Rhode Island Code of Regulations
Title 216 - Department of health
Chapter 30 - Infectious Diseases
Subchapter 05 - Infectious Diseases
Part 1 - Reporting and Testing of Infectious, Environmental, and Occupational Diseases
Section 216-RICR-30-05-1.5 - Timeframe, Methods, and Reportable Conditions

Current through April 6, 2022

1.5.1 Timeframes

A. The lists cited in § 1.5.3 of this Part pertain to individuals and facilities required to report pursuant to § 1.4.1 of this Part. Cases due to the diseases listed below shall be reported to the RIDOH within the timelines indicated. Reportable diseases are grouped as follows:
1. Immediately reportable diseases shall be reported within twenty-four (24) hours of recognition or strong suspicion of disease.

2. All other reportable conditions shall be reported within four (4) days of recognition or suspicion.

1.5.2 Methods

A. Case reports must be submitted on a RIDOH case report form as specified by the RIDOH website. The minimal information required when submitting a case report form includes: disease being reported, patient's full name, address, city, State, zip code, phone number, date of birth, gender, race and ethnicity, date of onset, and physicians' name and phone number.

B. Clinical laboratories, including those outside of Rhode Island, performing examinations on any specimens derived from Rhode Island residents that yield evidence of infection due to the diseases listed in § 1.5.3 of this Part shall report such evidence of infection directly to RIDOH.
1. Clinical laboratories shall submit specimens, isolate, or samples to RIDOH immediately upon request.

C. The minimal information required when submitting a laboratory report includes: a laboratory contact, test results, date of specimen collection, patient's full name, date of birth, sex, address, patient's phone number, and name of ordering health care provider.

D. Reporting methods include, but are not limited to the following:
1. Mail to: Rhode Island Department of Health, Division of Preparedness, Response, Infectious Diseases, and Emergency Medical Services, 3 Capitol Hill, Providence RI 02908-5097.

2. Fax to RIDOH using fax numbers on the reporting forms.

3. Telephone: Between 8:30 am - 4:30 pm (Monday - Friday): (401) 222-2577. For telephone reporting for immediately reportable diseases after hours call (401) 272-5952.

4. Electronic reporting of clinical and laboratory results to RIDOH.

5. Organizations that house reportable disease data must allow RIDOH to access the database for data mining from various data sources, including, but not limited to: electronic laboratory reports, medical records, health information exchange feeds, syndromic surveillance feeds, immunization and other disease registries, and billing data.

1.5.3 Reportable Disease and Conditions

A. For the conditions listed below, invasive disease must be confirmed by isolation from blood, cerebral spinal fluid, pericardial fluid, pleural fluid, peritoneal fluid, joint fluid, urine, or other normally sterile site.

B. Pregnant women with a reportable infectious disease listed in § 1.5.3 of this Part that can be transmitted to the unborn child or infant must be reported within four (4) days of recognition. For example, HIV, Zika, syphilis, Hepatitis B, Hepatitis C, rubella, etc.

C. If testing is positive for any of the reportable conditions listed below and is performed with a Culture Independent Diagnostic Test (CIDT), the laboratory must perform reflexive culture or transport the original specimen to another laboratory to perform culture. If the culture is positive, the isolate must be recovered and sent to the Rhode Island State Health Laboratories for those organisms as indicated in §§ 1.4.3(D) and (E) of this Part. Both positive and negative culture results must be reported to RIDOH.

D. Immediately Reportable Diseases and Conditions must be reported within twenty-four (24) hours.
1. Animal bites

2. Anthrax (Bacillus anthracis and Bacillus cereus biovar anthracis)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

3. Arboviral infections (e.g., West Nile, Eastern Equine Encephalitis, Powassan, Zika, Chikungunya, Yellow Fever)

4. Botulism (Clostridium botulinum)
a. Laboratories must submit the specimen to the Rhode Island State Health Laboratories.

