Public health agency for Snohomish County
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CD Reporting ( For Healthcare Professionals & Schools )
The Snohomish Health District investigates over 60 communicable diseases and conditions that are reportable to the local health jurisdiction in accordance with WAC 246-101. In certain situations, clusters of illness (i.e., norovirus and influenza) are also reportable, especially in healthcare facilities, schools and child cares. Here you will find more information about specific diseases, what must be reported, how to make reports and other pertinent resources (includes school absenteeism reporting).
What to Report
Per WAC 246-101, certain conditions must be reported to local public health. For detailed lists of notifiable conditions and reporting timeframes, click “read more”. Washington State Department of Health’s website provides additional notifiable condition information including surveillance data and disease investigation guidelines. Snohomish Health District also provides Communicable Disease Fact Sheets.
Notifiable Conditions Posters
How to Report
The Snohomish Health District (SHD) has four different programs to investigate specific communicable diseases, each with different requirements for reporting. See below for specific program contact information and any available reporting forms.
  • Communicable Disease (CD) Program
    Includes all notifiable conditions, except TB, STD, and HIV/AIDS; also includes animal bites.

    For Non-Urgent Reports:
    • Messages can be left on the 24 hour report line; please also fax the lab report to us.
    • Print out the reporting form, complete and fax to us along with the lab result.
      DO NOT email the report form to us.

    For Urgent Reports:
    Requiring immediate public health intervention (i.e., measles or meningococcal disease)
    • During business hours, contact the main phone number.
    • For healthcare providers and labs ONLY: After business hours, call the 24 hour report line for further instructions.

    Office Hours
    Main Phone
    Fax
    24 Hour Report Line
    Report Form
    : Monday - Friday 8:00am – 5:00pm
    : 425.339.5278
    : 425.339.8706
    : 425.339.5235
    : Disease Report Form
  • HIV/AIDS Program
    Reports should be made either to the 24 hour report line or by faxed report.
    DO NOT email the report form to us.

    Office Hours
    Main Phone
    Fax
    24 Hour Report Line
    Report Form
    : Monday - Friday 8:00am – 5:00pm
    : 425.339.5298
    : 425.339.8707
    : 425.339.5235
    : Case Report Form
  • Sexually Transmitted Diseases (STD) Program
    Reports should be made to the 24 hour report line.

    Office Hours
    Main Phone
    Fax
    24 Hour Report Line
    Report Form
    : Monday - Friday 8:00am – 5:00pm
    : 425.339.5298
    : 425.339.8707
    : 425.339.5235
    : STD Report Form
  • Tuberculosis Control (TB) Program
    Clients with a first time positive Tuberculosis Skin Test (TST) need to follow-up first with their own healthcare provider. If the client has no signs or symptoms of active TB disease, and a clean chest x-ray, then the healthcare provider is responsible for treatment and follow-up of their condition called Latent TB Infection (LTBI). For those clients who show signs and symptoms suspicious for active TB disease, then call SHD TB Control Program. The Snohomish Health District no longer manages LTBI cases, but we do provide consultation to healthcare providers and clients in the community.

    When healthcare providers should contact us:
    • You have a client you suspect of having active TB disease.
    • You have a client who has been exposed recently to a person with active TB disease.
    • For consultation purposes.

    For Non-Urgent Reports:
    • During business hours, contact the main phone number.
    • After business hours, messages can be left on the 24 hour report line; please also fax the lab report to us.

    For Urgent Reports:
    Requiring immediate public health intervention or consultation
    • During business hours, contact the main phone number.
    • For healthcare providers and labs ONLY: After business hours, call the 24 hour report line for further instructions.

