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(Effective until January 31, 2022)

PDFWAC 246-101-101

Notifiable conditions and the health care provider.

This section describes the conditions that Washington's health care providers must notify public health authorities of on a statewide basis. The board finds that the conditions in Table HC-1 of this section are notifiable for the prevention and control of communicable and noninfectious diseases and conditions in Washington.
(1) Principal health care providers shall notify public health authorities of the conditions identified in Table HC-1 of this section as individual case reports following the requirements in WAC 246-101-105, 246-101-110, 246-101-115, and 246-101-120.
(2) Other health care providers in attendance, other than the principal health care provider, shall notify public health authorities of the conditions identified in Table HC-1 of this section unless the condition notification has already been made.
(3) Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.
Table HC-1 (Conditions Notifiable by Health Care Providers)
Notifiable Condition
Time Frame for Notification
Notifiable to Local Health Department
Notifiable to State Department of Health
Acquired Immunodeficiency Syndrome (AIDS)
Within 3 business days
 
Animal Bites (when human exposure to rabies is suspected)
Immediately
 
Anthrax
Immediately
 
Arboviral Disease (acute disease only including, but not limited to, West Nile virus, eastern and western equine encephalitis, dengue, St. Louis encephalitis, La Crosse encephalitis, Japanese encephalitis, and Powassan)
Within 3 business days
 
Asthma, occupational
Monthly
 
Birth Defects - Autism Spectrum Disorders
Monthly
 
Birth Defects - Cerebral Palsy
Monthly
 
Birth Defects - Alcohol Related Birth Defects
Monthly
 
Botulism (foodborne, infant, and wound)
Immediately
 
Brucellosis (Brucella species)
Within 24 hours
 
Burkholderia mallei (Glanders) and pseudomallei (Melioidosis)
Immediately
 
Campylobacteriosis
Within 3 business days
 
Chancroid
Within 3 business days
 
Chlamydia trachomatis infection
Within 3 business days
 
Cholera
Immediately
 
Cryptosporidiosis
Within 3 business days
 
Cyclosporiasis
Within 3 business days
 
Diphtheria
Immediately
 
Disease of suspected bioterrorism origin
Immediately
 
Domoic acid poisoning
Immediately
 
E. coli - Refer to "Shiga toxin-producing E. coli"
Immediately
 
Emerging condition with outbreak potential
Immediately
 
Giardiasis
Within 3 business days
 
Gonorrhea
Within 3 business days
 
Granuloma inguinale
Within 3 business days
 
Haemophilus influenzae (invasive disease, children under age 5)
Immediately
 
Hantavirus pulmonary syndrome
Within 24 hours
 
Hepatitis A (acute infection)
Within 24 hours
 
Hepatitis B (acute infection)
Within 24 hours
 
Hepatitis B surface antigen + pregnant women
Within 3 business days
 
Hepatitis B (chronic infection) - Initial diagnosis, and previously unreported prevalent cases
Monthly
 
Hepatitis C (acute infection)
Within 3 business days
 
Hepatitis C (chronic infection)
Monthly
 
Hepatitis D (acute and chronic infection)
Within 3 business days
 
Hepatitis E (acute infection)
Within 24 hours
 
Herpes simplex, neonatal and genital (initial infection only)
Within 3 business days
 
Human immunodeficiency virus (HIV) infection
Within 3 business days
 
Influenza, novel or unsubtypable strain
Immediately
 
Influenza-associated death (lab confirmed)
Within 3 business days
 
Legionellosis
Within 24 hours
 
Leptospirosis
Within 24 hours
 
Listeriosis
Within 24 hours
 
Lyme Disease
Within 3 business days
 
Lymphogranuloma venereum
Within 3 business days
 
Malaria
Within 3 business days
 
Measles (rubeola) - Acute disease only
Immediately
 
Meningococcal disease (invasive)
Immediately
 
Monkeypox
Immediately
 
Mumps (acute disease only)
Within 24 hours
 
Outbreaks of suspected foodborne origin
Immediately
 
Outbreaks of suspected waterborne origin
Immediately
 
Paralytic shellfish poisoning
Immediately
 
Pertussis
Within 24 hours
 
Pesticide poisoning (hospitalized, fatal, or cluster)
Immediately
 
Pesticide poisoning (all other)
Within 3 business days
 
Plague
Immediately
 
Poliomyelitis
Immediately
 
Prion disease
Within 3 business days
 
Psittacosis
Within 24 hours
 
Q Fever
Within 24 hours
 
Rabies (Confirmed Human or Animal)
Immediately
 
Rabies, suspected human exposure (suspected human rabies exposures due to a bite from or other exposure to an animal that is suspected of being infected with rabies)
Immediately
 
