Ill. Admin. Code tit. 77 § 690.10

Current through Register Vol. 48, No. 49, December 6, 2024
Section 690.10 - Definitions

"Acceptable Laboratory" - A laboratory that is certified under the Centers for Medicare and Medicaid Services, Department of Health and Human Services, Laboratory Requirements (42 CFR 493), which implements the Clinical Laboratory Improvement Amendments of 1988 (42 U.S.C. 263).

"Act" - The Department of Public Health Act of the Civil Administrative Code of Illinois [20 ILCS 2305 ].

"Airborne Precautions" or "Airborne Infection Isolation Precautions" - Infection control measures designed to reduce the risk of transmission of infectious agents that may be suspended in the air in either dust particles or small particle aerosols (airborne droplet nuclei (5 µm or smaller in size)) (see Section 690.20(a)(7)).

"Arboviral Infection or Disease" - Diseases caused by infection from a group of RNA viruses that are transmitted to humans from the bite of infected blood-sucking arthropods, including ticks, mosquitoes, sandflies and biting midges with clinical manifestations ranging from mild febrile illness to severe encephalitis.

"Authenticated Fecal Specimen" - A specimen for which a public health authority or a person authorized by a public health authority has observed either or both the patient producing the specimen or conditions under which no one other than the case, carrier or contact could be the source of the specimen.

"Bioterrorist Threat or Event" - The intentional use of any microorganism, virus, infectious substance or biological product that may be engineered as a result of biotechnology, or any naturally occurring or bioengineered component of any microorganism, virus, infectious substance, or biological product, to cause death, disease or other biological malfunction in a human, an animal, a plant or another living organism.

"Business" - A person, partnership or corporation engaged in commerce, manufacturing or a service.

"Carbapenem Antibiotics" - A class of broad-spectrum beta-lactam antibiotics.

"Carrier" - A living or deceased person who harbors a specific infectious agent in the absence of discernible clinical disease and serves as a potential source of infection for others.

"Case" - Any living or deceased person having a recent illness due to a notifiable condition.

"Confirmed Case" - A case that is classified as confirmed in accordance with federal or State case definitions.

"Probable Case" - A case that is classified as probable in accordance with federal or State case definitions.

"Suspect Case" - A case whose medical history or symptoms suggest that the person may have or may be developing a communicable disease or notifiable condition and who does not yet meet the definition of a probable or confirmed case in accordance with federal or State case definitions.

"CDC" - Centers for Disease Control and Prevention.

"Certified Local Health Department" - A local health authority that is certified pursuant to Section 600.210 of the Certified Local Health Department Code (77 Ill. Adm. Code 600).

"Chain of Custody" - The methodology of tracking specimens for the purpose of maintaining control and accountability from initial collection to final disposition of the specimens and providing for accountability at each stage of collecting, handling, testing, storing, and transporting the specimens and reporting test results.

"Child Care Facility" - A center, private home, or drop-in facility open on a regular basis where children are enrolled for care or education.

"Cleaning" - The removal of visible soil (organic and inorganic material) from objects and surfaces, normally accomplished by manual or mechanical means using water with detergents or enzymatic products.

"Clinical Materials" - A clinical isolate containing the infectious agent, or other material containing the infectious agent or evidence of the infectious agent.

"Closure" - A selective restriction on, limitation to, or denial of entry to an area, building, or part of an area or building, or the stoppage or suspension of operations, services or activities within an area, building or business or part of an area, building or business where persons are exposed to, infected with, or reasonably suspected to be infected with, a notifiable disease, or to prevent transmission of a notifiable disease or condition among a vulnerable population.

"Closure, Modified" - A selective, partial restriction on, limitation to, or denial of entry to an area, building, or part of an area or building, or the stoppage or suspension of operations, services or activities within an area, building or business or part of an area, building or business where persons are exposed to, infected with, or reasonably suspected to be infected with, a notifiable disease or condition, or to prevent transmission of a notifiable disease or condition among a vulnerable population. Modified closure is designed to meet particular situations and includes, but is not limited to, limiting or discontinuing admissions, closing a specific area, discontinuing a medical procedure or use of a medical device, or ceasing food production or serving a particular implicated food product.

