Missouri Code of State Regulations
Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES
Division 20 - Division of Community and Public Health
Chapter 20 - Communicable Diseases
Section 19 CSR 20-20.020 - Reporting Infectious, Contagious, Communicable, or Dangerous Diseases

(1) The diseases within the immediately reportable disease category pose a risk to national security because they: can be easily disseminated or transmitted from person to person; result in high mortality rates and have the potential for major public health impact; might cause public panic and social disruption; and require special action for public health preparedness. Immediately reportable diseases or findings shall be reported to the local health authority or to the Department of Health and Senior Services immediately upon knowledge or suspicion by telephone (1 (800) 392-0272), facsimile, or other rapid communication. Immediately reportable diseases or findings are-

(2) Reportable within one (1) day, diseases or findings shall be reported to the local health authority or to the Department of Health and Senior Services within one (1) calendar day of first knowledge or suspicion by telephone, facsimile, or other rapid communication. Reportable within one (1) day, diseases or findings are-

(3) Reportable within three (3) days diseases or findings shall be reported to the local health authority or the Department of Health and Senior Services within three (3) calendar days of first knowledge or suspicion. These diseases or findings are-

Acquired immunodeficiency syndrome (AIDS)/Human immunodeficiency virus (HIV) infection, Stage 3

Babesiosis

California serogroup virus neuroinvasive disease

California serogroup virus non-neuroinvasive disease

Campylobacteriosis

Carbon monoxide exposure

CD4+ T cell count and percent

Chancroid

Chemical poisoning, acute, as defined in the most current ATSDR CERCLA Priority List of Hazardous Substances; if terrorism is suspected, refer to subsection (1)(B)

Chlamydia trachomatis, infections

Coccidioidomycosis

Creutzfeldt-Jakob disease

Cryptosporidiosis

Cyclosporiasis

Eastern equine encephalitis virus neuroinvasive disease

Eastern equine encephalitis virus non-neuroinvasive disease

Ehrlichiosis/Anaplasmosis (Ehrlichia chaffeensis infection, Ehrlichia ewingii infection, Anaplasma phagocytophilum infection, and Ehrlichiosis/Anaplasmosis, human, undetermined)

Giardiasis

Gonorrhea

Hansen's disease (Leprosy)

Heavy metal poisoning including, but not limited to, arsenic, cadmium, and mercury

Hepatitis B, acute

Hepatitis B, chronic

Hepatitis B surface antigen (prenatal HBsAg) in pregnant women

Hepatitis B Virus Infection, perinatal (HBsAg positivity in any infant aged equal to or less than twenty-four (<=24) months who was born to an HBsAg-positive mother)

Hepatitis C, acute

Hepatitis C, chronic

Human immunodeficiency virus (HIV) infection, exposed newborn infant (i.e., newborn infant whose mother is infected with HIV)

Human immunodeficiency virus (HIV) infection, including any test or series of tests used for the diagnosis or periodic monitoring of HIV infection. For series of tests which indicate HIV infection, all test results in the series (both positive and negative) must be reported.

Human immunodeficiency virus (HIV) infection, including any negative, undetectable, or indeterminate test or series of tests used for the diagnosis or periodic monitoring of HIV infection conducted within one hundred eighty (180) days prior to the test result used for diagnosis of HIV infection

Human immunodeficiency virus (HIV) infection, pregnancy in newly identified or pre-existing HIV positive women

Human immunodeficiency virus (HIV) infection, test results (including both positive and negative results) for children less than two (2) years of age whose mothers are infected with HIV

Human immunodeficiency virus (HIV) infection, viral load measurement (including undetectable results)

Hyperthermia

Hypothermia

Lead (blood) level less than forty-five micrograms per deciliter (<45 µg/dl) in any person

Leptospirosis

Listeriosis

Lyme disease

Malaria

Methemoglobinemia, environmentally induced

Mumps

Non-tuberculosis mycobacteria (NTM)

Occupational lung diseases including silicosis, asbestosis, byssinosis, farmer's lung, and toxic organic dust syndrome

