Health Care Practioner Report Guidelines for Reportable Diseases and Conditions in Florida

Transcript

1 Health Care Practitioner Reporting Guidelines for Reportable Diseases and Conditions in Florida Based on Revisions to Rule 64D-3.029 Florida Administrative Code Effective October 20, 2016

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3 To All State of Florida Licensed Practitioners Dear Colleagues: , and laboratories in Florida are required to notify the Florida All practitioners, hospitals ) of diseases Department of Health ( conditions of pu blic health significance Department and ection 381.0031 , Florida Statutes , and Chapter 64D - 3, Florida Administrative Code. under s ractitione P laboratories, schools, nursing homes, state rs, hospitals, medical facilities, , and other locations providing health services are required to notify the Department institutions Table of of diseases or conditions and the associated laboratory test results listed in the , Rule 64D - 3.029, Florida Administrative Reportable Diseases or Conditions to Be Reported Code . Laboratory notification of test results does not nullify the practit ioner’s obligation to also notify the Department of the disease or condition. The public health system depends upon notification of diseases by physicians, laboratorians, infection preventionists and other health care to monitor the health of the community and to guide preventive action. practitioners Practitioners are required to notify of certain diseases of urgent public health the Department importance upon initial clinical suspicion of the disease to confirmatory diagnosis . Diseases prior warranting notification upon suspicion (termed Suspect Immediately ) should be reported 24 hours a day, seven days a week so the necessary public health response can be initiated in a timely and effective manner. Practitioners are also responsible for providing labora tories with all necessary information for the laboratories to fulfill laboratory notification requirements. he Department has updated the Table of Reportable Diseases or Conditions to Be Reported , T Rule 64D - 3.029, Florida Administrative Code ( effective O ctober 20, 2016 ), and s ection 381.985, (effective July 1, 2017), Florida Statutes rela ted to reporting elevated blood lead levels and screening results to the Department In an effort to assist practitioners in meet ing their . the Department of reportable diseases and conditions, has obligations to notify the Department 3, - Chapter Florida 64D prepared this guide. This guide is not intended to cover every aspect of reporting , but rather to provide a summation and explanation of practitioner Administrative Code requirements. To obtain more information, such as the updated version of Chapter 64D 3, Florida - , or other important reporting documents and guidelines, please: Administrative Code Visit www.FloridaHealth.gov/DiseaseReporting 1. 2. ’s Central Office (see page 2 of this guide) Contact the Department 3. Contact your local county health department (visit www.FloridaHealth.gov/CHDEpiContact locate contact information ) to The included list of reportable is current as of October 2016. This list is diseases and conditions not static and will change . over time We hope you will find this guide a useful aid as we all work to improve reportable disease and condition surveillance, prevention , and control in Florida. The assistance and support of health care providers invaluable. Thank you for your partnership. are Sincerely, C arina Blackmore, DVM, PhD, Dipl ACVPM Director, Division of Disease Control and Health P rotection State Epidemiologist Florida Department of Health

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5 Table of Contents - Notification Information ... ... ... AFTER HOURS 1 I. Contact Information, Florida Department of Health ... 2 ... II. Frequently Asked Questions (FAQs) ... ... ... 3 1. What are the practitioner notification requirements for reportable diseases under Chapter 64D - 3 , Florida Administrative Code ? ... ... ... 3 condition 2. Who m should practitioners notify when a reportable disease or is identified ? ... 3 ... 3 ... 3. When should notification of reportable diseases or conditions occur? ... 4. the Department ? What information are practitioners required to submit to ... 4 5. Do notification requirements for practitioners and laboratori es differ? ... ... 4 6. What information do practitioners need to provide laboratories to enable laboratories to fulfill their notification requirements? ... ... ... 5 about 7. Should practitioners call the Department suspect ed cases of diseases or conditions of a highly infectious nature of urgent public health importance? ... ... 5 8. Are there special testing requirements for STDs in pregnant women that impact practitioner notification? ... ... ... ... 5 9. A re there diseases or conditions with exceptions or special practitioner notification requirements? ... ... ... . 6 ... 7 Are laboratory results required to be submitted electronically? ... 10. ... 11. Does the Health Insurance Portability and Accountability Act (HIPAA) affect notification requirements 7 ... ... ... ... ? III. ... ... ... ... 8 Notification Timeframes ... ... ... ... 8 Suspect Immediately Immediately ... ... ... ... ... 8 ... Next Bu ... ... siness Day ... 8 Other ... ... ... ... ... 8 notification timeframes Difference between the and Immed iately ... 9 Suspect Immediately IV. Table of Reportable Diseases or Conditions to Be Reporte d ... ... 10 V. Notations, Table of Reportable Diseases or Conditions to Be Reported ... 16 One Page Practitioner Guide 19 VI. ... ... ... Form Notification Practitioner Disease VII. 20 ... ... ... AFTER HOURS notification of Suspect Immediately and Immediately reportable - diseases or conditions, accessible 24 hours a day, 7 days a week (24/7): Notifications before or after regular county health department business hours shall be made to the after - hours duty official. after , visit hours disease reporting phone - number  To locate local county health department daHealth.gov/CHDEpiContact www.Flori Record your county health department contact information below. Business hours phone: _________________________ Fax: _________________________ After - hours phone: _________________________ - hours official health department , contact : after  If unable to reach the county 4401 - (850) 245 hours phone: - Bureau of Epidemiology after - Bureau of Public Health Laboratories after - LABS) - FLA hours phone: 5227 (866 - (866) 352 Coming soon: “What’s Reportable?” app for iOS and Android orida Department of Health Fl county health department For local contact information, visit www.FloridaHealth.gov/CHDEpiContact 1 www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

