Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 PART 1: COMMUNICABLE DISEASE CONTROL MEASURES Index: Section 1. Los Angeles County Lists of Reportable Diseases and Conditions Section 2. Healthcare Professional Mandatory Reporting Webpage Section 3. Confidential Morbidity Report (CMR) Section 4. Web-Based Reporting—Integrated Reporting, Investigation, and Surveillance System (IRIS) Section 5. Epidemiologic Case History Section 6. Sensitive Occupations or Situations Section 7. Reporting to Jurisdictions Outside of Los Angeles County Section 8. Long Beach and Pasadena Section 9. Interaction with Community Partners SECTION 1. LOS ANGELES COUNTY LISTS OF REPORTABLE DISEASES AND CONDITIONS The Los Angeles County Department of Public Health (LAC DPH) maintains lists of reportable diseases and conditions for both healthcare providers and laboratories as authorized by Title 17 of the California Code of Regulations (CCR) Sections 2500, 2505, and 2643.10. Both lists are unique to LAC and include reporting requirements specific to this jurisdiction, as well as including state and federal reporting requirements. In addition, both the provider and laboratories lists include LAC-specific reporting contact information and supplemental information. Accordingly, local providers and laboratories should adhere to LAC DPH’s reporting standards. Because these reporting requirements change frequently, accessing these lists online via our webpages is important to ensure aspects described are current. • List of Reportable Diseases and Conditions (Title 17 CCR, Section 2500) summarizes the LAC reporting requirements for healthcare professions and is available at: http://publichealth.lacounty.gov/acd/docs/ReportableDiseaseList.pdf • Reportable Conditions: Notification by Laboratories (Title 17 CCR, Sections 2505 and 2643.10) summarizes the LAC reporting standards for laboratories including required corresponding specimen submissions. This list is available at: http://publichealth.lacounty.gov/acd/docs/LabList.pdf PART 1: Communicable Disease Control Measures Page 1 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 In addition, the required timeline for reporting diseases and conditions can vary. It is especially important for healthcare professionals and laboratorians to be familiar with the diseases and conditions that require more urgent reporting since several must be reported immediately by phone to LAC DPH whether the cases are confirmed or suspected. Note: It is the duty of every health care provider, knowing of or in attendance on a case or suspected case of any of the diseases or conditions contained within the List of Reportable Diseases and Conditions, to report to the local health officer for the jurisdiction where the patient resides. Health care provider encompasses physicians (surgeons, osteopaths, complementary and alternative medicine practitioners), veterinarians, podiatrists, physician assistants, registered nurses (nurse practitioners, nurse midwives, school nurses), infection control professionals, medical examiners/coroners, dentists, and chiropractors, as well as any other person with knowledge of a case or suspected case. SECTION 2. HEALTH PROFESSIONAL MANDATORY REPORTING WEBPAGE Because there are many facets to disease reporting in LAC, a summary of reporting areas are provided on the webpage: Health Professional Mandatory Reporting available at: http://www.publichealth.lacounty.gov/clinicians/report/ As of December 2022, the Health Professional Mandatory Reporting webpage includes links for supplemental information to these unique reporting categories: COVID-19 Cases and Multisystem http://publichealth.lacounty.gov/acd/ncorona2019/reporti Inflammatory Syndrome in Children ng.htm#ReportingCases (MIS-C) COVID-19 Deaths http://publichealth.lacounty.gov/acd/ncorona2019/reporti ng.htm#ReportingDeaths Communicable Diseases (except COVID- http://www.publichealth.lacounty.gov/acd/Cdrs.htm 19, HIV, STD, TB) Tuberculosis http://ph.lacounty.gov/tb/reporting.htm Sexually Transmitted Diseases http://publichealth.lacounty.gov/dhsp/ReportCase.htm#ST D_Reporting_Information HIV/AIDS http://publichealth.lacounty.gov/dhsp/ReportCase.htm Animal Bites to Humans http://publichealth.lacounty.gov/vet/biteintro.htm Animals with a Disease http://publichealth.lacounty.gov/vet/disintro.htm PART 1: Communicable Disease Control Measures Page 2 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 Pesticide Related Illnesses http://www.publichealth.lacounty.gov/clinicians/report/pes ticide.htm Disorders Characterized by Lapses of http://www.publichealth.lacounty.gov/clinicians/report/LO Consciousness C.htm Parkinson’s Disease, reported to the https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDSRB California Department of Public Health /Pages/California-Parkinson's-Disease-Registry.aspx (CDPH) Suspected Foodborne Illness, reporting https://iris.ph.lacounty.gov/WorldCarePublicPortal/pages/f for the general public oodborneillness/reportincident.aspx In addition, the Health Professional Mandatory Reporting provides a link to the LAC DPH Clinical Consultation webpage (http://publichealth.lacounty.gov/professconsult.htm). This page lists the various phone numbers, by disease area, that healthcare providers can call to obtain 24-hour guidance regarding disease reporting and infection control. SECTION 3. CONFIDENTIAL MORBIDITY REPORT (CMR) (CCR, Title 17, Sections 2500([d] 1-2) California