"Cluster" - Two or more persons with a similar illness or condition, usually associated by place or time, unless defined otherwise in Subpart D.

"Communicable Disease" - An illness or condition caused by an infectious agent or its toxins that occurs through the direct or indirect transmission of the infectious agent or its products from an infected individual or via an animal, vector or the inanimate object or environment to a susceptible animal or human host.

"Contact" - Any person known to have been sufficiently associated with or exposed to a case or carrier of a communicable disease to have been the source of infection for that person or to have been sufficiently associated with the case or carrier of a communicable disease to have become infected by the case or carrier; and, based on the knowledge of disease transmission, there is a risk of the individual contracting the infectious disease. A contact can be a household or non-household contact.

"Contact Precautions" - Infection prevention and control measures designed to reduce the risk of transmission of infectious agents that can be spread through direct contact with the suspected or known case or indirect contact with potentially infectious items or surfaces (see Section 690.20(a)(7)).

"Contagious Disease" - An infectious disease that can be transmitted from person to person by direct or indirect contact.

"Dangerously Contagious or Infectious Disease" - An illness due to a specific infectious agent or its toxic products that arises through transmission of that agent or its products from an infected person, animal or inanimate reservoir to a susceptible host, either directly or indirectly through an intermediate plant or animal host, a vector or the inanimate environment, and may pose an imminent and significant threat to the public health, resulting in severe morbidity or high mortality.

"Decontamination" - A procedure that removes pathogenic microorganisms from objects so they are safe to handle, use or discard.

"Department" - The Illinois Department of Public Health or designated agent.

"Diarrhea" - The occurrence of three or more loose stools within a 24-hour period.

"Director" - The Director of the Department, or his or her duly designated officer or agent.

"Disinfection" - A process, generally less lethal than sterilization, that eliminates virtually all recognized pathogenic microorganisms, but not necessarily all microbial forms (e.g., bacterial spores).

"Droplet Precautions" - Infection prevention and control measures designed to reduce the risk of transmission of infectious agents via large particle droplets that do not remain suspended in the air and are usually generated by coughing, sneezing, or talking (see Section 690.20(a)(7)).

"Electronic Disease Surveillance System" or "EDSS" - A secure, web-based electronic disease surveillance system utilized by health care providers, laboratories and State and local health department staff to report notifiable diseases and conditions, and to collect and analyze additional demographic, epidemiological and medical information for surveillance purposes and outbreak detection and response.

"Electronic Laboratory Reporting (ELR)" - The electronic transmission from laboratories to public health of laboratory reports which identify notifiable diseases and conditions.

"Electronic Case Reporting (eCR)" - The automated, real-time exchange of case report information between electronic health records (EHRs) and public health agencies of notifiable diseases and conditions.

"Emergency" - An occurrence or imminent threat of an illness or health condition that:

is believed to be caused by any of the following:

bioterrorism;

the appearance of a novel or previously controlled or eradicated infectious agent or biological toxin;

a natural disaster;

a chemical attack or accidental release; or

a nuclear attack or incident; and

poses a high probability of any of the following harms:

a large number of deaths in the affected population;

a large number of serious or long-term disabilities in the affected population; or

widespread exposure to an infectious or toxic agent that poses a significant risk of substantial future harm to a large number of people in the affected population.

"Emergency Care" - The performance of rapid acts or procedures under emergency conditions, especially for those who are stricken with sudden and acute illness or who are the victims of severe trauma, in the observation, care and counsel of persons who are ill or injured or who have disabilities.

"Emergency Care Provider" - A person who provides rapid acts or procedures under emergency conditions, especially for those who are stricken with sudden and acute illness or who are the victims of severe trauma, in the observation, care and counsel of persons who are ill or injured or who have disabilities.

"Enhanced Barrier Precautions" - An infection prevention and control intervention designed to reduce transmission of antimicrobial resistant organisms that employs targeted gown, glove, and other personal protective equipment use during high contact resident care activities.

"Epidemic" - The occurrence in a community or region of cases of a communicable disease or condition (or an outbreak) clearly in excess of expectancy.

"Exclusion" - Removal of individuals from a setting in which the possibility of disease transmission exists. For a food handler, this means to prevent a person from working as an employee in a food establishment or entering a food establishment as an employee.

