Final Text
Part III
Reporting of Disease
12VAC5-90-80. Lists of diseases that shall be reported.
A. Reportable disease list. The board declares suspected or confirmed cases of the following named diseases, toxic effects, and conditions to be reportable by the persons enumerated in 12VAC5-90-90. Conditions identified by an asterisk (*) require immediate communication to the local health department by the most rapid means available upon suspicion or confirmation, as defined in subsection C of this section. Other conditions should be reported within three days of suspected or confirmed diagnosis, unless otherwise specified in this section. Neonatal Abstinence Syndrome shall be reported as specified in subsection E of this section.
Acquired immunodeficiency syndrome (AIDS)
Amebiasis (Entamoeba histolytica)
*Anthrax (Bacillus anthracis)
Arboviral infections (e.g., CHIK, dengue, EEE, LAC, SLE, WNV, Zika)
Babesiosis (Babesia spp.)
*Botulism (Clostridium botulinum)
*Brucellosis (Brucella spp.)
Campylobacteriosis (Campylobacter spp.)
Candida auris, infection or colonization
Carbapenemase-producing organism, infection or colonization
Chancroid (Haemophilus ducreyi)
Chickenpox (Varicella) (Varicella virus)
Chlamydia trachomatis infection
*Cholera (Vibrio cholerae O1 or O139)
*Coronavirus infection, severe
Creutzfeldt-Jakob disease if younger than 55 years of age
Cryptosporidiosis (Cryptosporidium spp.)
Cyclosporiasis (Cyclospora spp.)
*Diphtheria (Corynebacterium diphtheriae)
*Disease caused by an agent that may have been used as a weapon
Ehrlichiosis/Anaplasmosis (Ehrlichia spp., Anaplasma phagocytophilum)
Escherichia coli infection, Shiga toxin-producing
Giardiasis (Giardia spp.)
Gonorrhea (Neisseria gonorrhoeae)
Granuloma inguinale (Calymmatobacterium granulomatis)
*Haemophilus influenzae infection, invasive
Hantavirus pulmonary syndrome
Hemolytic uremic syndrome (HUS)
*Hepatitis A
Hepatitis B (acute and chronic)
Hepatitis C (acute and chronic)
Hepatitis, other acute viral
Human immunodeficiency virus (HIV) infection
Influenza, confirmed
*Influenza-associated deaths in children if
younger than 18 years of age
Lead, reportable blood levels
Legionellosis (Legionella spp.)
Leprosy (Hansen's disease) (Mycobacterium leprae)
Leptospirosis (Leptospira interrogans)
Listeriosis (Listeria monocytogenes)
Lyme disease (Borrelia spp.)
Lymphogranuloma venereum (Chlamydia trachomatis)
Malaria (Plasmodium spp.)
*Measles (Rubeola)
*Meningococcal disease (Neisseria meningitidis)
Mumps
Neonatal abstinence syndrome (NAS)
Ophthalmia neonatorum
*Outbreaks, all (including foodborne, healthcare-associated
health care-associated, occupational, toxic substance-related, waterborne,
and waterborne) any other outbreak)
*Pertussis (Bordetella pertussis)
*Plague (Yersinia pestis)
*Poliovirus infection, including poliomyelitis
*Psittacosis (Chlamydophila psittaci)
*Q fever (Coxiella burnetii)
*Rabies, human and animal
Rabies treatment, post-exposure
*Rubella, including congenital rubella syndrome
Salmonellosis (Salmonella spp.)
Shiga toxin-producing Escherichia coli infection
Shigellosis (Shigella spp.)
*Smallpox (Variola) (Variola virus)
Spotted fever rickettsiosis (Rickettsia spp.)
Staphylococcus aureus infection, vancomycin-intermediate or vancomycin-resistant
Streptococcal disease, Group A, invasive or toxic shock
Streptococcus pneumoniae infection, invasive, in children
if younger than five years of age
Syphilis (report *primary and *secondary syphilis by rapid
means) (Treponema pallidum) report *congenital, *primary, *secondary,
and other
Tetanus (Clostridium tetani)
Toxic substance-related illness
Trichinosis (Trichinellosis) (Trichinella spiralis)
*Tuberculosis, active disease (Mycobacterium tuberculosis complex)
Tuberculosis infection in children younger than four years
of age
*Tularemia (Francisella tularensis)
*Typhoid/Paratyphoid fever infection (Salmonella
Typhi, Salmonella Paratyphi)
*Unusual occurrence of disease of public health concern
*Vaccinia, disease or adverse event
Vancomycin-intermediate or vancomycin-resistant Staphylococcus aureus infection
*Vibrio infection *Vibriosis (Vibrio spp.)
