WSR 09-13-043

EMERGENCY RULES

DEPARTMENT OF HEALTH


[ Filed June 11, 2009, 10:03 a.m. , effective June 11, 2009, 10:03 a.m. ]


Effective Date of Rule: Immediately.

Purpose: The purpose of the rule is to obtain immediately from health care providers and health care facilities notification of cases and suspected cases caused by novel influenza A (H1N1) resulting in hospitalization or death. This information will allow for the monitoring of hospitalizations as opposed to monitoring all illnesses due to influenza and will identify periods when epidemic flu "thresholds" are exceeded. In addition, such a system will identify groups at-risk for serious illness in order to prioritize their vaccination in any influenza vaccination programs in the coming 2009-2010 influenza season.

Citation of Existing Rules Affected by this Order: Amending WAC 246-101-101 and 246-101-301.

Statutory Authority for Adoption: RCW 43.20.050.

Other Authority: WAC 246-101-015(4).

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

Reasons for this Finding: Observing the time requirements of the regular rule-making process would impede the department's ability to track, respond and understand the novel influenza A (H1N1) virus before the upcoming 2009-2010 influenza season. It is necessary to obtain this information to identify groups at-risk for serious illness in order to prioritize their vaccination in any influenza vaccination programs. For this reason, immediate adoption of this rule is necessary to protect the public health.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 2, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 2, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.

Date Adopted: June 2, 2009.

Mary C. Selecky

Secretary

OTS-2429.1


AMENDATORY SECTION(Amending WSR 05-03-055, filed 1/11/05, effective 2/11/05)

WAC 246-101-101   Notifiable conditions and the health care provider.   This section describes the conditions that Washington's health care providers must notify public health authorities of on a statewide basis. The board finds that the conditions in the table below (Table HC-1) are notifiable for the prevention and control of communicable and noninfectious diseases and conditions in Washington. Principal health care providers shall notify public health authorities of these conditions as individual case reports using procedures described throughout this chapter. Other health care providers in attendance shall notify public health authorities of the following notifiable conditions, unless the condition notification has already been made. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.

WAC 246-101-105, 246-101-110, 246-101-115, and 246-101-120 also include requirements for how notifications shall be made, when they shall be made, the content of these notifications, and how information regarding notifiable conditions cases must be handled and may be disclosed.


Table HC-1 (Conditions Notifiable by Health Care Providers)


Notifiable Condition Time Frame for Notification Notifiable to Local Health Department Notifiable to State Department of Health
Acquired Immunodeficiency Syndrome (AIDS) Within 3 work days
Animal Bites Immediately
Arboviral Disease Within 3 work days
Asthma, occupational Monthly
Birth Defects Autism Spectrum Disorders Monthly
Birth Defects Cerebral Palsy Monthly
Birth Defects Alcohol Related Birth Defects Monthly
Botulism (foodborne, infant, and wound) Immediately
Brucellosis (Brucella species) Immediately
Campylobacteriosis Within 3 work days
Chancroid Within 3 work days
Chlamydia trachomatis infection Within 3 work days
Cholera Immediately
Cryptosporidiosis Within 3 work days
Cyclosporiasis Within 3 work days
Diphtheria Immediately
Disease of suspected bioterrorism origin (including):

Anthrax

Smallpox

Immediately
Disease of suspected foodborne origin (communicable disease clusters only) Immediately
Disease of suspected waterborne origin (communicable disease clusters only) Immediately
Enterohemorrhagic E. coli (shiga-like toxin producing infections only) such as E. coli O157:H7 Infection Immediately
Giardiasis Within 3 work days
Gonorrhea Within 3 work days
Granuloma inguinale Within 3 work days
Haemophilus influenzae (invasive disease, children under age 5) Immediately
Hantavirus pulmonary syndrome Within 3 work days
Hemolytic uremic syndrome Immediately
Hepatitis A (acute infection) Immediately
Hepatitis B (acute infection) Within 3 work days
Hepatitis B surface antigen + pregnant women Within 3 work days
Hepatitis B (chronic) Initial diagnosis, and previously unreported prevalent cases Monthly
Hepatitis C Acute and chronic Monthly
Hepatitis (infectious), unspecified Within 3 work days
Herpes simplex, neonatal and genital (initial infection only) Within 3 work days
Human immunodeficiency virus (HIV) infection Within 3 work days
Legionellosis Within 3 work days
Leptospirosis Within 3 work days
Listeriosis Immediately
Lyme Disease Within 3 work days
Lymphogranuloma venereum Within 3 work days
Malaria Within 3 work days
Measles (rubeola) Immediately
Meningococcal disease Immediately
Mumps Within 3 work days
Novel influenza A (HlNl) (hospitalized or fatal only) Immediately
Paralytic shellfish poisoning Immediately
Pertussis Immediately
Pesticide poisoning (hospitalized, fatal, or cluster) Immediately
Pesticide poisoning (all other) Within 3 work days
Plague Immediately
Poliomyelitis Immediately
Psittacosis Within 3 work days
Q Fever Within 3 work days
Rabies (Confirmed Human or Animal) Immediately
Rabies (Including use of post-exposure prophylaxis) Within 3 work days
Relapsing fever (borreliosis) Immediately
Rubella (including congenital rubella syndrome) Immediately
Salmonellosis Immediately
Serious adverse reactions to immunizations Within 3 work days
Shigellosis Immediately
Syphilis Within 3 work days
Tetanus Within 3 work days
Trichinosis Within 3 work days
Tuberculosis Immediately
Tularemia Within 3 work days
Typhus Immediately
Vibriosis Within 3 work days
Yellow fever Immediately
Yersiniosis Within 3 work days
Other rare diseases of public health significance Immediately
Unexplained critical illness or death Immediately

[Statutory Authority: RCW 43.20.050, 70.24.125. 05-03-055, 246-101-101, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 70.24.125 and 70.28.010. 00-23-120, 246-101-101, filed 11/22/00, effective 12/23/00.]