6 Florida Department of Health Contact Information, I. about a the Department contact To during regular disease or condition reportable or receive consultation regarding diagnosis and management of patients and business hours contacts, . health department their contact practitioners should county t www.FloridaHealth.gov/CHDEpiContact ocal county health department contact l Visit o obtain . information and , , diagnosis notification For technical consultation or consultation regarding disease management of patients and contacts, contact the Department’s Central Office : Division of Disease Control and Health Useful websites: Protection Diseases and Conditions 245 - - 4300 - Phone: (850) and www.floridahealth.gov/diseases conditions/index.html Physical: 4025 Esplanade Way Mailing: 4052 Bald Cypress Way , A - 09 Disease Reporting Information for Health Care Tallahassee, Florida 32399 1720 - Providers and Laboratories Bureau of Epidemiology www.Floridahealth.gov/DiseaseReporting Phone: (850) 245 - 4401, accessible 24/7 Florida Birth Defects Registry (850) 414 - 6894 Confidential Fax: www.FloridaHealth.gov/AlternateSites/FBDR/ Bureau of Communicable Diseases Registry Florida Cancer HIV/AIDS Section and - www.floridahealth.gov/diseases - Phone:(850) 245 - 4334 conditions/cancer/cancer - registry/index.html Immunization Section Florida Lead Poisoning Prevention Program (850) 245 - 4342 - www.floridahealth.gov/environmental poisoning/index.html Sexually Transmitted Disease and Viral /lead health - Hepatitis Section Florida Meaningful Use Public Health Reporting (850) 245 - 4303 www.FloridaHealth.gov/MeaningfulUse Tuberculosis Control Section Electronic Laboratory Reporting - (850) 245 4350 email: [email protected] - INFO (800) 4TB For laboratory consultation or to arrange for receipt of specimens, contact the Bureau of Public Health Laboratories: Tampa Jacksonville (813) 974 - Phone: Phone: (904) 791 - 1500 8000 3425 Fax: (904) 791 - 1567 Fax: - 974 (813) 3602 Spectrum Boulevard Address: Physical: 1217 North Pearl Street Tampa, F lorida 33612 Jacksonville, Florida 32202 P Box 210 O . . Mailing: Miami Jacksonville, Florida 32231 - 2432 Phone: (305) 324 - 2560 Fax: (305) 324 1325 Northwest 14th Avenue Address: Florida 33125 Miami, - 24/7 Laboratories Phone: LABS) - FLA 5227 (866 - (866) 352 Bureau of Public Health . During regular business hours, use contact informa tion above Florida Department of Health 2 For local www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

7 II. Frequently (FAQs) Questions Asked 1. under for reportable diseases What are the practitioner notification requirements , Chapter 64D - 3 Florida Administrative Code ? - 3.0030 s 64D Practitioner and medical facility reporting requirements are described in Rule - 64D and . , medical Each licensed practitioner Florida Administrative Code , 3.0032 and medical examiner who diagnoses, treats, or suspects a case or an facility, occurrence of a disease or condition listed in the Table of Reportable Diseases or Conditions to Be Reported , is required , Rule 64D - 3.029, Florida Administrative Code the Depar for the 15 - 10 ee pages S that case or occurrence Table of to notify tment of . Reportable Diseases or Conditions to Be Reported on alth system depends . The public he of disease to monitor the health of the community and to preventive inform notification . s n actio Laboratories to notify of reportable diseases and are also required the Department conditions. Duplicate reporting of the same illness may occur, though laboratories and ). Information contained in practitioners have different reporting requirements (see FAQ # 5 practitioner reports supplements data provided by laboratories by providing additional ncy status, treatment, occupation, information on symptoms, pregna in family illness members, etc the Department does not Laboratory submission of test results to . nullify the practitioner’s obligation to also report the disease or condition. Practitioners also play an important role in supplying laboratories with all necessary Public health authorities information to fulfill laboratory notification requirements. will identify any duplicate reports received and de - duplicate the records. Although multiple referable to not receiving any report, which would likely reports may be received, this is p All people with reporting lead to additional transmission and increased morbidity. systems are in place at the medical practices notification responsibilities should verify that and hospitals in whi ch they work and at the laboratories they use. should practitioners notify when a reportable disease or condition is 2. Who m ? identified made disease or condition should be Notification of a reportable to the directly where the patient resides in the county . It is important to county health department know how to contact county health department epidemiology staff during business hours as well as after hours for notification of Suspect Immediately and Immediately Table of Reportable Diseases the reportable diseases or conditions in 15 - 10 see pages ). ( or Conditions to Be Reported note that there are some diseases with different notification requirements. Please See FAQ # for additional 9 information on exceptions. 3. When should notification of reportable diseases or conditions occur? Notification of reportable diseases or conditions should be submitted accordi ng to timeframes specified in the Table of Reportable Diseases or Conditions to Be Reported ( see t imeframe, 10 15 ) . For a description of the requirements for each - n see otification pages written report within Notification . via telephone should be followed with a subsequent page 8 , of dential means or other confi written ta transfer by facsimile, electronic da 72 hours communication. Fl orida Department of Health For local 3 county health department www.FloridaHealth.gov/CHDEpiContact contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