*Viral hemorrhagic fever
*Yellow fever
Yersiniosis (Yersinia spp.)
B. Conditions reportable by directors of laboratories. Laboratories shall report all test results indicative of and specific for the diseases, infections, microorganisms, conditions, and toxic effects specified in this subsection for humans. Such tests include microbiological culture, isolation, or identification; assays for specific antibodies; and identification of specific antigens, toxins, or nucleic acid sequences. Additional condition-specific requirements are noted in this subsection and subsection D of this section. Conditions identified by an asterisk (*) require immediate communication to the local health department by the most rapid means available upon suspicion or confirmation, as defined in subsection C of this section. Other conditions should be reported within three days of suspected or confirmed diagnosis.
Amebiasis - by microscopic examination, culture, antigen
detection, nucleic acid detection, or serologic results consistent with recent
infection (Entamoeba histolytica)
*Anthrax - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Bacillus
anthracis)
Arboviral infection, for example, CHIK, dengue, EEE, LAC (also
known as California encephalitis), SLE, WNV, or Zika - by
culture, antigen detection, nucleic acid detection, or serologic results
consistent with recent infection
Babesiosis - by culture, antigen detection, nucleic acid
detection, microscopic examination, or serologic results consistent with recent
infection (Babesia spp.)
*Botulism - by culture, nucleic acid detection, or
identification of neurotoxin in a clinical specimen (Clostridium
botulinum)
*Brucellosis - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Brucella
spp.)
Campylobacteriosis - by culture or culture-independent
diagnostic test (CIDT) (i.e., antigen detection or nucleic acid detection). For
CIDT, also submit all available culture results (positive or negative)
associated with a positive result. (Campylobacter spp.)
Candida auris - Include available antimicrobial susceptibility findings in report.
Carbapenemase-producing organism - Include available antimicrobial susceptibility findings in report.
Chancroid - by culture, antigen detection, or nucleic acid
detection (Haemophilus ducreyi)
Chickenpox (Varicella) - by culture, antigen detection,
nucleic acid detection, or serologic results consistent with recent infection
(Varicella virus)
Chlamydia trachomatis infection - by culture, antigen
detection, nucleic acid detection or, for lymphogranuloma venereum, serologic
results consistent with recent infection
*Cholera - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Vibrio
cholerae O1 or O139)
*Coronavirus infection, severe - by culture, nucleic acid
detection, or serologic results consistent with recent infection (e.g.,
SARS-CoV, MERS-CoV)
Creutzfeldt-Jakob disease if younger than 55 years of age by
histopathology in patients under the age of 55 years
Cryptosporidiosis - by microscopic examination, antigen
detection, or nucleic acid detection (Cryptosporidium spp.)
Cyclosporiasis - by microscopic examination or nucleic acid
detection (Cyclospora spp.)
*Diphtheria - by culture or histopathology (Corynebacterium
diphtheriae)
Ehrlichiosis/Anaplasmosis - by culture, nucleic acid
detection, microscopic examination, or serologic results consistent with recent
infection (Ehrlichia spp., Anaplasma phagocytophilum)
Escherichia coli infection, Shiga toxin-producing - by
culture, Shiga toxin detection (e.g., nucleic acid detection, EIA), or
serologic results consistent with recent infection
Giardiasis - by microscopic examination, antigen detection,
or nucleic acid detection (Giardia spp.)
Gonorrhea - by microscopic examination of a urethral smear
(males only) or endocervical smear (females only), culture, antigen detection,
or nucleic acid detection. (Neisseria gonorrhoeae) - Include
available antimicrobial susceptibility findings in report.
*Haemophilus influenzae infection, invasive - by culture,
antigen detection, or nucleic acid detection from a normally sterile site
Hantavirus pulmonary syndrome - by antigen detection
(immunohistochemistry), nucleic acid detection, or serologic results consistent
with recent infection
*Hepatitis A - by detection of IgM antibodies
Hepatitis B (acute and chronic) - by detection of HBsAg,
HBeAg, or IgM antibodies or nucleic acid detection. For any reportable
hepatitis finding, submit All hepatitis B patients, also report
available results of serum alanine aminotransferase (ALT) and all available
results from the hepatitis panel.
Hepatitis C (acute and chronic) - by hepatitis C virus
antibody (anti-HCV) positive, HCV antigen positive, or HCV RNA positive by
nucleic acid test. For all hepatitis C patients with any positive
HCV test, also report all results of HCV viral load tests, including
undetectable viral loads and report available results of serum alanine
aminotransferase (ALT) and all available results from the hepatitis panel.
