MASSACHUSETTS - COMMUNICABLE, OCCUPATIONAL, AND ENVIRONMENTAL DISEASES AND INJURIES

January 1, 2008

Massachusetts state laws and regulations that affect your medical practice

1. Which diseases or conditions must be reported in Massachusetts?

Amebiasis

Anthrax

Babesiosis

Botulism

Brucellosis

Calicivirus infection, including but not limited to gastroenteritis caused by Norwalk and Norwalk-like viruses

Campylobacteriosis

Cholera

Creutzfeldt-Jakob disease

Cryptococcosis

Cryptosporidiosis

Diphtheria

E. coli O157:H7

Ehrlichiosis

Encephalitis, any case

Food poisoning and toxicity (includes poisoning by mushroom toxins, ciguatera, scombrotoxin, tetrodotoxin, paralytic shellfish toxin and amnesic shellfish toxin, and other toxins)

Giardiasis

Group A streptococcus, invasive infection

Group B streptococcus, invasive infection

Guillain Barre syndrome

Haemophilus influenzae, invasive infection

Hansen's disease (Leprosy)

Hantavirus infection

Hemolytic uremic syndrome (HUS)

Hepatitis A

Hepatitis B

Hepatitis C

Hepatitis, infectious, not otherwise specified

Influenza

Legionellosis

Leptospirosis

Listeriosis

Lyme disease

Malaria

Measles

Meningitis, bacterial, community-acquired

Meningitis, viral (aseptic) and other infections (non-bacterial)

Meningococcal disease, invasive infection (N. meningitidis)

Monkeypox and infection with any other orthopox virus in humans

Mumps

Pertussis

Plague

Poliomyelitis

Psittacosis

Q Fever

Rabies in humans

Reye syndrome

Rheumatic fever

Rickettsialpox

Rocky Mountain spotted fever

Rubella

Salmonellosis

Severe Acute Respiratory Syndrome (SARS) and infection with the SARS-associated coronavirus

Shigellosis

Shiga toxin-producing organisms isolated from humans, including enterohemorrhagic E. coli (EHEC)

Smallpox

Streptococcus pneumoniae, invasive infection

Tetanus

Toxic shock syndrome

Toxoplasmosis

Trichinosis

Tularemia

Varicella (chickenpox)

Viral hemorrhagic fevers

Yersiniosis

105 MA ADC 300.100

2. To whom must the above-listed diseases be reported?

Cases or suspect cases of the diseases listed above shall be reported by household members, physicians and other health care providers, laboratories and other officials designated by the Department, by telephone, in writing, by facsimile or other electronic means as deemed acceptable by the Department, immediately, but in no case more than 24 hours after diagnosis or identification, to the board of health in the community where the case is diagnosed or suspect case is identified.

105 MA ADC 300.100

3. What information should be included in each report?

When available, name, date of birth, age, sex, address, place of employment, school and disease must be included for each report.

105 MA ADC 300.100

4. What are the reporting requirements for animal diseases potentially infectious to humans?

Any veterinarian or local board of health with knowledge of an animal disease potentially infectious to humans must report the disease to the Department of Food and Agriculture (DFA), Bureau of Animal Health. DFA will immediately notify the Department of any potential occurrence of such zoonotic disease. Notwithstanding requirements to report such cases to DFA, veterinarians shall also report to the Department within 24 hours any case of anthrax, plague, West Nile virus infection, or Eastern equine encephalitis virus infection diagnosed in an animal. The Department will notify the local board of health of all such reports within 24 hours of receipt.

105 MA ADC 300.140

5. When is a disease considered immediately reportable, under surveillance and/or subject to isolation and quarantine?

The Commissioner, as necessary to reduce morbidity and mortality in Massachusetts shall require the reporting, authorize the surveillance and/or establish isolation and quarantine requirements, on a time-limited basis, of confirmed and suspect cases of diseases or conditions which are newly recognized or recently identified or suspected as a public health concern. Such declarations shall be authorized for a period of time not to exceed 12 months.

105 MA ADC 300.150

6. What is the procedure for an unusual illness or a cluster of an outbreak of disease?

Whenever there shall occur in any municipality report of a case of unusual illness or cluster or outbreak of disease, including but not limited to suspected food poisoning, or an increased incidence of diarrheal and/or unexplained febrile illness, it shall be the duty of the local board of health to report immediately by telephone, by facsimile, or other electronic means the existence of such an unusual disease, outbreak, cluster, or increased incidence of illness to the Department.

