topleft CSBA.org >  Services >  Governance Technology > 

Legal Resources | Code of Regulations, Title 17 |  T17  2505  

Chapter 4. Preventive Medical Service. Subchapter 1. Reportable Diseases and Conditions. Reporting (Refs & Annos). Notification by Laboratories.   

arrow Previous bar Next arrow

(a) To assist the local health officer, the laboratory director, or the laboratory director's designee, of a clinical laboratory, an approved public health laboratory or a veterinary laboratory in which a laboratory examination of any specimen derived from the human body (or from an animal, in the case of rabies or plague testing) yields microscopical, cultural, immunological, serological, or other evidence suggestive of those diseases listed in subsections (e)(1) and (e)(2) below, shall report such findings to the health officer of the local health jurisdiction where the health care provider who first submitted the specimen is located.

(1) For those diseases listed in subsection (e)(1), the report of such findings shall be made within one hour after the laboratory notifies the health care provider or other person authorized to receive the report. If the laboratory that makes the positive finding received the specimen from another laboratory, the laboratory making the positive finding shall notify the health officer of the jurisdiction in which the health care provider is located within one hour from the time the laboratory notifies the referring laboratory that submitted the specimen.

(2) For those diseases listed in subsection (e)(2), the report of such findings shall be made within one working day from the time that the laboratory notifies the health care provider or other person authorized to receive the report. If the laboratory that makes the positive finding received the specimen from another laboratory, the laboratory making the positive finding shall notify the health officer of the jurisdiction in which the health care provider is located within one working day from the time the laboratory notifies the referring laboratory that submitted the specimen.

(b) To permit local health officer follow-up of laboratory findings, all specimens submitted for laboratory tests or examinations related to a disease or condition listed in subsections 2505(e)(1) or 2502(e)(2) shall be accompanied by a test requisition which includes the name, gender, and age or date-of-birth of the person from whom the specimen was obtained and the name, address and telephone number of the health care provider or other authorized person who submitted the specimen. Whenever the specimen, or an isolate therefrom, is transferred between laboratories, a test requisition with the above patient and submitter information shall accompany the specimen. The laboratory that first receives a specimen shall be responsible for obtaining the patient and submitter information at the time the specimen is received by that laboratory.

(c) Each notification to the local health officer shall include the date the specimen was obtained, the patient identification number, the specimen accession number or other unique specimen identifier, the laboratory findings for the test performed, the date that any positive laboratory findings were identified, the name, gender, address, telephone number (if known) and age or date of birth of the person from whom the specimen was obtained, and the name, address, and telephone number of the health care provider for whom such examination or test was performed.

(d) The notification shall be submitted as specified in subsections (e)(1) and (e)(2) of this Section to the local health officer in the jurisdiction where the health care provider who submitted the specimen is located. When the specimen is from an out-of-state submitter, the state epidemiologist of the submitter shall be provided the same positive findings per subsections (e)(1) and (e)(2) of this Section. If the laboratory that finds evidence for any of those diseases listed in subsections (e)(1) and (e)(2) is an out-of-state laboratory, the California clinical laboratory that receives a report of such findings from the out-of-state laboratory shall notify the local health officer in the same way as if the finding had been made by the California laboratory.

(e) Laboratory reports to the local health officer shall include the information as specified in (c) of this Section and laboratories shall submit the reports within the following timeframes:

(1) The diseases or agents specified shall be reported within one hour after the health care provider or other person authorized to receive the report has been notified. Laboratories shall make the initial reports to the local health officer by telephone and follow the initial report within one working day by a report in writing submitted by electronic facsimile transmission or electronic mail to the local health officer. Within one year of the establishment of the state electronic reporting system, all List (e)(1) diseases, in addition to being reported by telephone within one hour, shall be reported electronically to the state electronic reporting system within one working day of identification. Reporting to the state electronic reporting system substitutes reporting by electronic facsimile transmission and electronic mail. Laboratory findings for these diseases are those that satisfy the most recent communicable disease surveillance case definitions established by the CDC (unless otherwise specified in this Section). The diseases or agents reported pursuant to this requirement are:

Anthrax, human (B. anthracis) (see section 2551 for additional reporting instructions)

Anthrax, animal (B. anthracis)

Botulism (see section 2552 for additional reporting instructions)

Brucellosis, human (all Brucella spp.) (see section 2553 for special reporting instructions)

Burkholderia pseudomallei and B. mallei (detection or isolation from a clinical specimen)

Influenza, novel strains (human) (see (i) for additional reporting requirements)

Plague, human (see section 2596 for additional reporting instructions)

