Communicable Disease Reporting

WHY REPORT?

We wish that reporting of notifiable diseases was as much a reflex for providers as carrying a stethoscope. We know, unfortunately, that it is not true. Some providers do not know what to report. Some think reporting is voluntary. In fact, it is the law. Some physicians are concerned about confidentiality. Local, state and federal law strictly protect all reports. Other providers wonder "why bother when the lab (or the hospital) is going to report anyway?" But that is often not true. While laboratory reporting is critical, not all notifiable diseases are diagnosed by laboratory criteria, and not all patients with notifiable diseases are hospitalized. In any event, laboratory reports do not provide the clinical and demographic information needed for disease control and prevention, planning and research. For that we depend on the provider. We hope you will join in the effort against communicable diseases by your example of prompt reporting.

A Few Good Reasons To Report
How To Report
The Law
Notifiable Diseases
Available Assistance
Communicable Disease Websites

SYPHILIS-A LOCAL EPIDEMIC

Nashville is in the midst of a syphilis epidemic. While rates nationwide are below 3 per 100,000, Davidson County's rate is nearly 40 per 100,000. This puts Metro in the top five for syphilis in the country. This is based on cities with populations over 200,000. There is a nationwide effort underway, led by the Centers for Disease Control and Prevention (CDC), to eliminate this disease by 2005. But unlike measles, smallpox and polio, there is no vaccine for syphilis. Elimination depends on detection, reporting and treatment of existing cases, and prevention of new cases.

LOCAL EFFORTS LEAD THE WAY

The Metro Health Department took early and aggressive action to fight this epidemic. The STD Free! Initiative began in 1998 to attack this disease through coalitions of government, professional, and community representatives. Program goals include increased testing, reporting, and contact tracing of syphilis cases. In addition to educating policy makers and the community, STD Free! Targets nurses, physicians, clinics and medical students, stressing the importance of testing and reporting in both public and private practice.

THE COST OF SYPHILIS

Syphilis costs the United States nearly $1 billion annually in direct and indirect costs. It at least doubles the risk of HIV transmission, thus increasing the social and financial costs associated with the AIDS epidemic. Syphilis also has a drastic impact on infant health and racial health disparities: nearly 80 percent of national cases are among African Americans, and in Nashville, over 90 percent.

WHY NOW?

Because of the 7- to 10-year disease cycle and the lowest nationwide rates ever, now is the perfect time to eliminate syphilis. The tight clustering of active syphilis enhances local efforts-half of all new cases in 1998 were reported in 1 percent of US counties. But despite local and national attention, the number of syphilis cases in Nashville continues to increase. To reverse this trend and beat this disease it is essential that nurses, physicians, clinics and hospitals increase their syphilis screening among high-risk patients and report all cases of syphilis to the Metro Health Departments' Central Reporting System. To report, call (615) 340-5632 of fax a Notifiable Case Report to (615) 340-2114. Local, state and federal laws protect all reports. For more information on treatment of syphilis, call (615) 340-5695.

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HOW TO REPORT

In order to simplify the reporting process and address the needs of your busy practice we have developed a CENTRAL REPORTING SYSTEM. This provides one phone and fax number available to your office 24 hours a day, 365 a year to report notifiable diseases.

CENTRAL REPORTING TELEPHONE NUMBER:   (615) 340-5632

CENTRAL FAX NUMBER:    (615) 340-2114

REPORTING REQUIREMENTS:

·Send a copy of the laboratory work.

·Use the Notifiable Disease Case

·Report Form PH-1600 for Hospitals, Physicians and Laboratories and indicate the disease code, patient name, address, race, sex, and date of birth. You can obtain these forms by calling the reporting number.

·Phone or fax the report to the Central Reporting number.

·Be timely.

-Immediately report those diseases designated on the notifiable disease list.
-Follow all telephone reports with a written report using the Case Report form.
-Report all other notifiable diseases weekly.
-Report influenza by number of cases only.
-Report chickenpox by number of deaths only.

Reporters with an existing procedure for reporting notifiable diseases to Metropolitan Health Department may continue to use the established procedure. Please review the procedure to ensure that it:

1. Reports all notifiable diseases.
2. Reports in a timely manner.
3. Does not depend on a laboratory as a substitute reporter.

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THE LAW

1. Whenever any physician examines or treats any person known or suspected by him to be affected with any of the diseases or conditions declared to be notifiable by these regulations, he shall give notice of such disease as follows: For diseases for which immediate telephone reporting is required, he shall telephone as soon as possible and no later than twelve hours. To the local health department in the county, district or region in which such physician practices or to the Tennessee Department of Health and Environment, giving the name, age, sex, race, address of the patient and the name of the known or suspected disease or conditions.

2. For all of the diseases and conditions listed (including those for which telephonic communication is required), written notification using forms provided by the Department or other suitable means shall be made each week to the local health department in the county, district or region in which the physician practices or to the Tennessee Department of Health and Environment, giving the name, age, sex, race and address of the patient and the name of the known or suspected disease or condition. The following shall be reported only by number of cases, influenza, chickenpox, aseptic meningitis, and nongonococcal urethritis.

3. For diseases for which a confidential report is required, the person reporting must enclose the information in an opaque envelope for mailing and must not use a post card reporting method.

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NOTIFIABLE DISEASES

The diseases and conditions listed below are declared to be communicable and/or dangerous to the public and are to be reported to the local health department by all hospitals, physicians, laboratories, and other persons knowing of or suspecting a case in accordance with the provision of the statues and regulations governing the control of communicable diseases in Tennessee.

Category 1: Immediate telephonic reporting required followed with a written report using PH-1600, copy of lab slip:

Category 2: Only written report using form PH-1600 required and copy of lab slip:

Category 3: Requires special confidential reporting to designated health department personnel:

Acquired Immunodeficiency Syndrome (AIDS)
Human Immunodeficiency Virus (HIV)

Category 4: Laboratories required to report all blood lead test results meeting criteria:

Lead Poisoning (blood lead levels > 10ug/dl for children 0-72 months of age)

PLEASE SEND A COPY OF THE LAB WITH THE PH-1600 FORM.

TO REPORT: FAX: 615-340-2114-Central Reporting, Metro Health Department

POSSIBLE BIOTERRORISM INDICATORS

Anthrax
Plague
Venezuelan Equine Encephalitis
Smallpox
Botulism
Q Fever
Staph Enterotoxin B pulmonary poisoning
Viral Hemorrhagic Fever
Brucellosis
Ricin Poisoning
Tularemia

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AVAILABLE ASSISTANCE

The persons listed below will be available to answer questions related to disease, treatment guidelines, and prevention:

LOCAL HEALTH DEPARTMENT CENTERS:

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COMMUNICABLE DISEASE WEBSITES

The following CDC websites provide access to updated disease information, educational materials (in various languages), and links to other pertinent sites.

Tuberculosis
http://www.cdc.gov/nchstp/tb

Communicable Disease (includes Sexually Transmitted Diseases)
http://www.cdc.gov

Immunizations
www.cdc.gov/nip
or www.immunize.org

If you would like a copy of the current case definitions (both clinical and diagnostic) for all Notifiable Diseases, this can be downloaded from: http://www2cdc.gov/mmwr site, click on search and enter "Case Definitions for Infectious Conditions Under Public Health Surveillance."