Education + Advocacy = Change

Click a topic below for an index of articles:




Financial or Socio-Economic Issues


Health Insurance



Institutional Issues

International Reports

Legal Concerns

Math Models or Methods to Predict Trends

Medical Issues

Our Sponsors

Occupational Concerns

Our Board

Religion and infectious diseases

State Governments

Stigma or Discrimination Issues


If you would like to submit an article to this website, email us at for a review of this paper

any words all words
Results per page:

“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


Missouri State Law regarding the reporting of Diseases
(Numbers represent ICD 9 and ICD 10 codes)

The following diseases are reportable and must be communicated to the health department within certain time frames. This list is very extensive, and is broken down by the time allotted for reporting the disease (depending on how serious or infectious the diseases or conditions)
Revised 1-13-04

19 CSR 20-20.020 Reporting Communicable, Environmental and Occupational Diseases. PURPOSE: This rule designates the diseases, disabilities, conditions and findings that must be reported to the local health authority or the Department of Health. It also establishes when they must be reported.

(1) Category I diseases or findings shall be reported to the local health authority or to the Department of Health and Senior Services within twenty-four (24) hours of first knowledge or suspicion by telephone, facsimile or other rapid communication.
Category I diseases or findings are—
(A) Diseases, findings or agents that occur naturally or from accidental exposure:
Animal (mammal) bite wound in humans (E906.0, E906.5, W54, W55)
Diphtheria (032, A36)
Haemophilus influenza, invasive disease (038, 041.5, 320, G00.0)
Hantavirus pulmonary syndrome (079.81, 480.8, J12.8)
Hepatitis A (070.1, B15)
Hyperthermia (992, T67)
Hypothermia (991, 991.6, T68)
Influenza, suspected nosocomial outbreaks and public or private school closures
Lead (blood) level greater than or equal to forty-five micrograms per deciliter (>45 :g/dl) in any person equal to or less than seventy-two (<72) months of age (984, T56.0)
Measles (rubeola) (055, B05)
Meningococcal disease, invasive (036, A39.0)
Outbreaks or epidemics of any illness, disease or condition that may be of public health concern
Pertussis (033, A37.0)
Poliomyelitis (045, A80)
Rabies, animal or human (071, A82)
Rubella, including congenital syndrome (056, 771.0 B06, P35.0)
Staphylococcus aureus, vancomycin resistant (041.1, V09.8)
Syphilis, including congenital syphilis ((090-090.9, 093-097.9, A50, A51-A52)
Tuberculosis disease (010-018, A15-A19)
Typhoid fever (002, A01.0)
(B) Diseases, findings or agents that occur naturally or that might result from a terrorist attack involving biological, radiological, or chemical weapons:
Adult respiratory distress syndrome (ARDS) in patients < 50 years of age (without a contributing medical history) (518, J80)
Anthrax (022, A22)
Botulism (0005.1, A05.1)
Brucellosis (023, A23)
Cholera (001, A00)
Encephalitis, Venezuelan equine (066.2, A99.2)
Glanders (024, A24.0)
Hemorrhagic fever (e.g., dengue, yellow fever) (060, 061, 065.0, 065.4, 078.8, 078.89, A90, A91, A95, A96.2, A98.0, A98.3, A98.4)
Plague (020, A20)
Q fever (083, A78)
Ricin (988.2, T62.1)
Smallpox (variola) (050, B03)
Staphylococcal enterotoxin B
T-2 mycotoxins (T64)
Tularemia (021, A21)

(C) Diseases, findings or adverse reactions that occur as a result of inoculation to prevent smallpox, including but not limited to yhe following:
Accidental administration (E858.9, T50.b11, E949.0
Accidental implantation (inadvertant autoinoculation) (999.0, T88, E949.0)
Bacterial infection of site of inoculation (999.3, T88, E949.0)
Congenital vaccinia (771.2, P35.9, E949.0)
Contact vaccinia ((i.e. vaccinia virus infection in a contact of a smallpox vaccinee) 051.0, B08.0, E949.0)
Eczema vaccinatum (999.0, T88.1, E949.0)
Erythema multiforme (695.1, L51, E949.0)
Generalized vaccinia (999.0, B08.0, E949.0)
Post-vaccinial encephalitis ((323.5, G04.0, E949.0)
Progressive vaccinia (vaccinia necrosum, vaccinia gangrenosa, disseminated vaccinia) (999.0, B08.0, E949.0)
Vaccinia keratitis (999.0, B08.0, E949.0)


