09-13-043

WSR 09-13-043

EMERGENCY RULES

DEPARTMENT OF HEALTH

[ Filed June 11, 2009, 10:03 a.m. , effective June 11, 2009, 10:03 a.m. ]

     Effective Date of Rule: Immediately.

     Purpose: The purpose of the rule is to obtain immediately from health care providers and health care facilities notification of cases and suspected cases caused by novel influenza A (H1N1) resulting in hospitalization or death. This information will allow for the monitoring of hospitalizations as opposed to monitoring all illnesses due to influenza and will identify periods when epidemic flu "thresholds" are exceeded. In addition, such a system will identify groups at-risk for serious illness in order to prioritize their vaccination in any influenza vaccination programs in the coming 2009-2010 influenza season.

     Citation of Existing Rules Affected by this Order: Amending WAC 246-101-101 and 246-101-301.

     Statutory Authority for Adoption: RCW 43.20.050.

     Other Authority: WAC 246-101-015(4).

     Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

     Reasons for this Finding: Observing the time requirements of the regular rule-making process would impede the department's ability to track, respond and understand the novel influenza A (H1N1) virus before the upcoming 2009-2010 influenza season. It is necessary to obtain this information to identify groups at-risk for serious illness in order to prioritize their vaccination in any influenza vaccination programs. For this reason, immediate adoption of this rule is necessary to protect the public health.

     Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

     Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 2, Repealed 0.

     Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.

     Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0;      Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.

     Date Adopted: June 2, 2009.

Mary C. Selecky

Secretary

OTS-2429.1

AMENDATORY SECTION(Amending WSR 05-03-055, filed 1/11/05, effective 2/11/05)

WAC 246-101-101   Notifiable conditions and the health care provider.   This section describes the conditions that Washington's health care providers must notify public health authorities of on a statewide basis. The board finds that the conditions in the table below (Table HC-1) are notifiable for the prevention and control of communicable and noninfectious diseases and conditions in Washington. Principal health care providers shall notify public health authorities of these conditions as individual case reports using procedures described throughout this chapter. Other health care providers in attendance shall notify public health authorities of the following notifiable conditions, unless the condition notification has already been made. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.

     WAC 246-101-105, 246-101-110, 246-101-115, and 246-101-120 also include requirements for how notifications shall be made, when they shall be made, the content of these notifications, and how information regarding notifiable conditions cases must be handled and may be disclosed.

Table HC-1 (Conditions Notifiable by Health Care Providers)

