R386-702-3. Reportable Events

  (1) The Department declares the following events to be of concern to public health and reporting of all instances is required or authorized by Sections 26-6-6 and 26-23b.

  (2) Events Reportable by All Entities.

  (a) Acute flaccid myelitis;

  (b) Adverse event resulting from smallpox vaccination (Vaccinia virus, Orthopox virus);

  (c) Anaplasmosis (Anaplasma phagocytophilium);

  (d) Anthrax (Bacillus anthracis) or anthrax-like illness caused by Bacillus cereus strains that express anthrax toxin genes;

  (e) Antibiotic resistant organisms from any clinical specimen that meet the following criteria:

  (i) Resistant to a carbapenem in:

  (A) Acinetobacter species,

  (B) Enterobacter species,

  (C) Escherichia coli, or

  (D) Klebsiella species,

  (ii) Resistant to vancomycin in:

  (A) Staphylococcus aureus (VRSA),

  (iii) Demonstrated carbapenemase production in:

  (A) Acinetobacter species,

  (B) Enterobacter species,

  (C) Escherichia coli,

  (D) Klebsiella species, or

  (E) Any other Enterobacteriaceae species.

  (f) Arbovirus infection, including but not limited to:

  (i) Chikungunya virus infection,

  (ii) West Nile virus infection, and

  (iii) Zika virus infection, including congenital;

  (g) Babesiosis (Babesia spp.);

  (h) Botulism (Clostridium botulinum);

  (i) Brucellosis (Brucella spp.);

  (j) Campylobacteriosis (Campylobacter spp.);

  (k) Candida auris or Candida haemulonii from any body site;

  (l) Chagas disease (Trypanosoma cruzi);

  (m) Chancroid (Haemophilus ducreyi);

  (n) Chickenpox (Varicella zoster virus, VZV, Human herpesvirus 3, HHV-3);

  (o) Chlamydia (Chlamydia trachomatis);

  (p) Coccidioidomycosis (Coccidioides spp.), also known as valley fever;

  (q) Colorado tick fever (Colorado tick fever virus, Coltivirus spp.), also known as American mountain tick fever;

  (r) Cryptosporidiosis (Cryptosporidium spp.);

  (s) Cyclosporiasis (Cyclospora spp., including Cyclospora cayetanensis);

  (t) Dengue fever (Dengue virus);

  (u) Diphtheria (Corynebacterium diphtheriae);

  (v) Ehrlichiosis (Ehrlichia spp.);

  (w) Encephalitis (bacterial, fungal, parasitic, protozoan, and viral);

  (x) Shiga toxin-producing Escherichia coli (STEC) infection;

  (y) Giardiasis (Giardia lamblia), also known as beaver fever;

  (z) Gonorrhea (Neisseria gonorrhoeae), including sexually transmitted and ophthalmia neonatorum;

  (aa) Haemophilus influenzae, invasive disease;

  (bb) Hantavirus infection (Sin Nombre virus);

  (cc) Hemolytic uremic syndrome, postdiarrheal;

  (dd) Hepatitis, viral, including but not limited to:

  (i) Hepatitis A,

  (ii) Hepatitis B (acute, chronic, and perinatal),

  (iii) Hepatitis C (acute, chronic, and perinatal),

  (iv) Hepatitis D, and

  (v) Hepatitis E;

  (ee) Human immunodeficiency virus (HIV) infection, including acquired immune deficiency syndrome (AIDS) diagnosis;

  (ff) Influenza virus infection:

  (i) Associated with a hospitalization,

  (ii) Associated with a death in a person under 18 years of age, or

  (iii) Suspected or confirmed to be caused by a non-seasonal influenza strain;

  (gg) Legionellosis (Legionella spp.), also known as Legionnaires' disease;

  (hh) Leptospirosis (Leptospira spp.);

  (ii) Listeriosis (Listeria spp., including Listeria monocytogenes);

  (jj) Lyme disease (Borrelia burgdorferi, Borrelia mayonii);