Relapsing fever (borreliosis)
Within 24 hours
 
Rubella (including congenital rubella syndrome) (acute disease only)
Immediately
 
Salmonellosis
Within 24 hours
 
SARS
Immediately
 
Serious adverse reactions to immunizations
Within 3 business days
 
Shiga toxin-producing E. coli infections (enterohemorrhagic E. coli including, but not limited to, E. coli O157:H7)
Immediately
 
Shigellosis
Within 24 hours
 
Smallpox
Immediately
 
Syphilis
Within 3 business days
 
Tetanus
Within 3 business days
 
Trichinosis
Within 3 business days
 
Tuberculosis
Immediately
 
Tularemia
Immediately
 
Vaccinia transmission
Immediately
 
Vancomycin-resistant Staphylococcus aureus (not to include vancomycin-intermediate)
Within 24 hours
 
Varicella-associated death
Within 3 business days
 
Vibriosis
Within 24 hours
 
Viral hemorrhagic fever
Immediately
 
Yellow fever
Immediately
 
Yersiniosis
Within 24 hours
 
Other rare diseases of public health significance
Within 24 hours
 
Unexplained critical illness or death
Within 24 hours
 
 
(√) Indicates which agency should receive case and suspected case reports.
[Statutory Authority: RCW 43.20.050. WSR 11-02-065, § 246-101-101, filed 1/4/11, effective 2/4/11. Statutory Authority: RCW 43.20.050, 70.24.125. WSR 05-03-055, § 246-101-101, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 70.24.125 and 70.28.010. WSR 00-23-120, § 246-101-101, filed 11/22/00, effective 12/23/00.]
(Effective January 31, 2022)

PDFWAC 246-101-101

Notifiable conditionsHealth care providers and health care facilities.

(1) For the purposes of this section:
(a) "Local health jurisdiction" means where the patient resides, or, in the event the patient's residence cannot be determined, the local health jurisdiction in which the patient received treatment.
(b) "Unexplained critical illness or death" means a severe illness or death with infectious hallmarks, but no known etiology, in a previously healthy person one to forty-nine years of age excluding those with chronic medical conditions such as malignancy, diabetes, AIDS, or cirrhosis.
(2) The conditions identified in Table HC-1 are notifiable to public health authorities under this table and this chapter.
Table HC-1 (Conditions Notifiable by Health Care Providers and Health Care Facilities)
Notifiable Condition (Agent)
Laboratory Confirmation Required Before Submitting Case Report
Time Frame for Notification from Identification of a Case
Who Must Be Notified
Who Must Report: Health Care Providers (Providers) or Health Care Facilities (Facilities)
Acquired immunodeficiency syndrome (AIDS)
 
Within 3 business days
DOH (for facilities) and LHJ (for providers)
Both
Amebic meningitis
 
Immediately
LHJ
Both
Anaplasmosis
 
Within 3 business days
LHJ
Both
Anthrax (Bacillus anthracis and confirmed Bacillus cereus biovar anthracis only - Do not report all Bacillus cereus)
Yes
Immediately
LHJ
Both
Arboviral disease (acute disease only) including, but not limited to:
     Chikungunya
     Dengue
     Eastern and western equine
        encephalitis
     Japanese encephalitis
     La Crosse encephalitis
     Powassan virus infection
     St. Louis encephalitis
     West Nile virus infection
     Zika virus infection
See also "Yellow fever"
 
Within 3 business days
LHJ
Both
Asthma, occupational
 
Within 30 days
Washington state department of labor and industries (L&I)
Both
Babesiosis
 
Within 3 business days
LHJ
Both
Baylisascariasis
 
Within 24 hours
LHJ
Both
Birth defects - Abdominal wall defects (inclusive of gastroschisis and omphalocele)
 
Within 30 days
DOH
Facilities
Birth defects - Autism spectrum disorders
 
Within 30 days
DOH
Both
Birth defects - Cerebral palsy
 
Within 30 days
DOH
Both
Birth defects - Down syndrome
 
Within 30 days
DOH
Facilities
Birth defects - Alcohol related birth defects
 
Within 30 days
DOH
Both
Birth defects - Hypospadias
 
Within 30 days
DOH
Facilities
Birth defects - Limb reductions
 
Within 30 days
DOH
Facilities
Birth defects - Neural tube defects (inclusive of anencephaly and spina bifida)
 
Within 30 days
DOH
Facilities
Birth defects - Oral clefts (inclusive of cleft lip with/without cleft palate)
 
Within 30 days
DOH
Facilities
Blood lead level
RST results
(See WAC 246-101-200)
 
Providers and facilities performing blood lead level RST shall report as a laboratory and comply with the requirements of WAC 246-101-201 through 246-101-230.
Botulism, foodborne, infant, and wound
 