    Office Hours
    Main Phone
    Fax
    24 Hour Report Line
    Report Form
    : Monday - Friday 8:00am – 5:00pm
    : 425.339.5225
    : 425.339.5217
    : 425.339.5235
    : Not Available
Who Must Report
Health care providers, health care facilities, laboratories, schools and child care programs are required to report certain communicable diseases to SHD. Please supply as much of the following information as possible, either by phone or faxed report
  • Patient's name
  • Date of birth
  • Race
  • Gender
  • Home and cell phone
  • Work phone
  • Address
  • Disease
  • Method of diagnosis
  • Date of onset
  • Chief symptoms/complaints
  • Lab test results
  • Treatment given
  • Possible source
  • Attending physician
  • Physician's phone number
  • Additional comments
  • Name and title of person making report
  • Phone number of person making report
  • Hospital admission/ER visit date
  • Discharge date
Rules Governing CD Reporting
List of rules that govern the Communicable Disease Reporting: HIPAA and WACS
HIPAA
The HIPAA Privacy Rule permits covered entities to disclose Protected Health Information (PHI), without authorization, to public health authorities, such as Snohomish Health District, that are legally authorized to receive such information for the purpose of preventing or controlling disease, injury or disability. Included here is a letter that further discusses healthcare providers’ ability to report patients with notifiable conditions (as well as their medical information), and an NOPP letter for patients.
Washington Administrative Codes
The WACs specify who must report notifiable conditions.
WAC 246-101-101 (5)
Health Care Providers
WAC 246-101-201 (5)
Laboratories
WAC 246-101-401 (5)
Others
WAC 246-101-405 (5)
Veterinarians
WAC 246-101-415 (5)
Child daycare facilities
WAC 246-101-420 (5)
Schools
For Schools and Care Facilities
Provides guidance related to illness reporting, including information about school absenteeism and reporting outbreaks/clusters, norovirus and influenza.
Outbreaks or Clusters
In certain situations, clusters of illness (i.e., norovirus and influenza) are also reportable, especially in healthcare facilities, schools and child cares. Any cluster or pattern of cases, suspected cases, deaths or increased incidence of any potentially infectious disease or condition beyond that expected in a given period which may indicate an outbreak, epidemic or related public health hazard shall be reported immediately by telephone to the appropriate program. Although a disease may not require a report, you are always welcome to call for advice, especially when dealing with outbreaks of illness.
Please report outbreaks of possible Influenza or Norovirus to the SHD Communicable Disease Program at 425.339.5278. For infection control guidelines and other resources see the specific topics below.
School Illness Reporting
In general, schools only need to report outbreaks of illness to the Snohomish Health District. Defining what constitutes an outbreak can be difficult and will vary depending on the type of disease and school/SHD protocols. Here you will find more information about when schools should report to SHD and other resources (including 10% absenteeism reports).
Essentially, schools should report outbreaks to us when the situation is abnormal for your school (i.e., any significant increase of illness above the norm) and is uncontrolled (i.e., your current infection control practices are not working to control the spread of illness among the students/staff).
  • When the school nurse and/or school administrators feel that there may be an outbreak, please report to the SHD Communicable Disease Program at 425.339.5278.
  • When you call us, we will assess the situation and determine what interventions (if any) are necessary.
  • You can also call any time for consultation about communicable disease concerns.
Resources:
  1. 10% Absenteeism Reporting Form (SHD)  file
    Snohomish Health District
  2. Health Services (OSPI)  web
    State of Washington OSPI Resource
  3. Healthy Schools Healthy Youth  web
    CDC Resource for Healthy Schools Healthy Youth
  4. School Absenteeism Letter (SHD)  file
    Snohomish Health District
Influenza
Influenza surveillance is conducted throughout our county and involves schools, healthcare providers, and long term care facilities. Infection control guidelines and other influenza resources are listed below. Please report outbreaks of Influenza-like illness to the SHD Communicable Disease Program at 425.339.5278.
Resources:
  1. Communicable Disease Flu Update  web
    DOH Resource for Communicable Disease Flu Update
  2. Infection Control Guidelines and Recommendations  web
    CDC Resource for Infection Control Guidelines and Recommendations
  3. Influenza Fact Sheet (SHD)  file
    Snohomish Health District
  4. Influenza Surveillance  web
    CDC Resource for Influenza Surveillance
  5. Influenza-like-illness Tracking Form (SHD)  file
    Snohomish Health District
  6. Skagit County Health Department  web
    Public Health resources for Skagit County
Norovirus
