Statutes, codes, and regulations
Vermont Administrative Code
Agency 13 - AGENCY OF HUMAN SERVICESSubagency 140 - DEPARTMENT OF HEALTH
Chapter 007 - SUBCHAPTER 1 REPORTABLE AND COMMUNICABLE DISEASES RULE
Section 13 140 007 - SUBCHAPTER 1 REPORTABLE AND COMMUNICABLE DISEASES RULE

13-007 Code Vt. R. 13-140-007-X

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Current through August, 2024
Section 13 140 007 - SUBCHAPTER 1 REPORTABLE AND COMMUNICABLE DISEASES RULE
Section 1.0 Authority.

These regulations are pursuant to 18 V.S.A. §§ 102 and 1001 and 3 V.S.A. § 3003, 20 V.S.A. § 3801, and 13 V.S.A. § 3504(h).

Section 2.0 Purpose.

The purpose of these regulations is to protect public health through the control of communicable and dangerous diseases. These regulations require the early and prompt reporting of listed diseases so that the Department of Health may take any necessary protective action.

Section 3.0 Definitions.
3.1 "Commissioner" means the Commissioner of Health.
3.2 "Communicable disease" or "communicable syndrome" means an illness due to the infectious agent or its toxic products which is transmitted directly or indirectly to a person from an infected person or animal, host, or vector, or through the inanimate environment.
3.3 "Department" means the Vermont Department of Health
3.4 "Electronic laboratory reporting" means the transmission of a reportable laboratory finding and associated required report elements from the reporting entity to the Department in a structured format, including but not limited to HL7 messaging, flat file, and web-based entry.
3.5 "Laboratory" means a facility performing testing that identifies a reportable finding as defined in this rule, including but not limited to point-of-care testing, in-clinic testing, hospital laboratory testing, and reference laboratory testing.
3.6 "Subject species" means any mammal species which may carry and potentially serve as a reservoir species for rabies including but not limited to raccoons, foxes, bats, skunks, woodchucks, and domestic animals.
Section 4.0 Confidentiality Requirements.
4.1 Any person or entity required to report under this rule must have written policies and procedures in place that ensure the confidentiality of the records. Such policies and procedures must, at a minimum, include the following:
4.1.1 Identification of those positions/individuals who are authorized to have access to confidential disease-reporting information and the limits placed upon their access;
4.1.2 A mechanism to assure that the confidentiality policies and procedures are understood affected staff;
4.1.3 Process for training staff in the confidential handling of records;
4.1.4 A quality assurance plan to monitor compliance and to institute corrective action when necessary;
4.1.5 Process for the confidential handling of all electronically-stored records;
4.1.6 Process for authorizing the release of confidential records; and
4.1.7 Provision for annual review and revision of confidentiality policies and procedures.
4.2 In relation to the reporting of HIV and AIDS, the Department shall maintain the following:
4.2.1 Procedures for ensuring the physical security of reports including procedures for personnel training and responsibilities for handling physical reports and data;
4.2.2 Computer security procedures;
4.2.3 Communication procedures;
4.2.4 Procedures for the release of data; and
4.2.5 4.2.5 Procedures to ensure that a disclosure of information from the confidential public health record is made consistent with 18 V.S.A. § 1001(b).
Section 5.0 Reporting Requirements for Both Diseases and Laboratory Findings.
5.1 Persons Required to Report Reportable Diseases and Laboratory Findings
5.1.1 The professionals listed below are required to report all diseases and laboratory findings, listed in Section 6.3 and Section 7.3, to the Department of Health. Professionals employed at nonmedical community- based organizations are exempt from these requirements. The following are required reporters:
5.1.1.1 Infection preventionists;
5.1.1.2 Laboratory directors;
5.1.1.3 Nurse practitioners;
5.1.1.4 Nurses;
5.1.1.5 Physician assistants;
5.1.1.6 Physicians;
5.1.1.7 School health officials;
5.1.1.8 Administrators of long-term care and assisted living facilities;
5.1.1.9 Pharmacists; and
5.1.1.10 Any other health care provider, as defined by 18 V.S.A § 9402.
5.1.2 Required reporters listed in Section 5.1.1 shall report all suspected and confirmed diseases listed in Section 6.3, Table 1: Diseases, Syndromes, and Treatments Required to be Reported (Table 1), and in Section 7.3, Table 2: Laboratory Findings Required to be Reported (Table 2), unless otherwise specified in Table 1 and Table 2.
5.1.3 Required reporters listed in Section 5.1.1 shall report all positive, presumptive positive, confirmed, isolated, or detected cases found by laboratory tests listed in Table 1 and Table 2, unless otherwise specified in Table 1 and Table 2.
5.1.4 Diseases, syndromes, treatments, and laboratory findings denoted with an asterisk (*) shall be reported to the Department immediately, by telephone.
5.2 Additional Reporting Requirements for Diseases and Laboratory Findings
5.2.1 The following are additional reporting requirements that shall be reported to the Department, within 24 hours, following the requirements listed in Section 6.1 and Section 7.1, for the surveillance of any infectious agents, outbreaks, epidemics, related public health hazard, or act of bioterrorism:
5.2.1.1 Any single unusual occurrence of a communicable disease of a major public health concern;
5.2.1.2 Any single unusual occurrence of a laboratory finding of a major public health concern; or
5.2.1.3 Any unexpected pattern or cluster of cases, suspected cases, or deaths from a disease or laboratory finding of a major public health concern.
Section 6.0 Communicable Disease Reports.
6.1 Content of Report
6.1.1 The report of communicable diseases, and other dangerous and rare infectious diseases listed in Section 6.3, Table 1, shall include the following information as it relates to the affected person:
6.1.1.1 Name;
6.1.1.2 Date of birth;
6.1.1.3 Age;
6.1.1.4 Sex;
6.1.1.5 Race;
6.1.1.6 Ethnicity;
6.1.1.7 Address;
6.1.1.8 Telephone number;
6.1.1.9 Name of health care provider/physician;
6.1.1.10 Address of health care provider/physician;
6.1.1.11 Name of disease being reported;
6.1.1.12 Date of onset of the disease;
6.1.1.13 Clinical assessment of signs and symptoms relevant to the disease or syndrome, if requested;
6.1.1.14 Laboratory and diagnostic results relevant to the disease or syndrome, if requested; and
6.1.1.15 Any other information deemed pertinent by the reporter.
6.2 How to Report Diseases, Syndromes, and Treatments
6.2.1 The report shall be made by telephone, in writing, or electronically within 24 hours to the Department, unless denoted by an asterisk (*).
6.2.2 Diseases, syndromes, treatments, and laboratory findings denoted with an asterisk (*), shall be reported to the Department immediately, by telephone.
6.2.3 HIV and AIDS reports shall be made on the Adult HIV/AIDS Confidential Case Report Form or the Pediatric HIV/AIDS Confidential Case Report Form, as appropriate.
6.3 Diseases, Syndromes, and Treatments Required to be Reported
6.3.1 Table 1 is a list of all reportable diseases, syndromes, and treatments.
6.3.1.1 Diseases, syndromes, treatments, and laboratory findings denoted with an asterisk (*) shall be reported to the Department immediately, by telephone:

