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.

Editor's Note: The following material is incorporated into this rule by reference: 1) 56 Federal Register 52166—52175, October 17, 1991 (Washington: U.S. Government Printing Office, 1991). In accordance with section 536.031(4), RSMo, the full text of material incorporated by reference will be made available to any interested person at the Office of the Secretary of State and the headquarters of the adopting state agency.

1. (1) Category I diseases or findings shall be reported to the local health authority or to the Department of Health within twenty-four (24) hours of first knowledge or suspicion by telephone, facsimile or other rapid communication. Category I diseases or findings are— Acute chemical poisoning as defined in 56 FR 52166—52175 Anthrax Botulism Brucellosis Cholera Diphtheria Group A Streptococcal disease, invasive Haemophilus influenzae disease, invasive, including meningitis Hantavirus Hemolytic Uremic Syndrome, post-diarrheal Hepatitis A Hyperthermia Hypothermia Measles Meningococcal disease, invasive, including meningitis Methemoglobinemia Outbreaks or epidemics of any illness, disease or condition that may be of public health concern Pesticide poisoning Plague Poliomyelitis Psittacosis Rabies Rubella Syphilis Tuberculosis disease Typhoid fever

Acquired immunodeficiency syndrome (AIDS) Arsenic poisoning Cadmium poisoning Campylobacter infections Carbon monoxide poisoning Chancroid Chlamydia trachomatis infections Cryptosporidiosis E. coli O157:H7 Ehrlichiosis Encephalitis, arthropod-borne Giardiasis Gonorrhea Hepatitis B (acute) Hepatitis B Surface Antigen (prenatal HBsAg) positive screening of pregnant women Hepatitis non-A, non-B Human immunodeficiency virus (HIV) infection, confirmed Influenza Kawasaki disease Lead exposure greater than or equal to ten micrograms per deciliter ((cid:1)10 µg/dl) in persons under age eighteen (<18) or greater than or equal to twenty-five micrograms per deciliter ((cid:1) 25 µg/dl) in persons age eighteen or greater ((cid:1) 18) Legionellosis Leptospirosis Listeria monocytogenes Lyme disease Malaria Meningitis, aseptic Mercury poisoning Mumps Mycobacterial disease other than tuberculosis (MOTT) Nosocomial outbreaks Occupational lung diseases including silicosis, asbestosis, byssinosis, farmer’s lung and toxic organic dust syndrome Pertussis Respiratory diseases triggered by environmental factors including environmentally or occupationally induced asthma and bronchitis Reye syndrome Rocky Mountain spotted fever Salmonella infections Shigella infections Tetanus T-Helper (CD4+) lymphocyte count on any person with HIV infection Toxic shock syndrome Trichinosis Tuberculosis infection Tularemia Yersinia enterocolitica

1. (3) The occurrence of any outbreak or epidemic of any illness or disease which may be of public health concern, including any illness in a food handler that is potentially transmissible through food, 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.

2. (4) A physician, physician’s assistant, nurse, hospital, clinic, or other private or public institution providing care to any person who is suffering from any disease, condition or finding listed in sections (1)–(3) of this rule, or who is suspected of having any of those 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.

   1. (A) A physician, physician’s assistant, or nurse providing care to any patient, with any disease, condition or finding listed in sections (1)–(3) of this rule, in an institution 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.
   2. (B) Duplicate reporting of the same case by health care providers in the same institution is not required.

3. (5) A case report as required in section (4) of this rule shall include the patient’s name, address, age, sex, race, 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, and the date of report.

   1. (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.
4. (6) Any person in charge of a public or private school, summer camp or day 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.
5. (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. 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).
6. (8) Information from patient medical records received by the Department of Health is to be considered confidential records and not public records.
7. (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.
8. (10) This rule will expire on June 30, 2000.

AUTHORITY : sections 192.006.1., 192.020, 201.040 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, 19 CSR 20-20 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.

*Original authority: 192.006.1., RSMo 1993, amended 1995; 192.020, RSMo 1939, amended 1945, 1951; 210.040, RSMo 1941, amended 1993; and 210.050, RSMo 1941, amended 1993.