5. Brucellosis (Brucella species)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

6. Cholera (Vibrio cholerae)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

7. Ciguatera

8. Clostridium perfringens epsilon toxin

9. Diphtheria (Corynebacterium diptheriae)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

10. Encephalitis (any infectious cause)

11. Glanders (Burkholderia mallei)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

12. Hantavirus (All species)

13. Hepatitis A
a. Laboratories must report aspartate aminotransferase (AST), alanine aminotransferase (ALT), and Bilirubin Total and Bilirubin Direct.

14. Measles (Rubeola)
a. Laboratories must submit the specimen to the Rhode Island State Health Laboratories.

15. Melioidosis (Burkholderia pseudomallei)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

16. Meningococcal Disease- invasive (Neisseria meningitidis)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

17. Novel or emerging respiratory viruses

18. Outbreaks and clusters as defined in § 1.5.4 of this Part

19. Paralytic shellfish poisoning

20. Plague (Yersinia pestis)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

21. Poliomyelitis (polio virus)

22. Q-Fever (Coxiella burnetii)
a. Laboratories must submit specimen to the Rhode Island State Health Laboratories.

23. Rabies (animal)
a. Laboratories must submit the animal to the Rhode Island State Health Laboratories.

24. Rabies (human)
a. Laboratories must submit specimen to the Rhode Island State Health Laboratories.

25. Ricin poisoning

26. SARS-CoV-2 (COVID-19)
a. Laboratories must submit specimen to the Rhode Island State Health Laboratories.

b. Any public or private entity administering an FDA-approved COVID- 19 test shall submit all results, including positive and negative results, promptly with RIDOH.

27. SARS-CoV-2 associated deaths

28. SARS-CoV-2 associated hospitalizations

29. Scombroid poisoning

30. Smallpox (Variola)
a. Laboratories must submit specimen to the Rhode Island State Health Laboratories.

31. Staphylococcal enterotoxin B poisoning

32. Staphylococcus aureus invasive infections: Vancomycin Resistant Staphylococcus aureus (VRSA) or Vancomycin Intermediate Staphylococcus aureus (VISA)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

33. Tularemia (Francisella tularensis)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

34. Typhoid fever (Salmonella typhi)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

35. Unexplained deaths (possibly due to unidentified infectious causes)

36. Vibriosis (all Vibrio species)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

37. Viral hemorrhagic fevers (Ebola, Lassa, Marburg, etc.)
a. Laboratories must submit specimen to the Rhode Island State Health Laboratories.

E. Other Reportable Conditions must be reported within four (4) days
1. Acute Flaccid Myelitis

2. Anaplasmosis (Anaplasma phagocytophilium)

3. Babesiosis (all species)

4. Campylobacteriosis (Campylobacter all species)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

5. Carbapenem-resistant Gram-negative bacteria
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

6. Chancroid (Haemophilus ducreyi)

7. Chlamydia trachomatis (genital and ophthalmic)

8. Coccidioidomycosis (Coccidioides immitis)

9. Cryptosporidiosis (Cryptosporidium all species)

10. Cyclosporiasis (Cyclospora cayetanensis)

11. Dengue virus

12. Ehrlichiosis (Ehrlichia chaffeensis)

13. Escherichia coli, Shiga toxin-producing (STEC)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

14. Giardiasis (Giardia lamblia)

15. Gonorrhea (Neisseria gonorrhoeae)

16. Granuloma Inguinale (Klebsiella granulomatis)

17. Haemophilus influenzae disease, all serotypes-invasive
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

18. Hansen's disease or Leprosy (Mycobacterium leprae)

19. Hemolytic uremic syndrome (HUS)

20. Hepatitis B, C, D, E, and unspecified viral hepatitis
a. Laboratories must report all positive results.

b. Laboratories must report aspartate aminotransferase (AST), alanine aminotransferase (ALT), and Bilirubin Total and Bilirubin Direct.

c. Physicians must report all acute Hepatitis cases.

d. Physicians must report pregnancy in a chronic Hepatitis B or Hepatitis C-positive woman using forms required by RIDOH.

21. Human Immunodeficiency Virus (HIV) 1 and 2 /Acquired Immunodeficiency Syndrome (AIDS)
a. Laboratories must report every CD4 cell count and HIV viral load test result performed on an HIV-positive individual.

b. Physicians must report pregnancy in an HIV-positive woman using forms required by RIDOH.

