ADMINISTRATIVE CODE

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER k: NOTIFIABLE DISEASES AND CONDITIONS CONTROL AND IMMUNIZATIONS
PART 696 CONTROL OF TUBERCULOSIS CODE

SUBPART A: GENERAL PROVISIONS

Section 696.100 Definitions

Section 696.110 Incorporated and Referenced Materials

SUBPART B: TUBERCULOSIS PREVENTION AND CONTROL MEASURES

Section 696.130 Responsibilities of Health Care Settings

Section 696.140 Screening for Latent Tuberculosis Infection (LTBI) and Active Tuberculosis (TB) Disease

Section 696.150 Management of Persons with Latent Tuberculosis Infection (LTBI)

Section 696.160 Diagnosis and Management of Persons with Suspected or Confirmed Active Tuberculosis Disease

Section 696.170 Reporting

SUBPART C: ENFORCEMENT OF TUBERCULOSIS PREVENTION AND CONTROL MEASURES

Section 696.180 Role of the Department or Local TB Control Authority in Enforcement and Control

Section 696.190 Role of the Local Tuberculosis Control Authority in Enforcement (Repealed)

Section 696.200 Types of Directives (Repealed)

Section 696.210 Potential Recipients of Directives (Repealed)

Section 696.APPENDIX A Mantoux Skin Testing Procedures (Repealed)

Section 696.APPENDIX B Waivers for Initial TB Screening Tests (Repealed)

Section 696.APPENDIX C Summary of the Interpretation of Tuberculin Skin Test Results (Repealed)

SUBPART A: GENERAL PROVISIONS

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER k: NOTIFIABLE DISEASES AND CONDITIONS CONTROL AND IMMUNIZATIONS
PART 696 CONTROL OF TUBERCULOSIS CODE
SECTION 696.100 DEFINITIONS

Section 696.100 Definitions

"Active Tuberculosis Disease" or "Active TB Disease" means a diagnosis demonstrated by clinical, bacteriologic or diagnostic imaging evidence, or a combination thereof. Persons who have been diagnosed as having active TB and have not completed a course of TB treatment are still considered to have active tuberculosis and may be infectious.

"Bacteriologic Examinations" means tests done in a mycobacteriology laboratory to diagnose active TB disease, including smears for acid-fast bacilli (AFB), cultures and other tests for Mycobacterium (M.) tuberculosis, and drug susceptibility tests.

"Confirmed Case" means an occurrence of active TB disease that is laboratory confirmed or, in the absence of laboratory confirmation, an occurrence that meets the clinical case definition.

Laboratory confirmation – Laboratory criteria for diagnosis include isolation of M. tuberculosis from a clinical specimen; demonstration of M. tuberculosis by other laboratory technique; or demonstration of acid-fast bacilli in a clinical specimen when a culture has not been or cannot be obtained.

Clinical case definition – A clinical case meets all the following criteria: a positive TB screening test; other signs and symptoms compatible with active TB disease, such as an abnormal, unstable (worsening or improving) chest radiograph, or clinical evidence of current disease; treatment with two or more anti-tuberculosis medications; and completed diagnostic evaluation.

"Contact" means a person who has been exposed to M. tuberculosis by sharing air space with a person with infectious TB.

"Department" means the Illinois Department of Public Health.

"Directly Observed Therapy" or "DOT" means a process by which a trained health care worker or other designated trained person watches the patient swallow each dose of TB medication.

"Health Care Setting" means any relationship (physical or organizational) in which a health care worker might share air space with a person with active TB disease or in which a health care worker might be in contact with clinical specimens.

"Health Care Worker" means a paid or unpaid person working in a health care setting who has the potential for exposure to M. tuberculosis through air space shared with persons with infectious TB disease, or contact with clinical specimens.

"High-Risk Groups" means categories of people with an increased probability of becoming infected with TB, or who, once infected, have increased probability of progressing to active TB disease.

"Infectious" means that a person has, or is suspected of having, active TB disease of the respiratory tract capable of producing infection or disease in others as demonstrated by the presence of AFB in the sputum or bronchial secretions or by chest radiograph and clinical findings.