"Extensively Drug-Resistant Organisms" or "XDRO" - A pathogen that is difficult to treat because it is non-susceptible to all or nearly all antimicrobials.

"Fever" - The elevation of body temperature above the normal (typically considered greater than or equal to 100.4 degrees Fahrenheit).

"First Responder" - Individuals who in the early stages of an incident are responsible for the protection and preservation of life, property, evidence, and the environment, including emergency response providers as defined in section 2 of the Homeland Security Act of 2002 (6 U.S.C. 101), as well as emergency management, public health, clinical care, public works, behavioral health, and other skilled support personnel (such as equipment operators) that provide immediate support services during prevention, response, and recovery operations.

"Food Handler" - Any person who has the potential to transmit foodborne pathogens to others from working with unpackaged food, food equipment, clean utensils, oral medications, or food-contact surfaces; any person who has the potential to transmit foodborne pathogens to others by directly preparing or handling food drinks, or providing oral medications or oral care. Food handler does not include individuals in private homes preparing or serving food for individual family consumption.

"Health Care" - Care, services and supplies related to the health of an individual. Health care includes preventive, diagnostic, therapeutic, rehabilitative, maintenance or palliative care, and counseling, among other services. Health care also includes the sale and dispensing of prescription drugs or devices.

"Health Care Facility" - Any institution, building or agency, or portion of an institution, building or agency, whether public or private (for-profit or nonprofit), that is used, operated or designed to provide health services, medical treatment or nursing, rehabilitative or preventive care to any person or persons. This includes, but is not limited to, ambulatory surgical treatment centers, home health agencies, hospices, hospitals, end-stage renal disease facilities, long-term care facilities, medical assistance facilities, mental health centers, outpatient facilities, public health centers, rehabilitation facilities, residential treatment facilities, school health offices, medical spas, and adult day care centers.

"Health Care Provider" - Any person or entity who provides health care services, including, but not limited to, hospitals, medical clinics and offices, certified midwives, long-term care facilities, medical laboratories, physicians, pharmacists, dentists, physician assistants, nurse practitioners, nurses, paramedics, emergency medical or laboratory technicians, and ambulance and emergency workers.

"Health Care Worker" - Any person who is employed by, volunteers his or her services to or learning in a student or trainee role at a health care facility to provide direct personal services to others. This definition includes, but is not limited to, physicians, dentists, nurses and nursing assistants.

"Health Information Exchange" - The mobilization of healthcare information electronically securely across organizations within a state, region, community or hospital system; or, for purposes of this Part, an electronic network whose purpose is to accomplish the exchange, or an organization that oversees and governs the network.

"Health Level Seven" - Health Level Seven International or "HL7" is a not-for-profit, American National Standards Institute (ANSI)-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7 produces standards for message formats, such as HL7 2.5.1, that are adopted for use in public health data exchange between health care providers and public health.

"Immediate Care" - The delivery of ambulatory care in a facility dedicated to the delivery of medical care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Immediate care facilities are primarily used to treat patients who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an emergency department.

"Incubation Period" - The time interval between initial contact with an infectious agent and the first appearance of symptoms associated with the infection.

"Infectious Disease" - A disease caused by a living organism or other pathogen, including a fungus, bacteria, parasite, protozoan, prion, or virus. An infectious disease may, or may not, be transmissible from person to person, animal to person, or insect to person.

"Infection preventionist" - A person designated by a hospital, nursing home, medical clinic, or other health care facility as having responsibility for prevention, detection, reporting, and control of infections within the facility.

"Institution" - An established organization or foundation, especially one dedicated to education, public service, or culture, or a place for the care of persons who are destitute, disabled, or mentally ill.

"Institutions of Higher Education" - Any place and/or building, or portion thereof, that offers or is intended to provide post-secondary education, including colleges and universities.

"Isolation" - The physical separation and confinement of an individual or groups of individuals who are infected or reasonably believed to be infected with a contagious or possibly contagious disease from non-isolated individuals, to prevent or limit the transmission of the disease to non-isolated individuals.

