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EMERGENCY REGULATIONS TITLE 12. HEALTH Hepatitis, other acute viral Human immunodeficiency virus (HIV) infection Influenza STATE BOARD OF HEALTH Kawasaki syndrome Lead-elevated blood levels Title of Regulation: 12 VAC 5-90. Regulations for Disease Legionellosis Reporting and Control (amending 12 VAC 5-90-80). Leprosy (Hansen disease) Statutory Authority: § 32.1-35 of the Code of Virginia. Listeriosis Lyme disease Effective Dates: June 24, 2003, through June 23, 2004. Lymphogranuloma venereum Malaria Preamble: *Measles (Rubeola) The emergency regulation is necessary due to an imminent *Monkeypox threat to public health. The first cases of monkeypox ever *Meningococcal infection diagnosed in the United States have occurred in May and Mumps June of this year. The emergency action amends 12 VAC Ophthalmia neonatorum 5-90-80, the reportable disease list from the Regulations for *Outbreaks, all (including foodborne, nosocomial, Disease Reporting and Control, to add “Monkeypox” to the occupational, toxic substance-related, waterborne, and list, thereby making this a reportable condition in Virginia other outbreaks) and allowing the Virginia Department of Health to track and *Pertussis (Whooping cough) respond to cases that occur in the Commonwealth. *Plague *Poliomyelitis Agency Contact: Diane Woolard, Director, Division of *Psittacosis Surveillance and Investigation, Department of Health, 1500 E. Q fever Main Street, Suite 113, Richmond, VA 23219, telephone (804) *Rabies, human and animal 786-6615, e-mail [email protected]. Rabies treatment, post-exposure 12 VAC 5-90-80. Reportable disease list. Rocky Mountain spotted fever Rubella (German measles), including congenital rubella A. The board declares the following named diseases, toxic syndrome effects, and conditions to be reportable by the persons Salmonellosis enumerated in 12 VAC 5-90-90. Conditions identified by an *Severe acute respiratory syndrome (SARS) (see asterisk (*) require rapid communication as defined in emergency regulation effective April 24, 2003 through subsection B of this section: April 23, 2004, published in 19:18 VA.R. 2737-2738 May Acquired Immunodeficiency Syndrome (AIDS) 19, 2003) Amebiasis Shigellosis *Anthrax Smallpox Arboviral infections (e.g., EEE, LAC, SLE, WNV) Streptococcal disease, Group A, invasive *Botulism Streptococcus pneumoniae, invasive in <5 years of age Brucellosis Syphilis (report *primary and *secondary syphilis by rapid Campylobacter infection means) Chancroid Tetanus Chickenpox Toxic shock syndrome Chlamydia trachomatis infections Toxic substance-related illness *Cholera Trichinosis (Trichinellosis) Creutzfeld-Jakob disease if < 55 years of age *Tuberculosis disease Cryptosporidiosis Tuberculosis infection in children ages <4 years Cyclosporiasis (Mantoux tuberculin skin test reaction >=10 mm) *Diphtheria Tularemia Ehrlichiosis Typhoid fever Escherichia coli O157:H7 and other enterohemorrhagic E. Typhus coli infections Unusual occurrence of disease of public health concern Giardiasis *Vaccinia, disease or adverse event (see emergency Gonorrhea regulation effective February 11, 2003 through February Granuloma inguinale 10, 2004 published in 19:13 VA.R. 1971-1972 March 10, *Haemophilus influenzae infection, invasive 2003) Hantavirus pulmonary syndrome Vancomycin-resistant Staphylococcus aureus Hemolytic uremic syndrome (HUS) Vibrio infection *Hepatitis A (lgM +) Viral hemorrhagic fever Hepatitis B: *Yellow Fever Acute disease (lgM +) B. Reportable diseases requiring rapid communication. HBsAg positive pregnant women Certain of the diseases in the list of reportable diseases, Hepatitis C (acute and chronic) because of their extremely contagious nature or their potential