"Isolation" means the physical separation and confinement of a person with suspected or confirmed active TB disease in a place and under conditions that prevent the transmission of the infection.

"Latent TB Infection" or "LTBI" means the condition in which organisms capable of causing disease (i.e., M. tuberculosis) enter the body and elicit a response from the host's immune defenses. LTBI may or may not progress to clinical disease.

"Local TB Control Authority" means the agency at the local level recognized by the Department as having jurisdiction over the prevention and control of tuberculosis. The local TB control authority may be an autonomous TB board or a TB program within a local health department.

"Mantoux Tuberculin Skin Test" or "Mantoux Skin Test" means a method of skin testing that is performed by injecting 0.1 mL of purified protein derivative (PPD) tuberculin containing five tuberculin units into the dermis of the forearm with a needle and syringe.

"Non-infectious" means a person previously determined to be infectious who now meets all the following criteria:

has received a minimum of two weeks of standard multidrug anti-tuberculosis treatment in accordance with Treatment of Tuberculosis, incorporated by reference in Section 696.110(a);

has demonstrated clinical improvement in response to therapy; and

has three consecutive negative AFB sputum smear results from sputum collected in eight-hour or greater intervals, with at least one being an early morning specimen.

"Serious Adverse Medication Reaction" means any reaction to a medication used for the treatment of active TB or Latent TB Infection that requires a treatment interruption or a change in the treatment regimen, or results in significant or permanent damage or impairment, hospitalization or death.

"Suspected Case" means a tentative diagnosis, while diagnostic procedures are being completed, of active TB disease, whether or not treatment has been started, or a person with an illness marked by signs, symptoms and/or laboratory tests that may be indicative of tuberculosis.

"TB Screening Test" means a federal Food and Drug Administration (FDA) approved screening test to detect TB infection. Examples of screening tests include, but are not limited to, the Mantoux tuberculin skin test and whole blood interferon-gamma release assays.

(Source: Amended at 36 Ill. Reg. 15267, effective October 2, 2012)

Section 696.110 Incorporated and Referenced Materials

a) The following materials are incorporated by reference in this Part:

1) Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC, U.S. Department of Health and Human Services, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), July 7, 2006; 55 (No. RR9):1-44).

2) Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in Health-Care Settings, 2005 (referred to as "Guidelines for Health-Care Settings"), U.S. Department of Health and Human Services, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), December 30, 2005; 54 (No. RR17):1-141).

3) Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), May 17, 2019; 68(19):439–443.)

4) Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), June 9, 2000; 49 (No. RR-6)).

5) Treatment of Tuberculosis, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), June 20, 2003; 52 (No. RR-11)).

6) Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis: Recommendations from the National Tuberculosis Association and CDC (referred to as "Guidelines for Investigation of Contacts"), U.S. Department of Health and Human Services, Coordinating Center for Health Information and Service, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333 (Morbidity and Mortality Weekly Report (MMWR), December 16, 2005; 54 (No. RR15):1-47).

7) Privacy Rule (Standards for Privacy of Individually Identifiable Health Information) of the Health Insurance Portability and Accountability Act of 1996 and 45 CFR 164.512(a) and (k)(6) (October 1, 2007).

b) All incorporations by reference of federal regulations and guidelines refer to the regulations, guidelines and standards on the date specified and do not include any amendments or editions subsequent to the date specified.

c) The following materials are referenced in this Part:

1) Medical Studies Act [735 ILCS 5/8-2101]

2) Illinois Health Statistics Act [410 ILCS 520]

3) Control of Notifiable Diseases and Conditions

Code (77 Ill. Adm. Code 690)

4) Section 2 of the Department of Public Health Act [20 ILCS 2305/2]

(Source: Amended at 49 Ill. Reg. 202, effective December 18, 2024)

SUBPART B: TUBERCULOSIS PREVENTION AND CONTROL MEASURES

Section 696.130 Responsibilities of Health Care Settings

a) TB Risk Assessment. Every health care setting shall conduct initial and ongoing evaluation of the risk for transmission of M. tuberculosis, regardless of whether patients with suspected or confirmed active TB disease are expected to be encountered in the setting. The TB risk assessment shall address administrative, environmental and respiratory-protection controls needed for the health care setting and shall be reviewed at least annually.