Hepatitis, other acute viral - any Any finding
indicative of acute infection with hepatitis D, E, or other cause of viral
hepatitis. For any reportable hepatitis finding, submit all available results
from the hepatitis panel.
Human immunodeficiency virus (HIV) infection - by culture,
antigen detection, nucleic acid detection, or detection of antibody. For
HIV-infected patients, report all results of CD4 and HIV viral load tests,
including undetectable viral loads. For HIV-infected patients, report all HIV
genetic nucleotide sequence data associated with HIV drug resistance tests by
electronic submission. For children younger than three years of age, report all
tests regardless of the test findings (e.g., negative or positive).
Influenza, confirmed - by
By culture, antigen detection by direct fluorescent antibody (DFA), or
nucleic acid detection.
Lead, reportable blood levels - by any
detectable blood lead level in children ages 0-15 years or levels greater than
or equal to five μg/dL in persons older than 15 years of age All
lead results from tests of venous or capillary blood performed by a laboratory
certified by the Centers for Medicare and Medicaid Services in accordance with
42 USC § 263a, the Clinical Laboratory Improvement Amendment of 1988
(CLIA-certified).
Legionellosis - by culture, antigen detection (including
urinary antigen), nucleic acid detection, or serologic results consistent with
recent infection (Legionella spp.)
Leptospirosis - by culture, microscopic examination by dark
field microscopy, nucleic acid detection, or serologic results consistent with
recent infection (Leptospira interrogans)
Listeriosis - by culture from a normally sterile site. If
associated with miscarriage or stillbirth, by culture from placental or fetal
tissue (Listeria monocytogenes), invasive or if associated with
miscarriage or stillbirth from placental or fetal tissue
Lyme disease - by culture, antigen detection, or detection
of antibody confirmed with a supplemental test (Borrelia spp.)
Malaria - by microscopic examination, antigen detection, or
nucleic acid detection (Plasmodium spp.)
*Measles (Rubeola) - by culture, antigen detection, nucleic
acid detection, or serologic results consistent with recent infection
*Meningococcal disease - by culture, nucleic acid detection,
or antigen detection from a normally sterile site (Neisseria
meningitidis), invasive - Include identification of gram-negative diplococci.
Mumps - by culture, nucleic acid detection, or serologic
results consistent with recent infection
*Mycobacterial diseases - (See 12VAC5-90-225 B) Report any of the following:
1. Acid fast bacilli by microscopic examination;
2. Mycobacterial identification - preliminary and final
identification by culture or nucleic acid detection M. tuberculosis
complex or any other mycobacteria;
3. Drug Antimicrobial susceptibility test
results for M. tuberculosis complex.
*Pertussis - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Bordetella
pertussis)
*Plague - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Yersinia
pestis)
*Poliovirus infection - by culture
*Psittacosis - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Chlamydophila
psittaci)
*Q fever - by culture, antigen detection, nucleic acid
detection, immunohistochemical methods, or serologic results consistent with
recent infection (Coxiella burnetii)
*Rabies, human and animal - by culture, antigen detection by
direct fluorescent antibody test, nucleic acid detection, or, for humans only,
serologic results consistent with recent infection
*Rubella - by culture, nucleic acid detection, or serologic
results consistent with recent infection
Salmonellosis - by culture, antigen detection, or nucleic
acid detection (Salmonella spp.)
Shiga toxin-producing Escherichia coli infection
Shigellosis - by culture, antigen detection, or nucleic acid
detection (Shigella spp.)
*Smallpox (Variola) - by culture or nucleic acid detection
(Variola virus)
Spotted fever rickettsiosis - by culture, antigen detection
(including immunohistochemical staining), nucleic acid detection, or serologic
results consistent with recent infection (Rickettsia spp.)
Staphylococcus aureus infection, resistant, specifically:
Vancomycin-intermediate or vancomycin-resistant
Staphylococcus aureus infection - by antimicrobial susceptibility testing of a
Staphylococcus aureus isolate, with a vancomycin susceptibility result of
intermediate or resistant, cultured from a clinical specimen. Include available
antimicrobial susceptibility findings in report.