Immediately
LHJ
Both
Brucellosis
 
Within 24 hours
LHJ
Both
Campylobacteriosis
 
Within 3 business days
LHJ
Both
Cancer (See chapter 246-102 WAC)
 
 
 
 
Candida auris infection or colonization
 
Within 24 hours
LHJ
Both
Carbapenem-resistant Enterobacteriaceae infections limited to:
     Klebsiella species
     E. coli
     Enterobacter species
Yes
Within 3 business days
LHJ
Both
Chagas disease
 
Within 3 business days
LHJ
Both
Chancroid
 
Within 3 business days
LHJ
Both
Chlamydia trachomatis infection
Yes
Within 3 business days
LHJ
Both
Cholera (Vibrio cholerae O1 or O139)
Yes
Immediately
LHJ
Both
Coccidioidomycosis
 
Within 3 business days
LHJ
Both
Coronavirus infection (severe communicable)
     SARS-associated coronavirus
     MERS-associated coronavirus
     Novel coronavirus (COVID-19)
Yes
Immediately
LHJ
Both
Coronavirus infection (severe communicable)
     Novel coronavirus (COVID-19)
RST results
(See WAC 246-101-200)
 
Providers and facilities performing Novel coronavirus (COVID-19) RST shall report as a laboratory and comply with the requirements of WAC 246-101-201 through 246-101-230.
Cryptococcus gattii or undifferentiated Cryptococcus species (i.e., Cryptococcus not identified as C. neoformans)
Yes
Within 3 business days
LHJ
Both
Cryptosporidiosis
 
Within 3 business days
LHJ
Both
Cyclosporiasis
 
Within 3 business days
LHJ
Both
Cysticercosis
 
Within 3 business days
LHJ
Both
Diphtheria
 
Immediately
LHJ
Both
Domoic acid poisoning
 
Immediately
LHJ
Both
E. coli (See "Shiga toxin-producing E. coli")
 
 
 
 
Echinococcosis
 
Within 3 business days
LHJ
Both
Ehrlichiosis
 
Within 3 business days
LHJ
Both
Giardiasis
 
Within 3 business days
LHJ
Both
Glanders (Burkholderia mallei)
Yes
Immediately
LHJ
Both
Gonorrhea
 
Within 3 business days
LHJ
Both
Granuloma inguinale
 
Within 3 business days
LHJ
Both
Gunshot wounds (nonfatal)
 
Within 30 days
DOH
Facilities
Haemophilus influenzae (invasive disease, children under 5 years of age)
Yes
Immediately
LHJ
Both
Hantaviral infection
 
Within 24 hours
LHJ
Both
Hepatitis A (acute infection)
Yes
Within 24 hours
LHJ
Both
Hepatitis B (acute infection)
Yes
Within 24 hours
LHJ
Both
Hepatitis B, report pregnancy in hepatitis B virus infected patients (including carriers)
Yes
Within 3 business days
LHJ
Both
Hepatitis B (chronic infection) - Initial diagnosis, and previously unreported prevalent cases
Yes
Within 3 business days
LHJ
Both
Hepatitis B (perinatal) - Initial diagnosis, and previously unreported cases
Yes
Within 3 business days
LHJ
Both
Hepatitis C (acute infection)
Yes
Within 24 hours
LHJ
Both
Hepatitis C (acute infection)
RST results
(See WAC 246-101-200)
 
Providers and facilities performing hepatitis C (acute infection) RST shall report as a laboratory and comply with the requirements of WAC 246-101-201 through 246-101-230.
Hepatitis C (chronic infection)
Yes
Within 3 business days
LHJ
Both
Hepatitis C (perinatal) - Initial diagnosis, and previously unreported cases
Yes
Within 24 hours
LHJ
Both
Hepatitis C (chronic infection)
RST results
(See WAC 246-101-200)
 
Providers and facilities performing hepatitis C (chronic infection) RST shall report as a laboratory and comply with the requirements of WAC 246-101-201 through 246-101-230.
Hepatitis D (acute and chronic infection)
Yes
Within 24 hours
LHJ
Both
Hepatitis E (acute infection)
Yes
Within 24 hours
LHJ
Both
Herpes simplex, neonatal and genital (initial infection only)
 
Within 3 business days
LHJ
Providers
Histoplasmosis
 
Within 3 business days
LHJ
Both
Human immunodeficiency virus (HIV) infection
 
Within 3 business days
LHJ
Both
Human immunodeficiency virus (HIV) infection
RST results
(See WAC 246-101-200)
 
Providers and facilities performing HIV infection RST shall report as a laboratory and comply with the requirements of WAC 246-101-201 through 246-101-230.
Human prion disease
 