b) Written Plans. A written TB infection control plan shall be developed that includes: protocols for the screening and management of latent TB infection (LTBI) among health care workers and clients; protocols for the screening, diagnosis and management of active TB disease among health care workers and clients; data collection; evaluation of data; reporting of persons with suspected or confirmed active TB disease to the local TB control authority; and a health care worker education program. All components of the plan shall reflect compliance with this Part. The plan shall include the name of the person or persons responsible for the TB prevention and control program at each health care setting; procedures to protect health care workers and clients from contracting tuberculosis; and a referral mechanism to ensure that transmission of TB is prevented and treatment is completed for clients with TB who leave the health care settings. The written plan shall be updated at least annually. (See the Guidelines for Health-Care Settings.)

c) TB Prevention and Control Program. A program shall be executed in accordance with the written TB infection control plan.

d) Health Care Worker Education. All health care workers shall be trained upon hiring and periodically thereafter to ensure employee knowledge relevant to the employee's work responsibilities and the level of risk in the health care setting. (See the Guidelines for Health-Care Settings.)

e) Collaboration. Health care settings shall consult with the local TB control authority, as necessary, to determine their respective responsibilities in the screening, diagnosis and management of latent TB infection and active TB disease, reporting of active TB disease, and the education of health care workers.

f) Records. Records shall be maintained on TB screening test results; TB diagnostic evaluation results (including whether the tuberculosis was drug-resistant); other information about any persons exposed to tuberculosis; and the current written plan as required in subsection (b). Individual and aggregate data shall be analyzed periodically to identify the health care setting's level of risk and changes in the risk of TB transmission. All records required in this subsection shall be made available for inspection by the Department or the local TB control authority upon request by the Department or the local TB control authority.

(Source: Amended at 49 Ill. Reg. 202, effective December 18, 2024)

Section 696.140 Screening for Latent Tuberculosis Infection (LTBI) and Active Tuberculosis (TB) Disease

A TB screening test shall be used when screening persons for latent TB infection (LTBI). Persons who have signs and symptoms of active TB disease or a positive TB screening test result shall complete a diagnostic evaluation for active TB disease in accordance with the Centers for Disease Control and Prevention (CDC) guidelines, Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection and Guidelines for Health-Care Settings.

a) Screening for Latent TB Infection

1) Persons who are contacts to suspected or confirmed cases of active TB disease shall be evaluated in accordance with the CDC Guidelines for the Investigation of Contacts.

2) Workers and clients at health care settings and other residential settings serving high-risk groups shall be screened in accordance with this subsection (a)(2) and the following CDC guidelines: Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection; Guidelines for Health-Care Settings; Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC.

A) Health care workers and workers in other residential care settings shall have baseline (preplacement) TB symptom evaluation, TB test (Interferon Gamma Release Assay (IGRA) blood test or Mantoux Tuberculin Skin Test (TST)), and an individual risk assessment.

B) Evaluate symptoms for all healthcare workers when an exposure is recognized and perform a test (IGRA or Mantoux TST) for those with a baseline (preplacement) negative TB test, and no prior TB disease or LTBI. A negative IGRA or Mantoux TST shall be repeated 8-10 weeks after the most recent exposure.

C) All clients in non-acute care residential health care settings serving high-risk groups shall obtain an entry TB screening according to the healthcare facility written protocol. Routine periodic screening shall be determined by completing a Department approved a risk assessment tool performed in cooperation with the local TB control authority. The TB Risk Assessment Form is available on the Department's website at https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/tuberculosis-risk-assessment.pdf.

D) TB screening shall be instituted in other residential care settings serving high-risk groups as directed by the local TB control authority or the Department when a community or residential care setting has a higher than expected incidence of active TB disease or prevalence of LTBI.

E) Inmates and employees in correctional and detention facilities shall be screened in accordance with the CDC guideline Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC.

