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January 1, 2001
http://www.tdh.state.tx.us/phpep/
Recent Changes in Reporting Rules
Vol. 61 No. 1
State statute requires health care providers, hospitals, laboratories, schools, and others to report confirmed
or suspected cases designated as a "reportable disease" (Title 25 Texas Administrative Code, Article 97
and Chapter 81 of the Health & Safety Code). Included as reportable diseases are outbreaks, exotic
diseases, and unusual group expressions of disease. Thus, any disease that may be caused by a
bioterrorist-including anthrax, brucellosis, foodborne botulism, plague, Q fever, smallpox, tularemia,
Venezuelan equine encephalitis (VEE), and viral hemorrhagic fevers-should be reported.
To ensure prompt receipt of reports on infec-
tious diseases, the Texas Department of
Health (TDH) has amended certain reporting
requirements. These changes went into effect
December 20, 2000. Minor, though numerous,
editorial changes were made; among these, the term
"reportable disease" was changed to "notifiable
condition." One important legislative requirement
has not been modified: failure to report a notifiable
condition is still a Class B misdemeanor.
The most extensive changes were to the reporting
regulations for chickenpox (varicella) and hepatitis
C. In the past reporters provided only the number
of chickenpox cases and age groups of patients.
With the advent of the chickenpox vaccine, reporters
must now also include patient name, address,
telephone number, age, date of birth, sex, race
and ethnicity; type of diagnosis; date of onset; and
physician name, address, and telephone number.
This additional information will allow chickenpox
cases to be investigated like those of any other
vaccine preventable disease.
The change in hepatitis C reporting reflects the fact
that the majority of acute hepatitis C infections are
asymptomatic, and most acute infections become
chronic. Effective December 20, 2000, the rules
include all cases newly diagnosed since January 1,
2000. Knowledge of all newly diagnosed cases will
help health care workers better understand the
scope of hepatitis C infection in Texas and facilitate
public health planning. Hepatitis C cases should
continue to be reported weekly.
A number of simple but important changes were
made for many diseases that can result from acts of
bioterrorism. Anthrax, foodborne botulism, brucel-
losis, plague, VEE, and viral hemorrhagic fevers
have been notifiable in Texas for a number of years.
Q fever, tularemia, and smallpox had been removed
from Texas' notifiable condition list years ago
because of low (or no) incidence, but have been put
back on the list due to their potential for use by
bioterrorists. Suspected cases of anthrax (previ-
ously reportable within one week of identification),
foodborne botulism, plague, smallpox, VEE, and
viral hemorrhagic fevers are public health emer-
gencies and must be reported immediately by
telephone (call 800/705-8868 or 800/252-8239).
Suspected cases of brucellosis, Q fever, and tulare-
mia must be reported by telephone within one
working day.
The following small reporting changes were
implemented to increase the probability of a timely
public health response to food- and waterborne
disease. Cyclosporiasis has been added to the noti-
fiable disease list because there have been large
nationwide Cyclospora outbreaks associated with
imported berries in recent years. The number of
serotypes of notifiable Escherichia coli has been in-
creased to include all enterohemorrhagic E. coli
(rather than just E. coli 0157:H7). Vibrio infections
(including cholera) and acute hepatitis A must be
reported within one working day instead of
weekly. The change pertaining to Vibrio infections
will also allow compliance with federal Food and
Drug Administration guidelines for investigation
of illnesses potentially associated with shellfish
consumption. The hepatitis A change reflects the
fact that infection can spread quickly within a family
or daycare facility or from a food handler. The
accelerated reporting deadline should translate
into quicker intervention and reduced community
morbidity.
Last (but not least), invasive streptococcal disease
reporting is limited to group A and B Streptococcus
infections.
Prepared by Kate Hendricks, MD, MPH&TM,
Director, and Gary Heseltine, MD, MPH, In-
fectious Disease Epidemiology and Surveillance.
Also in this issue
Notifiable Conditions in Texas
Hepatitis C: Supplemental Information
Texas Department
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