2.7 Preventing Infectious Disease: Nevada's Exclusion & Refusal Rules
Key Takeaways
- NAC 644A.775 bars a person afflicted with a transmissible infectious or communicable disease, or an infestation of animal parasites, from working or training in an establishment or school
- The regulation names nine conditions with specific return-to-work timings, from fever-accompanied respiratory illness to scabies
- Bloodborne diseases such as hepatitis B, HIV, and AIDS are expressly NOT treated as infectious or communicable diseases for purposes of NAC 644A.775
- NAC 644A.780 bars any service on skin that is inflamed, infected, broken, or otherwise compromised, and any service on a client whose skin secretes bodily fluids
- Violations of NAC 644A.740, 644A.765, and 644A.775 to 644A.790 are classified as gross malpractice under NAC 644A.865
Two Directions, Two Regulations
Nevada's outline lists Prevention of infectious disease as a distinct Domain I sub-topic, and Nevada backs it with two regulations that run in opposite directions. Confusing them is the most common error on this material.
| Regulation | Who is restricted | What is prohibited |
|---|---|---|
| NAC 644A.775 | The technician (and students) | Working or training in an establishment or school while afflicted with a transmissible infectious or communicable disease, or an infestation of animal parasites |
| NAC 644A.780 | The client | Receiving any service on skin that is inflamed, infected, broken, or otherwise compromised, or where the skin shows secretion of any bodily fluids |
Both are on the gross malpractice list in NAC 644A.865, alongside NAC 644A.740 (disinfection), 644A.765 (handwashing), 644A.785 (skin removal limits), 644A.790 (invasive procedures), and 644A.800 (banned cosmetic products).
When the Technician Must Stay Home (NAC 644A.775)
The regulation has three operative rules and then a list:
- A person afflicted with an infectious or communicable disease that may be transmitted during the practice of cosmetology, or with an infestation of animal parasites, shall not work or train in an establishment or school.
- An establishment or school shall not knowingly require, permit or allow a student or licensee to perform any service on a client afflicted with such a disease.
- An establishment or school shall not require or allow a student or licensee to perform any service on a client with an infestation of animal parasites.
The Named Conditions and Their Timings
Memorize this table. It is the kind of concrete, numeric list a 25-item law exam and a safety-heavy theory domain both love.
| Condition | May not work until |
|---|---|
| Cold, influenza, or other respiratory illness accompanied by a fever | 24 hours after the fever subsides |
| Streptococcal pharyngitis (strep throat) | Both 24 hours after treatment has started and 24 hours after the fever subsides |
| Purulent conjunctivitis (pink eye) | Examined by a physician and approved for return to work |
| Varicella (chicken pox) | The lesions have dried and crusted |
| Mumps | 9 days after the onset of parotid gland swelling |
| Tuberculosis | Examined by a physician and declared noninfectious |
| Impetigo | 24 hours after treatment has begun |
| Pediculosis (head lice) | The morning after the first treatment is received |
| Scabies | After treatment has been completed |
Patterns that make the table easier to hold:
- Two conditions require a physician to clear you: purulent conjunctivitis and tuberculosis.
- Three conditions key off 24 hours: respiratory illness with fever, strep throat (a double 24-hour test), and impetigo.
- Mumps is the outlier number: 9 days from the onset of parotid gland swelling.
- The two parasitic infestations resolve fastest on paper — head lice the morning after the first treatment, scabies after treatment is completed.
The Bloodborne Carve-Out
The regulation closes with a sentence that surprises almost everyone:
"Blood-borne diseases, such as hepatitis B, human immunodeficiency virus and acquired immune deficiency syndrome, are not considered infectious or communicable diseases for the purposes of this section."
That does not mean bloodborne pathogens are harmless or that precautions relax. It means NAC 644A.775 is about conditions transmitted during ordinary cosmetology practice — respiratory droplets, contact lesions, parasites — and a licensee who is HBV, HCV, or HIV positive is not excluded from working on that basis. Bloodborne risk is managed by universal precautions, the waste rules in NAC 644A.705, and the service-stop rule in NAC 644A.780. On an exam item asking which condition on a list does not trigger the NAC 644A.775 work exclusion, the bloodborne disease is the answer.
When the Client Must Be Turned Away (NAC 644A.780)
The rule is short and absolute:
- "A licensee shall not perform any service upon a surface of the skin or scalp of a client where such skin is inflamed, infected, broken or otherwise compromised."
- "Licensees shall not perform any service on a client whose skin shows signs of secretion of any bodily fluids."
For a nail technician, "inflamed, infected, broken or otherwise compromised" covers:
- A red, swollen, tender, or weeping nail fold (the presentation of paronychia).
- A thick, yellow-brown, crumbling plate separating from the bed (the presentation of onychomycosis).
- Any open cut, abrasion, blister, ulcer, or torn hangnail bed in the service area.
- Cracked or fissured heels that have broken the skin barrier.
- Any lesion, growth, or undiagnosed pigmented band.
Notice how this dovetails with NAC 644A.735(1)(a), which requires you to check the client's feet and legs before a foot spa service and, if open sores or skin wounds are present — including insect bites, scratches, scabbed-over wounds, or any condition that weakens the skin barrier — to explain to the client why he or she should not use the foot spa. Nevada names scabbed-over wounds and insect bites specifically, so a healing scratch counts.
You are not diagnosing when you decline. You are applying a rule about skin condition.
Handwashing Is the Other Half of Prevention
NAC 644A.765 is also on the gross-malpractice list. Every licensee and student must thoroughly wash his or her hands with liquid soap before and after serving each client and after each use of the restroom; hand sanitizer must be made available at each station for use by the client; and the use of hand sanitizer or gloves is not an acceptable substitute for hand washing for a licensee. Combined with NAC 644A.740 (implement disinfection) and NAC 644A.730 (linens and single-use disposal), that is Nevada's complete chain-of-infection strategy: break the pathogen's route at the hands, the implements, the linens, the water, and the client's intact skin.
Putting It Together in a Real Shift
| Situation | Correct action |
|---|---|
| You wake with a fever and a bad cough | Do not work; return 24 hours after the fever subsides |
| You have pink eye with discharge | Do not work until a physician examines you and approves return |
| Your child brought home head lice and you were treated last night | You may return the morning after the first treatment |
| You are hepatitis C positive and feel well | NAC 644A.775 does not exclude you; observe universal precautions |
| A client has a scabbed-over scratch on the ankle | Explain why she should not use the foot spa; a waterless service may still be possible if no skin in the service area is compromised |
| A client's cuticle begins to bleed mid-service | Stop the service (NAC 644A.780), run the blood-exposure procedure, and dispose of contaminated disposables in a sealable bag (NAC 644A.705(4)) |
Under NAC 644A.775, which of these conditions does NOT bar a licensee from working in a Nevada cosmetological establishment?
A licensee is diagnosed with strep throat and starts antibiotics Monday morning; the fever breaks Monday evening. Under NAC 644A.775, when may the licensee return to work?