  (kk) Malaria (Plasmodium spp.);

  (ll) Measles (Measles virus), also known as rubeola;

  (mm) Meningitis (bacterial, fungal, parasitic, protozoan, and viral);

  (nn) Meningococcal disease (Neisseria meningitidis), invasive;

  (oo) Middle East Respiratory Syndrome (MERS);

  (pp) Mumps (Mumps virus);

  (qq) Mycobacterial infections, including:

  (i) Tuberculosis (Mycobacterium tuberculosis complex),

  (ii) Leprosy (Mycobacterium leprae), also known as Hansen's Disease,

  (iii) All other mycobacterial infections (Mycobacterium spp.);

  (rr) Pertussis (Bordetella pertussis);

  (ss) Plague (Yersinia pestis);

  (tt) Poliomyelitis (Poliovirus), paralytic and nonparalytic;

  (uu) Psittacosis (Chlamydophila psittaci), also known as ornithosis;

  (vv) Q fever (Coxiella burnetii);

  (ww) Rabies (Rabies virus), human and animal;

  (xx) Relapsing fever (Borrelia spp.), tick-borne and louse-borne;

  (yy) Rubella (Rubella virus), including congenital syndrome;

  (zz) Salmonellosis (Salmonella spp.);

  (aaa) Severe acute respiratory syndrome, also known as SARS (SARS coronavirus or SARS-CoV);

  (bbb) Shigellosis (Shigella spp.);

  (ccc) Smallpox (Variola major and Variola minor);

  (ddd) Spotted fever rickettsioses (Rickettsia spp.), including Rocky Mountain spotted fever (Rickettsia rickettsii);

  (eee) Streptococcal disease, invasive, due to:

  (i) Streptococcus pneumoniae,

  (ii) Group A Streptococcus (Streptococcus pyogenes), and

  (iii) Group B Streptococcus (Streptococcus agalactiae);

  (fff) Syphilis (Treponema pallidum), including:

  (i) all stages,

  (ii) congenital, and

  (iii) syphilitic stillbirths;

  (ggg) Tetanus (Clostridium tetani);

  (hhh) Toxic shock syndrome, staphylococcal (Staphylococcus aureus) or streptococcal (Streptococcus pyogenes);

  (iii) Transmissible spongiform encephalopathies (prion diseases), including Creutzfeldt-Jakob disease;

  (jjj) Trichinellosis (Trichinella spp.);

  (kkk) Tularemia (Francisella tularensis);

  (lll) Typhoid (Salmonella typhi), cases and carriers;

  (mmm) Vibriosis (Vibrio spp.), including Cholera (Vibrio cholerae);

  (nnn) Viral hemorrhagic fevers, including but not limited to:

  (i) Ebola fever (Ebolavirus spp.),

  (ii) Lassa fever (Lassa virus), and

  (iii) Marburg fever (Marburg virus);

  (ooo) Yellow fever (Yellow fever virus).

  (3) Perinatally Transmissible Conditions Reportable by All Entities.

  (a) Pregnancy is a reportable event for the following communicable diseases, and reporting is required even if the communicable disease was reported to public health prior to the pregnancy:

  (i) Hepatitis B infection;

  (ii) Hepatitis C infection;

  (iii) HIV infection;

  (iv) Listeriosis;

  (v) Rubella;

  (vi) Syphilis infection; and

  (vii) Zika virus infection.

  (4) Antimicrobial Susceptibility Tests Reportable by All Entities.

  (a) Full panel antimicrobial susceptibility test results, including minimum inhibitory concentration and results suppressed to the ordering clinician, are reportable when performed on the following organisms:

  (i) Candida auris/Candida haemulonii from any body site;

  (ii) Mycobacterium tuberculosis;

  (iii) Neisseria gonorrhoeae;

  (iv) Salmonella species;

  (v) Shigella species; and

  (vi) Streptococcus pneumoniae.