Streptococcal disease, Group A, invasive or toxic shock -
for invasive disease, by culture from a normally sterile site; for
streptococcal toxic shock, by culture from any body site
Streptococcus pneumoniae infection, invasive, in children
if younger than five years of age - by culture from a normally
sterile site in a child under the age of five years
*Syphilis - by darkfield microscopy, antigen detection,
nucleic acid detection, or serology by either treponemal or nontreponemal
methods (Treponema pallidum)
Toxic substance-related illness - by By blood or
urine laboratory findings above the normal range, including but not limited
to heavy metals, pesticides, and industrial-type solvents and gases. When
applicable and available, report speciation of metals when blood or urine
levels are elevated in order to differentiate the chemical species (elemental,
organic, or inorganic).
Trichinosis (Trichinellosis) - by microscopic examination of
a muscle biopsy or serologic results consistent with recent infection (Trichinella
spiralis)
Tuberculosis infection
*Tularemia - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection (Francisella
tularensis)
*Typhoid/Paratyphoid fever infection - by
culture, antigen detection, or nucleic acid detection (Salmonella Typhi,
Salmonella Paratyphi A, Salmonella Paratyphi B, Salmonella Paratyphi C)
*Vaccinia, disease or adverse event - by culture or nucleic
acid detection
Vancomycin-intermediate or vancomycin-resistant Staphylococcus aureus infection - Include available antimicrobial susceptibility findings in report.
*Vibrio infection - isolation of any species of the family
Vibrionaceae (other than toxigenic Vibrio cholera O1 or O139, which are
reportable as cholera) from a clinical specimen by culture, antigen detection,
or nucleic acid detection *Vibriosis (Vibrio spp., Photobacterium
damselae, Grimontia hollisae), other than toxigenic Vibrio cholera O1 or O139,
which are reportable as cholera
*Viral hemorrhagic fever - by culture, antigen detection
(including immunohistochemical staining), nucleic acid detection, or serologic
results consistent with recent infection
*Yellow fever - by culture, antigen detection, nucleic acid
detection, or serologic results consistent with recent infection
Yersiniosis - by culture, nucleic acid detection, or
serologic results consistent with recent infection (Yersinia spp.)
C. Reportable diseases requiring rapid communication. Certain
of the diseases in the list of reportable diseases, because of their extremely
contagious nature or their, potential for greater harm, or both,
availability of a specific intervention that must be administered in a
timely manner require immediate identification and control. Reporting of
persons confirmed or suspected of having these diseases, listed in this
subsection, shall be made immediately by the most rapid means available,
preferably by telephone to the local health department. (These same diseases
are also identified by an asterisk (*) in subsections A and B, where applicable,
of this section.)
Anthrax (Bacillus anthracis)
Botulism (Clostridium botulinum)
Brucellosis (Brucella spp.)
Cholera (Vibrio cholerae O1 or O139)
Coronavirus infection, severe
Diphtheria (Corynebacterium diphtheriae)
Disease caused by an agent that may have been used as a weapon
Haemophilus influenzae infection, invasive
Hepatitis A
Influenza-associated deaths in children if
younger than 18 years of age
Influenza A, novel virus
Measles (Rubeola) (Rubeola virus)
Meningococcal disease (Neisseria meningitidis)
Outbreaks, all
Pertussis (Bordetella pertussis)
Plague (Yersinia pestis)
Poliovirus infection, including poliomyelitis
Psittacosis (Chlamydophila psittaci)
Q fever (Coxiella burnetii)
Rabies, human and animal
Rubella, including congenital rubella syndrome
Smallpox (Variola) (Variola virus)
Syphilis, congenital, primary, and secondary (Treponema pallidum)
Tuberculosis, active disease (Mycobacterium tuberculosis complex)
Tularemia (Francisella tularensis)
Typhoid/Paratyphoid fever infection (Salmonella
Typhi, Salmonella Paratyphi (all types))
Unusual occurrence of disease of public health concern
Vaccinia, disease or adverse event
Vibrio infection Vibriosis (Vibrio spp.,
Photobacterium damselae, Grimontia hollisae), other than toxigenic Vibrio
cholerae O1 or O139, which are reportable as cholera
Viral hemorrhagic fever
Yellow fever
D. Toxic substance-related illnesses. All toxic
substance-related illnesses, including pesticide and heavy metal poisoning or
illness resulting from exposure to an occupational dust or fiber or radioactive
substance, shall be reported.
If such illness is verified or suspected and presents an
emergency or a serious threat to public health or safety, the report of such
illness shall be made immediately by the most rapid means available, preferably
by telephone.
E. Outbreaks. The occurrence of outbreaks or clusters of
any illness that may represent a group expression of an illness that may be of
public health concern shall be reported to the local health department
immediately by the most rapid means available, preferably by telephone.