Code of Regulations requires that knowledge of specified diseases and conditions be communicated to the local Health Officer in a timely manner. This obligation can be met in several ways, including telephone, mail (postal service), facsimile device, and via internet. Regardless of the format, each report should contain the case’s full name, race, sex, age or date of birth, address, disease, date of onset, date of diagnosis, date of death (if applicable), and name and contacting information of the person making the report. While the California State CMR is the official reporting mechanism in California. LAC DPH uses a revision of that form with expanded variables including gender identity, sexual orientation, and sex at birth. LAC DPH’s CMR is posted online (http://www.publichealth.lacounty.gov/acd/pubs/reports/CMR-H-794.pdf) in a fillable format which can be emailed, mailed, or faxed in order to file the case report. Send forms by email to LAC DPH ACDC Morbidity Unit: [email protected] Send forms by mail to: Morbidity Unit, 313 N. Figueroa Street #117, Los Angeles CA 90012 Send forms by facsimile (fax): 888-397-3778 or 213-482-5508 Assistance is available by calling the Morbidity Unit at: 888-397-3993 PART 1: Communicable Disease Control Measures Page 3 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 This form is not intended for reporting HIV, AIDS, sexually transmitted diseases, or tuberculosis. In addition, COVID-19 reports require additional information. For these reports, consult the appropriate websites as provided on the Health Professional Mandatory Reporting webpage and described above in SECTION 2. SECTION 4. WEB-BASED REPORTING—INTEGRATED REPORTING, INVESTIGATION, AND SURVEILLANCE SYSTEM (IRIS) LAC DPH also receives reports electronically through our web-based system. The system previously titled Web vCMR, was improved and is now titled: the LAC DPH Integrated Reporting, Investigation, and Surveillance System (IRIS). IRIS is an electronic reporting system for communicable diseases. Its main purpose is to make disease reporting, investigation, and tracking more efficient for Disease Control Programs in LAC. IRIS contains information for the full investigative cycle of a disease or outbreak from date of onset to the final resolution. Questions regarding our web-based reporting system can be addressed to: [email protected] SECTION 5. EPIDEMIOLOGIC CASE HISTORY The California Code of Regulations, Title 17, Section 2502(b) lists state and federal disease reporting forms for certain communicable diseases. Forms specific to the county also exist and are utilized, in addition to state and federal forms, for disease reporting. A list of these forms is posted on the Epidemiologic Case History Report Form webpage (http://publichealth.lacounty.gov/acd/EpiForms.htm). For diseases not requiring specific forms, the Outbreak/Unusual Disease Report (CDPH-8554) is used Epidemiologic case history forms are initiated by either the investigating district Public Health Nursing Supervisor (PHNS) or a representative from Acute Communicable Disease Control (ACDC). Investigations should proceed even if disease confirmation or complete laboratory information is not available and should be completed within the time frame indicated under each disease. If the investigator determines that no reportable disease existed, the CMR should be canceled by notifying the PHNS. Investigations completed by ACDC are returned to the LAC DPH Morbidity Unit for processing. SECTION 6. SENSITIVE OCCUPATIONS OR SITUATIONS Persons with certain communicable diseases or their contacts may be a risk to the community by nature of their work duties. Reports of such cases or contacts in sensitive occupations or situations (SOS) are PART 1: Communicable Disease Control Measures Page 4 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 reviewed by LAC DPH to determine whether their duties impact public safety and might require removal from work. SOS include, but are not limited to, those involved in direct care of persons in health care facilities (e.g., hospitals, clinics, physician offices, dental offices, nursing facilities) or group settings (e.g., child-care settings, institutions, shelters) where transmission from a case is a potential public health concern. In addition, persons in SOS may include, but are not limited to, persons who attend any form of child-care, or other congregate programs where transmission from a case is a potential public health concern. Factors that might impact the spread of disease, such as demonstrating the ability to capably wash hands, might be used to consider whether an individual should or should not be excluded from the location. Food handler is an occupation that often is under consideration for SOS. A food employee as defined in Health and Safety Code 113788 (California Retail Food Code) as an employee working with food, food equipment or utensils, or food-contact surfaces; or any occupation involving the preparation, serving, or handling of food, including milk, to be consumed by individuals other than the person’s immediate family. For example, a vendor handling entirely wrapped bread is not a food handler, whereas a baker who handles unwrapped bakery products is a food handler. In general, persons handling food items which will not undergo further processing (e.g., canning, cooking, etc.) must be carefully assessed as to potential for transmission