Table 1: Diseases, Syndromes, and Treatments Required to be Reported

Diseases, Syndromes, and Treatments

Reportable Laboratory Findings

Anaplasmosis

Anaplasma phagocytophilum

Animal bites are reportable to Town Health Officers only per Section 12.0 of this rule. Reporting form available at HS_ID_TownHealthOfficerAnimalBiteReportForm.pdf

N/A

(healthvermont.gov).

Anthrax*

Bacillus anthracis*

Babesiosis

Babesia microti, Babesia divergens, Babesia duncani

Blastomycosis

Blastomyces species

Blood lead levels

All results, including undetectable

Botulism*

Clostridium botulinum*

Brucellosis*

Brucella species*

Campylobacteriosis

Campylobacter species

Candida auris illness

Candida auris

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection/colonization

Carbapenem-resistant Acinetobacter baumannii (CRAB), including susceptibility results

Carbapenem-resistant Enterobacterales (CRE) infection/colonization

Carbapenem-resistant Enterobacterales (CRE), including susceptibility results

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection/colonization

Carbapenem-resistant Pseudomonas aeruginosa (CRPA), including susceptibility results

Chikungunya virus disease

Chikungunya virus

Chlamydia trachomatis infection

Chlamydia trachomatis

Cholera*

Vibrio cholerae serogroups O1 or O139*

COVID-19

SARS-CoV-2

COVID-19-related pediatric deaths

SARS-CoV-2

Creutzfeldt-Jakob disease/transmissible spongiform encephalopathies

N/A

Cryptosporidiosis

Cryptosporidium species

Cyclosporiasis

Cyclospora cayetanensis

Dengue

Dengue virus

Diphtheria*

Corynebacterium diphtheriae*

Eastern equine encephalitis

Eastern equine encephalitis virus

Ehrlichiosis

Ehrlichia chaffeensis, Ehrlichia ewingii, Ehrlichia muris eauclairensis

Encephalitis

N/A

Glanders*

Burkholderia mallei*

Gonorrhea

Neisseria gonorrhoeae

Haemophilus influenzae disease, invasive*

Haemophilus influenzae, isolated from a normally sterile site, including susceptibility results*

