TITLE 410 INDIANA STATE DEPARTMENT OF HEALTH
Final Rule
LSA Document #06-425(F)
DIGEST
Adds 410 IAC 1-2.3-37.5 to define pandemic influenza activity. Amends 410 IAC 1-2.3-47 to require the reporting of influenza associated human deaths to the department. Effective 30 days after filing with the Publisher.
410 IAC 1-2.3-37.5 "Pandemic influenza activity" defined
Authority: IC 16-41-2-1
Sec. 37.5. "Pandemic influenza activity" means influenza infection caused by a novel influenza virus for humans, which is efficiently transmitted from person to person, and that results in moderate or severe illness.
(Indiana State Department of Health; 410 IAC 1-2.3-37.5; filed Apr 16, 2008, 2:21 p.m.: 20080514-IR-410060425FRA)
410 IAC 1-2.3-47 Reporting requirements for physicians and hospital administrators
Authority: IC 16-41-2-1
Sec. 47. (a) It shall be the duty of each:
(2) administrator of a hospital licensed under IC 16-21, or the administrator's representative;
to report all cases and suspected cases of the diseases listed in subsection (d). Reporting of specimen results by a laboratory to health officials does not nullify the physician's or administrator's obligations to report said case.
(b) The report required by subsection (a) shall be made to the local health officer in whose jurisdiction the patient was examined at the time the diagnosis was made or suspected. If the patient is a resident of a different jurisdiction, the local health jurisdiction receiving the report shall forward the report to the local health jurisdiction where the patient resides. If a person who is required to report is unable to make a report to the local health officer within the time mandated by this rule, a report shall be made directly to the department within the time mandated by this rule.
(c) Any reports of diseases required by subsection (a) shall include the following:
(1) The patient's:
(A) full name;
(B) street address;
(C) city;
(D) zip code;
(E) county of residence;
(F) telephone number;
(G) age or date of birth;
(H) sex; and
(I) race and ethnicity, if available.
(2) Date of onset.
(3) Diagnosis.
(4) Definitive diagnostic test results, for example:
(A) culture;
(B) IgM;
(C) serology; or
(D) Western Blot.
(5) The name, address, and telephone number of the attending physician.
(6) Other epidemiologically necessary information requested by the local health officer or the commissioner.
(7) Persons who are tested anonymously at a counseling and testing site cannot be reported using personal identifiers; rather, they are to be reported using a numeric identifier code. The following shall also be reported:
(A) Age.
(B) Race.
(C) Sex.
(D) Risk factors.
(E) County of residence.
(8) The name, address, and telephone number of the person completing report.
(d) The dangerous communicable diseases and conditions described in this subsection shall be reported within the time specified. Diseases or conditions that are to be reported immediately to the local health officer shall be reported by telephone or other instantaneous means of communication on first knowledge or suspicion of the diagnosis. Diseases that are to be reported within seventy-two (72) hours shall be reported to the local health officer within seventy-two (72) hours of first knowledge or suspicion of the diagnosis by telephone, electronic data transfer, other confidential means of communication, or official report forms furnished by the department. During evening, weekend, and holiday hours, those required to report should report diseases required to be immediately reported to the after-hours duty officer at the local health department. If unable to contact the after-hours duty officer locally, or one has not been designated locally, those required to report shall file their reports with the after-hours duty officer at the department at (317) 233-1325 or (317) 233-8115.