Volume 19, Issue 22 Virginia Register of Regulations Monday, July 14, 2003 1 Emergency Regulations for greater harm, or both, require immediate identification and supplemental test such as the western blot or by rapid tests control. Reporting of persons confirmed or suspected of with confirmation) are considered to have HIV infection. having these diseases, listed below and identified by asterisks in subsection A of this section and 12 VAC 5-90-90 B, shall be E. Toxic substance-related diseases or illnesses. All toxic made within 24 hours by the most rapid means available, substance-related diseases or illnesses, including pesticide preferably that of telecommunication (e.g., telephone, and heavy metal poisoning or illness or disease resulting from telephone transmitted facsimile, telegraph, teletype, etc.) to exposure to an occupational dust or fiber or radioactive the local health director or other professional employee of the substance, shall be reported. department: If such disease or illness is verified or suspected and presents Anthrax an emergency or a serious threat to public health or safety, Botulism the report of such disease or illness shall be by rapid Cholera communication as in subsection B of this section. Diphtheria F. Outbreaks. The occurrence of outbreaks or clusters of any Haemophilus influenza infection, invasive illness which may represent a group expression of an illness Hepatitis A which may be of public health concern shall be reported to the Measles (Rubeola) local health department by the most rapid means available. Meningococcal infection Monkeypox G. Unusual or ill-defined diseases or emerging or reemerging Outbreaks, all pathogens. Unusual or emerging conditions of public health Pertussis concern shall be reported to the local health department by Plague the most rapid means available. In addition, the commissioner Poliomyelitis or his designee may establish temporary surveillance systems Psittacosis for diseases or conditions that are not on the list of reportable Rabies in man and animals diseases. Such surveillance may be established to identify Severe acute respiratory syndrome (SARS) (see cases (delineate the magnitude of the situation), to identify the emergency regulation effective April 24, 2003 through mode of transmission and risk factors for the disease, and to April 23, 2004 published in 19:18 VA.R. 2737-2738 May identify and implement appropriate action to protect public 19, 2003) health. Any person reporting information at the request of the Syphilis, primary and secondary department for special surveillance or other epidemiological Tuberculosis disease studies shall be immune from liability as provided by § 32.1-38 Vaccinia, disease or adverse event (see emergency of the Code of Virginia. regulation effective February 11, 2003 through February H. Contact tracing. When notified about a disease specified in 10, 2004 published in 19:13 VA.R. 1971-1972 March 10, subsection A of this section, the local health department shall 2003) perform contact tracing for HIV infection, infectious syphilis, Yellow Fever and tuberculosis and may perform contact tracing for the other C. Diseases to be reported by number of cases. The following diseases if deemed necessary to protect the public health. disease in the list of reportable diseases shall be reported as The local health director shall have the responsibility to number-of-cases only: accomplish contact tracing by either having patients inform their potential contacts directly or through obtaining pertinent Influenza (by type, if available) information such as names, descriptions, and addresses to D. Human immunodeficiency virus (HIV) infection. Every enable the health department staff to inform the contacts. All physician practicing in this Commonwealth shall report to the contacts of HIV infection shall be afforded the opportunity for local health department any patient of his who has tested appropriate counseling, testing, and individual face-to-face positive for human immunodeficiency virus (HIV). Every disclosure of their test results. In no case shall names of person in charge of a medical care facility shall report the informants or infected persons be revealed to contacts by the occurrence in or admission to the facility of a patient with HIV health department. All information obtained shall be kept infection unless there is evidence that the occurrence has strictly confidential. been reported by a physician. When such a report is made, it /s/ Mark R. Warner shall include the information required in 12 VAC 5-90-90 A. Governor Only individuals who have laboratory results which indicate Date: June 20, 2003 the presence of HIV antigen, nucleic acid, or antibodies (such as at least two enzyme-linked immunosorbent assays (done in VA.R. Doc. No. R03-238; Filed June 24, 2003, 11:01 a.m. duplicate at the same time or singly at different times), and a GENERAL NOTICES/ERRATA

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