Hantavirus disease

Hantaviruses

Hard tick relapsing fever

Borrelia miyamotoi

Hemolytic uremic syndrome (HUS)

N/A

Hepatitis A (acute)*

Hepatitis A virus (anti-HAV IgM)*

Hepatitis B

Hepatitis B virus (HBsAg, anti- HBcIgM, HBeAg, HBV DNA)

Hepatitis B, positive surface antigen in a pregnant person

Hepatitis B virus (HbsAg)

Hepatitis C

Positive hepatitis C antibody results and all positive and non-detectable nucleic acid test results, including genotype

Hepatitis E

Hepatitis E virus (IgM anti-HEV)

Human immunodeficiency virus (HIV) infection/AIDS

Human immunodeficiency virus (HIV) including the following: [] HIV viral load measurement (including non- detectable results) []

All HIV subtype and HIV nucleotide sequence data from antiretroviral drug resistance testing

Infant botulism*

Clostridium botulinum*

Influenza: Report -Individual cases of influenza only if due to a novel strain of Influenza A* - Pediatric influenza-related deaths - Institutional outbreaks

N/A (except for novel influenza A)

Jamestown Canyon virus disease

Jamestown Canyon virus

La Crosse virus disease

La Crosse virus

Legionellosis

Legionella species

Leptospirosis

Leptospira species

Listeriosis

Listeria monocytogenes

Lyme disease

Borrelia burgdorferi, Borrelia mayonii

Malaria

Plasmodium species

Measles (Rubeola)*

Measles virus*

Melioidosis*

Burkholderia pseudomallei*

Meningitis, bacterial*

Neisseria meningitidis isolated from a normally sterile site*, including susceptibility results, Streptococcus pneumoniae isolated from a normally sterile site, including susceptibility results, Haemophilus influenzae isolated from a normally sterile site, including susceptibility results

Meningococcal disease*

Neisseria meningitidis, isolated from a normally sterile site, including susceptibility results *

Middle East Respiratory Syndrome (MERS)*

MERS CoV*

Mpox (human monkeypox)

MPXV Clade I and Clade II, non- variola Orthopoxvirus

Multisystem inflammatory syndrome in children (MIS- C)

SARS-CoV-2

Mumps

Mumps virus

Pertussis (whooping cough)

Bordetella pertussis

Plague*

Yersinia pestis*

Poliovirus infection, including poliomyelitis*

Poliovirus*

Powassan virus disease

Powassan virus

Psittacosis

Chlamydia psittaci

Q fever

Coxiella burnetii

Rabies, human* and animal* cases

Rabies virus*

Rabies postexposure prophylaxis in humans Reporting form available at HS_ID_RabiesPostexposureProphylaxisReportForm.pdf

N/A

(healthvermont.gov).

Reye syndrome

N/A

Ricin toxicity

Ricin toxin

Rubella (German measles)*

Rubella virus

Rubella, congenital rubella syndrome

Rubella virus

Salmonella Paratyphi infection*

Salmonella enterica serotypes Paratyphi A, B $(tartrate negative$), and C $(S. Paratyphi$)*

Salmonella Typhi infection*

Salmonella enterica serotype Typhi*

Salmonellosis

Salmonella species (non-Typhi)

Severe Acute Respiratory Syndrome (SARS)*

SARS-CoV/SARS-associated virus*

Shiga toxin-producing E.coli (STEC)

Shiga toxin-producing E.coli (STEC) (including O157:H7)

Shigellosis

Shigella species

Smallpox*

Variola virus*

Spotted fever group rickettsioses

Rickettsia species

St. Louis encephalitis

St. Louis encephalitis virus

Streptococcal disease, group A, invasive

Streptococcus pyogenes (group A), isolated from a normally sterile site

Streptococcal disease, group B invasive (infants less than one month of age)

Streptococcus agalactiae (group B), isolated from a normally sterile site (infants less than one month of age)

Streptococcus pneumoniae disease, invasive

Streptococcus pneumoniae, isolated from a normally sterile site, including susceptibility results

Syphilis

Treponema pallidum and all confirmatory tests for syphilis that result from an initial positive screening test, regardless of result (positive and negative)

Tetanus

Clostridium tetani

Toxic shock syndrome

N/A

Trichinellosis

Trichinella species

Tuberculosis disease*

Mycobacterium tuberculosis complex, including susceptibility results, interferon gamma release assay (IGRA), tuberculin skin test (TST)

Tuberculosis infection, latent

Interferon gamma release assay (IGRA), tuberculin skin test (TST)