F. Unusual or ill-defined diseases or emerging or
reemerging pathogens. Unusual or emerging conditions of public health concern
shall be reported to the local health department immediately by the most rapid
means available, preferably by telephone. In addition, the commissioner or his
designee may establish surveillance systems for diseases or conditions that are
not on the list of reportable diseases. Such surveillance may be established to
identify cases (delineate the magnitude of the situation), to identify the mode
of transmission and risk factors for the disease, and to identify and implement
appropriate action to protect public health. Any person reporting information
at the request of the department for special surveillance or other
epidemiological studies shall be immune from liability as provided by
§ 32.1-38 of the Code of Virginia.
D. Submission of initial isolate or other specimen for further public health testing. A laboratory identifying evidence of any of the conditions in this subsection shall notify the local health department of the positive culture or other positive test result within the timeframes specified in subsection B of this section and submit the initial isolate (preferred) or other initial specimen to the Division of Consolidated Laboratory Services or other public health laboratory where specified in this subsection within seven days of identification. All specimens must be identified with the patient and physician information required in 12VAC5-90-90 B.
Anthrax (Bacillus anthracis)
Botulism (Clostridium botulinum)
Brucellosis (Brucella sp.)
Candida auris
Candida haemulonii
Carbapenem-resistant Enterobacteriaceae
Carbapenem-resistant Pseudomonas aeruginosa
Cholera (Vibrio cholerae O1 or O139)
Coronavirus infection, severe (e.g., SARS-CoV, MERS-CoV)
Diphtheria (Corynebacterium diphtheriae)
Haemophilus influenzae infection, invasive
Influenza, unsubtypeable
Listeriosis (Listeria monocytogenes)
Meningococcal disease (Neisseria meningitidis)
Plague (Yersinia pestis)
Poliovirus infection
Q fever (Coxiella burnetii)
Salmonellosis (Salmonella spp.)
Shiga toxin-producing E. coli infection (Laboratories that identify a Shiga toxin but do not perform simultaneous culture for Shiga toxin-producing E. coli should forward all positive stool specimens or positive enrichment broths to the Division of Consolidated Laboratory Services for confirmation and further characterization.)
Shigellosis (Shigella spp.)
Streptococcal disease, Group A, invasive
Tuberculosis (A laboratory identifying Mycobacterium tuberculosis complex (see 12VAC5-90-225) shall submit a representative and viable sample of the initial culture to the Division of Consolidated Laboratory Services or other laboratory designated by the board to receive such specimen.)
Tularemia (Francisella tularensis)
Typhoid/Paratyphoid infection (Salmonella Typhi, Salmonella Paratyphi (all types))
Vancomycin-intermediate or vancomycin-resistant Staphylococcus aureus infection
Vibriosis (Vibrio spp., Photobacterium damselae, Grimontia hollisae)
Yersiniosis (Yersinia spp.)
Other diseases as may be requested by the health department.
G. E. Neonatal abstinence syndrome. Neonatal
abstinence syndrome shall be reported by physicians and directors of medical
care facilities when a newborn has been diagnosed with neonatal abstinence
syndrome, a condition characterized by clinical signs of withdrawal from
exposure to prescribed or illicit drugs. Reports shall be submitted within one
month of diagnosis by entering the information into the Department of Health's
online Confidential Morbidity Report portal (http://www.vdh.virginia.gov/clinicians).
F. Outbreaks. The occurrence of outbreaks or clusters of any illness that may represent a group expression of an illness that may be of public health concern shall be reported to the local health department immediately by the most rapid means available, preferably by telephone.
G. Toxic substance-related illnesses. All toxic substance-related illnesses, including pesticide and heavy metal poisoning or illness resulting from exposure to an occupational dust or fiber or radioactive substance, shall be reported.
If such illness is verified or suspected and presents an emergency or a serious threat to public health or safety, the report of such illness shall be made immediately by the most rapid means available, preferably by telephone.
H. Unusual occurrence of disease of public health concern. Unusual or emerging conditions of public health concern shall be reported to the local health department immediately by the most rapid means available, preferably by telephone. In addition, the commissioner or the commissioner's designee may establish surveillance systems for diseases or conditions that are not on the list of reportable diseases. Such surveillance may be established to identify cases (delineate the magnitude of the situation), to identify the mode of transmission and risk factors for the disease, and to identify and implement appropriate action to protect public health. Any person reporting information at the request of the department for special surveillance or other epidemiological studies shall be immune from liability as provided by § 32.1-38 of the Code of Virginia.