Notifiable Condition	Time Frame for Notification	Notifiable to Local Health Department	Notifiable to State Department of Health
Acquired Immunodeficiency Syndrome (AIDS)	Within 3 work days	√
Animal Bites	Immediately	√
Arboviral Disease	Within 3 work days	√
Asthma, occupational	Monthly		√
Birth Defects ? Autism Spectrum Disorders	Monthly		√
Birth Defects ? Cerebral Palsy	Monthly		√
Birth Defects ? Alcohol Related Birth Defects	Monthly		√
Botulism (foodborne, infant, and wound)	Immediately	√
Brucellosis (Brucella species)	Immediately	√
Campylobacteriosis	Within 3 work days	√
Chancroid	Within 3 work days	√
Chlamydia trachomatis infection	Within 3 work days	√
Cholera	Immediately	√
Cryptosporidiosis	Within 3 work days	√
Cyclosporiasis	Within 3 work days	√
Diphtheria	Immediately	√
Disease of suspected bioterrorism origin (including): ? Anthrax ? Smallpox	Immediately	√
Disease of suspected foodborne origin (communicable disease clusters only)	Immediately	√
Disease of suspected waterborne origin (communicable disease clusters only)	Immediately	√
Enterohemorrhagic E. coli (shiga-like toxin producing infections only) such as E. coli O157:H7 Infection	Immediately	√
Giardiasis	Within 3 work days	√
Gonorrhea	Within 3 work days	√
Granuloma inguinale	Within 3 work days	√
Haemophilus influenzae (invasive disease, children under age 5)	Immediately	√
Hantavirus pulmonary syndrome	Within 3 work days	√
Hemolytic uremic syndrome	Immediately	√
Hepatitis A (acute infection)	Immediately	√
Hepatitis B (acute infection)	Within 3 work days	√
Hepatitis B surface antigen + pregnant women	Within 3 work days	√
Hepatitis B (chronic) ? Initial diagnosis, and previously unreported prevalent cases	Monthly	√
Hepatitis C ? Acute and chronic	Monthly	√
Hepatitis (infectious), unspecified	Within 3 work days	√
Herpes simplex, neonatal and genital (initial infection only)	Within 3 work days	√
Human immunodeficiency virus (HIV) infection	Within 3 work days	√
Legionellosis	Within 3 work days	√
Leptospirosis	Within 3 work days	√
Listeriosis	Immediately	√
Lyme Disease	Within 3 work days	√
Lymphogranuloma venereum	Within 3 work days	√
Malaria	Within 3 work days	√
Measles (rubeola)	Immediately	√
Meningococcal disease	Immediately	√
Mumps	Within 3 work days	√
Novel influenza A (HlNl) (hospitalized or fatal only)	Immediately	√
Paralytic shellfish poisoning	Immediately	√
Pertussis	Immediately	√
Pesticide poisoning (hospitalized, fatal, or cluster)	Immediately		√
Pesticide poisoning (all other)	Within 3 work days		√
Plague	Immediately	√
Poliomyelitis	Immediately	√
Psittacosis	Within 3 work days	√
Q Fever	Within 3 work days	√
Rabies (Confirmed Human or Animal)	Immediately	√
Rabies (Including use of post-exposure prophylaxis)	Within 3 work days	√
Relapsing fever (borreliosis)	Immediately	√
Rubella (including congenital rubella syndrome)	Immediately	√
Salmonellosis	Immediately	√
Serious adverse reactions to immunizations	Within 3 work days	√
Shigellosis	Immediately	√
Syphilis	Within 3 work days	√
Tetanus	Within 3 work days	√
Trichinosis	Within 3 work days	√
Tuberculosis	Immediately	√
Tularemia	Within 3 work days	√
Typhus	Immediately	√
Vibriosis	Within 3 work days	√
Yellow fever	Immediately	√
Yersiniosis	Within 3 work days	√
Other rare diseases of public health significance	Immediately	√
Unexplained critical illness or death	Immediately	√

[Statutory Authority: RCW 43.20.050, 70.24.125. 05-03-055, § 246-101-101, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 70.24.125 and 70.28.010. 00-23-120, § 246-101-101, filed 11/22/00, effective 12/23/00.]

AMENDATORY SECTION(Amending WSR 05-03-055, filed 1/11/05, effective 2/11/05)

WAC 246-101-301   Notifiable conditions and health care facilities.   This section describes the conditions that Washington's health care facilities must notify public health authorities of on a statewide basis. The board finds that the conditions in the table below (Table HF-1) are notifiable for the prevention and control of communicable and noninfectious diseases and conditions. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction. Health care facilities are required to notify public health authorities of cases that occur in their facilities. Health care facilities may choose to assume the notification for their health care providers for conditions designated in Table HF-1. Health care facilities may not assume the reporting requirements of laboratories that are components of the health care facility. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.

     WAC 246-101-305, 246-101-310, 246-101-315, and 246-101-320 also include requirements for how notifications shall be made, when they are made, the content of these notifications, and how information regarding notifiable conditions cases must be handled and may be disclosed.

Table HF-1 (Conditions Notifiable by Health Care Facilities)

