Los Angeles County Municipal Code Part II Reporting

(Reference: Sections 2500, 2502, 2503, 2504, and 2508, Title 17, California Administrative Code)

SEC. 1 - REPORTING DISEASES (Section 2500)

Every person must report to the Health Officer any diagnosed or suspected case of any of the following diseases or conditions:

Amebiasis

Anthrax

Botulism

Brucellosis (Undulant Fever)

Chancroid

Cholera

Coccidioidomycosis

Conjunctivitis, Acute Infectious of the Newborn

(Gonorrheal Ophthalmia, Ophthalmia Neonatorum, and Babies' Sore Eyes in the first 21 days of life)

Dengue

Diarrhea of the Newborn

Diphtheria

Disorders Characterized by Lapses of Consciousness

Dysentery, Bacillary (See Shigella infections)

Encephalitis, viral

Food Poisoning (other than Botulism)

German Measles (Rubella)

Gonococcal Infections

Granuloma Inguinale

Hepatitis, Infectious (A)

Hepatitis, Serum (B)

Hepatitis, unspecified

Leprosy (Hansen's Disease)

Leptospirosis (including Weil's Disease)

Lymphogranuloma Venereum (Lymphogranuloma Inguinale)

Malaria

Measles (Rubeola)

Meningitis, Viral

Meningococcal Infections

Mumps

Paratyphoid Fever, A, B, and C (see Salmonella infections)

Pertussis (Whooping cough)

Plague

Poliomyelitis, paralytic

Psittacosis

Q Fever

Rabies, Human or Animal

Relapsing Fever

Rheumatic Fever, Acute

Rocky Mountain Spotted Fever

Salmonella, Infectious (exclusive of typhoid fever)

Scarlet fever

Shigella infections

Smallpox (Variola)

Streptococcal Infections, hemolytic (including Scarlet Fever, and Streptococcal Sore Throat)

Syphilis

Tetanus

Trachoma

Trichinosis

Tuberculosis

Tularemia

Typhoid fever, cases and carriers

Typhus fever

Viral Exanthem in Pregnant Women

Yellow fever

Unusual outbreaks of any disease

The report should include the person's full name, race, sex, age or date of birth, address, disease, date of onset, date of diagnosis, date of death, and name of person reporting.

The director of any clinical laboratory must report laboratory evidence suggestive of the diseases listed below to the District Health Officer on the same day that the physician who submitted the specimen is notified.

Diphtheria

Gonorrhea

Syphilis

Tuberculosis

Typhoid

The laboratory reports, which may be telephoned or written, must include the date, the result of the test, name, address, age of the patient and the name and address of the referring physician. Laboratory reports for tuberculosis received in the district should be sent to the Tuberculosis Register, Administrative Headquarters.

A laboratory report alone is not sufficient for the District Health Officer to contact the patient or his potential contacts. The diagnosis of the attending physician is essential before such a contact is made. The District Officer should make every effort to discuss the case and the laboratory report with the physician to facilitate the diagnosis. (Exceptions: In venereal disease cases, the professional staff in Venereal Disease Control may contact the attending physician.)

SEC. 2 - TELEPHONE REPORTS

Acute Communicable Disease Control staff may be reached during working hours at 974-7944. After working hours, on weekends or holidays, appropriate staff can be reached through the County operator at 974-1234.

The District Health Registrar immediately telephones reports of the following cases or suspected cases to the Morbidity Unit:

Anthrax

Botulism

Cholera

Dengue

Diphtheria

Food Poisoning

Meningitis, Meningococcal

Plague

Poliomyelitis

Rabies in humans/animals

Relapsing Fever (Louse-borne)

Smallpox

Typhoid Fever

Typhus Fever (Louse-borne)

Yellow Fever

Unusual Outbreak of Any Disease

The Morbidity Unit immediately delivers the CONFIRMATION OF NOTIFICATION OF COMMUNICABLE DISEASE INFORMATION, H-24, on cases listed above to the Chief, Acute Communicable Disease Control. In botulism and food poisoning, the TELEPHONE REPORT OF FOOD POISONING EPISODE, H-26, is immediately delivered to the Chief, Food and Drug Section.