Tularemia*

Francisella tularensis*

Vaccinia (disease or adverse event)

Vaccinia virus

Varicella (chickenpox only)

Varicella virus

Vibriosis

Vibrio species

VRSA, VISA infection

Staphylococcus aureus, vancomycin resistant (VRSA) and vancomycin intermediate (VISA), including susceptibility results

West Nile virus illness

West Nile virus

Yellow fever

Yellow fever virus

Yersiniosis

Yersinia enterocolitica

Zika virus disease and infection

Zika virus

Section 7.0 Reportable Laboratory Findings
7.1 Content of the Laboratory Report
7.1.1 The laboratory report of the conditions listed in Section 7.3, Table 2, shall include the following information as it relates to the affected person:
7.1.1.1 Patient name
7.1.1.2 Patient date of birth
7.1.1.3 Patient sex;
7.1.1.4 Patient race;
7.1.1.5 Patient ethnicity;
7.1.1.6 Patience address;
7.1.1.7 Patient telephone number;
7.1.1.8 Name of ordering health care provider/physician and NPI (as applicable);
7.1.1.9 Address of ordering health care provider/physician;
7.1.1.10 Telephone number of ordering provider/physician;
7.1.1.11 Accession number/specimen ID;
7.1.1.12 Specimen type(s), e.g., serum, swab, etc.;
7.1.1.13 Specimen source(s), e.g., cervix, throat, etc. (use national standardized codes;
7.1.1.14 Diagnostic test(s) performed (use national standardized codes);
7.1.1.15 Test results(s) (use national standardized codes);
7.1.1.16 Interpretation of result(s);
7.1.1.17 Date(s) of specimen collection;
7.1.1.18 Date test ordered;
7.1.1.19 Names of performing facility and CLIA number (if applicable); and
7.1.1.20 Address of performing facility.
7.1.2 Reports shall include any additional information required by federal statute or rule.
7.2 How to Make a Report for Laboratory Findings
7.2.1 Laboratories shall report to the Department through electronic laboratory reporting, in a manner approved by the Department. If electronic laboratory reporting is not available, the laboratory may substitute an alternate reporting method with permission from the Department.
7.2.2 If no positive reportable laboratory findings have been made during a given week, then a written report of "No reportable findings" shall be made. For laboratories with validated electronic laboratory reporting, a report of "No reportable findings" is not required.
7.2.3 Laboratories are required to report results to the Department irrespective of the required reporting of other parties listed under this rule.
7.3 Laboratory Findings Required to be Reported
7.3.1 All positive, presumptive positive, confirmed, isolated, or detected cases found by laboratory tests of the following conditions, to include any rare infectious disease or one dangerous to public health, must be reported. Laboratory findings required to be reported with negative, undetectable, or non-detectable results, are specified in Table 2. For those diseases or laboratory reports indicated by a "*" results shall be reported to the Department, by telephone, immediately:

Table 2: Laboratory Findings Required to be Reported

Reportable Laboratory Findings

Diseases, Syndromes, Treatments

Anaplasma phagocytophilum

Anaplasmosis

Babesia microti, Babesia divergens, Babesia duncani

Babesiosis

Bacillus anthracis*

Anthrax*

Blastomyces species

Blastomycosis

Blood lead levels (all results, including undetectable)

N/A

Bordetella pertussis

Pertussis (whooping cough)

Borrelia burgdorferi

Lyme disease

Borrelia mayonii

Lyme disease

Borrelia miyamotoi

Hard tick relapsing fever

Brucella species*

Brucellosis*

Burkholderia mallei*

Glanders*

Burkholderia pseudomallei*

Melioidosis*

Campylobacter species

Campylobacteriosis

Candida auris

Candida auris illness

Carbapenem-resistant Acinetobacter baumannii (CRAB), including susceptibility results

Carbapenem-resistant Acinetobacter baumannii (CRAB) infection/colonization

Carbapenem-resistant Enterobacterales (CRE), including susceptibility results

Carbapenem-resistant Enterobacterales (CRE) infection/colonization

Carbapenem-resistant Pseudomonas aeruginosa (CRPA), including susceptibility results

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection/colonization

CD4+ T-lymphocyte counts and percentages (all results)

N/A

Chikungunya virus

Chikungunya virus disease

Chlamydia psittaci

Psittacosis

Chlamydia trachomatis

Chlamydia trachomatis infection

Clostridium botulinum*

Botulism* and infant botulism*

Clostridium tetani

Tetanus

Corynebacterium diphtheriae*

Diphtheria*

Coxiella burnetii

Q fever

Cryptosporidium species

Cryptosporidiosis

CSF findings (all positive results)

