Wash. Admin. Code § 246-101-201

Current through Register Vol. 24-12, June 15, 2024

Section 246-101-201 - Notifiable conditions -Laboratories

(1) For the purposes of Table Lab-1:

(a) "At least annually" means deidentified negative screening results may be submitted in a single report no less than once per year, but may be submitted more frequently as a single report or as individual screening results.

(b) "Deidentified negative screening result" means an initial test result that indicates the absence of disease, and that has personally identifiable information removed from it using the Health Insurance Portability and Accountability Act of 1996 Safe Harbor method defined in 45 C.F.R. 164.514. A deidentified negative screening result does not include a negative test result associated with a previous positive test result, such as a negative nucleic acid or viral load test that is performed after a positive antibody or antigen test.

(c) "LHJ" means where the patient resides, or, in the event that patient residence cannot be determined, the local health jurisdiction in which the ordering health care provider practices, or the local health jurisdiction in which the laboratory operates.

(d) "Within two business days" means specimens must be in transit to the Washington state public health laboratories within two business days of:

(i) Completing a test and the specimen being ready for packaging; or

(ii) Receiving a request from a local health jurisdiction or the department, provided the specimen is still available at the time of the request.

(2) This chapter does not require a laboratory to:

(a) Test for agents (conditions) or speciate if the laboratory does not perform the test as part of its normal work. A laboratory director shall only report a condition if it is identified as part of their normal testing protocols; or

(b) Retain specimens indefinitely in anticipation of a request from a local health jurisdiction or the department.

(3) The agents (conditions) in Table Lab-1 are notifiable by a laboratory director as indicated in Table Lab-1 and this chapter.

Table Lab-1 (Conditions Notifiable by Laboratory Directors)

