agent: rubella virus) are as follows: (1) An investigation by a department field representative in cooperation with the local health officer shall be performed immediately and include case management, case ascertainment, previous immunization history, and identification of exposed pregnant female and other susceptible contacts. For outbreak control in public or private schools, daycare facilities, preschools, or postsecondary facilities, on the same day that a report of a suspected case of rubella is received, school personnel shall do the following: (A) Conduct an inquiry into absenteeism to determine the existence of any other cases of the illness. (B) Immediately report the suspect case or cases to the local health department or the department. (C) Send a notice home with each student, attendee, or employee born in or after 1957 who has not presented proof of immunity, explaining that the student or employee shall be excluded from a given day until acceptable proof of immunity is received by the school or, in the case of medical or religious exemptions, until twenty-three (23) days after the onset of the last reported rubella case. Acceptable proof shall consist of one (1) or more of the following: (i) A written record from the student's physician or parent or guardian that indicates the: (AA) date of vaccination (on or after the first birthday); and (BB) type of vaccine administered. (ii) A laboratory report showing a protective rubella antibody titer. (iii) A laboratory report showing confirmation of previous rubella infection. (D) Make available to officials of the local health department or the department, or both, involved in investigating and controlling the outbreak, immunization records of all students and employees born in or after 1957 in the school or postsecondary facility or attendees and employees born in or after 1957 in daycare or preschool. (2) Droplet precautions shall be followed for seven (7) days after the onset of a rash. Contact precautions shall be followed for suspected or known congenital rubella until one (1) year of age unless urine and nasopharyngeal cultures are negative for the virus after three (3) months. In hospitals and institutions, patients suspected of having rubella shall be managed in a private room. Infected persons shall be excluded from: (A) schools, daycare facilities, preschools, and postsecondary facilities; (B) places of work; (C) public gatherings; and (D) contact with susceptible persons outside the household; for seven (7) days after the onset of a rash. (3) Concurrent disinfection is not applicable. (4) Quarantine is not applicable. (5) Immunization, while not contraindicated (except during pregnancy), will not necessarily prevent infection or illness. Passive immunization with immune globulin may be given to a susceptible pregnant woman exposed to the disease but should only be administered after thorough consultation with her attending physician, and any such measure should be provided by her attending physician. Pregnant female contacts, especially those in the first trimester, should be referred immediately to their attending physician for: (A) serological testing to determine susceptibility or early infection (IgM) antibody; and (B) thorough medical consultation. (6) The Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists set the standard clinical and laboratory case definition.