N/A

Cyclospora cayetanensis

Cyclosporiasis

Dengue virus

Dengue

Eastern equine encephalitis virus

Eastern equine encephalitis

Ehrlichia chaffeensis, Ehrlichia ewingii, Ehrlichia muris eauclairensis

Ehrlichiosis

Francisella tularensis*

Tularemia*

Haemophilus influenzae, isolated from a normally sterile site*, including susceptibility results

Invasive Haemophilus influenzae disease*, bacterial meningitis

Hantaviruses

Hantavirus disease

Hepatitis A virus (anti-HAV IgM)*

Acute hepatitis A*

Hepatitis B virus (HBsAg, anti-HBc IgM, HBeAg, HBV DNA)

Hepatitis B (acute and chronic)

Hepatitis C virus (positive antibody results and all positive and non-detectable nucleic acid test results, including genotype)

Hepatitis C (acute and chronic)

Hepatitis E virus (IgM anti-HEV)

Hepatitis E

Human immunodeficiency virus (HIV) including the following: [] HIV viral load measurement (including non-detectable results) [] All HIV subtype and HIV nucleotide sequence data from antiretroviral drug resistance testing

HIV/AIDS

Interferon gamma release assay (IGRA)

Tuberculosis infection

Jamestown Canyon virus

Jamestown Canyon virus disease

La Crosse virus

La Crosse virus disease

Legionella species

Legionellosis

Leptospira species

Leptospirosis

Listeria monocytogenes

Listeriosis

Measles virus*

Measles (Rubeola)*

MERS CoV*

Middle East Respiratory Syndrome (MERS)*

MPXV Clade I and Clade II, non-variola Orthopoxvirus

Mpox (human monkeypox)

Mumps virus

Mumps

Mycobacterium tuberculosis complex, including susceptibility results

Tuberculosis (TB) disease*, latent TB infection

Neisseria gonorrhoeae

Gonorrhea

Neisseria meningitidis, isolated from a normally sterile site*, including susceptibility results

Bacterial meningitis, meningococcal disease*

Plasmodium species

Malaria

Poliovirus*

Poliovirus infection, including poliomyelitis*

Powassan virus

Powassan virus disease

Rabies virus*

Rabies, human* and animal* cases

Ricin toxin

Ricin toxicity

Rickettsia species

Spotted fever group rickettsioses

Rubella virus

Rubella (German measles)*, congenital rubella syndrome

Salmonella enterica serotype Typhi*

Salmonella Typhi infection*

Salmonella enterica serotypes Paratyphi A, B $(tartrate negative$), and C $(S. Paratyphi$)*

Salmonella Paratyphi infection*

Salmonella species (non-Typhi)

Salmonellosis

SARS-CoV/SARS-associated virus*

Severe Acute Respiratory Syndrome (SARS)*

SARS-CoV-2

COVID-19, COVID-19-related pediatric deaths

Shigella species

Shigellosis

Shiga toxin-producing E.coli (STEC) (including O157:H7)

Shiga toxin-producing E.coli (STEC)

St. Louis encephalitis virus

St. Louis encephalitis

Staphylococcus aureus, vancomycin resistant (VRSA) and vancomycin intermediate (VISA), including susceptibility results

VRSA, VISA infection

Streptococcus pyogenes (group A), isolated from a normally sterile site

Invasive group A streptococcal (GAS) disease

Streptococcus agalactiae (group B), isolated from a normally sterile site (infants less than one month of age)

Neonatal invasive group B streptococcal (GBS) disease

Streptococcus pneumoniae, isolated from a normally sterile site, including susceptibility results

Invasive Streptococcus pneumoniae disease

Treponema pallidum and all confirmatory tests for syphilis that result from an initial positive screening test, regardless of result (positive and negative)

Syphilis

Trichinella species

Trichinellosis

Tuberculin skin test (TST)

Tuberculosis infection

Vaccinia virus

Vaccinia disease or vaccine adverse event

Varicella virus

Varicella (only chickenpox is reportable)

