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
(http://www.atsdr.cdc.gov:8080/97list.html) 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
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