/Institutions/University-of-Texas-Rio-Grande-Valley/json/som/policies-local.json

/Institutions/University-of-Texas-Rio-Grande-Valley/json/som/policies.json

EAA004 Communicable Disease Policy

Policy Number: EAA004
Policy Title: Communicable Disease Policy

A. Purpose

The purpose of this policy is to provide clear guidelines for how to proceed in the event a student has a communicable disease.

B. Persons Affected

This policy will cover the students participating in the UTRGV SOM curriculum.

C. Implementation Date

This policy is effective with the UTRGV SOM inaugural class, the Class of 2020, and will remain in effect for future classes unless otherwise amended.

D. Policy

Students, including all visiting students, with communicable diseases or conditions, will not be permitted to engage in patient contact until such conditions have resolved as documented by a physician. This restriction is necessary to protect the health and safety of SOM patients and staff. Persons with the following medical conditions will not be allowed patient contact without prior medical clearance: 1) active chickenpox, measles, German measles, herpes zoster (shingles), acute hepatitis, and tuberculosis; 2) oral herpes with draining lesions; 3) group A streptococcal disease (i.e., strep throat) until 24 hours after treatment has been received; 4) draining or infected skin lesions (e.g. Methicillin-resistant Staphylococcus aureus (MRSA); or 5) HIV/AIDS (refer to the HIV/AIDS information provided below in this policy). Other epidemic or pandemic conditions may be added to this list of conditions limiting patient contact depending on guidance from public health authorities. 

A student who has a communicable disease and is unsure whether he/she should participate in patient care should seek medical care by a private physician or a physician on staff at UTRGV Student Health Services. All students with a communicable disease must receive written medical clearance by a physician prior to returning to clinical care activities. A case-by-case evaluation of each infected student will be done by his/her physician to determine eligibility to perform the duties required on the clinical rotation. Based on the recommendations of his/her physician, it is the responsibility of each infected medical student to notify the SOM Office of Student Affairs if he/she is unable to perform clinical work. Appropriate documentation is required. All such notifications will be kept strictly confidential.

Prior to the start of clinical experiences, a student who has chronic hepatitis B virus (HBV), chronic hepatitis C virus (HCV) or HIV/AIDS is required to notify the Office of Student Affairs of his/her status. All such notifications will be kept strictly confidential. Prior to the start of any clinical experiences, infected students are required to seek medical consultation by a physician to determine his/her ability to perform the duties required of the clinical rotation. Medical students are not obligated to answer patient questions related to their own HBV/ HCV/HIV/AIDS status, nor shall they answer such questions related to other students, other health care personnel, or patients. Serologic testing of medical students for HBV/HCV/HIV antibody will not be performed routinely unless the person is seropositive. Testing is recommended when there has been a documented needle or sharp instrument puncture or mucous membrane exposure to the blood or body fluids of patients, or when there has been a medical student-to -patient exposure.

Students who are at high risk of infection from patients or other personnel because of their immune status or any other reason are encouraged to discuss their work responsibilities and educational activities with their personal health care provider. If the health care provider believes that there are certain assignments the individual should not accept for personal health reasons, this should be discussed with the Associate Dean for Student Affairs or designee. Accommodations may be available under the Technical Standards. Students should contact the Office of Student Affairs to determine whether such accommodations are available. Medical students with HBV/HCV/HIV seropositivity shall have periodic physical examinations by their private physician or a physician on staff at Student Health Services. Written health clearance will be provided to the Associate Dean for Student Affairs or designee, who will notify the student's clerkship director of his/her ability to return to practice direct patient care. All correspondence will be kept confidential and will not be used as a basis for discrimination.

The greatest theoretical risk of medical student-to-patient transmission of HBV, HCV or HIV/AIDS involves invasive or exposure-prone procedures with manipulation of needles or other sharp objects not under direct visualization. Medical students who have HBV/HCV/HIV seropositivity may not perform invasive or exposure -prone procedures unless such activity is approved in writing by: 1) an expert panel duly constituted to guide and review performance of such procedures (see CDC guidelines below for definition of exposure-prone procedures and recommendations for expert panel oversight); 2) the student's personal physician (who may be a physician from Student Health Services); 3) the clinical clerkship director; and 4) and the Associate Dean for Medical Education or designee.

The Centers for Disease Control and Prevention (CDC) guidelines for the Management of Hepatitis B virus-Infected Health-Care Providers and Students (http://www.cdc.gov/mmwr/PDF/rr/rr6103.pdf) and the Society for Healthcare Epidemiology of America (Henderson DK et al. Infection Control and Hospital Epidemiology, 2010; 31 (3): 203-232.) suggest that medical students with HBV, HCV and HIV seropositivity can continue to attend classes and participate in clinical clerkships and preceptorships. For chronically infected HBV/HCV or HIV health -care providers and students who plan on performing exposure-prone procedures, an expert panel will be duly constituted to guide and review performance of such procedures (see CDC guidelines above for definition of exposure-prone procedures and recommendations for expert panel oversight). Chronically infected HBV-infected health-care providers and students are NOT required to: 1) repeatedly demonstrate non-detectable HBV viral loads on a greater than semiannual frequency; 2) prenotify patients of his/her HBV-infection status; or 3) submit to mandatory antiviral therapy. Standard Precautions should be adhered to rigorously in all health care settings for the protection of both patient and provider.

Education and Training
All students initially receive general information pertaining to the prevention and transmission of occupational exposures during the orientation to the SOM. During this time, students will be required to receive immunizations against hepatitis B, meningitis & varicella, and tuberculosis screening if not documented on the history and physical exam form submitted prior to registration. More formal clinical information about the prevention and pathophysiology of all infectious diseases that might potentially be transmitted in a clinical care setting is provided prior to the start of clinical clerkships. This would include education regarding hepatitis A, hepatitis B, hepatitis C, varicella, influenza, meningitis, tuberculosis, and HIV. Students will be provided with education on universal blood and body fluid precautions during orientation sessions for first-year students, and prior to the start of the clinical clerkships. Students will also receive information on infection control and prevention of the spread of communicable disease. During the first day, students are assigned to work at a clinical rotation site, the faculty at the affiliate site will provide information regarding the policies and procedures at their respective site that students must follow in the event of exposure.