8 4. What information are practitioners required to submit to the Department ? As per Rule 64D - 3.030, Florida A dministrative Code , report content must include: a. The patient’s: 1. First and last name, including middle initial ZIP and ) ode c 2. Address ( inclu ding street, city, state , Telepho ne number ( including area code ) 3. 4. Date of birth 5. Sex 6. Race Hispanic) - 7. Eth nicity (Hispanic or non P regnancy status , if applicable 8. 9. Social security number 10. Date of symptom onset Diagnosis 11. b. leic acid amplification test, culture, IgM, serology, nuc Type of diagnostic tests (e.g., Western blot) Specimen collection date c. pecimen S d. ) ol, urine, blood, mucus sto e.g., ( type e. men collection site (e.g., cer vix, eye ) , if applicable Speci Diagnostic test results , including reference range, titer when quantitative procedures f. n of the are performed, and all available results concerning additional characterizatio organism g. For Tuberculosis, the 15 - digit spoligotype (octal code) h. Treatment given i. Attending practitioner’s : 1. Name street, ZIP and , city, state including ( ddress A 2. ) ode c elephone number 3. T (including area code) National provider identifier (NPI) 4. Other necessary epidemiological information as well as additional specimen j. director or collection or laboratory testing requested by the county health department a dministrator or their designee 5. Do notification requirements for practitioners and laboratori es differ? Yes, practitioners and laboratories have slightly different notification requirements . For example, practitioners are required to report treatment information, which is not applicable Submission methods also differ; results s are required to submit laboratorie for laboratories. Table of Reportable Diseases or Conditions to Be . Please refer to the electronically for practitioners and laboratories. for specific requirements - ) 10 see pages ( Reported 15 Please note that laboratory notification does not nullify the practitioner notification requirements. Florida Department of Health 4 For local www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

9 What information do practitioners need to provide laboratories to enable laboratories 6. to fulfill their notification requirements? Practitioners are responsible for assisting laboratories to fulfill their notification requirements. Practitioners are responsible for obtaining and providing the following information to laboratories at the time a specimen is sent to or received by th e laboratory: a. The pati ent’s: name, including middle initial First and last 1. Address, inclu ding city, state and ZIP C ode 2. 3. Telepho ne number, including area code 4. Date of birth Sex 5. 6. Race 7. Ethnicity ( Hispanic or non - Hispanic) 8. Pregnancy status , if applicable 9. Social s ecurity number of specimen collection b. Date c. Type of specimen (e.g., sto ol, urine, blood, mucus) d. Specimen collection site ( e.g., cervix, eye) , if applicable e. Submitting practitioner’s information, including name, address (street, city, ZIP Provider Identifier (NPI) telephone number , and National C ode), 7. Should practitioners cases of diseases or ed suspect about the Department call conditions of a highly infectious nature of urgent public health importance? Yes, practitioners are required to call suspected cases of certain the Department about diseases of urgent public health importance. Practitioners should refer to Table of the the column labeled Reportable Diseases or Conditions to Be Reported ( see pages 10 - 15 ); designates Suspect Immediately as s should result in notifying diseases or condition which prior to confirmatory diagnostic results. upon initial suspicion of disease, the Department Requests for laboratory test s for identification of an organism are considered evidence that the disease is considered as part of the practitioner’s differential diagnosis and should be the uld immediately (24 hours a day, seven days a week) Practitioners sho reported. call ir Upon . Suspect Immediately iseases designated as d about county health department their call confirmation of the disease or presence of the agent, the practitioner should also confirmation. of tment county health depar Are there special testing requirements for STDs in pregnant women that impact 8. practitioner notification? Yes, practitioners attending a woman for prenatal care must test the woman for chlamydia, , and syphilis at initial examination and then again at 28 to 32 gonorrhea, hepatitis B, HIV weeks gestation. Practitioners attending a woman at delivery or within 30 days postpartum , who has no record of prenatal HIV/STD testing must test the woman for hepatitis B, HIV Practitioners attending a woman who presents to an emergency department at and syphilis. 12 weeks gestation or greater with no record of prenatal care must either test the woman for s . Prior HIV/STD county health department to or provide her with a written referral to the ir any required testing, a woman must be notified of the tests to be performed and of the right to refuse testing. If a woman refuses testing, she must sign a statement to that effect or the further information, practitioner must document the refusal(s) in the medical record. For please contact the Department’s Sexually Transmitted Disease and Viral Hepatitis Section 3 (see page for contact information). Fl orida Department of Health county health department contact information, visit For local www.FloridaHealth.gov/CHDEpiContact 5 To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

10 diseases or conditions with exceptions or special practitioner notification re there A 9. requirements? es, there are exceptions or special notification requirements for the diseases below. Y Cancer  Congenital anomalies   HIV/AIDS and HIV - exposed infants  Neonatal abstinence syndrome (NAS) Lead poisoning  Details are provided for each disease or condition below. process is different Notification : , freestanding radiation therapy centers, , laboratories ll health care facilities A Cancer:  ambulatory patient care centers and any practitioner licensed to practice medicine in DS) of the state of Florida are required to notify the Florida Cancer Data System (FC all cancer diagnoses or treatment within six months. All cases must be transmitted accordance with the FCDS Data Submission Policies and to FCDS in electronically Procedures outlined in the FCDS Data Acquisition Manual. For more information, visit the FCDS website ( http:// fcds.med.miami.edu/inc/path.shtml ). by licensed hospitals or licensed practitioners Congenital  : N otification anomal ies occurs when these conditions are reported to the Agency for Health Care - Administration in its inpatient discharge data report pursuant to Chapter 59E 7, The Florida Birth Defects Registry (FBDR) compiles . Florida Administrative Code data from linked administrative data sets to identify infants born with congenital anomalies in Florida. NAS N  otification by licensed hospitals occurs when NAS cases are reported to the : Agency for Health Care Administration in its inpatient discharge data report pursuant - 7, Florida Administrative Code . FBDR compiles data from linked to Chapter 59E administrative data sets to identify infants born with NAS in Florida. Positive and negative laboratory results should be submitted, not just case information: Lead poisoning :  county health μg/dL) should be submitted to the cases (≥ 5 site blood lead analysis devices department . Additionally, results produced by on - (i.e., portable lead care analyzers or other portable devices used to perform blood μg/dL must be submitted within 10 business days electronically. lead analysis) of < 5 - at (850) 245 contact the Florida Lead Poisoning Prevention Program For questions, 4401. Special notification forms are required:  ase C : HIV or AIDS Adult HIV within two weeks using the notification should occur ) for cases in Ca Confidential 2013 se Report Form, CDC 50.42A (revised March people ≥13 years old or the Pediatric HIV Confidential Case Report, CDC 50.42B contact Practitioners should . 3 1 20 (revised March ) for cases in people <13 years old their . these forms county health department for HIV exposed newborns or  - infants <18 months old born to a n HIV - infected N : woman by the next business day. Practitioners should otification should be (r ised March ev complete the Pediatric HIV Confidential Case Report, CDC 50.42B contact these forms. for th department county heal their Practitioners should 2003 . ) Florida Department of Health 6 For local www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