Notifiable Condition	Time Frame for Notification	Notifiable to Local Health Department	Notifiable to State Department of Health
Acquired Immunodeficiency Syndrome (AIDS)	Within 3 work days		√
Animal Bites	Immediately	√
Arboviral Disease	Within 3 work days	√
Asthma, occupational	Monthly		√
Birth Defects ? Abdominal Wall Defects (inclusive of gastroschisis and omphalocele)	Monthly		√
Birth Defects ? Autism Spectrum Disorders	Monthly		√
Birth Defects ? Cerebral Palsy	Monthly		√
Birth Defects ? Down Syndrome	Monthly		√
Birth Defects ? Alcohol Related Birth Defects	Monthly		√
Birth Defects ? Hypospadias	Monthly		√
Birth Defects ? Limb reductions	Monthly		√
Birth Defects ? Neural Tube Defects (inclusive of anencephaly and spina bifida)	Monthly		√
Birth Defects ? Oral Clefts (inclusive of cleft lip with/without cleft palate)	Monthly		√
Botulism (foodborne, infant, and wound)	Immediately	√
Brucellosis (Brucella species)	Immediately	√
Cancer (See chapter 246-430 WAC)	Monthly		√
Chancroid	Within 3 work days	√
Chlamydia trachomatis infection	Within 3 work days	√
Cholera	Immediately	√
Cryptosporidiosis	Within 3 work days	√
Cyclosporiasis	Within 3 work days	√
Diphtheria	Immediately	√
Disease of suspected bioterrorism origin (including): ? Anthrax ? Smallpox	Immediately	√
Disease of suspected foodborne origin (communicable disease clusters only)	Immediately	√
Disease of suspected waterborne origin (communicable disease clusters only)	Immediately	√
Enterohemorrhagic E. coli (shiga-like toxin producing infections only) such as E. coli O157:H7 Infection	Immediately	√
Giardiasis	Within 3 work days	√
Gonorrhea	Within 3 work days	√
Granuloma inguinale	Within 3 work days	√
Gunshot wounds (nonfatal)	Monthly		√
Haemophilus influenzae (invasive disease, children under age 5)	Immediately	√
Hantavirus pulmonary syndrome	Within 3 work days	√
Hemolytic uremic syndrome	Immediately	√
Hepatitis A (acute infection)	Immediately	√
Hepatitis B (acute infection)	Within 3 work days	√
Hepatitis B surface antigen + pregnant women	Within 3 work days	√
Hepatitis B (chronic) ? Initial diagnosis, and previously unreported prevalent cases	Monthly	√
Hepatitis C ? Acute and chronic	Monthly	√
Hepatitis (infectious), unspecified	Within 3 work days	√
Human immunodeficiency virus (HIV) infection	Within 3 work days	√
Legionellosis	Within 3 work days	√
Leptospirosis	Within 3 work days	√
Listeriosis	Immediately	√
Lyme Disease	Within 3 work days	√
Lymphogranuloma venereum	Within 3 work days	√
Malaria	Within 3 work days	√
Measles (rubeola)	Immediately	√
Meningococcal disease	Immediately	√
Mumps	Within 3 work days	√
Novel influenza A (HlNl) (hospitalized or fatal only)	Immediately	√
Paralytic shellfish poisoning	Immediately	√
Pertussis	Immediately	√
Pesticide poisoning (hospitalized, fatal, or cluster)	Immediately		√
Plague	Immediately	√
Poliomyelitis	Immediately	√
Psittacosis	Within 3 work days	√
Q Fever	Within 3 work days	√
Rabies (Confirmed Human or Animal)	Immediately	√
Rabies (Use of post-exposure prophylaxis)	Within 3 work days	√
Relapsing fever (borreliosis)	Immediately	√
Rubella (including congenital rubella syndrome)	Immediately	√
Salmonellosis	Immediately	√
Serious adverse reactions to immunizations	Within 3 work days	√
Shigellosis	Immediately	√
Syphilis	Within 3 work days	√
Tetanus	Within 3 work days	√
Trichinosis	Within 3 work days	√
Tuberculosis	Immediately	√
Tularemia	Within 3 work days	√
Typhus	Immediately	√
Vibriosis	Within 3 work days	√
Yellow fever	Immediately	√
Yersiniosis	Within 3 work days	√
Other rare diseases of public health significance	Immediately	√
Unexplained critical illness or death	Immediately	√

[Statutory Authority: RCW 43.20.050, 70.24.125. 05-03-055, § 246-101-301, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 43.70.545, 70.24.125, 70.28.010 and 70.104.030. 00-23-120, § 246-101-301, filed 11/22/00, effective 12/23/00.]