105 CMR, § 300.020
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. See105 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 see105 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.
105 CMR, § 300.020