11 10. Are laboratory results required to be submitted electronically? Yes, laboratories are required to submit test results electronically. For information about at Department electronic laboratory reporting (ELR), please contact the n liaiso ELR ’s - [email protected] . Practitioners conducting in house laboratory testing should review the laboratory reporting guidelines as well as practitioner guidelines to ensure compliance to aid in an effective and timely public health response. e requirement to report by telephone those Please note: ELR does not remove th diseases with notification timeframes of Suspect Immediately in the Immediately and 10 Table of Reportable Diseases or Conditions to Be ( see pages Reported - 15 ). 11. Does the Health Insurance Portability and Accountability Act (HIPAA) affect notification requirements ? the Department to notify , HIPAA does not change the obligation No of of practitioners reportable diseases or conditions or the obligation to cooperate with the Department’s miologic investigations. HIPAA s an includes 160.203(c) specifically CFR ection 45 epide exception “reports of disease, for procedures established under state law providing for CFR injury, child abuse, birth or death for the conduct of public health” and 45 section 164.512(b) mation for the states that “A covered entity may disclose protected health infor public health activities and purposes...to a public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, t he reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions . ” medical facilities, All practitioners, and laboratories in Florida are required to notify the ection 381.0031, blic health significance under s of diseases or conditions of pu Department Florida Statutes and Florida Administrative Code of , Chapter 64D 3. - Administrators laboratories, practitioner s, hospitals, medical facilities, schools, nursing homes, state the Department institutions , or other locations providing health services are required to notify of Table of diseases or conditions and the associated laboratory test results listed in the , Rule 64D ortable Diseases or Conditions to Be Reported Rep - 3.0029, Florida Administrative ( ). These state requirements are not reduced or changed by the - Code see pages 15 10 federal law . Fl orida Department of Health For local 7 county health department www.FloridaHealth.gov/CHDEpiContact contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

12 Notification Timeframes III. Suspect Immediately ! are of These r and condition s s immediate public health concern due to eportable disease their high ly infectious nature or need for immediate intervention. P ractitioners should call their county health department immediately , 24 hours a day, seven days a week by phone upon initial clinical suspicion or laboratory test order. Practitioners should call their county health department without delay upon the occurrence of any of the following: initial clinical suspicion, suspecte d diagnosis , receipt of a specimen with an accompanying request for an indicative or confirmatory test, and s indicative finding call . The g Suspect Immediately thereof timeframe is to oal of the public health authorities as soon as possible during the case evaluation period so the necessary public health response ( e.g., issuance of isolation, quarantine, proph ylaxis, anti - toxin request , mosquito control notification ) can be initiated in a timely and effective manner to prevent further exposure or infection. Notification should be directly to the county health department . Notifications before or after regular business hours shall be made to the county health department after - hours duty o obtain t www.FloridaHealth.gov/CHDEpiContact Visit county health local official. county health department after - hours duty contact information . the If unable to reach - Bureau of Epidemiology after Department’s - after department hours official, contact the hours duty official at (850) 245 4401. - Immediately These r eportable disease s and condition s are of urgent public health importance . ractitioners should P their call county health department by phone immediately 24 nfirmatory test result, hours a day, seven days a week following a n indicative or co finding , or diagnosis. county health department . Notifications before or after Notification should be directly to the hours duty after - regular business hours shall be made to the county health department www.FloridaHealth.gov/CHDEpiContact Visit official. county health local obtain o t the rtment . If unable to reach contact information county health depa department after - hours - official, contact the Department’s Bureau of Epidemiology after hours duty official at (850) 4401. - 245 Next Bu siness Day their Practitioners should n otify no later than the close of the county health department next business day following confirmatory testing or diagnosis. Other pecific timeframes are s. S ther reporting timeframe Some diseases and conditions have o indicated in the “Other” column of the Table of Reportable Diseases or Conditions to Be 10 - 15 ). Reported ( see pa ges Florida Department of Health For local www.FloridaHealth.gov/CHDEpiContact county health department 8 contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/DiseaseReporting

13 Submit isolates or specimens for confirmation , isolates, sera, slides L aboratories are required to send specimens, or diagnostic preparations for certain etiologic agents to the Department’s Bureau of Public Health L aboratories for confirmation or additional characterization of the organism. Difference between the Suspect Immediately and Immed iately notification timeframes about county health department their call Practitioners should d iseases that are listed as hours a day, seven days a Suspect Immediately or Immediately as soon as possible, 24 upon by phone. Suspect Immediately diseases and conditions should be reported week . Notification initial suspicion should occur prior to a confirmatory diagnosis when the disease in question is considered highly suspect. Requests for laboratory test identification of an organism are conside red evidence that the disease is part of the clinician’s differential call timeframe is to Suspect Immediately d be reported. The goal of the diagnosis and shoul public health authorities as soon as possible during the case evaluation so the necessary toxin issuance of isolation, quarantine, prophylaxis, e.g., public health response ( - anti request , mosquito control notification ) can be initiated in a timely and eff ective manner to priority diseases but - also applies to high Immediately prevent further exposure or infection. following confirmatory testing or diagnosis notification should occur . Fl orida Department of Health For local 9 county health department www.FloridaHealth.gov/CHDEpiContact contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