Within 3 business days
LHJ
Both
Hypersensitivity pneumonitis, occupational
 
Within 30 days
L&I
Both
Influenza, novel or unsubtypable strain
 
Immediately
LHJ
Both
Influenza-associated death (laboratory confirmed)
Yes
Within 3 business days
LHJ
Both
Legionellosis
 
Within 24 hours
LHJ
Both
Leptospirosis
 
Within 24 hours
LHJ
Both
Listeriosis
 
Within 24 hours
LHJ
Both
Lyme disease
 
Within 3 business days
LHJ
Both
Lymphogranuloma venereum
 
Within 3 business days
LHJ
Both
Malaria
 
Within 3 business days
LHJ
Both
Measles (rubeola) - Acute disease only
 
Immediately
LHJ
Both
Melioidosis (Burkholderia pseudomallei)
Yes
Immediately
LHJ
Both
Meningococcal disease, invasive
 
Immediately
LHJ
Both
Monkeypox
 
Immediately
LHJ
Both
Mumps, acute disease only
 
Within 24 hours
LHJ
Both
Outbreaks and suspected outbreaks
 
Immediately
LHJ
Both
Paralytic shellfish poisoning
 
Immediately
LHJ
Both
Pertussis
 
Within 24 hours
LHJ
Both
Pesticide poisoning (hospitalized, fatal, or cluster)
 
Immediately
DOH
Both
Pesticide poisoning (all other)
 
Within 3 business days
DOH
Both
Plague
 
Immediately
LHJ
Both
Poliomyelitis
 
Immediately
LHJ
Both
Pregnancy in patient with hepatitis B virus
 
See "Hepatitis B, report pregnancy in hepatitis B virus infected patients (including carriers)"
Psittacosis
 
Within 24 hours
LHJ
Both
Q fever
 
Within 24 hours
LHJ
Both
Rabies (suspect or laboratory confirmed human cases and laboratory confirmed animal cases)
Yes for animal cases
Immediately
LHJ
Both
Rabies, suspected human exposure (suspected human rabies exposures due to a bite from or other exposure to an animal that is suspected of being infected with rabies)
 
Immediately
LHJ
Both
Relapsing fever (borreliosis)
 
Within 3 business days
LHJ
Both
Rickettsia infection
 
Within 3 business days
LHJ
Both
Rubella, acute disease only (including congenital rubella syndrome)
 
Immediately
LHJ
Both
Salmonellosis
 
Within 24 hours
LHJ
Both
Serious adverse reactions to immunizations
 
Within 3 business days
LHJ
Both
Shiga toxin-producing E. coli (STEC) infections/enterohemorrhagic E. coli infections
Yes
Immediately
LHJ
Both
Shigellosis
 
Within 24 hours
LHJ
Both
Silicosis
 
Within 30 days
L&I
Both
Smallpox
 
Immediately
LHJ
Both
Syphilis
 
Within 3 business days
LHJ
Both
Taeniasis
 
Within 3 business days
LHJ
Both
Tetanus
 
Within 3 business days
LHJ
Both
Tick paralysis
 
Within 3 business days
LHJ
Both
Trichinosis
 
Within 3 business days
LHJ
Both
Tuberculosis disease (confirmed or highly suspicious, i.e., initiation of empiric treatment)
 
Within 24 hours
LHJ
Both
Tularemia
 
Immediately
LHJ
Both
Typhus
 
Within 3 business days
LHJ
Both
Vaccinia transmission
 
Immediately
LHJ
Both
Vancomycin-resistant Staphylococcus aureus (not to include vancomycin-intermediate)
Yes
Within 24 hours
LHJ
Both
Varicella-associated death
 
Within 3 business days
LHJ
Both
Vibriosis (Vibrio species not including Vibrio cholerae O1 or O139)
See Cholera (Vibrio cholerae O1 or O139)
Yes
Within 24 hours
LHJ
Both
Viral hemorrhagic fever
 
Immediately
LHJ
Both
Yellow fever
 
Immediately
LHJ
Both
Yersiniosis
 
Within 24 hours
LHJ
Both
Unexplained critical illness or death
 
Within 24 hours
LHJ
Both
[Statutory Authority: RCW 43.20.050, 70.28.032, 70.104.055, 43.70.545, and 70.24.130. WSR 21-11-040, § 246-101-101, filed 5/12/21, effective 1/31/22. Statutory Authority: RCW 43.20.050. WSR 11-02-065, § 246-101-101, filed 1/4/11, effective 2/4/11. Statutory Authority: RCW 43.20.050, 70.24.125. WSR 05-03-055, § 246-101-101, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 70.24.125 and 70.28.010. WSR 00-23-120, § 246-101-101, filed 11/22/00, effective 12/23/00.]
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