Plague, animal

Smallpox (Variola) (see section 2614 for additional reporting instructions)

Tularemia, human (F. tularensis) (see section 2626 for additional reporting instructions)

Viral Hemorrhagic Fever agents, human (VHF), e.g., Crimean-Congo, Ebola, Lassa, and Marburg viruses (see section 2638 for additional reporting instructions)

Viral Hemorrhagic Fever agents, animal (VHF), e.g., Crimean-Congo, Ebola, Lassa, and Marburg viruses

(2) The diseases or agents specified shall be reported within one working day after the health care provider or other person authorized to receive the report has been notified. Laboratories shall transmit these reports to the local health officer by courier, mail, electronic facsimile or electronic mail. Within one year of the establishment of the state electronic reporting system, all List (e)(2) diseases shall be reported electronically to the state electronic reporting system within one working day of identification Reporting to the state electronic reporting system substitutes. reporting by courier, mail, electronic facsimile transmission or electronic mail. Laboratory findings for these diseases are those that satisfy the most recent communicable disease surveillance case definitions established by the CDC (unless otherwise specified in this Section). The diseases or agents reported pursuant to this requirement are:

Acid fast bacillus (AFB) (see (g) for additional reporting requirements)

Anaplasmosis/Ehrlichiosis

Bordetella pertussis acute infection, by culture or molecular identification

Borrelia burgdorferi infection

Brucellosis, animal (Brucella spp. except Brucella canis)

Campylobacteriosis (Campylobacter spp.) (detection or isolation a clinical specimen)

Chancroid (Haemophilus ducreyi)

Chlamydia trachomatis infections, including lymphogranuloma venereum (LGV)

Coccidioidomycosis

Cryptosporidiosis

Cyclosporiasis (Cyclospora cayetanensis)

Dengue (dengue virus)

Diphtheria

Encephalitis, arboviral

Escherichia coli: shiga toxin producing (STEC) including E. coli O157(see (l) for additional reporting requirements)

Giardiasis (Giardia lamblia, intestinalis, or duodenalis)

Gonorrhea

Haemophilus influenzae (report an incident of less than 15 years of age, sterile site)

Hantavirus Infections

Hepatitis A, acute infection

Hepatitis B, acute or chronic infection (specify gender)

Hepatitis C, acute or chronic infection

Hepatitis D (Delta), acute or chronic infection

Hepatitis E, acute infection (detection of hepatitis E virus RNA from a clinical specimen or positive serology)

Legionellosis (Legionella spp.) (antigen or culture)

Leprosy (Hansen Disease) (Mycobacterium leprae)

Leptospirosis (Leptospira spp.)

Listeriosis (Listeria) (see (l) for additional reporting requirements)

Malaria (see (h) for additional reporting requirements)

Measles (Rubeola), acute infection (see (l) for additional reporting requirements)

Mumps (mumps virus), acute infection

Mycobacterium tuberculosis (see (f) for additional reporting requirements)

Neisseria meningitidis (sterile site isolate) (see (l) for additional reporting requirements)

Poliovirus

Psittacosis (Chlamydophila psittaci)

Q Fever (Coxiella burnetii)

Rabies, animal or human

Relapsing Fever (Borrelia spp.) (identification of Borrelia spp. spirochetes on peripheral blood smear)

Rickettsia, any species, acute infection (detection from a clinical specimen or positive serology)

Rocky Mountain Spotted Fever (Rickettsia rickettsii)

Rubella, acute infection

Salmonellosis (Salmonella spp.) (see Section 2612 (a) for additional reporting requirements)

Shiga toxin (detected in feces) (see (l) for additional reporting requirements)

Shigellosis (Shigella spp.)

Syphilis

Trichinosis (Trichinella)

Tuberculosis

Tularemia, animal (F. tularensis)

Typhoid

Vibrio species infections

West Nile virus infection

Yellow Fever (yellow fever virus)

Yersiniosis (Yersinia spp., non-pestis) (isolation from a clinical specimen)

(f) In addition to notifying the local health officer pursuant to subsection (a), any clinical laboratory or approved public health laboratory that isolates Mycobacterium tuberculosis from a patient specimen shall:

(1) Submit a culture as soon as available from the primary isolate on which a diagnosis of tuberculosis was established. Such a culture shall be submitted to the public health laboratory designated in Title 17 California Code of Regulations, Section 1075 for the local jurisdiction where the health care provider's office is located. The following information shall be submitted with the culture: the name, address, and the date of birth of the person from whom the specimen was obtained, the patient identification number, the specimen accession number or other unique specimen identifier, the date the specimen was obtained from the patient, and the name, address, and telephone number of the health care provider for whom such examination or test was performed. The public health laboratory shall retain the culture received (one culture from each culture-positive patient) in a viable condition for at least six months.