Agent (Condition)	Notification of Results		Specimen Submission to the Washington State Public Health Laboratories
	What to Submit in a Laboratory Report	When and Whom to Notify Upon Receiving Presumptive or Final Test Result	What to Submit	When to Submit
Amebic meningitis	Positive result by any method	Immediately to LHJ	Specimen associated with positive result, if available	Within 2 business days
Anaplasma species (Anaplasmosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result, if available	Within 2 business days of request by LHJ or DOH
Babesia species (Babesiosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result, if available	Within 2 business days of request by LHJ or DOH
Bacillus anthracis (Anthrax)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Bacillus cereus , biovar anthracis only	Confirmed positive result by any method	Immediately to LHJ	Do not ship specimen	Do not ship specimen
Baylisascaris (Bay-lisascariasis)	Positive result by any method	Within 24 hours to LHJ	Specimen associated with positive result, if available	Within 2 business days
Blood lead level	Results equal to or greater than 5 micrograms per deciliter for: RST Venous	Within 2 business days to DOH	N/A	N/A
	Results less than 5 micrograms per deciliter for: RST Venous	Within 30 days to DOH
Bordetella pertussis (Pertussis)	Positive results by: Culture or Nucleic acid detection nucleic acid testing (NAT or (nucleic acid amplification testing (NAAT	Within 24 hours to LHJ	Isolate	Within 2 business days
			If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Borrelia burgdorferi or Borrelia mayonii (Lyme disease)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Borrelia hermsii , park-eri , turicatae , miyamo-toi , or recurrentis (Relapsing fever, tick-or louse-borne)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Brucella species (Brucellosis)	Positive result by any method excluding Immunoglobulin G (IgG)	Within 24 hours to LHJ	Isolate, excluding confirmed positive B. meli-tensis, B. abortus, or B. suis If no isolate available, specimen associated with positive result	Within 2 business days
Burkholderia mallei (Glanders)	Positive result by any method excluding IgG	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Burkholderia pseudomallei (Melioidosis)	Positive result by any method excluding IgG	Immediately to LHJ	Presumptive positive isolate	Within 2 business days
			If no isolate available, specimen associated with presumptive positive result
California serogroup viruses, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Campylobacter species (Campylobacterio-sis)	Positive result by: Culture, Nucleic acid detection (NAT or NAAT), or Antigen detection	Within 2 business days to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Candida auris	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Carbapenem-resistant Enterobacteriaceae: Klebsiella species E. coli Enterobacter species	Positive for known car-bapenemase resistance gene (including, but not limited to, KPC, NDM, VIM, IMP, OXA-48) demonstrated by nucleic acid detection (NAT or NAAT), or whole genome sequencing Positive on a phenotypic test for carbapen-emase production including, but not limited to, Metallo-B-lact-amase test, modified Hodge test (MHT) (for E. coli and Klebsiella species only), Car-baNP, Carbapenem Inactivation Method (CIM) or modified CIM (mCIM) Resistant to any car-bapenem including, but not limited to, doripe-nem, ertapenem, imi-penem or meropenem	Within 2 business days to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
CD4 + counts1, or CD4 + percents2, or both (patients aged thirteen or older)	All results	Within 30 days to DOH except in King County where this is notifiable to the LHJ	N/A	N/A
Chikungunya virus, acute (Arbovirus)	Positive result by any method excluding Immunoglobulin G (IgG)	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Chlamydia psittaci (Psittacosis)	Positive result by any method excluding IgG	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Chlamydia trachomatis	Positive and indeterminate result by any method	Within 2 business days to LHJ	N/A	N/A
Chlamydia trachomatis	Deidentified negative screening result	At least annually to DOH	N/A	N/A
Clostridium botulinum (Botulism)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Coccidioides (Coccidioidomycosis)	Positive result by any method	Within 2 business days to LHJ	Isolate	Within 2 business days
			If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Coronavirus SARS-associated coronavirus MERS-associated coronavirus Novel coronavirus (SARS-CoV-2)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days of request by LHJ or DOH
Corynebacterium diph-theriae (Diphtheria)	Positive result by: Culture or Nucleic acid detection (NAT or NAAT)	Immediately to LHJ	Isolate	Within 2 business days
			If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Coxiella burnetii (Q fever)	Positive result by any method	Within 24 hours LHJ	Specimen associated with presumptive positive result	Within 2 business days
Crimean-Congo hemorrhagic fever virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Cryptococcus gattii or undifferentiated Cryptococcus species (i.e., Cryptococcus not identified as C. neoformans )	Positive results by any method excluding cryptococcal antigen	Within 2 business days to LHJ	Isolate If no isolate available, specimen associated with positive result (excluding serum)	Within 2 business days
			Serum	Within 2 business days of request by LHJ or DOH
Cryptosporidium (Cryptosporidiosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Cyclospora cayetanen-sis (Cyclosporiasis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Dengue virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
E. coli - Refer to "Shiga toxin-producing E. coli "
Eastern and western equine encephalitis virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result excluding specimens from viral culture	Within 2 business days of request by LHJ or DOH
Ebola virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive specimen	Within 2 business days
Echinococcus granulosus or E. multilocularis (Echinococcosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Ehrlichia species (Ehrlichiosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Francisella tularensis (Tularemia)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Giardia duodenalis, G. lamblia, G. intestinalis (Giardiasis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Guanarito virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Haemophilus influenzae (children < 5 years of age)	Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT)	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Hantavirus including, but not limited to: Andes virus Bayou virus Black Creek Canal virus Dobrava-Belgrade virus Hantaan virus Seoul virus Sin nombre virus	Positive result by any method	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days
Hepatitis A virus	Positive results for: IgM or Nucleic acid detection (NAT or NAAT) Hepatocellular enzyme levels to accompany report, if available, for positive IgM results	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Hepatitis B virus	Positive results for: IgM anti-HBc, HBsAg, HBeAg, or HBV Nucleic acid detection (NAT or NAAT) either qualitative or quantitative, for example PCR or genotyping If associated with a positive result listed above, and available: Hepatocellular enzyme levels, Pregnancy status, and Negative IgM anti-HBc result	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Hepatitis C virus	Positive result by any method Positive and nonpositive results for: HCV nucleic acid detection (NAT or NAAT) for qualitative, quantitative, and genotype tests If associated with a positive result and available: Hepatocellular enzyme levels, Pregnancy status, Negative result for IgM anti-HAV, and Negative result for IgM anti-HBc	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Hepatitis C virus	Deidentified negative screening result	At least annually to DOH	N/A	N/A