3) Workers in child day care and pre-school settings shall obtain a baseline risk assessment, TB screening test and symptom evaluation upon hiring. Routine, periodic screening of workers shall be determined by the child day care or pre-school facility's TB risk assessment performed in cooperation with the local TB control authority.

b) Screening for Active TB Disease. The following persons shall be screened for active TB disease:

1) Persons with a documented positive TB screening test result;

2) Clients admitted to health care settings and residential care settings serving high-risk groups; and

3) Inmates in correctional and detention facilities, who shall be screened for active TB disease in accordance with Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC.

(Source: Amended at 49 Ill. Reg. 202, effective December 18, 2024)

Section 696.150 Management of Persons with Latent Tuberculosis Infection (LTBI)

a) Treatment for LTBI. Persons with a positive TB screening test result shall complete a diagnostic evaluation for active TB disease. If there is no evidence of active TB disease, persons with LTBI shall be considered for treatment. Treatment for LTBI shall be conducted in accordance with the CDC guidelines Targeted Tuberculin Testing and Treatment of Latent TB Infection.

b) Monitoring for Adverse Medication Reaction. At a minimum, patients shall be monitored monthly during therapy and evaluated for adverse medication reactions.

(Source: Amended at 36 Ill. Reg. 15267, effective October 2, 2012)

Section 696.160 Diagnosis and Management of Persons with Suspected or Confirmed Active Tuberculosis Disease

a) Diagnostic Evaluation. The evaluation of persons with suspected or confirmed active TB disease shall include but not be limited to:

1) Medical history;

2) Physical examination;

3) TB screening test;

4) Chest radiograph;

5) Bacteriologic examinations on available specimens; and

6) Assessment of risk for HIV infection, and testing and counseling as indicated.

b) Clinical Management of Persons with Suspected or Confirmed Active TB Disease

1) Infection Control Measures. If infectious TB disease is suspected, precautions shall be taken to prevent transmission in accordance with the Guidelines for Health-Care Settings.

A) In settings that serve infectious TB patients, precautions that shall be implemented include early identification and airborne infection isolation of patients with suspected or confirmed active TB disease. Infection control measures shall be maintained until the patient is determined to be non-infectious.

B) Once determined to be infectious, a patient is considered infectious until medically determined to be non-infectious and not likely to become infectious again. When a consensus cannot be reached concerning the infectious or non-infectious status of a patient with a suspected or confirmed case of TB, the Department will make a final determination of infectiousness. Determination of infectiousness for patients with positive AFB sputum smear results with pending or negative AFB sputum cultures, and for patients with multi-drug resistant (MDR) TB, shall be made in consultation with the Department.

2) Treatment of Suspected or Confirmed Active TB Disease. Patients with suspected or confirmed active TB disease shall be treated in accordance with Treatment of Tuberculosis.

A) Treatment Regimen. Persons with suspected or confirmed active TB disease shall be treated with a multi-drug regimen in accordance with Treatment of Tuberculosis.

B) Adherence to Treatment. Health care providers shall use strategies such as directly observed therapy (DOT) and patient-centered case management to assure successful completion of treatment.

C) Monitoring for Response to Therapy. Patients shall be monitored for response to treatment in accordance with Treatment of Tuberculosis.

D) Monitoring for Adverse Medication Reaction. Patients shall be monitored for adverse medication reactions in accordance with Treatment of Tuberculosis.

c) The Department of Public Health shall investigate the causes of contagious, or dangerously contagious, or infectious diseases, especially when existing in epidemic form, and take means to restrict and suppress the same, and whenever such disease becomes, or threatens to become, epidemic in any locality and the local board of health or local authorities neglect or refuse to enforce efficient measures for its restriction or suppression or to act with sufficient promptness or efficiency, or whenever the local board of health or local authorities neglect or refuse to promptly enforce efficient measures for the restriction or suppression of dangerously contagious or infectious diseases, the Department of Public Health may enforce such measures as it deems necessary to protect the public health, and all necessary expenses so incurred shall be paid by the locality for which services are rendered. (Section 2(a) of the Public Health Act)

1) Contact Investigation. The local TB control authority is responsible for assuring that a contact investigation, including identification, prioritization and evaluation of contacts, is completed for each case of active TB disease of the respiratory tract. Contacts shall obtain an evaluation, including screening for signs and symptoms of active TB disease and a TB screening test, to identify latent TB infection. Contacts shall be retested eight to 10 weeks after the last exposure if their reaction to the first TB screening test was negative. (See Guidelines for the Investigation of Contacts.) Contacts who have signs and symptoms of active TB disease or a positive TB screening test result shall complete a diagnostic evaluation for active TB disease in accordance with Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection, and Guidelines for Health-Care Settings.