  (vii) Organisms resistant to a carbapenem in:

  (A) Acinetobacter species,

  (B) Enterobacter species,

  (C) Escherichia coli,

  (D) Klebsiella species;

  (viii) Organisms resistant to vancomycin in:

  (A) Staphylococcus aureus (VRSA)

  (b) All individual carbapenemase test results (positive, negative, equivocal, indeterminate), including the method used, are reportable when performed on the following organisms:

  (i) Resistant to a carbapenem, or with demonstrated carbapenemase, in:

  (A) Acinetobacter species,

  (B) Enterobacter species,

  (C) Escherichia coli, and

  (D) Klebsiella species.

  (b) Antiviral susceptibility test results; including nucleotide sequencing, genotyping, or phenotypic analysis; are reportable when performed on the following organisms:

  (i) Human immunodeficiency virus (HIV).

  (5) Unusual Events Reportable by All Entities.

  (a) Unusual events include one or more cases or suspect cases of a communicable disease, condition, or syndrome considered:

  (i) Rare, unusual, or new to Utah;

  (ii) Previously controlled or eradicated;

  (iii) Caused by an unidentified or newly identified organism;

  (iv) Exposure or infection that may indicate a bioterrorism event with potential transmission to the public; or

  (v) Any other infection not explicitly identified in Subsection R386-702-3(2) that public health considers a public health hazard.

  (6) Outbreaks, Epidemics, or Unusual Occurrences of Events Reportable by All Entities.

  (a) Entities shall report two or more cases or suspect cases, with or without an identified organism, including but not limited to:

  (i) Gastrointestinal illnesses;

  (ii) Respiratory illnesses;

  (iii) Meningitis or encephalitis;

  (iv) Infections caused by antimicrobial resistant organisms;

  (v) Illnesses with suspected foodborne or waterborne transmission;

  (vi) Illnesses with suspected ongoing transmission in any facility;

  (vii) Infections that may indicate a bioterrorism event; or

  (viii) Any other infections not explicitly identified in Subsection R386-702-3(2) that public health considers a public health hazard.

  (b) Entities shall report increases or shifts in pharmaceutical sales that may indicate changes in disease trends; or

  (7) Laboratory Results Reportable by Electronic Reporters.

  (a) In addition to laboratory results set forth in Subsections R386-702-3(2) through R386-702-3(6), entities reporting electronically shall include the following laboratory results or laboratory results that provide presumptive evidence of the following communicable diseases:

  (i) Influenza virus;

  (ii) Norovirus infection;

  (iii) Pseudomonas aeruginosa, resistant to a carbapenem, or with demonstrated carbapenemase production;

  (iv) Staphylococcus aureus from a normally sterile site with methicillin testing performed, reported as either methicillin-susceptible Staphylococcus aureus (MSSA) or methicillin-resistant Staphylococcus aureus (MRSA); and

  (v) Streptococcal disease, invasive due to all species.

  (b) Entities reporting electronically shall include all laboratory results (positive, negative, equivocal, indeterminate) associated with the following tests or conditions:

  (i) CD4+ T-Lymphocyte tests, regardless of known HIV status;

  (ii) Chlamydia;

  (iii) Clostridium difficile;

  (iv) Cytomegalovirus (CMV), congenital (infants less than or equal to 12 months of age);

  (v) Gonorrhea;

  (vi) Hepatitis A;

  (vii) Hepatitis B, including viral loads;

  (viii) Hepatitis C, including viral loads;

  (ix) HIV, including viral loads and confirmatory tests;

  (x) Liver function tests, including ALT, AST, and bilirubin associated with a viral hepatitis case;

  (xi) Lyme disease;

  (xii) Respiratory syncytial virus (RSV);

  (xiii) Syphilis;

  (xiv) Tuberculosis; and

  (xv) Zika virus.

  (c) Entities reporting electronically shall report full panel antibiotic susceptibility test results, including minimum inhibitory concentration and results suppressed to the ordering clinician, are reportable when performed on the following organisms:

  (i) Pseudomonas aeruginosa, resistant to a carbapenem, or with demonstrated carbapenemase.

