Article

January 1, 2008

CONNECTICUT - COMMUNICABLE, OCCUPATIONAL, AND ENVIRONMENTAL DISEASES AND INJURIES

State laws and regulations that affect your medical practice

1. Does Connecticut have a list of reportable diseases?

Yes. The Commissioner issues an annual list of reportable diseases and laboratory findings. The list includes the reporting category of each disease, procedures for the reporting, and minimum investigation and control measures for each disease. Listed diseases are declared reportable diseases as of the effective date of approval by the commissioner. The commissioner issues the annual list before January 1 to physicians licensed by the department, directors of clinical laboratories, local directors of health and health care facilities.

CT ADC § 19a-36-A2

The Department of Public Health revises the list annually. The following list is current as of 2006:

(1) Category 1:

Reportable immediately by telephone on the day of recognition or strong suspicion of disease. On weekdays, reports are made to the DPH and local health departments; in the evening and on weekends, to the DPH. A Confidential Disease Report or more disease-specific report should be mailed to both the DPH and local health departments within 12 hours.

Chickenpox (admission to hospital, any age; adults > 18 years, any clinical setting)

Cholera

Diphtheria

Influenza-associated deaths in children <18 years of age

Measles

Meningococcal disease

Outbreaks (foodborne (involving > 2 persons; institutional; unusual disease or illness)

Pertussis

Poliomyelitis

Rabies (human and animal)

Rubella (including congenital)

SARS-CoV

Staphylococcus aureus disease, reduced or resistant susceptibility to vancomycin

Tuberculosis

Yellow Fever

Diseases that are possible indicators of bioterrorism:

Anthrax

Botulism

Brucellosis

Plague

Q fever

Ricin Poisoning

Septicemia or meningitis with growth of gram positive rods within 32 hours of inoculation

Smallpox

Staphylococcal enterotoxin B pulmonary poisoning

Tularemia

Venezuelan equine encephalitis

Viral hemorrhagic fever

(2) Category 2:

Reportable by mail within 12 hours of recognition or strong suspicion to both the DPH and local health department.

Acquired Immunodeficiency Syndrome

Babesiosis

Campylobacteriosis

Carbon monoxide poisoning

Chancroid

Chlamydia (C. trachomatis) (all sites)

Chickenpox

Chickenpox-related death

Clostridium difficile, community-onset

Creutzfeldt-Jacob disease (age < 55 years)

Cryptosporidiosis

Cyclosporidiosis

Ehrlichiosis

Escherichia coli 0157:H7 gastroenteritis

Gonorrhea

Group A streptococcal disease, invasive

Group B streptococcal disease, invasive

Haemophilus influenzae disease, invasive, all serotypes

Hansen's disease (Leprosy)

Hemolytic-uremic syndrome

Hepatitis A

Hepatitis B (acute infection, HbsAg positive pregnant woman)

Hepatitis C, acute infection

Hepatitis Delta

HIV-1 exposure in infants born 1/1/2001 or later

HIV-1 infection in persons with active tuberculosis disease; persons with latent tuberculosis infection (history or tuberculin skin test > 5 mm in duration by Mantoux technique); and persons of any age

Lead Toxicity (blood test > 20 ug/dL)

Legionellosis

Listeriosis

Lyme disease

Lymphocytic chorlomeningitis virus infection

Malaria

Mercury poisoning

Mumps

Neonatal herpes (< 1 month of age)

Neonatal bacterial sepsis

Occupational asthma

Pneumococcal disease, invasive

Reye syndrome

Rheumatic fever

Rocky Mountain spotted fever

Salmonellosis

Shiga toxin-related disease (gastroenteritis)

Shigellosis

Silicosis

Staphylococcus aureus methicillin-resistant disease, invasive, community acquired

Staphylococcus epidermidis disease, reduced or resistant susceptibility to vancomycin

Syphillis

Tetanus

Trichinosis

Typhoid fever

Typhus

Vaccinia disease (persons not vaccinated; persons vaccinated with the following manifestations: autoinoculation, generalized vaccinia, eczema vaccinatum, progressive vaccinia, or post-vaccination encephalitis)

Vibrio infection (parahaemolyticus, vulnificus, other)

Department of Public Health; Connecticut Epidemiologist; January 2006

3. Who is responsible for reporting reportable diseases?

(1) Every health care provider who treats or examines any person who has or is suspected to have a reportable disease shall report to the local director of health or other health authority within whose jurisdiction the patient resides and to the department.

(2) If the case or suspected case of reportable disease is in a health care facility, the person in charge of such facility shall ensure that reports are made to the local director of health and the department. The person in charge shall designate appropriate infection control or record-keeping personnel for this purpose.

(3) If the case or suspected case of reportable disease is not in a health care facility and if a health care provider is not in attendance or is not known to have made a report within the appropriate time, such report of reportable diseases shall be made to the local director of health or other health authority within whose jurisdiction the patient lives and the department by:

(A) the administrator serving a public or private school or day care center attended by any person affected or apparently affected with such disease;

(B) the person in charge of any camp;

(D) the master or any other person in charge of any aircraft landing within the jurisdiction of the state;

(E) the owner or person in charge of any establishment producing, handling or processing dairy products, other food or non-alcoholic beverages for sale or distribution;

(F) morticians and funeral directors.

(4) Each local director of health shall report or ensure reporting to the department within 24 hours of each case or suspected case of a Category I reportable disease and any additional information.

(b) Reportable laboratory findings – The director of a laboratory that receives a primary specimen or sample which yields a reportable laboratory finding shall be responsible for reporting such findings within forty-eight (48) hours to the local director of health of the town in which the affected person normally resides, or in the absence of such information, of the town from which the specimen originated, and to the department on forms provided by the department.

(1) When a laboratory identifies or presumptively identifies a significant isolate or other finding that requires confirmation by the laboratory as required in the annual list, the director must submit that isolate or specimen from which the finding was made to the department's laboratory division.

(2) Laboratory tests and confirmatory tests for certain reportable diseases as specifically indicated on the annual list shall be exempted from any and all fees for the state laboratory services.

CT ADC § 19a-36-A3

4. What information must be included in a report of a case or suspected case of reportable disease?

(1) Each report of a case or suspected case of reportable disease shall include the full name and address of the person reporting and of the physician attending; the diagnosed or suspected disease and date of onset; the full name, age, race/ethnicity, sex and occupation of the affected individual and other facts the department or local director of health requires for purposes of surveillance, control and prevention of reportable diseases. The reports shall be sent in envelopes marked "CONFIDENTIAL."

(2) Reports may be written or oral as required by the category of disease as follows:

(A) Category I: diseases of high priority because of need for timely public health action: reportable immediately by telephone on day of recognition or suspicion of disease; on weekdays to both, the local health director of the town in which the patient resides and the department, on the weekends to the department. A completed disease report form provided by the department must also be mailed to both the local health director and the department within 12 hours.

(B) Category II: diseases of significant public health importance, usually requiring public health action: reportable by mail to the local health director and the department within 12 hours of recognition or suspicion on a form provided by the department.

(3) Each laboratory report of reportable findings shall include the name, address, age, sex and, if known, race/ethnicity of the person affected, the name and address of the attending physician, the identity of the infectious agent or other reportable laboratory findings, and the method of identification. Reports shall be mailed to the local director of health of the town in which the patient resides and to the department within 48 hours of making the finding in envelopes marked "CONFIDENTIAL."

CT ADC § 19a-36-A4