VDH should design this disease reporting requirment change in manner that it does not function as a disincentive for a hospital infection control person or the ID physican or laboratory  to pick up the phone and call their local health director when they think they really have something going on.  For outbreak management and infection control purposes timing can be everything.   Recommend that the regulations be written in a manner so that they do not limits the infectious disease reporting requirement and involvement of local public health officials, if needed,  to entering some data into an electronic database – especially outside VDH. 

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