10.06.01.03

.03 Reportable Diseases, Conditions, Outbreaks, and Unusual Manifestations; Submitting Clinical Materials.

A. A person, as set forth in Regulation .04 of this chapter, shall report the diseases or conditions listed in §C of this regulation, or any other condition as requested by the Secretary.

B. Upon a positive laboratory finding for a disease or condition listed in §C of this regulation, or upon request of the Secretary, the director of a medical laboratory or a laboratory that possesses a biological agent as defined in COMAR 10.10.11.03B(8) shall:

(1) Submit clinical material to the Department's public health laboratory; and

(2) Include information about the clinical material on a form provided by the Secretary.

C. List of Reportable Diseases and Conditions.

HEALTH CARE PROVIDERS,
INSTITUTIONS, AND OTHERS1
LABORATORIES TIME FRAME FOR REPORTING2
Diseases and Conditions Laboratory Evidence of Submit Clinical
Materials to the
Department3
Immediate Within 1 Working Day
(1) An outbreak of a disease of known or unknown etiology that may be a danger to the public health4 Similar etiological agents from a grouping or clustering of patients X
(2) A single case of a disease or condition not otherwise included in this table of known or unknown etiology, that may be a danger to the public health An etiologic agent suspected to cause that disease or condition X
(3) An unusual manifestation of a communicable disease in an individual An etiologic agent suspected to cause that disease X
(3-1) An exposure or potential exposure of a person to a biological agent as defined in COMAR 10.10.11.03B(8) An exposure or potential exposure of a person to a biological agent as defined in COMAR 10.10.11.03B(8)   X
(4) Acquired immunodeficiency syndrome (AIDS)6 Refer to COMAR 10.18 Refer to COMAR 10.18
(5) Amebiasis Entamoeba histolytica X
(6) Anaplasmosis Anaplasma phagocytophilum   X
(7) Animal bites Not Applicable X
(8) Anthrax Bacillus anthracis X X
(9) Arboviral infections including, but not limited to:
     (a) Dengue fever;
     (b) Eastern equine encephalitis;
     (c) LaCrosse virus infection;
     (d) St. Louis encephalitis;
     (e) Western equine encephalitis;
     (f) West Nile virus infection;
     (g) Yellow fever
Any associated arbovirus including, but not limited to:
     (a) Dengue virus;
     (b) Eastern equine encephalitis virus;
     (c) LaCrosse virus;
     (d) St. Louis encephalitis virus;
     (e) Western equine encephalitis virus;
     (f) West Nile virus;
     (g) Yellow fever virus
X X
(10) Babesiosis Babesia species X
(11) Botulism Clostridium botulinum, botulinum toxin, or other botulism producing Clostridia X X
(12) Brucellosis Brucella species X X
(13) Campylobacteriosis Campylobacter species X X
(14) Chancroid Haemophilus ducreyi X
(15) Chlamydia trachomatis infection, including lymphogranuloma venereum (LGV) Chlamydia trachomatis X (if LGV strain) X
(16) Cholera Vibrio cholerae X X
(17) Coccidioidomycosis Coccidioides immitis X
(18) Creutzfeldt-Jakob disease 14-3-3 protein from CSF or any brain pathology suggestive of CJD X
(19) Cryptosporidiosis Cryptosporidium species X
(20) Cyclosporiasis Cyclospora cayatensis X
(21) Diphtheria Corynebacterium diphtheriae X X
(22) Ehrlichiosis Ehrlichia species X
(23) Encephalitis, infectious Isolation from or demonstration in brain tissue, central nervous system tissue, or cerebrospinal fluid, of any pathogenic organism X (Infectious agents as indicated elsewhere in §C of this regulation and viral agents except for HSV) X
(24) Epsilon toxin of Clostridium perfringens Clostridium perfringens, epsilon toxin X
(25) Escherichia coli O157:H7 infection Escherichia coli O157:H7 X X
(26) Giardiasis Giardia species X
(27) Glanders Burkholderia mallei X X
(28) Gonococcal infection Neisseria gonorrhoeae X
(29) Haemophilus influenzae invasive disease Haemophilus influenzae, isolated from a normally sterile site X X
(30) Hantavirus infection Hantavirus X X
(31) Harmful algal bloom related illness Not Applicable X
(32) Hemolytic uremic syndrome, post-diarrheal Not Applicable X
(33) Hepatitis A acute infection Hepatitis A virus IgM X
(34) Hepatitis, viral (B, C5, D, E, G, all other types, and undetermined) Hepatitis B, C5, D, E, and G virus, other types X
(35) Human immunodeficiency virus (HIV)6 Refer to COMAR 10.18 Refer to COMAR 10.18
(36) Influenza- associated pediatric mortality Influenza virus-associated pediatric mortality in persons younger than 18 years old (if known) X
(37) Influenza: novel influenza A virus infection Isolation of influenza virus from humans of a novel or pandemic strain X X
(38) Isosporiasis Cystoisospora belli (synonym Isospora belli) X
(39) Kawasaki syndrome Not Applicable X
(40) Legionellosis Legionella species X (if isolate from human) X
(41) Leprosy Mycobacterium leprae X X
(42) Leptospirosis Leptospira interrogans X X
(43) Listeriosis Listeria monocytogenes X X
(44) Lyme disease Borrelia burgdorferi X
(45) Malaria Plasmodium species X X
(46) Measles (rubeola) Measles virus X
(47) Melioidosis Burkholderia pseudomallei X X
(48) Meningitis, infectious Isolation or demonstration of any bacterial, fungal, or viral species in cerebrospinal fluid X (Infectious agents as indicated elsewhere in §C of this regulation and viral agents except for HSV) X
(49) Meningococcal invasive disease Neisseria meningitidis (including serogroup, if known), isolated from a normally sterile site X X
(50) Microsporidiosis Various microsporidian protozoa, including but not limited to Encephalitozoon species X
(51) Mumps (infectious parotitis) Mumps virus X
(52) Mycobacteriosis, other than tuberculosis and leprosy Mycobacterium species, other than Mycobacterium tuberculosis complex or Mycobacterium leprae X
(53) Pertussis Bordetella pertussis X
(54) Pertussis vaccine adverse reactions Not Applicable X
(55) Pesticide related illness Cholinesterase below the normal laboratory range X
(56) Plague Yersinia pestis X X
(57) Pneumonia in a health care worker resulting in hospitalization Various organisms X
(58) Poliomyelitis Poliovirus X X
(59) Psittacosis Chlamydophila psittaci (formerly Chlamydia psittaci) X
(60) Q fever Coxiella burnetii X X
(61) Rabies (human) Rabies virus X
(62) Ricin toxin poisoning Ricin toxin (from Ricinus communis castor beans) X
(63) Rocky Mountain spotted fever Rickettsia rickettsii X
(64) Rubella (German measles) and congenital rubella syndrome Rubella virus X
(65) Salmonellosis (nontyphoidal) Salmonella species, including serogroup, if known X X
(66) Severe acute respiratory syndrome (SARS) SARS-associated coronavirus (SARS-CoV) X X
(67) Shiga-like toxin producing enteric bacterial infections Shiga toxin, shiga-like toxin, or the toxin-producing bacterium X X
(68) Shigellosis Shigella species, including species or serogroup, if known X X
(69) Smallpox and other orthopoxvirus infections Variola virus, vaccinia virus, and other orthopox viruses X X
(70) Staphylococcal enterotoxin B poisoning Staphylococcus enterotoxin B X
(71) Streptococcal invasive disease, Group A Streptococcus pyogenes, Group A, isolated from a normally sterile site X X
(72) Streptococcal invasive disease, Group B Streptococcus agalactiae, Group B, isolated from a normally sterile site X X
(73) Streptococcus pneumoniae invasive disease Streptococcus pneumoniae, isolated from a normally sterile site X X
(74) Syphilis7 Treponema pallidum7 X
(75) Tetanus Clostridium tetani X
(76) Trichinosis Trichinella spiralis X
(77) Tuberculosis, active disease and suspected active tuberculosis8 Mycobacterium tuberculosis complex8 X X
(77-1) Tuberculosis, latent infection (LTBI)9 Mycobacterium tuberculosis complex, latent infection9 X
(78) Tularemia Francisella tularensis X X
(79) Typhoid or Paratyphoid fever (case, carrier, or both, of Salmonella Typhi or Paratyphi) Salmonella Typhi X X
(80) Vancomycin-intermediate Staphylococcus aureus (VISA) infection or colonization Intermediate resistance of the S. aureus isolate to vancomycin X X
(81) Vancomycin-resistant Staphylococcus aureus (VRSA) infection or colonization Resistance of the S. aureus isolate to vancomycin X X
(82) Varicella (chicken pox), fatal cases only Varicella-zoster virus (Human herpesvirus 3) X
(83) Vibriosis, non-cholera10 All non-cholera Vibrio species10 X X
(84) Viral hemorrhagic fevers (all types) All hemorrhagic fever viruses, including but not limited to Crimean-Congo, Ebola, Marburg, Lassa, Machupo viruses X
(85) Yersiniosis Yersinia species X X