14 d IV. Table of Reportable Diseases or Conditions to Be Reporte www.FloridaHealth.gov/DiseaseReporting Table available electronically at Practitioner Notification Laboratory Notification Timeframe (see page 8 Timeframe (see page ) ) 8 Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, serotype, and antimicrobial susceptibility *2 results) confirmation *1 Other Next Business Day Other Immediately Next Business Day Suspect Suspect Immediately Submit isolates or Immediately Immediately specimens for Outbreaks of any disease, any case, cluster of cases, or exposure to an Detection in one or more specimens of infectious disease, - infectious or non etiological agents of a disease or condition, or agent found in the general condition not listed that is of urgent public ! ! community or any defined setting (e.g., health significance; agents suspected to hospital, school, other institution) not ‡ be the cause of a cluster or outbreak of urgent public health listed that is significance † Acquired immune 2 Laboratory notification not applicable weeks deficiency syndrome (AIDS) Naegleria fowleri, Balamuthia Amebic encephalitis species mandrillaris, and Acanthamoeba Bacillus anthracis Anthrax ! ! Antimicrobial susceptibility results for isolates from a normally sterile site for Acinetobacter baumannii, Citrobacter Practitioner notification not X species, Enterococcus species, Antimicrobial resistance surveillance applicable species, , Escherichia coli Enterobacter Klebsiella species, Pseudomonas species *3 , and Serratia aeruginosa Laboratory results as specified in the X X Arsenic poisoning *4a surveillance case definition *4a Arboviruses not otherwise listed, including but not limited to: Flaviviridae, Arboviral diseases not otherwise listed Togaviridae (e.g., Western equine ! ! encephalitis virus), and Bunyaviridae *5 (e.g., Heartland virus, Rift Valley fever virus) *5 Babesiosis species Babesia X X Clostridium botulinum and botulinum Botulism, foodborne, wound, and toxin in food, wound or unspecified ! ! unspecified source Clostridium botulinum and botulinum X Botulism, infant X toxin in infants <12 months old Brucella Brucellosis species ! ! X California serogroup viruses (e.g., X California serogroup virus disease Jamestown Canyon, Keystone, Lacrosse) Campylobacter Campylobacteriosis *4b species *4b X X - melanoma Cancer, excluding non Pathological or tissue diagnosis of skin cancer and including benign and melanoma skin - cancer, excluding non 6 months 6 months cancer and including benign and borderline intracranial and CNS borderline intracranial and CNS tumors tumors *6 Volume fraction ≥0.09 (9%) of X monoxide poisoning Carbon X carboxyhemoglobin in blood 4 absolute count and percentage of Practitioner notification not CD - - 4 absolute count and percentage of CD 3 days total lymphocytes *7 total lymphocytes applicable Florida Department of Health 10 For local www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

15 IV. Table of Reportable Disease (Continued) s or Conditions to Be Reported electronically at Table available www.FloridaHealth.gov/DiseaseReporting Practitioner Notification Laboratory Notification ) Timeframe (see page 8 ) 8 Timeframe (see page Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, susceptibility serotype, and antimicrobial Business Day *2 results) Submit isolates or Other Immediately specimens for Immediately Immediately confirmation *1 Immediately Suspect Other Suspect Next Business Day Next Chanc roid X X Haemophilus ducreyi Chikungunya virus X X Chikungunya fever Chikungunya fever, locally - acquired Chikungunya virus X Chlamydia *8 X X Chlamydia trachomatis type O1 Vibrio cholerae Cholera ! ! Laboratory notification not applicable X Ciguatera fish poisoning Laboratory notification not applicable 6 months Congenital anomalies *9 Conjunctivitis in neonates <14 days old applicable Laboratory notification not X 3 or tau protein detection in CSF or - 3 - 14 immunohistochemical test or any brain X Creutzfeldt - Jakob disease (CJD) *10 X pathology suggestive of CJD *10 Cryptosporidiosis *4b X species *4b Cryptosporidium X X Cyclospora cayetanensis Cyclosporiasis X Dengue virus *5 Dengue fever *5 ! ! Corynebacterium diphtheriae Diphtheria ! ! X Eastern equine encephalitis virus X Eastern equine encephalitis Ehrlichiosis/anaplasmosis Anaplasma species and Ehrlichia species X X - , Shiga toxin Escherichia coli Escherichia coli producing or infection, Shiga toxin - X X producing *4b Shiga toxin *4b X species *4b Giardia Giardiasis, acute *4b X Burkholderia mallei Glanders ! ! Neisseria X X Gonorrhea *8 gonorrhoeae Granuloma inguinale X Klebsiella granulomatis X invasive isolated from a Haemophilus influenzae Haemophilus influenzae ! ! normally sterile site for all ages*11 disease in children <5 years old X (leprosy) Hansen’s disease X Mycobacterium leprae orida Department of Health Fl contact information, visit county health department For local www.FloridaHealth.gov/CHDEpiContact 11 To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