"Isolation, Modified" - A selective, partial limitation of freedom of movement or actions of a person or group of persons infected with, or reasonably suspected to be infected with, a contagious or infectious disease. Modified isolation is designed to meet particular situations and includes, but is not limited to, 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 Precautions" - Infection control measures for preventing the transmission of infectious agents, i.e., standard precautions, airborne precautions (also known as airborne infection isolation precautions), contact precautions, droplet precautions and transmission-based precautions (see Section 690.20(a)(7)).

"Law" - The Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois [20 ILCS 2310 ].

"Least Restrictive" - The minimal limitation of the freedom of movement and communication of a person or group of persons while under an order of isolation or an order of quarantine, which also effectively protects unexposed and susceptible persons from disease transmission.

"Local Health Authority" - The health authority (i.e., full-time official health department, as recognized by the Department) having jurisdiction over a particular area, including city, village, township and county boards of health and health departments and the responsible executive officers of those boards, or any person legally authorized to act for the local health authority. In areas without a health department recognized by the Department, the local health authority shall be the Department.

"Medical laboratory" - A facility with a current Clinical Laboratory Improvement Amendments (CLIA) certificate that receives, forwards, or analyzes specimens of original material from the human body, or referred cultures of specimens obtained from the human body, and reports the results to a health care practitioner who uses the data for purposes of patient care or public health.

"Medical Record" - A written or electronic account including a patient's medical history, current illness, diagnosis, details of treatments, chronological progress notes, laboratory testing, medical imaging tests, and discharge recommendations.

"Monitoring" - The practice of watching, checking or documenting medical findings of potential contacts for the development or non-development of an infection or illness. Monitoring may also include the institution of community-level physical distancing measures designed to reduce potential exposure and unknowing transmission of infection to others. Monitoring measures may include, but are not limited to, reporting of geographic location for a period of time, restricted use of public transportation, recommended or mandatory mask use, temperature and/or other symptoms screening prior to entering public buildings or attending public gatherings.

"Multi-Drug-Resistant Organisms" or "MDRO" - A pathogen that is resistant to one or more antimicrobial agents and is usually resistant to all but one or two commercially available antimicrobial agents.

"Non-Duplicative Isolate" - The first isolate obtained from any source during each unique patient/resident encounter, including those obtained for active surveillance or clinical decision making.

"Novel Influenza" - An influenza A virus subtype that is different from the current circulating human influenza A subtypes such as H1 and H3.

"Notifiable disease or condition" - A disease or condition that, when diagnosed or suspected based on epidemiological data or test results, requires health providers and other mandated reporters (usually by law) to report to state or local public health officials. Notifiable diseases are of public interest by reason of their contagiousness, severity, or frequency.

"Observation" - The practice of close medical or other supervision of contacts to promote prompt recognition of infection or illness.

"Observation and Monitoring" - Close medical or other supervision, including, but not limited to, review of current health status, by health care personnel, of a person or group of persons on a voluntary or involuntary basis to permit prompt recognition of infection or illness.

"Outbreak" - The occurrence in a community, facility, workplace or region of a case or cases of an illness in excess of the number usually expected. The number of cases indicating an outbreak or cluster will vary according to the agent, disease, or condition, 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.

"Outbreak Reporting System" or "ORS" - A secure, web-based electronic outbreak reporting system used by state and local health departments to document and report outbreaks of disease and health conditions, and to collect a final report summarizing outbreak outcomes and investigation. Outbreak information requested by the CDC is uploaded from ORS.

"Point Prevalence Screening" - A data collection activity tool used to identify the number of persons with a disease or condition at a specific point in time.

"Premises" - The physical portion of a building or other structure and its surrounding area designated by the Director of the Department, his or her authorized representative, or the local health authority.

"Public Health Order" - A written or verbal command, directive, instruction or proclamation issued or delivered by the Department or certified local health department.

"Public Transportation" - Any form of transportation that sets fares and is available for public use, such as taxis; multiple-occupancy car, van or shuttle services; airplanes; buses; trains; subways; ferries; and boats.

"Quarantine" - The physical separation and confinement of an individual or groups of individuals who are or may have been exposed to a contagious disease or possibly contagious disease and who do not show signs or symptoms. "Quarantine" also includes the definition of "Quarantine, modified".