| | |
DANGEROUS COMMUNICABLE DISEASES AND CONDITIONS |
Disease | When to Report | Disease Intervention |
| | Methods |
| (from probable diagnosis) | (section in this rule) |
Acquired immunodeficiency syndrome | See HIV Infection/Disease | Sec. 76 |
Animal bites | Within 24 hours | Sec. 52 |
Anthrax | Immediately | Sec. 53 |
Babesiosis | Within 72 hours | Sec. 54 |
Botulism | Immediately | Sec. 55 |
Brucellosis | Within 72 hours | Sec. 56 |
Campylobacteriosis | Within 72 hours | Sec. 57 |
Chancroid | Within 72 hours | Sec. 58 |
Chlamydia trachomatis, genital infection | Within 72 hours | Sec. 59 |
Cholera | Immediately | Sec. 60 |
Cryptosporidiosis | Within 72 hours | Sec. 61 |
Cyclospora | Within 72 hours | Sec. 62 |
Diphtheria | Immediately | Sec. 63 |
Ehrlichiosis | Within 72 hours | Sec. 64 |
Encephalitis, arboviral, Calif, EEE, WEE, SLE, West Nile | Immediately | Sec. 65 |
Escherichia coli, infection (including E. coli 0157:H7 and other enterohemorrhagic types) | Immediately | Sec. 66 |
Gonorrhea | Within 72 hours | Sec. 67 |
Granuloma inguinale | Within 72 hours | Sec. 68 |
Haemophilus influenzae invasive disease | Immediately | Sec. 69 |
Hansen's disease (leprosy) | Within 72 hours | Sec. 70 |
Hantavirus pulmonary syndrome | Immediately | Sec. 71 |
Hemolytic uremic syndrome, postdiarrheal | Immediately | Sec. 66 |
Hepatitis, viral, Type A | Immediately | Sec. 72 |
Hepatitis, viral, Type B | Within 72 hours | Sec. 73 |
Hepatitis, viral, Type B, pregnant woman (acute and chronic), or perinatally exposed infant | Immediately (when discovered at or close to time of birth) | Sec. 73 |
Hepatitis, viral, Type C (acute) | Within 72 hours | Sec. 74 |
Hepatitis, viral, Type Delta | Within 72 hours | Sec. 73 |
Hepatitis, viral, unspecified | Within 72 hours | |
Histoplasmosis | Within 72 hours | Sec. 75 |
HIV infection/disease | Within 72 hours | Sec. 76 |
HIV infection/disease, pregnant woman, or perinatally exposed infant | Immediately (when discovered at or close to time of birth) | Sec. 76 |
Influenza | See subsection (f) | |
Legionellosis | Within 72 hours | Sec. 77 |
Leptospirosis | Within 72 hours | Sec. 78 |
Listeriosis | Within 72 hours | Sec. 79 |
Lyme disease | Within 72 hours | Sec. 80 |
Lymphogranuloma venereum | Within 72 hours | Sec. 81 |
Malaria | Within 72 hours | Sec. 82 |
Measles (rubeola) | Immediately | Sec. 83 |
Meningitis, aseptic | Within 72 hours | Sec. 84 |
Meningococcal disease, invasive | Immediately | Sec. 85 |
Mumps | Within 72 hours | Sec. 86 |
Pertussis | Immediately | Sec. 88 |
Plague | Immediately | Sec. 89 |
Poliomyelitis | Immediately | Sec. 90 |
Psittacosis | Within 72 hours | Sec. 91 |
Q Fever | Immediately | Sec. 92 |
Rabies in humans or animals (confirmed and suspect animal with human exposure) | Immediately | Sec. 93 |
Rabies, postexposure treatment | Within 72 hours | Secs. 93 and 52 |
Rocky Mountain spotted fever | Within 72 hours | Sec. 94 |
Rubella (German measles) | Immediately | Sec. 95 |
Rubella congenital syndrome | Immediately | Sec. 95 |
Salmonellosis, other than typhoid fever | Within 72 hours | Sec. 96 |
Shigellosis | Immediately | Sec. 97 |
Smallpox (variola infection) | Immediately | Sec. 97.5 |
Adverse events or complications due to smallpox vaccination (vaccinia virus infection) or secondary transmission to others after vaccination. This includes accidental implantation at sites other than the vaccination site, secondary bacterial infections at vaccination site, vaccinia keratitis, eczema vaccinatum, generalized vaccinia, congenital vaccinia, progressive vaccinia, vaccinia encephalitis, death due to vaccinia complications, and other complications requiring significant medical intervention. | Immediately | Sec. 97.5 |
Staphylococcus aureus, Vancomycin resistance level of MIC > 8 μg/mL | Immediately | Sec. 98 |
Streptococcus pneumoniae, invasive disease, and antimicrobial resistance pattern | Within 72 hours | Sec. 99 |
Streptococcus, Group A, invasive disease | Within 72 hours | Sec. 100 |
Streptococcus, Group B, invasive disease | Within 72 hours | Sec. 101 |
Syphilis | Within 72 hours | Sec. 102 |
Tetanus | Within 72 hours | Sec. 103 |
Toxic shock syndrome (streptococcal or staphylococcal) | Within 72 hours | Sec. 104 |
Trichinosis | Within 72 hours | Sec. 105 |
Tuberculosis, cases and suspects | Within 72 hours | Sec. 106 |
Tularemia | Immediately | Sec. 107 |
Typhoid fever, cases and carriers | Immediately | Sec. 108 |
Typhus, endemic (flea borne) | Within 72 hours | Sec. 109 |
Varicella, resulting in hospitalization or death | Within 72 hours | Sec. 110 |
Yellow fever | Within 72 hours | Sec. 111 |
Yersiniosis | Within 72 hours | Sec. 112 |
(e) Reporting of HIV infection/disease shall include classification as defined in the CDC Morbidity and Mortality Weekly Report, Volume 41, No. RR-17, 1993 Revised Classification System for HIV Infection and Expanded Surveillance Case Definition for AIDS among Adolescents and Adults. Reporting of HIV infection/disease in children less than thirteen (13) years of age shall include classification as defined in the CDC Morbidity and Mortality Weekly Report, Volume 43, No. RR-12, 1994 Revised Classification System for Human Immunodeficiency Virus Infection in Children Less Than 13 Years of Age. Supplemental reports shall be provided by the physician when an individual's classification changes. The CD4+ T-lymphocyte count and percentage or viral load count, or both, shall be included with both initial and supplemental reports.