(2) Unless drug susceptibility testing has been performed by the clinical laboratory on a strain obtained from the same patient within the previous three months or the health care provider who submitted the specimen for laboratory examination informs the laboratory that such drug susceptibility testing has been performed by another laboratory on a culture obtained from that patient within the previous three months, the clinical laboratory shall:

(A) Perform or refer for drug susceptibility testing on at least one isolate from each patient from whom Mycobacterium tuberculosis was isolated; and

(B) Report the results of drug susceptibility testing to the local health officer of the city or county where the submitting physician's office is located within one working day from the time the health care provider or other authorized person who submitted the specimen is notified; and

(C) If the drug susceptibility testing determines the culture to be resistant to at least isoniazid and rifampin, in addition, submit one culture or subculture from each patient from whom multidrug-resistant Mycobacterium tuberculosis was isolated to the official public health laboratory designated in Title 17 California Code of Regulations Section 1075 for the local health jurisdiction in which the health care provider's office is located. The local public health laboratory shall forward such cultures to the Department's Microbial Diseases Laboratory. The following information shall be submitted with the culture: the name, address, and the date of birth of the person from whom the specimen was obtained, the patient identification number, the specimen accession number or other unique specimen identifier, the date the specimen was obtained from the patient, and the name, address, and telephone number of the health care provider for whom such examination or test was performed.

(g) Whenever a clinical laboratory finds that a specimen from a patient with known or suspected tuberculosis tests positive for acid fast bacillus (AFB) staining and the patient has not had a culture which identifies that acid fast organism within the past 30 days, the clinical laboratory shall culture and identify the acid fast bacteria or refer a subculture to another laboratory for those purposes.

(h) In addition to notifying the local health officer pursuant to subsection (a), any clinical laboratory that makes a finding of malaria parasites in the blood film of a patient shall immediately submit one or more such blood film slides for confirmation to the public health laboratory designated in Title 17 California Code of Regulations Section 1075 for the local health jurisdiction where the health care provider is located. When requested, all blood films shall be returned to the submitter.

(i) Whenever a laboratory receives a specimen for the laboratory diagnosis of influenza, novel strains in a human such laboratory shall communicate immediately by telephone with the Department's Viral and Rickettsial Disease Laboratory for instruction.

(j) All laboratory notifications herein required are acquired in confidence and shall not be disclosed by the local health officer except (1) as authorized by these regulations; (2) as required by state or federal law; or (3) with the written consent of the individual to whom the information pertains or the legal representative of that individual.

(k) The local health officer shall disclose any information, including personal information, contained in a laboratory notification to state, federal or local public health officials in order to determine the existence of the disease, its likely cause and the measures necessary to stop its spread.

(l) A culture or a specimen as listed in this subsection shall be submitted as soon as available to the public health laboratory designated in Section 1075 for the local health jurisdiction where the health care provider is located. The following information shall be submitted with the culture or specimen: the name, address, and the date of birth of the person from whom the specimen or culture was obtained, the patient identification number, the specimen or culture accession number or other unique identifier, the date the specimen or culture was obtained from the patient, the name, address, and telephone number of the health care provider for whom such examination or test was performed, and the name, address, telephone number and the laboratory director's name of the laboratory that isolated the culture or specimen. The cultures or specimens pursuant to this requirement are:

Listeria monocytogenes isolates

Measles immunoglobulin M (IgM)-positive sera

Neisseria meningitidis isolates from sterile sites

Shiga toxin-positive fecal broths

Shiga toxin-producing Escherichia coli (STEC) O157 and non-O157 isolates

Authority cited:

Health and Safety Code 100275

Health and Safety Code 120130

Health and Safety Code 125095

Health and Safety Code 131050

Health and Safety Code 131051

Health and Safety Code 131052

Health and Safety Code 131080

Health and Safety Code 131200

Reference:

Health and Safety Code 100180

Health and Safety Code 120125

Health and Safety Code 120130

Health and Safety Code 120140

Health and Safety Code 120175

Health and Safety Code 120575

Health and Safety Code 121365

Health and Safety Code 125100

Health and Safety Code 131080

Business and Professions Code 1209

Business and Professions Code 1246.5

Business and Professions Code 1288

Evidence Code Cal. Const., art. 1, S1; and S1040

(Amended by Register 2013, No. 49.)