(2) Category II diseases or findings shall be reported to the local health authority or to the Department of Health and Senior Services within three (3) days of first knowledge or suspicion by telephone, facsimile, or other rapid communication.
Category II diseases or findings are—
Acquired immunodeficiency syndrome (AIDS) (042, B20)
Arsenic poisoning (985.1, E866.3, T57.0)
Blastomycosis (116, B40)
Campylobacter infections (008.43, A04.5)
Carbon monoxide poisoning (986, T58)
CD4+ T cell count
Chancroid (099, A57)
Chemical poisoning, acute, if terrorism is suspected, refer to section (1)(B)
Chlamydia trachomatis, infections (099.8, A56)
Creutzfeldt-Jakob disease (046.1, A81.0)
Cryptosporidiosis (136.8, A81.0)
Cyclosporidiosis (007.5, A07.8)
Eastern equine viral encephalitis/meningitis (062.2, A83.2)
Ehrlichiosis, human granulocytic or monocytic (082.41, 082.49, A77.49, A77.41)
Ehrlichiosis, other unspecified agent (082.40, A77.40)
Escherichia coli O157:H7 (008.0, A04.1)
Giardiasis (007.1, A07.1)
Gonorrhea (098, A54)
Hansen disease (leprosy) (030, A30)
Heavy metal poisoning including, but not limited to, cadmium and mercury (961.2, 985.5, E866.4, T56.1, T56.3)
Hemolytic uremic syndrome (HUS), postdiarrheal (283.11, D59.3)
Hepatitis B, acute (070.3, B16)
Hepatitis B surface antigen (prenatal HBsAg) in pregnant women (070.3, B16)
Hepatitis C (070.5, B17.1)
Hepatitis non-A, non-B, non-C (070.9, B19)
HIV-exposed newborn infant (i.e. born to HIV+ mother)
HIV infection (042, B20)
HIV test results positive and negative for children < than 2 years whose mother is HIV+
HIV viral load results (including nondetectable results) (795.71, R75)
Influenza, laboratory-confirmed (487, J10)
Lead (blood) level (<45 ug/dl) in any person equal to or less than seventy two (<72) months of age and any lead (blood) level in persons >72 months of age (984, T56.0)
Legionellosis (482.8, A48.1)
Leptospirosis (100, A27)
Listeria monocytogenes (027.0, A32)
Lyme disease (104.8, 088.81)
Malaria (084.0-084.9, B50-B54)
Methemoglobinemia (289.7, D74)
Mumps (072, B26)
Mycobacterial disease other than tuberculosis (MOTT) (031, A31)
Nosocomial outbreaks
Occupational lung diseases including silicosis, asbestosis, byssinosis, farmer’s lung and toxic organic dust syndrome (495.0, 501, 502, J61, J62, J66.0, J67.0)
Pesticide poisoning (E863, 989.0, 989.2, 989.3, 989.4, T60)
Psittacosis (073, A70)
Respiratory diseases triggered by environmental contaminants including environmentally or occupationally induced asthma and bronchitis (490, 493.0, J44, J45.0)
Rocky Mountain spotted fever (082, A77.0)
Salmonellosis (003, A02.0)
Shigellosis (004, A03.0)
Streptococcal disease, invasive, Group A (041.01, 034,, A49.1, A38)
Streptococcus pneumoniae, drug resistance invasive disease (038.2, 481, B95.3, J13)
Tetanus (037, A35)
Toxic shock syndrome, staphylococcal or streptococcal (041.0, 041.1, 785.5, A48.3, A49.0, A49.1)
Trichinosis (124, B75)
Tuberculosis infection (results of positive testing) (795.5, 010, A15-A19)
Varicella deaths (052, 053, B01, B02)
West Nile Fever (066.4, A92.3)
West Nile viral encephalitis/meningitis (066.4, A92.3, A92.31)
Western equine viral encephalitis/meningitis (062.1, A83.1)
Yersinia enterocolitica (008.44, A04.6)

(3) The occurrence of an outbreak or epidemic of any illness, disease or condition which may be of public health concern, including any illness in a food handler that is potentially transmissible through food. This also includes public health threats than could result from terrorist activities such as clusters of unusual diseases or manifestations of illness and clusters of unexplained deaths. Such incidents shall be reported to the local health authority or the Department of Health by telephone, facsimile, or other rapid communication within twenty-four (24) hours of first knowledge or suspicion.