Hepatitis D virus	Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Hepatitis E virus	Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels	Within 24 hours to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Histoplasma capsula-tum (histoplasmosis)	Positive result by any method	Within 2 business days to LHJ	Isolate	Within 2 business days
			Serum	Within 2 business days of request by LHJ or DOH
Human immunodeficiency virus (HIV)	Positive and indeterminate results and subsequent negative results associated with those positive or indeterminate results for the tests below: Antibody detection tests (including RST), Antigen detection tests (including RST), or Viral culture All HIV nucleic acid detection (NAT or NAAT) tests: Qualitative and quantitative Detectable and undetectable HIV antiviral resistance testing genetic sequences	Within 2 business days to DOH except in King County where this is notifiable to the LHJ	N/A	N/A
Human immunodeficiency virus (HIV)	Deidentified negative screening result	At least annually to DOH	N/A	N/A
Human prion disease	Positive result by any method excluding Tau protein	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Influenza virus, novel or unsubtypable strain	Positive novel and unsubtypable result	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Japanese encephalitis virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Junin virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
La Crosse encephalitis virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Lassa virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Legionella species (Legionellosis)	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available but respiratory specimen available and associated with a positive test (as in the case of a PCR positive), respiratory specimen associated with positive result	Within 2 business days
Leptospira species (Leptospirosis)	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Listeria monocytogenes (Listeriosis)	Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT)	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Lujo virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Machupo virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Marburg virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Measles virus - See "Rubeola (measles virus)"
Mumps virus	Positive result for: Culture, Nucleic acid detection (NAT or NAAT), or IgM	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
			Specimen associated with positive IgM	Within 2 business days of request by LHJ or DOH
Mycobacterium tuberculosis complex (Tuberculosis)	Positive result for: Culture Nucleic acid detection (NAT or NAAT) Drug susceptibilities (molecular and culture based)	Within 2 business days to DOH	Mycobacterium tuberculosis complex positive isolate (earliest available isolate for the patient)	Within 2 business days
Neisseria gonorrhoeae (Gonorrhea)	Positive and indeterminate result by any method	Within 2 business days to LHJ	N/A	N/A
Neisseria gonorrhoeae (Gonorrhea)	Deidentified negative screening result	At least annually to DOH	N/A	N/A
Neisseria meningitidis (Meningococcal disease)	Positive result for specimen from a normally sterile site by any method	Immediately to LHJ	Isolate from a normally sterile site	Within 2 business days
			If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Plasmodium species (Malaria)	Positive results for: Nucleic acid detection (NAT or NAAT), Malaria-specific antigens by rapid diagnostic test, PCR, or Microscopy (thick or thin smear)	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Poliovirus (Poliomyelitis)	IgM positivity; PCR positivity	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Powassan virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Rabies virus	Positive result by any method	Immediately to LHJ	Specimen associated with positive result	Within 2 business days
Rickettsia species including, but not limited to: Rickettsia rickettsii Rickettsia africae Rickettsia conorii Rickettsia typhi Rickettsia parkeri Rickettsia philipii	Positive results by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Rubella	Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT)	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
			Other specimen	Within 2 business days of request by LHJ or DOH
Rubeola (measles virus)	Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT)	Immediately to LHJ	Isolate and specimen associated with positive culture Isolate and specimen association with positive NAT or NAAT result	Within 2 business days
			Specimen associated with positive IgM Other specimen	Within 2 business days of request by LHJ or DOH
Sabia virus (Viral hemorrhagic fever)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Salmonella species (Salmonellosis, typhoid fever)	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Shiga toxin-producing E. coli /enterohemor-rhagic E. coli (STEC)	Positive result by any method	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Shigella species (Shigellosis)	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
St. Louis encephalitis virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Taenia solium (Taeniasis or Cysticercosis)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Treponema pallidum (Syphilis)	Positive and indeterminate result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days
Treponema pallidum (Syphilis)	Deidentified negative screening result	At least annually to DOH	N/A	N/A
Trichinella species (Trichinellosis)	Positive serologic test for Trichinella	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Trypanosoma cruzi (Chagas disease)	Positive result by any method	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days
Vaccinia	Any request for testing associated with a suspect case	Immediately to LHJ	Any specimen collected from a suspect case	Immediately
Vancomycin-resistant Staphylococcus aureus	Resistance to vancomycin	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Variola virus (smallpox)	Any request for testing associated with a suspect case	Immediately to LHJ	Specimen collected from a suspect case	Immediately
Vibrio cholerae O1 or O139 (Cholera)	Positive result by any method	Immediately to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
Vibrio species (Vibriosis) not including Vibrio cholerae O1 or O139 (Cholera) See "Vibrio cholerae O1 or O139 (Cholera)"	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days
West Nile virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Yellow fever virus (Arbovirus)	Positive result by any method excluding IgG	Immediately to LHJ	Specimen associated with positive result	Within 2 business days
Yersinia enterocolit-ica, Y. pseudotuberculosis, Y. intermedia, Y. fredericksenii, or Y. kristensenii (Yersinio-sis)	Positive result by any method	Within 24 hours to LHJ	Isolate If no isolate available, specimen associated with positive result	Within 2 business days of request by LHJ or DOH
Yersinia pestis (Plague)	Positive result by any method	Immediately to LHJ	Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result	Within 2 business days
Zika virus, acute (Arbovirus)	Positive result by any method excluding IgG	Within 2 business days to LHJ	Specimen associated with positive result	Within 2 business days of request by LHJ or DOH

1 "CD4 + counts" means CD4 + (T4) lymphocyte counts.

2 "CD4 + percents" means CD4 + (T4) percents of total lymphocytes.

Wash. Admin. Code § 246-101-201

Amended by WSR 21-11-040, Filed 5/12/2021, effective 1/31/2022