10A NCAC 41A .0204       CONTROL MEASURES - SEXUALLY TRANSMITTED DISEASES

(a)  Local health departments shall provide diagnosis, testing, treatment, follow-up, and preventive services for syphilis, gonorrhea, chlamydia, nongonococcal urethritis, mucopurulent cervicitis, chancroid, lymphogranuloma venereum, and granuloma inguinale.  These services shall be provided upon request and at no charge to the patient.

(b)  Persons infected with, exposed to, or reasonably suspected of being infected with gonorrhea, chlamydia, non-gonococcal urethritis, and mucopurulent cervicitis shall:

(1)           Refrain from sexual intercourse until examined and diagnosed and treatment is completed, and all lesions are healed;

(2)           Be tested, treated, and re-evaluated in accordance with the STD Treatment Guidelines published by the U.S. Public Health Service.  The recommendations contained in the STD Treatment Guidelines are the required control measures for testing, treatment, and follow-up for gonorrhea, chlamydia, nongonococcal urethritis, and mucopurulent cervicitis, and are incorporated by reference including subsequent amendments and editions.  A copy  of this publication is on file for public viewing with the and a copy may be obtained free of charge by writing the Division of Public Health, 1915 Mail Service Center, Raleigh, North Carolina 27699-1915, and requesting a copy.  However, urethral Gram stains may be used for diagnosis of males rather than gonorrhea cultures unless treatment has failed;

(3)           Notify all sexual partners from 30 days before the onset of symptoms to completion of therapy that they must be evaluated by a physician or local health department.

(c)  Persons infected with, exposed to, or reasonably suspected of being infected with syphilis, lymphogranuloma venereum, granuloma inguinale, and chancroid shall:

(1)           Refrain from sexual intercourse until examined and diagnosed and treatment is completed, and all lesions are healed;

(2)           Be tested, treated, and re-evaluated in accordance with the STD Treatment Guidelines published by t h e U.S. Public Health Service.  The recommendations contained in the STD Treatment Guidelines are the required control measures for testing, treatment, and follow-up for syphilis, lymphogranuloma venereum, granuloma inguinale, and chancroid, except that chancroid cultures are not required;

(3)           Give names to a disease intervention specialist employed by the local health department or by the Division of Public Health for contact tracing of all sexual partners and others as listed in this Rule:

(A)          for syphilis:

(i)            congenital - parents and siblings;

(ii)           primary - all partners from three months before the onset of symptoms to completion of therapy and healing of lesions;

(iii)          secondary - all partners from six months before the onset of symptoms to completion of therapy and healing of lesions; and

(iv)          latent - all partners from 12 months before the onset of symptoms to completion of therapy and healing of lesions and, in addition, for women with late latent, spouses and children;

(B)          for lymphogranuloma venereum:

(i)            if there is a primary lesion and no buboes, all partners from 30 days before the onset of symptoms to completion of therapy and healing of lesions; and

(ii)           if there are buboes all partners from six months before the onset of symptoms to completion of therapy and healing of lesions;

(C)          for granuloma inguinale - all partners from three months before the onset of symptoms to completion of therapy and healing of lesions; and

(D)          or chancroid - all partners from ten days before the onset of symptoms to completion of therapy and healing of lesions.

(d)  All persons evaluated or reasonably suspected of being infected with any sexually transmitted disease shall be tested for syphilis, encouraged to be tested confidentially for HIV, and counseled about how to reduce the risk of acquiring sexually transmitted disease, including the use of condoms.

(e)  All pregnant women shall be tested for syphilis, chlamydia and gonorrhea at the first prenatal visit.  All pregnant women shall be tested for syphilis between 28 and 30 weeks of gestation and at delivery.  Hospitals shall determine the syphilis serologic status of the mother prior to discharge of the newborn  so that if necessary the newborn can be evaluated and treated as provided in (c)(2) of this rule.  Pregnant women 25 years of age and younger shall be tested for chlamydia and gonorrhea in the third trimester or at delivery if the woman was not tested in the third trimester.

(f)  Any woman who delivers a stillborn infant shall be tested for syphilis.

(g) All newborn infants shall be treated prophylactically against gonococcal ophthalmia neonatorum in accordance with the STD Treatment Guidelines published by the U.S. Public Health Service.  The recommendations contained in the STD Treatment Guidelines are the required prophylactic treatment against gonococcal ophthalmia neonatorum.

 

History Note:        Authority G. S. 130A-135; 130A-144;

Eff. December 1, 1991;

Amended Eff. April 1, 2008; November 1, 2007; April 1, 2003; July 1, 1993.