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(Effective until January 31, 2022)

PDFWAC 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 Table Lab-1 of this section 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.
(1) Laboratory directors shall notify public health authorities of positive preliminary test results and positive final test results of the conditions identified in Table Lab-1 of this section as individual case reports and provide specimen submissions following the requirements in WAC 246-101-205, 246-101-210, 246-101-215, 246-101-220, 246-101-225, and 246-101-230.
(2) Local health officers may require additional conditions to be notifiable within the local health officer's jurisdiction.
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)
Arboviruses
(West Nile virus, eastern and western equine encephalitis, dengue, St. Louis encephalitis, La Crosse encephalitis, Japanese encephalitis, Powassan, California serogroup, Chikungunya)
2 business days
 
On request
Acute:
IgM positivity
PCR positivity
Viral isolation
 
 
 
 
Bacillus anthracis (Anthrax)
Immediately
 
Culture (2 business days)
Blood Lead Level
Elevated Levels - 2 business days
Nonelevated Levels - Monthly
 
 
Bordetella pertussis (Pertussis)
Within 24 hours
 
Culture, when available (2 business days)
Borrelia burgdorferi (Lyme disease)
2 business days
 
On request
Borrelia hermsii or recurrentis (Relapsing fever, tick- or louse-borne)
Within 24 hours
 
On request
Brucella species (Brucellosis)
Within 24 hours
 
Cultures (2 business days)
Burkholderia mallei and pseudomallei
Immediately
 
Culture (2 business days); additional specimens when available
Campylobacter species (Campylobacteriosis)
2 business days
 
On request
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)
 
Chlamydophila psittaci (Psittacosis)
Within 24 hours
 
On request
Chlamydia trachomatis
2 business days
 
 
Clostridium botulinum (Botulism)
Immediately
 
Serum and/or stool; any other specimens available (i.e., foods submitted for suspected foodborne case; debrided tissue submitted for suspected wound botulism) (2 business days)
Corynebacterium diphtheriae (Diphtheria)
Immediately
 
Culture (2 business days)
Coxiella burnetii (Q fever)
Within 24 hours
 
Culture (2 business days)
Cryptococcus non v. neoformans
N/A
N/A
 
Culture (2 business days) or other specimens upon request
Cryptosporidium (Cryptosporidiosis)
2 business days
 
On request
Cyclospora cayetanensis (Cyclosporiasis)
2 business days
 
Specimen (2 business days)
E. coli - Refer to "Shiga toxin-producing E. coli"
Immediately
 
 
Francisella tularensis (Tularemia)
Immediately
 
Culture or other appropriate clinical material (2 business days)
Giardia lamblia (Giardiasis)
2 business days
 
On request
Haemophilus influenzae (children < 5 years of age)
Immediately
 
Culture, from sterile sites only, when type is unknown (2 business days)
Hantavirus
Within 24 hours
 
On request
Hepatitis A virus (acute) by IgM positivity
(Hepatocellular enzyme levels to accompany report)
Within 24 hours
 
On request
Hepatitis B virus (acute) by IgM positivity
Within 24 hours
 
On request
Hepatitis B virus
Monthly
 
 
 
- HBsAg (Surface antigen)
 
 
 
 
 
- HBeAg (E antigen)
 
 
 
 
 
- HBV DNA
 
 
 
 
Hepatitis C virus
Monthly
 
 
Hepatitis D virus
2 business days
 
On request
Hepatitis E virus
Within 24 hours
 
On request
Human immunodeficiency virus (HIV) infection (for example, positive Western Blot assays, P24 antigen or viral culture tests)
2 business 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)
 
Influenza virus, novel or unsubtypable strain
Immediately
 
Isolate or clinical specimen (2 business days)
Legionella species (Legionellosis)
Within 24 hours
 
Culture (2 business days)
Leptospira species (Leptospirosis)
Within 24 hours
 
On request
Listeria monocytogenes
(Listeriosis)
Within 24 hours
 
Culture (2 business days)
Measles virus (rubeola)
Acute:
IgM positivity
PCR positivity
Immediately
 
Isolate or clinical specimen associated with positive result (2 business days)
Mumps virus
Acute:
IgM positivity
PCR positivity
Within 24 hours
 
Isolate or clinical specimen associated with positive result (2 business days)
Mycobacterium tuberculosis (Tuberculosis)
2 business days
 
Culture (2 business days)
Mycobacterium tuberculosis (Tuberculosis) (Antibiotic sensitivity for first isolates)
2 business days
 
 
Neisseria gonorrhoeae (Gonorrhea)
2 business days
 
 
Neisseria meningitidis (Meningococcal disease)
Immediately
 
Culture (from sterile sites only) (2 business days)
Plasmodium species (Malaria)
2 business days
 
On request
Poliovirus
Acute:
IgM positivity
PCR positivity
Immediately
 
Isolate or clinical specimen associated with positive result (2 business days)
Rabies virus (human or animal)
Immediately
√ (Pathology Report Only)
 