105 MA ADC 300.160

7. Is there a requirement for reporting of antimicrobial resistant organisms?

Yes. The Department shall require laboratories to report results indicating antimicrobial resistance in specific organisms. Information requested shall include the name of a laboratory contact, the specified test results, date of specimen collection, source of specimen, and the case's full name, date of birth, sex, full address, and name of principal health care provider, when available. Selected isolates, as specified by the Department, shall also be required to be submitted directly to the State Laboratory Institute for further examination. Reports of antimicrobial resistance organisms shall include, but are not limited to, the following:

• Neisseria gonorrhoeae resistant to fluoroquinolones or ceftriaxone

• Vancomycin-resistant Staphylococcus aureus (VRSA)

• Vancomycin-intermediate Staphylococcus aureus (VISA)

• Invasive penicillin-resistant Streptococcus pneumoniae

If antimicrobial resistance of an unexplained or novel nature is identified in any infectious organism, the laboratory must contact the Department within five business days.

105 MA ADC 300.171

8. What diseases must be reported directly to the Department?

(A) Active Tuberculosis: Any health care provider, laboratory, board of health or administrator of a city, state or private institution or hospital who has knowledge of a case of confirmed or suspected tuberculosis shall notify the Division of Tuberculosis Prevention and Control in the Department within 24 hours. This notice shall include at a minimum, the case name, date of birth, sex and address, and the name and telephone number of the person reporting the case. Upon receipt of such notice, the Division of Tuberculosis Prevention and Control shall notify the local board of health in the community where the case resides within 24 hours.

(B) Latent Tuberculosis (Positive Tuberculin Skin Test): Any health care provider, board of health or administrator of a city, state or private institution or hospital who has knowledge of a case of latent tuberculosis infection (LTBI) as diagnosed by a tuberculin skin test performed with a purified protein derivative (PPD) antigen by the Mantoux method, or by any other diagnostic test approved for this purpose by the federal Food and Drug Administration, that results in a reaction that represents a positive test shall notify the Division of Tuberculosis Prevention with information regarding the name and address of the individual, date of birth, gender, size of the positive skin test or alternative test result, treatment initiated and information about risk of exposure to tuberculosis.

(C) The diseases listed below shall be reported directly to the Department by household members, physicians and other health care providers, laboratories and other officials designated by the Department, by telephone, in writing, by facsimile or other electronic means, as deemed acceptable by the Department. Each report shall be submitted no more than 24 hours after diagnosis or identification:

• Acquired immunodeficiency syndrome (AIDS)

• Chancroid

• Chlamydial infection (genital)

• Genital Warts

• Gonorrhea

• Granuloma inguinale

• Herpes simplex infection, neonatal (onset within 30 days after birth)

• Lymphogranuloma venereum

• Ophthalmia neonatorum caused by any agent

• Pelvic inflammatory disease of any etiology

• Syphilis

(D) Infection with Human Immunodeficiency Virus (HIV): HIV infection, as determined by a laboratory test diagnostic of HIV infection, shall be reported directly to the department of health care providers or other officials designated by the Department, in a form and manner designated by the Department, using a non-name reporting system. Each report of newly identified infection shall be submitted no more than 24 hours after diagnosis or identification.

(E) Work-Related Diseases and Injuries: The following work-related diseases and injuries are reportable directly to the Department by physicians and other health care providers in a manner approved by the Department no later than ten days after diagnosis or identification. Said report must include, as a minimum, the reporter's name and address; the patient's name, address, telephone number, age and sex; race, if known; the employer's name and location where the occupational exposure or injury reportably occurred; the diagnosis of the disease or description of the injury; the patient's occupation if known; and any other information as requested by the Department.

( 1 ) Occupational Lung Disease.

• Asbestosis

• Silicosis

• Beryllium Disease

• Chemical Pneumonitis

• Asthma caused by or aggravated by workplace exposures

( 2 ) Work-related Heavy Metal Absorption

• Mercury (blood > 15 mcg/L: urine > 35 mcg/grams creatinine)

• Cadmium (blood > 5 mcg/L: urine > five mcg/grams creatinine)

• Other

( 3 ) Work-related Acute Chemical Poisoning

• Carbon Monoxide Poisoning

• Pesticide Poisoning

• Other

( 4 ) Work-related Carpal Tunnel Syndrome

( F ) Reporting of Work-related Traumatic Injuries to a Person Less than 18 years of Age: Serious work-related traumatic injuries to persons less than 18 years of age shall be reported to the Department by the physician or other health care provider who treats the minor, within ten days after the physician or health care provider initially treats the injury. Physicians and other health care providers may report all work-related traumatic injuries to persons under 18 years of age.

Copyright Kern Augustine Conroy and Schoppmann, P.C. Used with permission.