"Quarantine, Modified" - A selective, partial limitation of freedom of movement or actions of a person or group of persons who are or may have been exposed to a contagious disease or possibly contagious disease. Modified quarantine is designed to meet particular situations and includes, but is not limited to, 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. Any travel within Illinois outside of the jurisdiction of the local health authority must be either approved by the Director or be under mutual agreement of the health authority of the jurisdiction and the public health official who will assume responsibility. Travel outside Illinois shall require written notice from the Illinois jurisdiction to the out-of-state jurisdiction that will assume responsibility.

"Recombinant Organism" - A microbe with nucleic acid molecules that have been synthesized, amplified or modified.

"REDCap" - Research electronic data capture (REDCap) is a mature, secure web application for building and managing online surveys and databases. It is used by state and local health authorities to collect data from persons associated with an outbreak and can be administered directly to exposed persons via a weblink for public health surveillance purposes.

"Registry" - A secure data collection and information system that is designed to support organized care and improve health outcomes.

"Residential Facility" - A facility that provides or coordinates custodial care to persons who, because of physical, mental or emotional disorders, or incarceration, are not able to live independently.

"Restrict from Work" - For food handlers, this means to limit the activity of a food handler so that there is no risk of transmitting a disease by making sure that the food handler does not work with food, cleaning equipment, clean utensils, clean dishes, clean linens or unwrapped single service or single use articles or in the preparation of food.

"School" - An institution for educating children from Pre-kindergarten to grade 12 supported either by the state, local government or a private organization or individual.

"Sensitive Occupation" - An occupation, excluding health care workers, involving the direct care of others, especially young children and the elderly, or any other occupation designated by the Department or the local health authority, including, but not limited to, child care facility personnel.

"Sentinel Surveillance" - A means of monitoring the prevalence or incidence of infectious diseases or syndromes through reporting of cases, suspect cases, carriers' symptoms or submission of clinical materials by selected sites.

"Specimens" - Include, but are not limited to, blood, sputum, urine, stool, other bodily fluids, wastes, tissues, and cultures necessary to perform required tests.

"Standard Precautions" - Infection prevention and control measures that apply to all patients regardless of diagnosis or presumed infection status (see Section 690.20(a)(7)).

"Sterilization" - The use of a physical or chemical process to destroy all microbial life, including large numbers of highly resistant bacterial endospores.

"Susceptible (non-immune)" - A person who is not known to possess sufficient protection against a particular pathogenic agent to prevent developing infection or disease if or when exposed to the agent.

"Syndromic Surveillance" - Surveillance using health-related data that are collected in near real-time to detect early changes in illness or injury that may precede final diagnosis or confirmatory testing and signal a sufficient probability of a case, event or outbreak to warrant further public health response.

"Tests" - Include, but are not limited to, any diagnostic or investigative analyses necessary to prevent the spread of disease or protect the public's health, safety and welfare.

"Transmission" - Any mechanism by which an infectious agent is spread from a source or reservoir to a person, including direct, indirect and airborne transmission.

"Transmission-Based Precautions" - The second tier of basic infection prevention and control measures that are to be used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission.

"Treatment" - The provision of health care by one or more health care providers. Treatment includes any therapeutic interventions, consultation, referral or other exchanges of information to manage a patient's care.

"Variant Influenza" - Influenza virus that usually circulates in swine but can cause an influenza infection in humans.

"Voluntary Compliance" - Deliberate consented compliance of a person or group of persons that occurs at the request of the Department or local health authority prior to instituting a mandatory order for isolation, quarantine, closure, physical examination, testing, collection of laboratory specimens, observation, monitoring or medical treatment pursuant to this Subpart.

"Zoonotic Disease" - Any disease that is transmitted between animals and people.

Ill. Admin. Code tit. 77, § 690.10

Renumbered from Section 690.900 and amended at 38 Ill. Reg. 5533, effective February 11, 2014

Amended at 39 Ill. Reg. 4116, effective 3/9/2015.
Amended at 39 Ill. Reg. 11063, effective 7/24/2015
Amended at 43 Ill. Reg. 2386, effective 2/8/2019
Amended at 47 Ill. Reg. 18112, effective 11/22/2023