  (d) The Department may, by authority granted through Section 26-23b, identify additional reporting criteria when deemed necessary for the management of outbreaks or identification of exposures.

  (e) Non-positive laboratory results reported for the events identified in Subsection R386-702-3(7)(b) will be used for the following purposes as authorized in Utah Health Code Subsections 26-1-30(2)(c), 26-1-30(2)(d), and 26-1-30(2)(f):

  (i) To determine when a previously reported case becomes non-infectious;

  (ii) To identify newly acquired infections through identification of a seroconversion window; or

  (iii) To provide information critical for assignment of a case status.

  (f) Information associated with a non-positive laboratory result will be kept by the Department for a period of 18 months.

  (i) At the end of the 18 month period, if the result has not been appended to an existing case, personal identifiers will be stripped and expunged from the result.

  (ii) The de-identified result will be added to a de-identified, aggregate dataset.

  (iii) The dataset will be kept for use by public health to analyze trends associated with testing patterns and case distribution, and identify and establish prevention and intervention efforts for at-risk populations.

  (8) Authorized Reporting of Syndromes and Conditions.

  (a) Reporting of encounters for the following syndromes and conditions is authorized by Chapter 26-23b, unless made mandatory by the declaration of a public health emergency:

  (i) Respiratory illness, including but not limited to:

  (A) Upper or lower respiratory tract infections,

  (B) Difficulty breathing, or

  (C) Adult respiratory distress syndrome;

  (ii) Gastrointestinal illness, including but not limited to:

  (A) Vomiting,

  (B) Diarrhea, or

  (C) Abdominal pain;

  (iii) Influenza-like constitutional symptoms or signs;

  (iv) Neurologic symptoms or signs indicating the possibility of meningitis, encephalitis, or unexplained acute encephalopathy or delirium;

  (v) Rash illness;

  (vi) Hemorrhagic illness;

  (vii) Botulism-like syndrome;

  (viii) Lymphadenitis;

  (ix) Sepsis or unexplained shock;

  (x) Febrile illness (illness with fever, chills or rigors);

  (xi) Nontraumatic coma or sudden death; and

  (xii) Other criteria specified by the Department as indicative of disease outbreaks or injurious exposures of uncertain origin.

  (b) Reporting of encounters for syndromes and conditions not specified in Subsection R386-702-3(8)(a) is also authorized by Chapter 26-23b, unless made mandatory by the declaration of a public health emergency.

  (c) Information included in the reporting of the events identified in Subsection R386-702-3(8)(a) and R386-702-3(8)(b) will be used for the following purposes:

  (i) To support early identification and ruling out of public health threats, disasters, outbreaks, suspected incidents, and acts of bioterrorism;

  (ii) To assist in characterizing population groups at greatest risk for disease or injury;

  (iii) To support assessment of the severity and magnitude of possible threats; or

  (iv) To satisfy syndromic surveillance objectives of the Federal Centers for Medicaid and Medicare Meaningful Use incentive program.

  (9) Reporting Exceptions

  (a) A university or hospital that conducts research studies exempt from reporting AIDS and HIV infection under Section 26-6-3.5 shall seek written approval of reporting exemption from the Department institutional review board prior to the study commencement.

  (b) The university or hospital shall submit the following to the HIV Epidemiologist within 30 days of Department institutional review board approval:

  (i) A summary of the research protocol, including funding sources and justification for requiring anonymity; and

  (ii) Written approval from the Department institutional review board.

  (c) The university or hospital shall submit a report that includes all of the indicators specified in Subsection 26-6-3.5(4)(a) to the HIV Epidemiologist annually during an ongoing research study.

  (d) The university or hospital shall submit a final report that includes all of the indicators specified in Subsection 26-6-3.5(4)(a) to the HIV Epidemiologist within 30 days of the conclusion of the research study.

  (e) Documents can be submitted to the HIV Epidemiologist by fax at [phone] or by mail to 288 North 1460 West Salt Lake City, Utah 84116.