Variola virus*

Smallpox*

Vibrio cholerae serogroups O1 or O139*

Cholera*

Vibrio species

Vibriosis

West Nile virus

West Nile virus illness

Yellow fever virus

Yellow fever

Yersinia enterocolitica

Yersiniosis

Yersinia pestis*

Plague*

Zika virus

Zika virus disease and infection

7.3.2 Further Analysis and Typing
7.3.2.1 The Department of Health Laboratory will provide transport containers and instruction on how to submit specimens or isolates.
7.3.2.2 Specimens or isolates of the following organisms shall be sent to the Vermont Department of Health Laboratory for further analysis, typing, or storage if the Department makes a request for further characterization:
7.3.2.2.1 Bacillus anthracis;
7.3.2.2.2 Bacillus cereus, biovar anthracis;
7.3.2.2.3 Brucella species;
7.3.2.2.4 Burkholderia mallei;
7.3.2.2.5 Burkholderia pseudomallei;
7.3.2.2.6 Campylobacter species;
7.3.2.2.7 Candida auris;
7.3.2.2.8 Carbapenem-resistant Acinetobacter baumannii (CRAB);
7.3.2.2.9 Carbapenem-resistant Enterobacteriaceae (CRE);
7.3.2.2.10 Carbapenem-resistant Pseudomonas aeruginosa (CRPA);
7.3.2.2.11 Clostridium botulinum;
7.3.2.2.12 Corynebacterium diphtheriae;
7.3.2.2.13 Coxiella burnetii;
7.3.2.2.14 Cryptosporidium species;
7.3.2.2.15 Eastern equine encephalitis virus;
7.3.2.2.16 Francisella tularensis;
7.3.2.2.17 Haemophilus influenza, isolated from a normally sterile site;
7.3.2.2.18 Hantaviruses;
7.3.2.2.19 Hemorrhagic fever viruses;
7.3.2.2.20 Influenza A, novel strains only;
7.3.2.2.21 Jamestown Canyon virus;
7.3.2.2.22 La Crosse virus;
7.3.2.2.23 Legionella species;
7.3.2.2.24 Leptospira species;
7.3.2.2.25 Listeria species;
7.3.2.2.26 MERS-CoV;
7.3.2.2.27 Mycobacterium tuberculosis;
7.3.2.2.28 Neisseria meningitidis, isolated from a normally sterile site;
7.3.2.2.29 Powassan virus;
7.3.2.2.30 Ricin toxin;
7.3.2.2.31 Salmonella species;
7.3.2.2.32 SARS-CoV/SARS-associated virus;
7.3.2.2.33 Shiga toxin-producing E. coli (STEC) (including O157:H7);
7.3.2.2.34 Shigella species;
7.3.2.2.35 St. Louis encephalitis virus;
7.3.2.2.36 Streptococcus pyogenes (group A), isolated from a normally sterile site;
7.3.2.2.37 Vibrio species;
7.3.2.2.38 VISA (vancomycin-intermediate Staphylococcus aureus);
7.3.2.2.39 VRSA (vancomycin-resistant Staphylococcus aureus);
7.3.2.2.40 West Nile virus;
7.3.2.2.41 Yersinia enterocolitica; and
7.3.2.2.42 Yersinia pestis.
Section 8.0 Pharmacist Reports.

Pharmacists are required to report to the Department any recognized unusual or increased prescription requests, unusual types of prescriptions, or unusual trends in pharmacy visits that may result from bioterrorist acts, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, and might pose a substantial risk of significant number of human fatalities or incidents of permanent or long-term disability within 24 hours of when they become aware of such an event.

Section 9.0 Data from Vermont Health Information Exchange.
9.1 The Vermont Health Information Exchange shall provide access to data to the Health Department related to communicable diseases in Vermont. These may include, but are not limited to, information for laboratory and case reporting, hospitalization data, and patient demographics.
9.2 The Vermont Health Information Exchange shall provide the Health Department with access to records reported to the Exchange for electronic laboratory reporting, immunizations, and information related to communicable diseases in Vermont.
Section 10.0 Prophylaxis for Eyes of Newborn.

Prophylaxis for conjunctivitis of the newborn (ophthalmia neonatorum) shall be administered by a health care provider to all infants immediately after birth by the medical provider attending the birth.

