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 20-20.080 - Duties of Laboratories

(1) The director, person in charge of any laboratory, or designee of the director or person in charge of any laboratory shall report to the local health authority or the Missouri Department of Health and Senior Services the result of any test that is positive for, or suggestive of, any disease or condition listed in 19 CSR 20-20.020. These reports shall be made according to the time and manner specified for each disease or condition following completion of the test and shall designate the test performed, all results of the test, including numeric results, if applicable, units of measure of the results, and reference ranges for normal and abnormal results, the name and address of the attending physician, the name of the disease or condition diagnosed or suspected, the date the test results were obtained, the name and home address (with zip code) of the patient and the patient's age, date of birth, sex, race, and ethnicity.

(2) In reporting findings for diseases or conditions listed in 19 CSR 20-20.020, laboratories shall report-

Arsenic-results of all biological specimens including time frame of urine specimen collection, if applicable;

Cadmium-results of all biological specimens including time frame of urine specimen collection, if applicable;

Carboxyhemoglobin proportion-all results;

Chemical/pesticide (blood or serum)-all results, including if none detected;

Lead level-results of all biological specimens;

Mercury-results of all biological specimens including time frame of urine specimen collection, if applicable; and

Methemoglobin proportion-all results.

(3) Isolates or specimens positive for the following reportable diseases or conditions must be submitted to the State Public Health Laboratory for epidemiological or confirmation purposes:

Anthrax (Bacillus anthracis)

Cholera (Vibrio cholerae)

Diphtheria (Corynebacterium diphtheriae)

Escherichia coli O157:H7

Glanders (Burkholderia mallei)

Haemophilus influenzae, invasive disease

Influenza Virus-associated mortality

Listeriosis

Malaria (Plasmodium species)

Measles (rubeola)

Melioidosis (Burkholderia pseudomallei)

Mycobacterium tuberculosis

Neisseria meningitidis, invasive disease

Orthopoxvirus (smallpox/cowpox-vaccinia/monkeypox)

Other Shiga Toxin positive organisms

Pertussis (Bordetella pertussis)

Plague (Yersinia pestis)

Salmonella species

Severe Acute Respiratory Syndrome-associated Coronavirus (SARS-CoV) disease

Shigella species

Tularemia (Francisella tularensis)

Potential Vancomycin Resistant Staphylococcus aureus (VRSA), with MIC greater than or equal to eight (>= 8)

(4) Every laboratory performing culture and sensitivity testing on human specimens in Missouri for health care facilities shall annually report these results to the Missouri Department of Health and Senior Services (MDHSS) for each facility provided this service. The data submitted should be in the format of antibiograms as defined by the Clinical and Laboratory Standards Institute (CLSI), M39-A2, Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data. Only data from the first unique isolate from each patient should be included. Duplicate cultures must be excluded when compiling these antibiograms. The antibiograms for the preceding year are to be sent to MDHSS by July 1 of the following year

(ex: 2006 data, January 1, 2006-December 31, 2006, will be due on July 1, 2007).