16 (Continued) IV. Table of Reportable Disease s or Conditions to Be Reported Table available electronically at www.FloridaHealth.gov/DiseaseReporting Practitioner Notification Laboratory Notification Timeframe (see page ) 8 Timeframe (see page ) 8 Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, serotype, and antimicrobial susceptibility Business Day *2 results) Suspect confirmation *1 Other specimens for Other Suspect Immediately Immediately Immediately Immediately Submit isolates or Next Next Business Day Hantavirus Hantavirus infection Hemolytic uremic syndrome (HUS) Laboratory notification not applicable Hepatitis A *4b, 12 Hepatitis A *4b, 12 Hepatitis B, C, D, E, and G viruses, all X Hepatitis B, C, D, E, and G *12 X test results (positive and negative) *12 Hepatitis B surface antigen (HBsAg) for Hepatitis B surface antigen in pregnant X X women and children <2 years old all ages Herpes B virus, possible exposure Laboratory notification not applicable Herpes simplex virus (HSV) in infants <60 days old with disseminated infection and liver involvement; HSV 1 and HSV 2 in children <12 years X X old *13 encephalitis; and infections limited to skin, eyes, and mouth; anogenital HSV in children <12 years old *7, 13 Repeatedly reactive enzyme immunoassay followed by a positive confirmatory test (e.g., Western blot, IFA). Positive result on any HIV 3 days Human immunodeficiency virus (HIV) virologic test 2 weeks (e.g., p24 AG, nucleic acid test infection [NAT/NAAT], viral culture). All viral load (detectable and undetectable) test results. *14, 15 All HIV test results (e.g., positive and negative immunoassay, positive and HIV - exposed infants <18 months old 3 days X negative virologic tests) for children <18 infected woman - born to an HIV months old Practitioner notification not Human papillomavirus (HPV) X HPV DNA *3 applicable associated laryngeal papillomas or HPV - recurrent respiratory papillomatosis in X HPV DNA *3 X children <6 years old; anogenital papillomas in children ≤12 years old *8 - Influenza associated pediatric mortality Influenza virus in children <18 years old in children <18 years old (if known) who died Influenza virus, novel or pandemic strain Influenza A, novel or pandemic strains ! ! isolated from humans Practitioner notification not Influenza virus, all test results (positive Influenza X and negative) *3 applicable Lead, all blood results (positive and Lead poisoning (blood lead level X X ≥5 μg/dL)*4, 16 negative) *3, 4, 16 species Legionella X Legionellosis X X Leptospirosis X species Leptospira Florida Department of Health 12 contact information, visit www.FloridaHealth.gov/CHDEpiContact For local county health department www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

17 (Continued) IV. Table of Reportable Disease s or Conditions to Be Reported www.FloridaHealth.gov/DiseaseReporting electronically at Table available Practitioner Notification Laboratory Notification Timeframe (see page ) Timeframe (see page 8 8 ) Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, susceptibility serotype, and antimicrobial Business Day *2 results) Suspect specimens for Immediately confirmation *1 Immediately Other Other Immediately Suspect Submit isolates or Immediately Next Next Business Day Listeriosis Listeria monocytogenes X Borrelia burgdorferi X Lyme disease Lymphogranuloma venereum (LGV) X Chlamydia trachomatis X Malaria X X Plasmodium species Measles virus *16 Measles (rubeola) ! ! Burkholderia pseudomallei Melioidosis ! ! Isolation or demonstration of any bacterial X Meningitis, bacterial or mycotic X or fungal species in CSF isolated from Neisseria meningitidis a Meningococcal disease ! normally sterile site indicative of poisoning as Mercury results X Mercury poisoning *4a X specified in the surveillance case definition *4a X Mumps virus Mumps X Neonatal abstinence syndrome (NAS) 6 months Laboratory notification not applicable *18 Brevetoxin associated with neurotoxic as specified in the shellfish poisoning Neurotoxic shellfish poisoning surveillance case definition *4a serotypes Paratyphi A, Salmonella Paratyphoid fever *4b Paratyphi B, and Paratyphi C *4b Pertussis Bordetella pertussis Pesticide - Laboratory results as specified in the related illness and injury, X X surveillance case definition *4 acute *4 Plague Yersinia pestis ! ! Poliomyelitis Poliovirus ! ! Psittacosis (ornithosis) X psittaci X Chlamydophila Q Fever Coxiella burnetii X X Rabies, animal or human Rabies virus in animal or human ! Laboratory notification not applicable Rabies, possible exposure *19 ! Practitioner notification not Respiratory syncytial virus, all test results Respiratory syncytial virus X applicable (positive and negative) *3 orida Department of Health Fl For local county health department 13 contact information, visit www.FloridaHealth.gov/CHDEpiContact To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

18 IV. Table of Reportable Disease s or Conditions to Be Reported (Continued) Table available electronically at www.FloridaHealth.gov/DiseaseReporting Practitioner Notification Laboratory Notification 8 Timeframe (see page 8 Timeframe (see page ) ) Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, serotype, and antimicrobial susceptibility Business Day *2 results) Suspect specimens for Immediately confirmation *1 Immediately Other Immediately Suspect Immediately Other Submit isolates or Next Next Business Day castor Ricinus communis Ricinine (from Ricin toxin poisoning ! ! beans) and other spotted Rickettsia rickettsii Rocky Mountain spotted fever and other X X spotted fever rickettsioses species Rickettsia fever Rubella Rubella virus *17 ! ! St. Louis encephalitis X X St. Louis encephalitis virus X species *4b Salmonella X Salmonellosis *4b Saxitoxin poisoning (paralytic shellfish X Saxitoxin X poisoning) Severe acute respiratory disease Coronavirus associated with severe acute syndrome associated with coronavirus ! ! respiratory disease infection X X Shigella species *4b Shigellosis *4b Variola virus (orthopox virus) Smallpox ! ! Staphylococcal enterotoxin B Staphylococcal enterotoxin B poisoning Staphylococcus aureus , intermediate or infection, Staphylococcus aureus full resistance to vancomycin (VISA, intermediate or full resistance to VRSA); laboratory results as specified in vancomycin (VISA, VRSA) the surveillance case definition *4 invasive Staphylococcus aureus Practitioner notification not isolated from a Staphylococcus aureus X infection normally sterile site *3 applicable invasive Streptococcus pneumoniae isolated from Streptococcus pneumoniae X X a normally sterile site for all ages *20 disease in children <6 years old pallidum Treponema X Syphilis X in pregnant women Syphilis in pregnant women and Treponema pallidum neonates and neonates X Clostridium tetani Tetanus X Trichinella spiralis Trichinellosis (trichinosis) X X X Tuberculosis (TB) *21 complex *21 X Mycobacterium tuberculosis Tularemia Francisella tularensis ! ! Typhoid fever *4b serotype Typhi *4b Salmonella Rickettsia prowazekii Typhus fever, epidemic ! ! Vaccinia disease Vaccinia virus ! ! Florida Department of Health county health department 14 For local www.FloridaHealth.gov/CHDEpiContact contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