The District Public Health Registrar immediately telephones reports of communicable disease, related to either dairy or to persons with or in contact with communicable diseases who are employed in sensitive occupations, to the Chief, Public Health Investigation. (See Sec. 13.)

The Morbidity Unit immediately notifies the Chief, Occupational Health when a communicable disease arises out of and in the course of employment, when the place of employment is in the County of Los Angeles jurisdiction. This includes, but is not limited to: anthrax, botulism, brucellosis, coccidioidomycosis, food poisoning, leptospirosis, psittacosis, Q fever, tetanus, and tularemia.

The Morbidity Unit telephones reports of deaths from quarantinable diseases to the Chiefs, Acute Communicable Disease Control and Public Health Investigation.

The Chief, Acute Communicable Disease Control, telephones or telegraphs reports of the following diseases to the State Department of Health: botulism, cholera, dengue, plague, relapsing fever (louse-borne), smallpox, typhus fever (louse-borne), yellow fever.

SEC. 3 - CONFIDENTIAL MORBIDITY REPORTS (CMR)—PM 110

The CMR is a standard report form on which tuberculosis, venereal disease and other communicable diseases must be reported within 24 hours of the diagnosis. This report form, PM 110, was formerly SDH 262-222.

SEC. 4 - EPIDEMIOLOGIC CASE HISTORY

Certain communicable diseases required an epidemiologic investigation and must be reported on forms specific for the disease entity. The forms required are in Part IV of this manual under the "reporting procedures" for each disease. For diseases not requiring specific forms, the CD INVESTIGATION, H-1138 is used. This form may also be used for supplemental data in any disease. Examples of epidemiologic case history forms and the processing of these forms are covered in the ACUTE COMMUNICABLE DISEASE FORMS MANUAL, B-160.

NOTE: All Epidemiologic Case History forms must be filled out completely. This information is vital for decision-making at all levels, local, state and federal.

SEC. 5

(Reference: Section 2502, Title 17, California Administrative Code)

Definition:

An outbreak is defined as an unusually high incidence of a disease in excess of normal expectancy in a given area or population group. One case of smallpox constitutes an outbreak, while several cases of measles, mumps or hepatitis in the population at large could be considered a normal occurrence. However, when these cases occur in a localized area of the community, a classroom, industry, apartment complex, hospital, etc., they would be considered outbreaks.

General Procedures:

Knowledge of an outbreak of infectious or parasitic disease or infestation, whether or not reportable, is investigated by the District Health Officer and reported to the Chief, Acute Communicable Disease Control. When the outbreak occurs anywhere other than in a health care facility, it is reported on the GENERAL INVESTIGATION RECORD, SDH-262501.

Health Care Facility Outbreaks:

Whoever receives knowledge of an outbreak initiates the CD OUTBREAK NOTICE—HEALTH CARE FACILITY, H-1163 and additionally, telephones Acute Communicable Disease Control when outbreak occurs in an acute care hospital.

Acute Care Hospital. Because of complex licensure requirements and the involvement of multiple districts, the Acute Communicable Disease Control staff is responsible for the epidemiological investigation in these facilities.

Convalescent Care Facility. The district Health Officer investigates and reports on the CD OUTBREAK INVESTIGATION— HEALTH CARE FACILITY, H-1164.

SEC. 6 - REPORTING OF UNUSUAL DISEASES

(Reference: Section 2503, Title 17, California Administrative Code)

When the District Health Officer encounters an unusual disease which warrants an investigation, he reports on the CD INVESTIGATION, H-1138.

Unusual diseases include but are not limited to cat scratch fever, echinococcosis, giardiasis, herpangina, histoplasmosis, rickettsialpox, toxoplasmosis and any unusual tropical infectious disease.