Section 11.0 Surveillance of Animal Diseases and Laboratory Findings.
11.1 Persons Required to Report
11.1.1 The professionals listed below are required to report all diseases and laboratory findings listed in Section 11.5 to the Department. The following are required reporters of these diseases and laboratory findings:
11.1.1.1 Veterinarians;
11.1.1.2 Veterinary diagnostic laboratory directors; and
11.1.1.3 Biologists.
11.1.2 Required reporters listed in Section 11.1.1 shall report all suspected and confirmed diseases listed in Section 11.5.
11.1.3 Required reporters listed in Section 11.1.1 shall report all positive, presumptive positive, confirmed, isolated, or detected cases found by laboratory tests listed in Section 11.5.
11.1.4 Diseases and laboratory findings denoted with an asterisk (*), shall be reported to the Department immediately, by telephone.
11.2 Additional Reporting Requirements for Animal Diseases and Laboratory Findings
11.2.1 The following are additional reporting requirements that shall be reported to the Department, within 24 hours, following the requirements listed in Section 11.5, for the surveillance of any infectious agents, outbreaks, epidemics, related public health hazard, or act of bioterrorism:
11.2.1.1 Any single unusual occurrence of an animal disease of a major public health concern;
11.2.1.2 Any single unusual occurrence of a laboratory finding of a major public health concern;
11.2.1.3 Any unexpected pattern or cluster of cases, suspected cases, or deaths from an animal disease or laboratory finding of a major public health concern; and
11.2.1.4 Any evidence or suspicion of terrorism, including intentional or threatened use of viruses, bacteria, fungi, toxins, chemicals, or radiologic material to produce malfunction, illness, or death in animals and/or humans.
11.3 Content of the Report
11.3.1 Clinical report: The report of a clinical diagnosis or suspicion of the diseases listed in Section 11.5, or any unusual cluster of animal illnesses or deaths shall include as much of the following information as is available:
11.3.1.1 Location or suspected location of the affected animal(s);
11.3.1.2 Name of any known owner;
11.3.1.3 Address of any known owner;
11.3.1.4 Name of reporting individual;
11.3.1.5 Address of reporting individual;
11.3.1.6 Name of disease or suspected disease being reported;
11.3.1.7 Type of animal(s) affected;
11.3.1.8 Number of animal(s) affected;
11.3.1.9 Date of confirmation of disease or onset of clinical signs;
11.3.1.10 Clinical assessment of signs and symptoms relevant to the disease or syndrome, if requested;
11.3.1.11 Laboratory and diagnostic results relevant to the disease or syndrome, if requested; and
11.3.1.12 Any other information deemed pertinent by the reporter.
11.3.2 Laboratory report: The report of positive, non-negative, presumptive, or confirmed isolation, detection or serological results shall include as much of the following information as is available:
11.3.2.1 Name of any known owner;
11.3.2.2 Address of any known owner;
11.3.2.3 Name of person who submitted specimen;
11.3.2.4 Address of person who submitted specimen;
11.3.2.5 Name of test;
11.3.2.6 Result of test;
11.3.2.7 Date submitted;
11.3.2.8 Date of positive test result;
11.3.2.9 Specimen type (e.g. swab); and
11.3.2.10 Specimen source (e.g. skin, mouth).
11.3.3 Laboratories are required to report the result to the Department irrespective of the required reporting of other parties listed under this rule.
11.4 How to Make a Report for Animal Disease and Laboratory Finding
11.4.1 The report shall be made by telephone, in writing, by fax or electronically (when available by email or internet) to the Department within 24 hours, unless denoted with an asterisk (*).
11.4.2 Diseases and laboratory findings, denoted with an asterisk (*), shall be reported to the Department immediately, by telephone.
11.5 Animal Diseases and Laboratory Findings Required to be Reported
11.5.1 The professionals listed in Section 11.1.1 shall report to the Department within 24 hours of the time when they become aware of clinical or laboratory diagnosis, suspicion of any rare infectious disease in animals that might pose a risk of a significant number of human and animal fatalities, or incidents of permanent or long-term disability. Diseases or laboratory findings denoted with an asterisk (*), shall be reported to the Department immediately, by telephone.
11.5.1.1 Anthrax (Bacillus anthracis)* ;
11.5.1.2 Arboviral infection;
11.5.1.3 Avian Chlamydiosis (Chlamydia psittaci);
11.5.1.4 Brucellosis (Brucella species);
11.5.1.5 Glanders (Burkholderia mallei)*;
11.5.1.6 Hantavirus;
11.5.1.7 Mpox;
11.5.1.8 Mycobacterium tuberculosis complex;
11.5.1.9 Novel influenza (avian, swine);
11.5.1.10 Plague (Yersinia pestis)*;
11.5.1.11 Q Fever (Coxiella burnetii);
11.5.1.12 Rabies*;
11.5.1.13 SARS-CoV-2 infection; and
11.5.1.14 Tularemia (Francisella tularensis)*.
Section 12.0 Rabies Control.
12.1 Animal Bite Report: The form to report an animal bite is available at www.healthvermont.gov.
12.1.1 Physician Report Responsibilities
12.1.1.1 Physicians shall report to the local health officer the full name, age and address of any person known to have been bitten by an animal of a species subject to rabies within 24 hours of actual or constructive notice.
12.1.2 Reporting Responsibilities When There is No Physician in Attendance