(4) A physician, physician’s assistant, nurse, hospital, clinic, or other private or public institution providing diagnostic testing, screening or care to any person with any disease, condition or finding listed in sections (1)–(3) of this rule, or who is suspected of having any of these diseases, conditions or findings, shall make a case report to the local health authority or the Department of Health, or cause a case report to be made by their designee, within the specified time.
(A) A physician, physician’s assistant, or nurse providing care in an institution to any patient with any disease, condition or finding listed in sections (1)–(3) of this rule may authorize, in writing, the administrator or designee of the institution to submit case reports on patients attended by the physician, physician’s assistant, or nurse at the institution. But under no other circumstances shall the physician, physician’s assistant, or nurse be relieved of this reporting responsibility. (B) Duplicate reporting of the same case by health care providers in the same institution is not required.


(5) A case report as required in section (4) of this rule shall include the patient’s name, home address with zip code, date of birth, age, sex, race, home phone number, name of disease, condition or finding diagnosed or suspected, the date of onset of the illness, name and address of the treating facility (if any) and the attending physician, any appropriate laboratory results, name and address of the reporter, treatment information for sexually transmitted diseases, and the date of report.
(A) A report of an outbreak or epidemic as required in section (3) of this rule shall include the diagnosis or principal symptoms, the approximate number of cases, the local health authority jurisdiction within which the cases occurred, the identity of any cases known to the reporter, and the name and address of the reporter.

(6) Any person in charge of a public or private school, summer camp or child or adult care facility shall report to the local health authority or the Department of Health the presence or suspected presence of any diseases or findings listed in sections (1)–(3) of this rule according to the specified time frames.

(7) All local health authorities shall forward to the Department of Health reports of all diseases or findings listed in sections (1)–(3) of this rule. All reports shall be forwarded within twenty-four (24) hours after being received, according to procedures established by the Department of Health director. Reports will be forwarded as expeditiously as possible if a terrorist event is suspected or
confirmed. The local health authority shall retain from the original report any information necessary to carry out the required duties in 19 CSR 20-20.040(2) and (3).

(8) Information from patient medical records received by local public health agencies or the Department of Health in compliance with this rule is to be considered confidential records and not public records.

(9) Reporters specified in section (4) of this rule will not be held liable for reports made in good faith in compliance with this rule.

(10) The following material is incorporated into this rule by reference:
(A) Agency for Toxic Substances and Disease Registry (ATSDR) Comprehensive
Environmental Response, Compensation, and Liability Act (CERCLA) Priority List of Hazardous Substances ( AUTHORITY: sections 192.006, RSMo Supp. 1999 and 192.020, 192.139, 210.040 and 210.050, RSMo 1994.* This rule was previously filed as 13 CSR 50 101.020. Original rule filed July 15, 1948, effective Sept. 13, 1948. Amended: Filed Sept. 1, 1981, effective Dec. 11, 1981. Rescinded and readopted: Filed Nov. 23, 1982, effective March 11, 1983. Emergency amendment filed June 10, 1983, effective June 20, 1983, expired Sept. 10, 1983. Amended: Filed June 10, 1983, effective Sept. 11, 1983. Amended: Filed Nov. 4, 1985, effective March 24, 1986. Amended: Filed Aug. 4, 1986, effective Oct. 11, 1986. Amended: Filed June 3, 1987, effective Oct. 25, 1987. Emergency amendment filed June 16, 1989, effective June 26, 1989, expired Oct. 23, 1989. Amended: Filed July 18, 1989, effective Sept. 28, 1989. Amended: Filed Nov. 2, 1990, effective March 14, 1991. Emergency amendment filed Oct. 2, 1991, effective Oct. 12, 1991, expired Feb. 8, 1992. Amended: Filed Oct. 2, 1991, effective Feb. 6, 1992. Amended: Filed Jan. 31, 1992, effective June 25, 1992. Amended: Filed Aug. 14, 1992, effective April 8, 1993. Amended: Filed Sept. 15, 1994, effective March 30, 1995. Amended: Filed Sept. 15, 1995, effective April 30, 1996. Emergency amendment filed June 1, 2000, effective June 15, 2000, expired Dec. 11, 2000. Amended: Filed June 1, 2000, effective Nov. 30, 2000. *Original authority: 192.006.1, RSMo 1993, amended 1995; 192.020, RSMo 1939, amended 1945, 1951; 192.139, RSMo 1988; 210.040, RSMo 1941, amended 1993; and 210.050, RSMo 1941, amended 1993. 19 CSR 20-20.030 Exclusion From School and Readmission

Helpful Links:

Note: The Columbia/ Boone County Health Department makes every effort to ensure the usefulness and inoffensive nature of all its WWW links, but the content of these sites and any of their links are beyond our control. We can take responsibility only for the content of our own site and those internal links which are clearly indicated as our own.