2) When cases of active TB disease occur in any business, organization, institution or private home, the business owner, the person in charge of the establishment or the homeowner shall cooperate with local TB control authorities in the investigation, including, but not limited to, release of name and other pertinent information about employees, customers, passengers, travelers, transportation crews or guests as the information relates to the investigation.

3) Entering a place of employment for the purpose of conducting investigations of those processes, conditions, structures, machines, apparatus, devices, equipment, records, and materials within the place of employment that are relevant, pertinent, and necessary to the investigation. Investigations shall be conducted during regular business hours, if possible, and with notice as is possible under the circumstances.

4) School, child care facility, and college/university authorities shall handle contacts of infectious disease cases in the manner prescribed in this Part, or as recommended by the local health authority.

(Source: Amended at 36 Ill. Reg. 15267, effective October 2, 2012)

Section 696.170 Reporting

Health care professionals listed in subsection (a)(1) shall report suspected and confirmed cases of active tuberculosis (TB) disease and report laboratory results consistent with TB disease to the local TB control authority or, in the absence of a local TB control authority, to the Department. The local TB control authority shall report to the Department.

a) Reports to the Local TB Control Authority. The reports shall be submitted electronically through the Illinois Disease Surveillance System (IDSS) or other web-based system authorized by the Department, or by facsimile followed up with a telephone call to the local TB control authority in whose jurisdiction the reporter is located. Reports made by facsimile shall be made on forms available from the local TB control authority or the Department.

1) Health Care Professionals Required to Report. Health care professionals including but not limited to physicians, physician assistants, nurses, dentists, coroners, medical examiners, laboratory personnel and the health coordinators of health care settings shall report to the local TB control authority or, in the absence of a local TB control authority, to the Department.

2) Reports of Suspected and Confirmed Cases of TB. Persons required to report under subsection (a)(1) of this Section (except for laboratory personnel) shall, within seven calendar days after the diagnosis of a suspected or confirmed case of TB, notify the local TB control authority of the following:

A) Diagnosis. Information shall be provided about the diagnosis of a suspected or confirmed case of TB, including the dates and results of TB screening tests (Mantoux skin test results shall be recorded in millimeters) and the results of bacteriologic examinations and chest radiographs.

B) Clinical Management Information. Information shall be provided about the clinical management of a suspected or confirmed case of TB, including the determination of the infectious or non-infectious status, isolation precautions taken, treatment regimen and serious adverse medication reactions.

C) Surveillance Information. Reportable demographic and locating information regarding the suspected or confirmed case of TB shall include: the name, address, date of birth, sex, race, ethnic origin, country of origin, and month and year the person arrived in the United States (if applicable). Other data, if available, may include: non-prescribed drug use and excess alcohol use within the year before the date of submission, occupation, address changes, names and addresses of contacts, and any other information required to complete the Centers for Disease Control and Prevention's Report of Verified Case of TB (RVCT) tuberculosis reporting form.

D) Other Information. Any other relevant information requested by the local TB control authority or the Department shall be provided. The information may include hospital discharge plans for out-patient follow-up and the names, locating information, test results and treatment information of all persons considered during a contact investigation.

b) Reports to the Department from Local TB Control Authorities. Local TB control authorities shall report to the Department on the diagnosis, clinical management and surveillance of suspected and confirmed cases of TB and the investigation of contacts, as follows. The local TB control authority shall make its records available for inspection by the Department when requested to carry out the provisions of this Part.

1) Reports of Suspected or Confirmed Cases of TB. Within seven calendar days after a local TB control authority's receipt of a report of a suspected or confirmed case of TB, the local TB control authority shall report available information to the Department electronically through the IDSS or other web-based system authorized by the Department. If the local TB control authority is unable to report electronically, reports shall be made by telephone or facsimile on forms available from the Department. Facsimile reports shall be followed up by telephone call.

