WSR 18-11-089
[Filed May 18, 2018, 2:30 p.m.]
Subject of Possible Rule Making: Chapter 246-101 WAC, Notifiable conditions, and WAC 246-100-011, communicable and certain other diseases definitions, the state board of health (board) and department of health (department) will consider adding notification and specimen submission requirements for "new conditions" and conditions currently identified as "other rare diseases of public health significance"; changing notification and specimen submission requirements for existing conditions; clarifying notification requirements for suspected cases; requiring electronic lab notification; revising reporting requirements for veterinarians and the Washington state department of agriculture; updating statutory references in the rules; updating references to the 2006 Security and Confidentiality Guidelines developed by the Centers for Disease Control and Prevention to the most recent publication; harmonizing definitions between WAC 246-100-011 and chapter 246-101 WAC; and improving clarity and usability.
Statutes Authorizing the Agency to Adopt Rules on this Subject: RCW 43.20.050, 70.104.055, and 43.70.545.
Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: The board and department will consider amending the rules to better protect public health by improving our understanding of emerging conditions, allowing more thorough case investigations, and improving the public health response to disease. The public health goals for these changes are to reduce the risk of disease transmission and prevent serious complications or fatalities. The board and department are considering adding the following "new conditions" to the rules as these pose significant public health risk:
Carbapenem-resistant Enterobacteriaceae (E.coli, Klebsiella species, and Enterobacter species)
MERS and other severe communicable coronavirus infections
Hantaviral infections (Andes virus, Bayou virus, Black Creek Canal virus, Dobrava-Belgrade virus, Haantan virus, Seoul virus, Sin Nombre virus)
Rickettsia prowazekii, Rickettsia typhi (typhus), and other nonspotted fever Rickettsia
B. cereus biovar anthracis
Candida auris
Fungal meningitis
Amoebic meningitis
Sleeping sickness
Chagas disease
Mycobacterium tuberculosis complex
Echinococcosis (Echinococcus granulosus or E. multilocularis)
Taeniasis/cysticercosis.(Taenia solium)
Occupational respiratory diseases
Inpatient hospitalizations associated with a workplace injury.
The board and department are also considering including reporting and specimen submission requirements for the following conditions currently identified in the rule as "other rare diseases of public health significance" to simplify and improve usability of the rules in order to increase reporting for these conditions:
Spotted fever rickettsiosis
Tick paralysis.
Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: The board has broad authority to establish rules for notifiable conditions and the department has authority to establish requirements for some notifiable conditions within chapter 246-101 WAC; therefore board and department staff will work in collaboration through joint rule making while developing the proposed rules. The department of agriculture has authority to develop conditional notification requirements for veterinarians. Board and department staff will consult will the department of agriculture while developing the proposed rules to ensure that all notification requirements for veterinarians in the state are harmonized.
Process for Developing New Rule: The board and department will use a collaborative rule-making process in developing the proposed rules. The board and department will consult with an advisory committee to receive recommendations for rule revision. The advisory committee will include members of the regulated community, related associations, local health jurisdictions, and other interested stakeholders. Once draft rules are prepared, the board and department will use a broader informal review and comment process to gather further input prior to the formal proposal of rules and public hearing.
Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Alexandra Montano, P.O. Box 47990, Olympia, WA 98504-7990, phone 360-236-4106, fax 360-236-4088, TTY 360-833-6388 or 711, email; or Vicki Bouvier, P.O. Box 47814, Olympia, WA 98504-7990 [98504-7814], phone 360-236-3011, TTY 360-833-6388 or 711, email
Additional comments: If you would like to be added to the listserv for this rule making email Alexandra.Montano@SBOH.WA.GOV with the subject line "Notifiable Conditions - Subscribe." For more information please view the web site at
May 18, 2018
Michelle A. Davis, MPA
State Board of Health
Executive Director
John Wiesman, DrPH, MPH
Secretary of Health