Note: Positive results only, unless otherwise specified. Immediate, Extremely Urgent – Report to the County or State Health Department by telephone within 4 hours of laboratory result, as well as submit electronically within 24 hours

• Bacillus anthracis
• Brucella species
• Burkholderia mallei
• Burkholderia pseudomallei
• Clostridium botulinum or botulinum toxin in food, wound, unspecified source, or an infant (<12 months old)
• Crimean-Congo hemorrhagic fever virus
• Francisella tularensis
• Ebola virus
• Lassa virus
• Lujo virus
• Marburg virus
• New World arenavirus – Chapare virus
• New World arenavirus – Guanarito virus
• New World arenavirus – Junin virus
• New World arenavirus – Machupo virus
• New World arenavirus – Sabia virus
• Poliovirus
• Variola virus (orthopox virus)
• Vaccinia virus
• Yersinia pestis

Standard Reporting by Laboratories – Report electronically within 24 hours  • Anaplasma species
• Babesia species
• Bordetella pertussis
• Borrelia burgdorferi
• California serogroup virus diseases (all results)
• Campylobacter species
• Chikungunya virus disease (all results)
• Chlamydia trachomatis
• Clostridium tetani
• Coccidioides species
• Corynebacterium diphtheriae
• Coxiella burnetii
• Cryptosporidium species
• Cyclospora cayetanensis
• Cytomegalovirus (if age <21 days old)
• Dengue virus (all results)
• Eastern equine encephalitis virus disease (all results)
• Ehrlichia species
• Escherichia coli, Shiga toxin-producing
• Grimontia hollisae
• Haemophilus ducreyi
• Haemophilus influenzae isolated from a normally sterile site
• Hepatitis A (IgM positives and genotyping results)
• Hepatitis B, C, and D (all results to include surface antigens, antibody, genotyping, viral load/RNA/DNA, and associated ALTs)
• HIV, all test results (e.g., positive and negative immunoassay, positive and negative virologic tests, and associated CD4 counts) for children <18 months old
• Human immunodeficiency virus (HIV), repeatedly reactive enzyme immunoassay followed by a positive confirmatory test (e.g., Western blot, IFA, or HIV differentiation). Positive result on any HIV virologic test (e.g., p24 AG, nucleic acid test (NAT/NAAT), viral culture). All viral load (detectable and undetectable) test results and associated CD4 counts.
• Influenza virus (molecular positive test results only)
• Lead, all blood results
• Legionella species
• Listeria monocytogenes from a normally sterile site
• Mantoux tuberculin skin test (TST) and interferon gamma release assay (IGRA) blood test, positives
• Measles (rubeola) virus
• Mumps virus
• Mycobacterium leprae
• Mycobacterium tuberculosis complex, culture, or NAAT (including PCR)
• Naegleria fowleri
• Neisseria gonorrhoeae
• Neisseria meningitidis isolated from a normally sterile site
• Photobacterium damselae
• Plasmodium species
• Powassan virus disease (all results)
• Rabies virus in animal or human
• Rapid plasma reagin (RPR), positive results
• Rickettsia rickettsii and other spotted fever Rickettsia species
• Rubella virus
• Salmonella species
• SARS-CoV-2
• Shigella species
• St. Louis encephalitis virus disease (all results)
• Staphylococcus aureus, intermediate or full resistance to vancomycin (VISA, VRSA)
• Streptococcus pneumoniae isolated from a normally sterile site
• Treponema pallidum
• Trichinella species
• Varicella virus
• Venereal Disease Research Laboratory (VDRL) test, positive results
• Vibrio cholerae type O1 and O139
• Vibrio species
• West Nile virus disease (all results)
• Western equine encephalitis virus disease (all results)
• Yellow fever virus (all results)
• Zika virus (all results)• Detection or isolation of one or more specimens of etiological agents of a disease or condition not listed that is of urgent public health significance
• Agents suspected to be the cause of a cluster or outbreak

State Health Department Telephone Number:

 Bureau of Clinical Laboratories 334-290-6130 (24-hour   coverage)

 Infectious Diseases & Outbreaks Division 334-206-5971 or 1-800-338-8374 (24-hour  coverage)

 Office of HIV Prevention & Care 334-206-5364 or 1-800-344-1153

 Division of Immunization 334-206-5023 or 1-800-469-4599

 Division of Sexually Transmitted Diseases 334-206-5350

 Division of Tuberculosis Control 334-206-5330

Author: Sherri L. Davidson, Ph.D, M.P.H.

Statutory Authority: Code of Ala. 1975, §22-11A-1.

History: New Rule: Published February 29, 2024; effective April 14, 2024.