(f) Influenza shall be reported within seventy-two (72) hours of either of the following occurrences:
(1) A human death in which an influenza diagnosis has been detected in the deceased by:
(A) commercial rapid antigen testing;
(B) viral culture;
(C) direct fluorescent antibody (DFA);
(D) indirect fluorescent antibody (IFA);
(E) enzyme immunoassay;
(F) reverse transcriptase-polymerase chain reaction (RT-PCR); or
(G) immunohistochemistry (IHC).
(2) A human death in which a strong probability of influenza has been detected in the deceased based on clinically compatible symptoms under any of the following circumstances:
(A) An influenza pandemic has been declared by the World Health Organization (WHO).
(B) Known pandemic influenza activity is occurring in the United States as determined by the Centers for Disease Control and Prevention (CDC).
(C) Known pandemic influenza activity is occurring in the local community as determined by the commissioner.
(f) (g) The department, under the authority of IC 4-22-2-37.1, may adopt emergency rules to include mandatory reporting of emerging infectious diseases. Reports shall include the information specified in subsection (c).
(g) (h) Outbreaks of any of the following shall be reported immediately upon suspicion:
(1) Any disease required to be reported under this section.
(2) Diarrhea of the newborn (in hospitals or other institutions).
(3) Foodborne or waterborne diseases in addition to those specified by name in this rule.
(4) Streptococcal illnesses.
(5) Conjunctivitis.
(6) Impetigo.
(7) Nosocomial disease within hospitals and health care facilities.
(8) Influenza-like illness.
(9) Unusual occurrence of disease.
(10) Any disease, that is:
(A) anthrax;
(B) plague;
(C) tularemia;
(D) Brucella species;
(E) smallpox; or
(F) botulinum toxin;
or chemical illness that is considered a bioterrorism threat, importation, or laboratory release.
(h) (i) Failure to report constitutes a Class A infraction as specified by IC 16-41-2-8.
(Indiana State Department of Health; 410 IAC 1-2.3-47; filed Sep 11, 2000, 1:36 p.m.: 24 IR 339; filed Oct 23, 2003, 4:10 p.m.: 27 IR 865; readopted filed Nov 8, 2006, 1:53 p.m.: 20061122-IR-410060424RFA; filed Jan 2, 2007, 2:49 p.m.: 20070131-IR-410050189FRA; filed Apr 16, 2008, 2:21 p.m.: 20080514-IR-410060425FRA)
Hearing Held: February 4, 2008
Approved by Attorney General: April 7, 2008
Approved by Governor: April 16, 2008
Filed with Publisher: April 16, 2008, 2:21 p.m.
Documents Incorporated by Reference: None Received by Publisher
Small Business Regulatory Coordinator: Robert Teclaw, Indiana State Department of Health, 2 North Meridian Street, 5K, Indianapolis, Indiana 46204, (317) 233-7807, rteclaw@isdh.in.gov
Posted: 05/14/2008 by Legislative Services Agency
DIN: 20080514-IR-410060425FRA
Composed: Apr 28,2024 6:18:14AM EDT
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