2) Reports of Follow-up Information. The Department shall be notified of the status of drug susceptibility test results, contact investigation information, case completion of therapy and other relevant information. The information shall be reported electronically through the IDSS or other web-based system authorized by the Department. If the local TB control authority is unable to report electronically, reports shall be made by telephone, facsimile or mail.

c) Reports from Laboratories. Within one calendar day after obtaining results, laboratories shall report as follows: by telephone followed by mail, facsimile or Department-approved electronic reporting format to the person who ordered the test to be performed and to the local TB control authority; and by mail, facsimile or approved electronic format to the Department. Laboratories shall report the following:

1) Smears positive for acid-fast bacilli;

2) Cultures or other tests positive for M. tuberculosis;

3) Any culture result associated with an AFB-positive smear (even if negative for M. tuberculosis complex (MTB complex));

4) Drug susceptibility test results; and

5) Microbiologic test results if specimens were collected.

d) Isolates to State Public Health Laboratory. Laboratories shall send one isolate for each person to the State Public Health Laboratory within seven days after culture results are positive for MTB complex. If specimens are submitted to an out-of-state reference laboratory, the submitter shall ensure that the isolate is sent to the State Public Health Laboratory.

e) Reports Between Jurisdictions. Reports, such as laboratory reports and other pertinent reports, shall be made by one local TB control authority to another local TB control authority when more than one jurisdiction is involved with a case or their contacts, i.e., when the party submitting a specimen for diagnosis is in a different jurisdiction from that in which the patient resides or when a patient or contact resides, works or attends school in, or moves to, a different jurisdiction. Local TB control authorities receiving reports of persons with suspected or active TB disease being discharged or transferred to another jurisdiction shall notify the receiving jurisdiction by telephone, followed by facsimile or mail, prior to the planned discharge or transfer.

f) Reports of Discharge or Transfer. Institutional settings, such as hospitals, long- term care facilities and correctional settings, shall report plans to discharge or transfer persons with suspected or active TB disease prior to discharge or transfer by telephone to the local TB control authority in whose jurisdiction the reporter is located.

g) Confidentiality. Confidentiality of information shall be maintained in accordance with 77 Ill. Adm. Code 690.200(d).

h) Identifiable data may be released to the extent necessary for the treatment, control, investigation and prevention of diseases and conditions dangerous to the public health. Identifiable data can be shared in special circumstances as permitted by the Privacy Rule, the Medical Studies Act, and the Illinois Health Statistics Act. As described in the Illinois Health Statistics Act, a Department-approved Institutional Review Board or its equivalent on the protection of human subjects in research shall review and approve requests from researchers for individually identifiable data.

i) Local TB control authorities can request a letter from the Department indicating they are a delegate of the Department so that information may be shared with federal or military institutions.

j) People with active TB are recommended to seek clearance from the local TB control authority before air travel. The local TB control authority shall report to the Department when a contagious patient intends to travel on commercial airlines and shall provide related information as requested by the Department or CDC. The Department shall report the information to the CDC. The CDC's process for deciding whether such a patient will be placed on its "Do Not Board List" is available at https://www.cdc.gov/port-health/travel-restrictions/index.html.

(Source: Amended at 49 Ill. Reg. 202, effective December 18, 2024)

SUBPART C: ENFORCEMENT OF TUBERCULOSIS PREVENTION AND CONTROL MEASURES

Section 696.180 Role of the Department or Local TB Control Authority in Enforcement and Control

The Department or local TB control authority may issue directives, seek court orders or issue emergency orders as necessary to protect the public health, safety and welfare.

a) Directives. When necessary to protect the public health, safety and welfare, the Department or local TB control authority may ensure prevention and control measures by issuing Department or local TB control authority directives. A directive is a letter that informs recipients what is required of them to be in compliance with this Part and the consequences of noncompliance.

b) The Department or local TB control authority shall implement matters of quarantine, isolation and closure in accordance with 77 Ill. Adm. Code 690. Subpart H.

(Source: Amended at 36 Ill. Reg. 15267, effective October 2, 2012)