AMENDATORY SECTION(Amending WSR 05-03-055, filed 1/11/05, effective 2/11/05)

WAC 246-101-301   Notifiable conditions and health care facilities.   This section describes the conditions that Washington's health care facilities must notify public health authorities of on a statewide basis. The board finds that the conditions in the table below (Table HF-1) are notifiable for the prevention and control of communicable and noninfectious diseases and conditions. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction. Health care facilities are required to notify public health authorities of cases that occur in their facilities. Health care facilities may choose to assume the notification for their health care providers for conditions designated in Table HF-1. Health care facilities may not assume the reporting requirements of laboratories that are components of the health care facility. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.

WAC 246-101-305, 246-101-310, 246-101-315, and 246-101-320 also include requirements for how notifications shall be made, when they are made, the content of these notifications, and how information regarding notifiable conditions cases must be handled and may be disclosed.


Table HF-1 (Conditions Notifiable by Health Care Facilities)


Notifiable Condition Time Frame for Notification Notifiable to Local Health Department Notifiable to State Department of Health
Acquired Immunodeficiency Syndrome (AIDS) Within 3 work days
Animal Bites Immediately
Arboviral Disease Within 3 work days
Asthma, occupational Monthly
Birth Defects Abdominal Wall Defects (inclusive of gastroschisis and omphalocele) Monthly
Birth Defects Autism Spectrum Disorders Monthly
Birth Defects Cerebral Palsy Monthly
Birth Defects Down Syndrome Monthly
Birth Defects Alcohol Related Birth Defects Monthly
Birth Defects Hypospadias Monthly
Birth Defects Limb reductions Monthly
Birth Defects Neural Tube Defects (inclusive of anencephaly and spina bifida) Monthly
Birth Defects Oral Clefts (inclusive of cleft lip with/without cleft palate) Monthly
Botulism (foodborne, infant, and wound) Immediately
Brucellosis (Brucella species) Immediately
Cancer (See chapter 246-430 WAC) Monthly
Chancroid Within 3 work days
Chlamydia trachomatis infection Within 3 work days
Cholera Immediately
Cryptosporidiosis Within 3 work days
Cyclosporiasis Within 3 work days
Diphtheria Immediately
Disease of suspected bioterrorism origin (including):

Anthrax

Smallpox

Immediately
Disease of suspected foodborne origin (communicable disease clusters only) Immediately
Disease of suspected waterborne origin (communicable disease clusters only) Immediately
Enterohemorrhagic E. coli (shiga-like toxin producing infections only) such as E. coli O157:H7 Infection Immediately
Giardiasis Within 3 work days
Gonorrhea Within 3 work days
Granuloma inguinale Within 3 work days
Gunshot wounds (nonfatal) Monthly
Haemophilus influenzae (invasive disease, children under age 5) Immediately
Hantavirus pulmonary syndrome Within 3 work days
Hemolytic uremic syndrome Immediately
Hepatitis A (acute infection) Immediately
Hepatitis B (acute infection) Within 3 work days
Hepatitis B surface antigen + pregnant women Within 3 work days
Hepatitis B (chronic) Initial diagnosis, and previously unreported prevalent cases Monthly
Hepatitis C Acute and chronic Monthly
Hepatitis (infectious), unspecified Within 3 work days
Human immunodeficiency virus (HIV) infection Within 3 work days
Legionellosis Within 3 work days
Leptospirosis Within 3 work days
Listeriosis Immediately
Lyme Disease Within 3 work days
Lymphogranuloma venereum Within 3 work days
Malaria Within 3 work days
Measles (rubeola) Immediately
Meningococcal disease Immediately
Mumps Within 3 work days
Novel influenza A (HlNl) (hospitalized or fatal only) Immediately
Paralytic shellfish poisoning Immediately
Pertussis Immediately
Pesticide poisoning (hospitalized, fatal, or cluster) Immediately
Plague Immediately
Poliomyelitis Immediately
Psittacosis Within 3 work days
Q Fever Within 3 work days
Rabies (Confirmed Human or Animal) Immediately
Rabies (Use of post-exposure prophylaxis) Within 3 work days
Relapsing fever (borreliosis) Immediately
Rubella (including congenital rubella syndrome) Immediately
Salmonellosis Immediately
Serious adverse reactions to immunizations Within 3 work days
Shigellosis Immediately
Syphilis Within 3 work days
Tetanus Within 3 work days
Trichinosis Within 3 work days
Tuberculosis Immediately
Tularemia Within 3 work days
Typhus Immediately
Vibriosis Within 3 work days
Yellow fever Immediately
Yersiniosis Within 3 work days
Other rare diseases of public health significance Immediately
Unexplained critical illness or death Immediately

[Statutory Authority: RCW 43.20.050, 70.24.125. 05-03-055, 246-101-301, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 43.70.545, 70.24.125, 70.28.010 and 70.104.030. 00-23-120, 246-101-301, filed 11/22/00, effective 12/23/00.]

Washington State Code Reviser's Office