WAC 246-101-201:

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246-101-120 << 246-101-201 >> 246-101-205

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.]