Pesticide poisoning

Powassan virus neuroinvasive disease

Powassan virus non-neuroinvasive disease

Psittacosis

Rabies Post-Exposure Prophylaxis (Initiated)

Respiratory diseases triggered by environmental contaminants including environmentally or occupationally induced asthma and bronchitis

Rickettsiosis, Spotted Fever

Saint Louis encephalitis/virus neuroinvasive disease

Saint Louis encephalitis virus non-neuroinvasive disease

Salmonellosis

Streptococcus pneumoniae, Invasive disease (IPD-Invasive Pneumococcal Disease)

Streptococcal toxic shock syndrome (STSS)

Toxic shock syndrome, non-streptococcal

Trichinellosis

Tuberculosis infection

Varicella (Chickenpox)

Varicella deaths

Vibriosis (non-cholera Vibrio species infections)

West Nile virus neuroinvasive disease

West Nile virus non-neuroinvasive disease

Western equine encephalitis virus neuroinvasive disease

Western equine encephalitis virus non-neuroinvasive disease

Yersiniosis.

(4) Reportable weekly diseases or findings shall be reported directly to the Department of Health and Senior Services weekly. These diseases or findings are:

Influenza, laboratory-confirmed

(5) Reportable quarterly diseases or findings shall be reported directly to the Department of Health and Senior Services quarterly. These diseases or findings are-

Carbapenem-resistant enterobacteriaceae (CRE), nosocomial

Methicillin-resistant Staphylococcus aureus (MRSA), nosocomial

Vancomycin-resistant enterococci (VRE), nosocomial.

(6) A physician, physician's assistant, nurse, hospital, clinic, or other private or public institution providing diagnostic testing, screening or care to any person with any disease, condition or finding listed in sections (1)-(4) of this rule or who is suspected of having any of these diseases, conditions or findings, shall make a case report to the local health authority or the Department of Health and Senior Services, or cause a case report to be made by their designee, within the specified time.

(7) Except for influenza, laboratory-confirmed and Varicella (Chickenpox); a case report as required in section (6) of this rule shall include the patient's name, home address with zip code, date of birth, age, sex, race, home phone number, name of disease, condition or finding diagnosed or suspected, the date of onset of the illness, name and address of the treating facility (if any) and the attending physician, any appropriate laboratory results, name and address of the reporter, treatment information for sexually transmitted diseases, and the date of report.

(8) Any person in charge of a public or private school, summer camp or child or adult care facility shall report to the local health authority or the Department of Health and Senior Services the presence or suspected presence of any diseases or findings listed in sections (1)-(4) of this rule according to the specified time frames.

(9) All local health authorities shall forward to the Department of Health and Senior Services reports of all diseases or findings listed in sections (1)-(4) of this rule. All reports shall be forwarded according to procedures established by the Department of Health and Senior Services director as listed in sections (1)-(4). Reports will be forwarded immediately if a terrorist event is suspected or confirmed. The local health authority shall retain from the original report any information necessary to carry out the required duties in 19 CSR 20-20.040(2) and (3).

(10) Information from patient medical records received by local public health agencies or the Department of Health and Senior Services in compliance with this rule is to be considered confidential records and not public records.

(11) Reporters specified in section (6) of this rule will not be held liable for reports made in good faith in compliance with this rule.

(12) The following material is incorporated into this rule by reference:

(13) Each hospital and ambulatory surgical center shall report on a quarterly basis antibiogram data for infection, not colonization, from all body sites monitored by that health care facility. Antibiogram data to be reported shall include nosocomial methicillin sensitive Staphylococcus aureus (S. aureus), nosocomial S. aureus, nosocomial vancomycin sensitive enterococci, and nosocomial enterococci isolates. Data shall be reported directly to the Department of Health and Senior Services. Reporting shall include only a patient's first diagnostic nosocomial isolate per admission of Staphylococcus aureus (S. aureus) and enterococci and the isolates corresponding methicillin or vancomycin sensitivity; irrespective of location or of other antimicrobial sensitivity(ies). Intermediate methicillin or vancomycin sensitivity shall be reported as resistant (i.e., methicillin resistant Staphylococcus aureus (MRSA) or vancomycinresistant enterococci (VRE), respectively).