Clinical specimen associated with positive result (2 business days)
Salmonella species (Salmonellosis)
Within 24 hours
 
Culture (2 business days)
SARS-associated coronavirus
Immediately
 
Isolate or clinical specimen associated with positive result (2 business days)
Shiga toxin-producing E. coli (enterohemorrhagic E. coli including, but not limited to, E. coli O157:H7)
Immediately
 
Culture (2 business days) or specimen if no culture is available
Shigella species (Shigellosis)
Within 24 hours
 
Culture (2 business days)
Treponema pallidum (Syphilis)
2 business days
 
Serum (2 business days)
Trichinella species
2 business days
 
On request
Vancomycin-resistant Staphylococcus aureus
Within 24 hours
 
Culture (2 business days)
Variola virus (smallpox)
Immediately
 
Isolate or clinical specimen associated with positive result (2 business days)
Vibrio cholerae O1 or O139 (Cholera)
Immediately
 
Culture (2 business days)
Vibrio species (Vibriosis)
Within 24 hours
 
Culture (2 business days)
Viral hemorrhagic fever:
Arenaviruses
Bunyaviruses
Filoviruses
Flaviviruses
Immediately
 
Isolate or clinical specimen associated with positive result (2 business days)
Yellow fever virus
Immediately
 
Serum (2 business days)
Yersinia enterocolitica or pseudotuberculosis
Within 24 hours
 
On request
Yersinia pestis (Plague)
Immediately
 
Culture or other appropriate clinical material (2 business days)
 
(√) Indicates which agency should receive case and suspected case reports.
(3) The local health department may request laboratory reporting of additional test results pertinent to an investigation of a notifiable condition (e.g., hepatocellular enzyme levels for hepatitis or negative stool test results on salmonellosis rescreening).
(4) Laboratory directors may notify the local health department, the department, or both of other laboratory results.
[Statutory Authority: RCW 43.20.050. WSR 11-02-065, § 246-101-201, filed 1/4/11, effective 2/4/11. Statutory Authority: RCW 70.24.125. WSR 06-16-117, § 246-101-201, filed 8/1/06, effective 9/1/06. Statutory Authority: RCW 43.20.050, 70.24.125. WSR 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. WSR 00-23-120, § 246-101-201, filed 11/22/00, effective 12/23/00.]
(Effective January 31, 2022)

PDFWAC 246-101-201

Notifiable conditionsLaboratories.

(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
Within 2 business days
 
 
 
If no isolate available, specimen associated with presumptive positive result
 
Bacillus cereus, biovar anthracis only
Confirmed positive result by any method
Immediately to LHJ
Do not ship specimen
Do not ship specimen
Baylisascaris (Baylisascariasis)
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, parkeri, turicatae, miyamotoi, 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. melitensis, B. abortus, or B. suis
Within 2 business days
 
 
 
If no isolate available, specimen associated with positive result
 
Burkholderia mallei (Glanders)
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
 
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 (Campylobacteriosis)
Positive result by:
  Culture,
  Nucleic acid detection (NAT or NAAT), or
  Antigen detection
Within 2 business days to LHJ
Isolate
Within 2 business days of request by LHJ or DOH
 
 
If no isolate available, specimen associated with positive result
 
Candida auris
Positive result by any method
Within 24 hours to LHJ
Isolate
Within 2 business days
 
 
 
If no isolate available, specimen associated with positive result
 
Carbapenem-resistant Enterobacteriaceae:
  Klebsiella species
  E. coli
  Enterobacter species
Positive for known carbapenemase 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 carbapenemase production including, but not limited to, Metallo-B-lactamase test, modified Hodge test (MHT) (for E. coli and Klebsiella species only), CarbaNP, Carbapenem Inactivation Method (CIM) or modified CIM (mCIM)
Resistant to any carbapenem including, but not limited to, doripenem, ertapenem, imipenem 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
Within 2 business days
 
 
 
If no isolate available, specimen associated with presumptive positive result
 
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 diphtheriae (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 cayetanensis (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
Within 2 business days
 
 
 
If no isolate available, specimen associated with presumptive positive result
 
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
Within 2 business days
 
 
 
If no isolate available, specimen associated with presumptive positive result
 
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 capsulatum (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/enterohemorrhagic 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 enterocolitica, Y. pseudotuberculosis, Y. intermedia, Y. fredericksenii, or Y. kristensenii (Yersiniosis)
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.
[Statutory Authority: RCW 43.20.050, 70.28.032, and 70.24.130. WSR 21-11-040, § 246-101-201, filed 5/12/21, effective 1/31/22. Statutory Authority: RCW 43.20.050. WSR 11-02-065, § 246-101-201, filed 1/4/11, effective 2/4/11. Statutory Authority: RCW 70.24.125. WSR 06-16-117, § 246-101-201, filed 8/1/06, effective 9/1/06. Statutory Authority: RCW 43.20.050, 70.24.125. WSR 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. WSR 00-23-120, § 246-101-201, filed 11/22/00, effective 12/23/00.]
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