SEC. 7 - REPORTING A CONTACT OR POSSIBLE SOURCE OF INFECTION, OTHER THAN TUBERCULOSIS OR VENEREAL DISEASE, LOCATED OUTSIDE THE HEALTH DISTRICT OF THE CASE

When the case and contact or possible source of infection reside in different districts in Los Angeles County, the Public Health Registrar in the district of the case notifies the district where the contact or possible source of infection resides

When either the contact or possible source of infection is in another health jurisdiction out of Los Angeles County:

The Public Health Registrar in the district of the case telephones the Morbidity Unit, who then notifies the other health jurisdiction.

The Chief, Acute Communicable Disease Control, prepares any required correspondence.

SEC. 8 - CHANGE OF RESIDENCE OF PERSONS IN STRICT ISOLATION OR QUARANTINE INCLUDING COMMUNICABLE TUBERCULOSIS

When it is necessary for persons in strict isolation or quarantine to move, written permission is first obtained from the owner of the new premises or his agent. Inspection of the proposed residence must establish that it is or can be made suitable for isolation or quarantine. Moving into a multiple dwelling is evaluated individually considering the disease and situation; any change of residence is under the supervision of the District Health Officer of the Chief, Public Health Investigation.

All cases covered by this section must be reported immediately to the District Health Officer, and in cases of legal isolation and quarantine, to the Chief, Public Health Investigation.

SEC. 9 - CHANGE OF RESIDENCE OF PATIENTS WITH COMMUNICABLE DISEASE WHO ARE NOT ISOLATED OR QUARANTINED

TUBERCULOSIS PATIENTS (Under treatment or needing further evaluation)

Moving out of Los Angeles County. The District Nursing Director or her representative notifies the Tuberculosis Register. Where time is important, the District Nursing Director directly notifies the other health jurisdiction of the new residence.

Arrangements for continued care may be made by the District Nursing Director or District Director Public Health Social Worker by telephone or by a brief written statement.

Moving to another health district in Los Angeles County. The District Nursing Director notifies the Tuberculosis Register. Arrangements for continued care are telephoned to the new health district and the chart transferred. (See Order 0603.)

VENEREAL DISEASE PATIENTS

Moving out of Los Angeles County. When a possibly contagious patient moves to another health jurisdiction, the responsible venereal disease interviewer records the new address on the VENEREAL DISEASE EPIDEMIOLOGICAL REPORT, CDC 9.2936. Venereal Disease Control forwards this report to the other health jurisdiction of the new residence.

Moving to another health district in Los Angeles County. Continued care is arranged by telephone and the chart transferred. The responsible venereal disease interviewer forwards VENEREAL DISEASE EPIDEMIOLOGICAL REPORT, CDC 9.2936, to the new district and INTER-DISTRICT TRANSFER, NOTICE—VDER (2936), to Venereal Disease Control for syphilis cases and/or suspects. Whenever arrangements for patients described in B-1. and 2. have been made by telephone, this information, with the date of the call, is recorded on the reverse side of VENEREAL DISEASE EPIDEMIOLOGICAL REPORT, CDC 9.2936.

Non-infectious venereal disease cases. If a non-contagious patient in the venereal disease clinic moves to a new address in or out of Los Angeles County, his name will not be reported on VENEREAL DISEASE EPIDEMIOLOGICAL REPORT, CDC- 9.2936, unless his follow-up is indicated. If requested, these patients may be given information of facilities in the area of new residence.

OTHER PATIENTS (Except tuberculosis or venereal disease patients).

Moving out of Los Angeles County. Morbidity Unit is responsible for notifying the appropriated health jurisdiction.

Moving to another health district in Los Angeles County. For cases previously reported, the District Public Health Registrar notifies only the new district. For cases not previously reported, the District Public Health Registrar telephones the new address to MORBIDITY UNIT and notifies the new district.