19 (Continued) s or Conditions to Be Reported IV. Table of Reportable Disease www.FloridaHealth.gov/DiseaseReporting electronically at Table available Notification Laboratory Practitioner Notification ) 8 Timeframe (see page ) Timeframe (see page 8 Evidence of current or recent infection with etiological agents and all associated testing results performed should be Reportable Disease or Condition reported (e.g. species, serogroup, susceptibility serotype, and antimicrobial Business Day *2 results) Suspect Immediately Immediately Immediately Other Submit isolates or specimens for Suspect confirmation *1 Immediately Other Next Next Business Day X Varicella (chickenpox) *22 Varicella virus X Venezuelan equine encephalitis Venezuelan equine encephalitis virus ! ! Vibrio Vibrio cholerae species excluding Vibriosis (infections of Vibrio species Photobacterium damselae type O1, X and closely related organisms, X (formerly V. damsela ), and Grimontia type O1) Vibrio cholerae excluding hollisae ) V. hollisae (formerly Arenaviruses (e.g., Lassa, Machupo, Lujo, new world), Filoviruses (e.g., Ebola, Viral hemorrhagic fevers ! ! Marburg), or viruses not otherwise listed that cause viral hemorrhagic fever X West Nile virus disease West Nile virus X Yellow fever Yellow fever virus ! Zika fever *5 Zika virus *5 ! ! Fl orida Department of Health For local 15 county health department www.FloridaHealth.gov/CHDEpiContact contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

20 Notations, Table of Reportable Diseases or Conditions to Be V. Reported : see page 8 for additional information on notification timeframes. Suspect Immediately ! Immediately : see page for additional information on notification timeframes. 8 † This includes human cases, clusters, or outbreaks spread person - to - person, by animals or vectors or from an environmental, fo od borne or waterborne source of exposure; those that result from a deliberate act of terrorism; and unexplained deaths possibly due to unidentified infectious or chemical causes. ‡ This includes the identification of etiological agents that are suspec ted to be the cause vectors of clusters or ou tbreaks spread person - to - person; by animals ; by ; or from an environmental, food borne e. This also includes , or waterborne source of exposur ted to be the cause of clusters or ou tbrea ks etiological agents that are suspec ing result fro m a deliberate act of terrorism and unexplained deaths due to unidentified infectious or chemical causes. *1 Submission of isolates or specimens for confirmation to the Department’s Bureau of Public Health Laboratories (BPHL): a. Each lab oratory that obtains a human isolate or a specimen from a patient shall send isolates or specimens (such as sera, slides or diagnostic preparations) for confirmation or additional characterization of the organism. b. Hospitals, practitioners and laborator ies submitting specimens for reportable , Florida Administrative Code 3.031(3), 64D - laboratory tests, pursuant to subsection are required to supply the laboratories with sufficient information to comply with the provisions of this section. BPHL ss of the closest For the addre c. 2 . , see page location Laboratories shall submit isolates or specimens for confirmation or additional d. characterization of the organism for reportable disease s listed in the Table of ) Reportable Diseases or Conditions to B e Reported ( see pages 10 - 15 . e. Laboratories are not prohibited from submitting isolates or specimens from a patient for a disease or condition that is not designated in the Table of Reportable Diseases or Conditions to B e Reported ( see pages 10 - 15 ) . imen is f. Submission should occur within two weeks from the time the isolate or spec received by the laboratory, unless otherwise noted by . the Department Include minimum inhibitory concentration *2 (MICs) MICs for , zone sizes for disk diffusion E - test or agar dilution and interpretation (susceptible, intermediate, resistant). laboratories performing required for is only . Notification *3 Paper reports are not required Florida electronic laboratory reporting as described in subsection 64D - 3.031(5), Administrative Code . Surveillance Case Definitions for Select Reportable Diseas *4 a. es in Florida are located ) . www.FloridaHealth.gov/DiseaseCaseDefinitions ( on the Department ’s webs ite Reports should include occupational information (e.g. b. employer name, address, , pho ne number). *5 Report on suspicion of infection. Reports should occur without delay on initial suspicion but reports do not need to be made after hours. Reports on initial suspicion - are to allow for disease control measures to be immediately implemented (such as notification of mosquito control) in order to prevent local transmission. Florida Department of Health www.FloridaHealth.gov/CHDEpiContact contact information, visit county health department For local 16 www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