Norovirus (previously called Norwalk-like virus) is usually only reportable as a cluster within high risk settings, such as long term care facilities, schools and child cares. In general, we offer consultation and resources for interrupting the transmission of illness. Outbreak management guidelines and other norovirus resources are listed below. Please report outbreaks of Norovirus-like illness to the SHD Communicable Disease Program at 425.339.5278.
Resources:
  1. Information for Healthcare Providers or Food Handlers  web
    CDC Information for Healthcare Providers or Food Handlers
  2. Norovirus Fact Sheet (SHD)  file
    Snohomish Health District
  3. Norovirus MMWR  web
    CDC Information about Norovirus MMWR
  4. Norovirus Q & A  web
    CDC Q&A about Norovirus
  5. Norovirus-like-illness Tracking Form (SHD)  file
    Snohomish Health District
  6. Outbreak Management Guidelines (SHD)  file
    Snohomish Health District
  7. Sample Norovirus Notice to Residents  file
    Snohomish Health District
  8. Sample Norovirus Notice to Visitors  file
    Snohomish Health District
Rabies Assessment and Post-Exposure Prophylaxis (PEP)
The Snohomish Health District is responsible for assessing the risk of rabies related to all animal bites and other exposures.
If there is any concern of potential rabies exposure, then SHD will help coordinate PEP for the exposed person. The goal of public health is, first, to prevent human exposure to rabies by education and second, to prevent the disease by PEP. More information about animal bites and rabies risk is listed below.
All animal bites are reportable to Snohomish Health District. Persons with any potential exposure to a bat or other wild animal should be reported immediately to the Communicable Disease Program for full assessment of need for PEP.
If someone has been bitten by any animal, or may have come into contact with a bat (i.e., bat found in a sleeping area), he or she needs to be evaluated by a healthcare provider and/or the Snohomish Health District to determine if PEP is necessary. The decision to start PEP is based on many different factors, including:
  • Type of animal
  • Surveillance information for the area where the animal exposure happened
  • Type of exposure
  • Whether lab testing is done (on the animal)
In Washington State, bats are the only known reservoir for rabies and less than 1% of bats in the wild are rabid. However, 5-10% of the sick and injured bats submitted for testing in WA are rabid. Bats are also the primary reservoir for rabies in Oregon, Idaho, and British Columbia. However, during 2000-2007, rabid non-bat animals were detected in these states and province. Oregon identified 6 rapid foxes with bat-variant rabies during 2000-2007. Idaho detected a rabid bobcat in 2001 and a rabid skunk in 2004 both with bat variant of rabies. British Columbia found 4 skunks in a park in Vancouver in 2004 and a cat in 2007 all infected with bat-variant rabies. This clearly demonstrates that rabies in bats spills over to other wild animals, as well as domestic animals.
Resources:
  1. MMWR – Human Rabies Prevention, 2008  web
    CDC MMWR – Human Rabies Prevention, 2008
  2. Rabies Activity in Washington  web
    DOH Rabies Activity in Washington
MRSA (Methicillin Resistant Staphylococcus Aureus)
MRSA is not a reportable condition to the Snohomish Health District.
The following are different MRSA resources for healthcare providers and schools.
Resources For Providers:
  1. Antibiotic Resistance  web
    WA DOH Antibiotic Resistance
  2. MRSA Features  web
    CDC MRSA Features
  3. MRSA in Healthcare Settings  web
    CDC MRSA in Healthcare Settings
  4. MRSA Toolkit for Outpatient Clinics/Offices  web
    Tacoma-Pierce County toolkit for clinics/offices
Resources For Schools:
  1. MRSA Toolkit for Elementary Schools  web
    Tacoma-Pierce County toolkits: MRSA Toolkit for Elementary Schools
  2. MRSA Toolkit for Middle & High Schools  web
    Tacoma-Pierce County toolkits: For middle and high school
  3. Q & A about MRSA in schools  web
    CDC Q & A about MRSA in schools
SHD CD Reports
List of Snohomish Health District Communicable Disease Report:
SHD Communicable Disease Annual Report: 2004-2008 (2)
SHD Communicable Disease Annual Report: 2004-2008
SHD Communicable Disease Annual Report: 2003-2007 (2)
SHD Communicable Disease Annual Report: 2003-2007
Resources
List of Resources:
  1. Centers for Disease Control (CDC)  web
    Public Health Resources
  2. DOH Surveillance and Reporting Guidelines  web
    Collection, investigation and distribution of data about illness and death
  3. Epi News  snohd
    Epi Newsletter published by Snohomish Health District
  4. Island County Health Department  web
    Public Health Resources for Island County
  5. Public Health - Seattle & King County  web
    Public Health Resources for Seattle & King County
  6. San Juan County Health Department  web
    Public Health Resources for San Juan County
  7. Skagit County Health Department  web
    Public Health Resources for Skagit County
  8. Whatcom County Health Department  web
    Public Health Resources for Whatcom County



Last Reviewed and updated 8/24/2010