1. A. Case control measures:

   1. 1. A diagnosing health care provider or an administrator of a health care institution, either personally or through a representative, shall:

      1. a. Isolate and institute droplet precautions for a pharyngeal diphtheria case or suspect case until

         two successive sets of cultures negative for Cornyebacterium diphtheriae are obtained from nose and throat specimens collected from the case or suspect case at least 24 hours apart and at least 24 hours after cessation of treatment;

         and

      2. b. Isolate and institute contact precautions for a cutaneous diphtheria case or suspect case until two successive sets of cultures negative for Cornyebacterium diphtheriae are obtained from skin specimens collected from the case or suspect case at least 24 hours apart and at least 24 hours after cessation of treatment

         .

   2. 2. A local health agency shall:

      1. a. Upon receiving a report under R9-6-202 of a diphtheria case or suspect case, notify the Department within 24 hours after receiving the report and provide to the Department the information contained in the report;
      2. b. Conduct an epidemiologic investigation of each reported diphtheria case or suspect case; and
      3. c. For each diphtheria case, submit to the Department, as specified in Table 2.4, the information required under R9-6-206(D).

2. B. Contact control measures: A local health agency shall:

   1. 1. Exclude each diphtheria contact from working as a food handler, caring for patients or residents in a health care institution, or caring for children in or attending a school or child care establishment until a set of cultures negative for Cornyebacterium diphtheriae is obtained from the contact’s nose and throat specimens;
   2. 2. In consultation with the Department, quarantine a contact of a diphtheria case, if indicated, until two successive sets of cultures negative for Cornyebacterium diphtheriae are obtained from nose and throat specimens collected from the contact at least 24 hours apart;
   3. 3. Offer each previously immunized diphtheria contact prophylaxis and a vaccine containing diphtheria toxoid; and
   4. 4. Offer each unimmunized diphtheria contact prophylaxis and the primary vaccine series.

Historical Note

Renumbered from R9-6-729 and amended effective October 19, 1993 (Supp. 93-4). Former Section R9-6-336 renumbered to R9-6-339; new Section R9-6-336 renumbered from R9-6-333 effective April 4, 1997 (Supp. 97-2). Former R9-6-336 renumbered to R9-6-343; new R9-6-336 renumbered from R9-6-327 and amended by final rulemaking at 10 A.A.R. 3559, effective October 2, 2004 (Supp. 04-3). Former R9-6-336 renumbered to R9-6-338; new R9-6-336 renumbered from R9-6-334 and amended by final rulemaking at 14 A.A.R. 1502, effective April 1, 2008 (Supp. 08-2). Section R9-6-336 renumbered to R9-6-342; new Section R9-6-336 renumbered from R9-6-331 and amended by final rulemaking at 23 A.A.R. 2605, effective January 1, 2018 (Supp. 17-3). Section R9-6-336 renumbered to R9-6-341; new Section R9-6-336 renumbered from R9-6-331 by final rulemaking at 31 A.A.R. 1317 (April 25, 2025), effective June 2, 2025 (Supp. 25-2).