22. Influenza associated deaths

23. Influenza associated hospitalizations

24. Influenza novel virus infections
a. Laboratories much submit all unsubtypable Influenza A specimens to the Rhode Island State Health Laboratories.

25. Latent Tuberculosis Infection (LTBI) (Mycobacterium tuberculosis)

26. Legionellosis (Legionella pneumophila)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

27. Leptospirosis (Leptospira interrogans)

28. Listeriosis- invasive (Listeria monocytogenes)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

29. Lyme disease (Borrelia burgdorferi)

30. Lymphogranuloma Venereum (Chlamydia trachomatis)

31. Malaria (Plasmodium species)

32. Meningitis (aseptic, bacterial, viral, or fungal)

33. Multisystem Inflammatory Syndrome in Children (MIS-C)

34. Mumps (Paramyxovirus)
a. Laboratories must submit the specimen to the Rhode Island State Health Laboratories.

35. Ornithosis/Psittacosis (Chlamydophila psittaci)

36. Pelvic inflammatory disease (PID): all cases, based upon clinical diagnosis

37. Pertussis (Bordetella pertussis)

38. Pneumococcal Disease-invasive (Streptococcus pneumoniae)
a. Laboratories must submit an isolate to the RI State Health Laboratories for any individual less than five (5) years of age.

39. Rickettsiosis, including Rocky Mountain Spotted Fever (Rickettsia - all species)

40. Rubella (including congenital rubella)
a. Laboratories must submit the specimen to the Rhode Island State Health Laboratories.

41. Salmonellosis (Salmonella - all species)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

42. Shigellosis (Shigella - all species)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

43. Streptococcal Disease-Group A - invasive
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

44. Streptococcal Disease - Group B- invasive

45. Streptococcal Toxic Shock Syndrome (Streptococcus pyogenes)

46. Syphilis - all stages including neurosyphilis and congenital syphilis (Treponema pallidum)

47. Tetanus (Clostridium tetani)

48. Toxic Shock Syndrome (non-Streptococcal)

49. Transmissible spongiform encephalopathies (including Creutzfeldt Jakob Disease)

50. Trichinosis (Trichinella species)

51. Tuberculosis Disease (Mycobacterium tuberculosis)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

52. Varicella (Varicella-Zoster virus)

53. Yersiniosis (Yersinia enterocolitica)
a. Laboratories must submit isolate to the Rhode Island State Health Laboratories.

1.5.4 Reporting of Outbreaks

A. Any person or entity who is required to report and has knowledge of an outbreak of infectious disease or a cluster of unexplained illness, infectious or non-infectious, whether or not listed in these Regulations, shall immediately report the facts to RIDOH.

B. Outbreaks required to be reported include, but are not limited to:
1. Exotic diseases and unusual group expressions of illness which may be of public health concern.

2. A single case of a disease long absent from a population or the first invasion by a disease not previously recognized in that area.

3. Outbreaks or clusters identified by significant increases in the usual occurrence of the disease in the same area, among the specified population, at the same season of the year.

4. The occurrence of two (2) or more cases of a similar illness resulting from the ingestion of a common food or water source.

5. A cluster of similar illness in institutional settings, including but not limited to nursing homes, hospitals, schools, and day care centers.

6. A single case of rare and/or unusual diagnoses, including but not limited to avian influenza, smallpox, Ebola, SARS, Zika, Borrelia miyamotoi, Candida auris, or human rabies.

7. Outbreaks of unusual diseases or illness that may indicate acts of terrorism using biological agents, including but not limited to anthrax and botulism. See complete list of biological agents in § 1.7.2(A)(1) of this Part.

8. Any condition compatible with exposure to nuclear, radiological, or chemical substances, which could be indicative of radiological or chemical terrorism events.

9. Clusters of overdoses or adverse reactions to a drug, whether prescription or illicit.

216 R.I. Code R. § 216-RICR-30-05-1.5

Amended effective 1/3/2022
Amended effective 1/15/2022

This section was updated on 1/24/2022 by overlay.

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