12.1.2.1 Minors: If no physician is in attendance and the person bitten is under 18 years of age, the parent or guardian shall make such report within 24 hours of actual or constructive notice to the local town health officer.
12.1.2.2 Adults: If no physician is in attendance and the person bitten is an adult, the person shall report, or cause to be reported, such information to the local town health officer.
12.2 Control Methods in Domestic and Confined Animals
12.2.1 Post exposure management: Any animal bitten or scratched by a wild mammal not available for testing shall be regarded as having been exposed to rabies.
12.2.1.1 Dogs, Cats and Ferrets: When an unvaccinated dog, cat or ferret is exposed to a rabid animal the Department may order that the exposed animal be euthanized immediately or be placed in strict isolation for 4 (dogs and cats) or 6 (ferrets) months. A rabies vaccine shall be administered immediately. Dogs, cats, and ferrets that are currently vaccinated shall be revaccinated immediately, kept under the owner's control, and observed for 45 days. Animals overdue for a booster vaccination need to be evaluated on a case-by-case basis.
12.2.1.2 Other Animals: Other animals exposed to rabies should be evaluated on a case-by-case basis.
12.2.2 Management of Animals that Bite Humans
12.2.2.1 The local health officer shall cause an apparently healthy dog, cat or ferret, regardless of vaccinations status, that bites a person to be confined and observed for 10 days.
12.2.2.2 A rabies vaccine should not be administered during the observation period and such animals must be evaluated by a veterinarian at the first sign of illness during confinement. Any illness in the animal must be reported immediately to the local health officer.
12.2.2.3 If clinical signs consistent with rabies develop, the animal must be euthanized immediately, its head removed, and the head shipped under refrigeration for examination by the state Health Department laboratory.
12.2.2.4 Other animals, which may have bitten and exposed a person to rabies, shall be reported within 24 hours to the local health officer. Prior vaccinations of an animal may not preclude the necessity for euthanasia and testing if the period of virus shedding is unknown for that species. Management of animals other than dogs, cats or ferrets depends on the species, the circumstances of the bite, the epidemiology of rabies in the area, and the biting animal's history, current health status, and potential for exposure to rabies.
12.3 Removal of Animal
12.3.1 A confined animal being observed for signs of rabies shall not be removed from one health district into another prior to the conclusion of the prescribed isolation period except with the permission of the local health officer from whose district such animal is to be removed and the permission of the health officer to whose jurisdiction such animal is to be transferred.
12.3.2 The former shall give permission only after securing the consent of the local health officer to whose jurisdiction the animal is to be transferred, except that if removal is to be to another state, they shall give permission only after securing the consent of the Commissioner.
12.3.3 Such removal shall be private conveyance, in charge of a responsible person and conducted in such manner as to prevent the escape of the animal or its coming in contact with other animals or persons.
12.4 Laboratory Specimens
12.4.1 Whenever any animal that has or is suspected of having rabies dies or is killed, it shall be the duty of the local health officer to ensure the head of such animal to be removed and sent immediately, properly packed, with a complete history of the case to a laboratory approved for this purpose by the Commissioner. The local health officer shall notify the health department of the specimen's intended arrival.
12.5 Destruction of Animals, Subject to Rabies; Precautions
12.5.1 Whenever an animal subject to rabies is brought to a veterinarian to be destroyed, an attempt shall be made by the veterinarian to ascertain that the animal has not bitten any person within the previous ten-day period; before destroying the animal, they shall require the owner to sign a statement to this effect, and they shall not destroy any animal which has bitten a person within ten days. The health officer must be notified by the veterinarian of any such biting incident. If a biting animal is euthanized within ten days of the bite, the veterinarian shall consult with the Department and cause the head of such animal to be removed and sent immediately, properly packed, with a complete history of the case to a laboratory approved for this purpose by the Commissioner.

13-007 Code Vt. R. 13-140-007-X

EFFECTIVE DATE:
December 1, 1986 Secretary of State Rule Log #86-85
AMENDED:
October 1, 1994 Secretary of State Rule Log #94-44; April 1, 1995 Secretary of State Rule Log #95-21; July 1, 1996 Secretary of State Rule Log #96-35; July 7, 1998 Secretary of State Rule Log #98-39; March 24, 2000 Secretary of State Rule Log #00-16; August 8, 2001 Secretary of State Rule Log #01-41; March 15, 2004 Secretary of State Rule Log #04-08; October 1, 2005 Secretary of State Rule Log #05-034; September 1, 2008 Secretary of State Rule Log #08-22; March 26, 2015 Secretary of State Rule Log #15-008; April 6, 2019 Secretary of State Rule Log #19-013; July 1, 2022 Secretary of State Rule Log #22-020; 8/10/2024 Secretary of State Rule Log #24-027

STATUTORY AUTHORITY:

3 V.S.A. §§ 801(b)(11), 3003(b); 13 V.S.A. § 3504; 18 V.S.A. §§ 102, 1001; 20 V.S.A. § 3801