21 Notations, Table of Reportable Diseases or Conditions to Be V. Reported (Continued) Notification within six months of diagnosis and within six months of each treatment. * 6 All CD and percentage of total lymphocytes, with or without s 4 absolute count - * 7 confirmed HIV infection. Child abuse should be considered by a practitioner upon collection of a specimen for 8 * , excluding neonates. Reporting of a old 12 years ≤ child laboratory testing in any the county health department does not relieve sexually transmissible disease case to arding child abuse the practitioner of their mandatory reporting responsibilities reg . pursuant to s ection 39.201, F lorida S tatutes * . 9 Exceptions are located in Rule 64D - 3.035, Florida Administrative Code Practitioners should contact the - * 10 Bureau of Epidemiology at (850) 245 Department ’s 4401 to arrange appropriate autopsy and specimen collection. sults associated with pe ople > 4 years test re old , only Haemophilus influenza For 1 *1 e Florida 3.031(5), - electronic reporting is required, in accordance with subsection 64D . Administrative Code epatitis B (acute and chronic), C (acute and h Special reporting requirements for 2 *1 chronic), D, E, G: Positive results should be accompanied by any hepatitis testing conducted (positive and negative results) , all serum aminotransferase levels, and if applicable, pregnancy test result or indication that testing wa s conducted as part of a pregnancy panel. For laboratories performing electronic laboratory reporting as described in subsection 64D - 3.031(5), Florida Administrative Code , all test results performed (positive and negative) are to be submitted, including screening test results (positive and negati ve). *1 3 A 4 - fold titer rise in paired sera by various serological tests confirmatory of primary specific IgM suggestive but not conclusive evidence of - infection; presence of herpes primary infection. hm for Recent HIV Seroconversion *1 Special requirements for Serologic Testing Algorit 4 (STARHS ): ies L a. aborator 13 years old must ≥ in persons s that report confirmed positive HIV test . also report STARHS result s b. In lieu of producing this test result, each laboratory that reports a confirmed positive HIV test must submit a sample for additional testing using STARHS. The blood specimen or an aliquot of at laboratory is permitted to send the remaining least 0.5 Miami (see page for addresses). - Jacksonville or BPHL - BPHL to mL 2 Laboratories electing to send a blood specimen will contact the Incidence and c. Molecular Coordinator, HIV/AIDS Section, at ( 850) 245 - 4430 to receive specimen maintenance and shipping instructions. d. Nationally based laboratories with an existing contract to ship specimens directly to a STARHS laboratory designated by the Centers for Disease Control and P revention will not be required to send a specimen to the Department . 5 for each confirmed positive HIV specimen on a *1 Laboratories shall submit a genotype FASTA file containing the nucleotide sequence data, including the protease and regions must be reported. reverse transcriptase Fl orida Department of Health For local 17 www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease Reporting

22 Notations, Table of Reportable Diseases or Conditions to Be V. (Continued) Reported 6 Special reporting requirements for reporting blood lead tests: *1 All blood lead tests a. the (positive and negative results) must be submitted to electronically. This reporting requirement pertains to laboratories all Department site blood lead analysis (i.e., practitioners that - and practitioners that conduct on use portable lead care analyzers or other devices to perform blood lead analysis). - site blood lead analysis devices (i.e., portable lead care . Results produced by on b blood lead analysis) <5 analyzers or other portable devices used to perform μg/dL Electronic reporting of results is must be reported within 10 business days. preferred. IgM serum antibody or viral culture test orders for measles (rubeola) or rubella should 7 *1 be reported as suspect immediately, but not IgG orders or results. lorida Statut F Each hospital licensed under Chapter 395, 8 *1 shall report each case of es l abstinence syndrome occurring in an infant admitted to the hospital. If a neonata hospital reports a case of neonatal abstinence syndrome to the Agency for Health Care Administration in its inpatient discharge data report, pursuant to Chapter 59E - 7, Florida Admi nistrative Code , then it need not comply with the reporting requirements of 3.029(1), . Florida Administrative Code subsection 64D - r - as defined in Rule 64D ( abies Exposure to 9 *1 ) that Florida Administrative Code 3.028, results in rabies prophylaxis for the person exposed, rabies testing, isolation or quarantine of the animal causing the exposure. Streptococcus pneumoniae For , only old * 20 ople > test results associated with pe 5 years electronic reporting is required, in accordance with subsection 64D - 3.031(5 ), Florida Administrative Code . Tuberculosis Test results must be submitted by laboratories to the 1 *2 Department’s Control Section, 4052 Bald Cypress Way, Bin A20, Tallahassee, Florida 32399 - 1717, - 4350. (850) 245 Practitioners shall also provide date *2 2 s of varicella vaccination. Florida Department of Health 18 For local www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

23 VI. One Page Practitioner Guide List www.FloridaHealth.gov/DiseaseReporting available electronically at Fl orida Department of Health For local 19 www.FloridaHealth.gov/CHDEpiContact county health department contact information, visit www.FloridaHealth.gov/Disease Reporting To obtain more copies of this guide, visit

24 Practitioner Disease Notification Form VII. available electronically at Form www.FloridaHealth.gov/DiseaseReporting Florida Department of Health For local www.FloridaHealth.gov/CHDEpiContact 20 contact information, visit county health department www.FloridaHealth.gov/DiseaseReporting To obtain more copies of this guide, visit

25 TES NO Fl orida Department of Health contact information, visit www.FloridaHealth.gov/CHDEpiContact 21 county health department For local Reporting To obtain more copies of this guide, visit www.FloridaHealth.gov/Disease

26 NOTES Florida Department of Health For local county health department contact information, visit 22 www.FloridaHealth.gov/CHDEpiContact To obtain more copies of this guide, visit www.FloridaHealth.gov/DiseaseReporting

27

28 Division of Disease Control and Health Protection Bureau of Epidemiology 4025 Bald Cypress Way, Bin #A - 12 www.FloridaHealth.gov/DiseaseReporting

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