Footnotes:

1. As required to report in Regulation .04A(1)—(3), (5), and (6) of this chapter.

2. The time frame for reporting is specified in Regulation .04C of this chapter.

3. Clinical material shall be submitted according to §B of this regulation.

4. Any grouping or clustering of patients having similar disease, symptoms, or syndromes that may indicate the presence of a disease outbreak.

5. Suspected hepatitis C as indicated by:

(a) Any hepatitis C antibody results that are positive;

(b) Any hepatitis C virus RNA results associated with the results in (a) of this footnote that are qualitative or quantitative, if the results are:

(i) Positive; or

(ii) Negative; and

(c) Any hepatitis C virus RNA results associated with the results in (a) of this footnote if the hepatitis C virus is:

(i) Detected; or

(ii) Undetected.

6. Acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV), including CD4+ lymphocyte count and viral load, are reportable under COMAR 10.18.

7. Suspected syphilis as indicated by:

(a) Any treponemal or non-treponemal results that are qualitative or quantitative, if the results are:

(i) Positive;

(ii) Reactive; or

(iii) Inconclusive; and

(b) Any negative or non-reactive results associated with the positive, reactive, or inconclusive results in (a) of this footnote.

8. Tuberculosis confirmed by culture and suspected tuberculosis as indicated by:

(a) A laboratory confirmed acid-fast bacillus on smear;

(b) An abnormal chest radiograph suggestive of active tuberculosis;

(c) A laboratory confirmed biopsy report consistent with active tuberculosis; or

(d) Initiation of two or more anti-tuberculosis medications.

9. Latent tuberculosis infection as indicated when:

(a) There is a positive result on an Interferon Gamma Release Assay, Tuberculin Skin Test, or any other test indicating tuberculosis infection; and

(b) Active or suspected tuberculosis has been ruled out.

10. Vibriosis, non-cholera, identified in any specimen taken from teeth, gingival tissues, or oral mucosa is not reportable.