WAC 246-101-201   Notifiable conditions and laboratories.  This section describes the conditions about which Washington's laboratories must notify public health authorities of on a statewide basis. The board finds that the conditions in the table below (Table Lab-1) are notifiable for the prevention and control of communicable and noninfectious diseases and conditions in Washington. The board also finds that submission of specimens for many of these conditions will further prevent the spread of disease. Laboratory directors must notify public health authorities of positive cultures and preliminary test results as individual case reports and provide specimen submissions using procedures described throughout this chapter. Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.

     WAC 246-101-205, 246-101-210, 246-101-215, 246-101-220, 246-101-225, and 246-101-230 also include requirements for how notifications and specimen submissions are made, when they are made, the content of these notifications and specimen submissions, and how information regarding notifiable conditions cases must be handled and may be disclosed.


Table Lab-1 (Conditions Notifiable by Laboratory Directors)

Notifiable Condition Time Frame for Notification Notifiable to Local Health Department Notifiable to Department of Health Specimen Submission to Department of Health (Type & Timing)
Arboviral Disease (Isolation; Detection of Viral Nucleic Acid or Antibody) 2 days √  
Blood Lead Level Elevated Levels – 2 Days

Nonelevated Levels – Monthly		 √
Botulism (Foodborne) Immediately √   Serum and Stool - If available, submit suspect foods (2 days)
Botulism (Infant) Immediately √   Stool (2 days)
Botulism (Wound) Immediately √   Culture, Serum, Debrided tissue, or Swab sample (2 days)
Brucellosis (Brucella species) 2 days √   Subcultures (2 days)
CD4 + (T4) lymphocyte counts and/or CD4 + (T4) (patients aged thirteen or older) Monthly Only when the local health department is designated by the Department of Health √ (Except King County)
Chlamydia trachomatis infection 2 days √  
Cholera Immediately √   Culture (2 days)
Cryptosporidiosis 2 days √  
Cyclosporiasis 2 days √   Specimen (2 days)
Diphtheria 2 days √   Culture (2 days)
Disease of Suspected Bioterrorism Origin (examples):

• Anthrax

• Smallpox		 Immediately √   Culture (2 days)
Enterohemorrhagic E. coli (shiga-like toxin producing infections only) such as E. coli O157:H7 Infection 2 days √   Culture (2 days)
Gonorrhea 2 days √  
Hepatitis A (IgM positive) 2 days √  
Hepatitis B Monthly √  
Hepatitis C Monthly √  
Human immunodeficiency virus (HIV) infection (for example, positive Western Blot assays, P24 antigen or viral culture tests) 2 days Only when the local health department is designated by the Department of Health √ (Except King County)
Human immunodeficiency virus (HIV) infection (ll viral load detection test results - detectable and undetectable) Monthly Only when the local health department is designated by the Department of Health √ (Except King County)
Listeriosis 2 days √  
Measles (rubeola) Immediately √   Serum (2 days)
Meningococcal disease 2 days √   Culture (Blood/CSF or other sterile sites) (2 days)
Pertussis 2 days √  
Plague Immediately √   Culture or other appropriate clinical material (2 days)
Rabies (human or animal) Immediately √ (Pathology Report Only)   Tissue or other appropriate clinical material (Upon request only)
Salmonellosis 2 days √   Culture (2 days)
Shigellosis 2 days √   Culture (2 days)
Syphilis     Serum (2 days)
Tuberculosis 2 days   √ Culture (2 days)
Tuberculosis (Antibiotic sensitivity for first isolates) 2 days   √
Tularemia     Culture or other appropriate clinical material (2 days)
Other rare diseases of public health significance Immediately √  

     Additional notifications that are requested but not mandatory include:

     (1) Laboratory directors may notify either local health departments or the department or both of other laboratory results through cooperative agreement.

     (2) Laboratory directors may submit malaria cultures to the state public health laboratories.



[Statutory Authority: RCW 70.24.125. 06-16-117, § 246-101-201, filed 8/1/06, effective 9/1/06. Statutory Authority: RCW 43.20.050, 70.24.125. 05-03-055, § 246-101-201, filed 1/11/05, effective 2/11/05. Statutory Authority: RCW 43.20.050, 70.24.125 and 70.28.010. 00-23-120, § 246-101-201, filed 11/22/00, effective 12/23/00.]