of disease. LAC DPH is available for consultation (LAC DPH Clinical Consultation) to determine whether an occupation or duties meet the definition of SOS. SECTION 7. REPORTING TO JURISDICTIONS OUTSIDE OF LAC When a case, contact, or possible source of infection resides in a jurisdiction outside of LAC, LAC DPH notifies the public health officials of the appropriate location. If the health jurisdiction is within the State of California, the LAC DPH Morbidity Unit notifies the other health jurisdiction. When notices are received on cases whose residence is outside of California, generally the Morbidity Unit will send them directly to the State Department of Public Health. For cases that require urgent follow-up or that involve contacts or possible sources of infection in a health jurisdiction outside of California, notification will be handled by ACDC via the State Department of Public Health. If a SOS is involved, removal from the job will be conducted by the Public Health Investigator (PHI) in the health jurisdiction where the case or contact works. PART 1: Communicable Disease Control Measures Page 5 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 SECTION 8. CITIES OF LONG BEACH AND PASADENA Within LAC, there are two other local health departments, as authorized by the State of California, which operate similar public health functions for their jurisdictions—these are the City of Long Beach and the City of Pasadena. LAC DPH routinely directs disease reports and surveillance information to these two jurisdictions so they can effectively monitor and respond to the public health needs of their residents. LAC DPH engages and coordinates with the Directors, Health Officers, and key staff from each of these two city health departments in planning for and responding to health data, lab results, new federal and state guidance, and other information and public health needs. Additionally, Long Beach and Pasadena Public Health Departments are incorporated seamlessly in the LAC Emergency Medical Services network and Hospital Preparedness Program functions and activities across LAC's 4,000 square miles. They are also included in the Medical Health Operational Area Coordination (MHOAC) structure that assesses and responds to health and public health resource needs locally, regionally, and statewide. Both these local health departments also each rely on LAC DPH's Public Health Lab as their Laboratory Response Network Lab, which provides environmental and clinical testing to rule out bioterrorism and other select agents. Additional information and reporting information for these two unique jurisdictions are available here: City of Pasadena Public Health Department - Main web page - https://www.cityofpasadena.net/public-health/ - Disease reporting page for healthcare - https://www.cityofpasadena.net/public- providers health/healthcare-providers/ Long Beach Health and Human Services - Main web page - https://www.longbeach.gov/health/ - Communicable disease reporting forms - https://www.longbeach.gov/health/inspections- and-reporting/forms/communicable-disease/ SECTION 9. INTERACTION WITH COMMUNITY PARTNERS LAC DPH routinely partners with other agencies, departments, and community stakeholders. A core aspect of LAC DPH’s duties include monitoring and tailoring public health information (such as case rates, hospitalization and fatality rates by age, sex, race, ethnicity, and geography) to better inform and improve the health and safety of the many diverse and unique communities within our jurisdiction. We PART 1: Communicable Disease Control Measures Page 6 of 7 Acute Communicable Disease Control Manual (B-73) Revised 12.22.22 collaborate with and inform many community-based organizations, faith-based organizations, and other county departments. This includes working closely with the Department of Corrections to track disease among persons who are incarcerated. We also work closely with organizations to ensure our efforts include, address, and assist persons experiencing homelessness. Our collaborations have enabled LAC DPH to enact comprehensive outreach and response activities such as distributing and dispensing vaccine in the most highly impacted communities. LAC DPH works especially closely with healthcare partners. This includes providing webinars and outreaches to improve infection control. Information about our Healthcare Outreach Unit is available on our website (http://publichealth.lacounty.gov/acd/HOU.htm). Health alerts are sent routinely to inform local medical professionals through the Los Angeles County Health Alert Network (LAHAN). Information to register for LAHAN as well as archival alerts are available on our webpage: http://publichealth.lacounty.gov/eprp/lahan/lahan.htm LAC DPH also monitors and responds to reports submitted by the public. These reports are received through multiple channels, including but not limited to, departmental email addresses (as displayed on our webpages), our Foodborne Incident Report system, and our Department of Environmental Health. Notifications from the public have initiated LAC DPH investigations—which have revealed outbreaks, product recalls, and more. These beneficial outcomes prompted by public reports demonstrate the value of maintaining connections with our constituents. Finally, LAC DPH develops and maintain an extensive library of educational materials for healthcare providers and the public. These materials are tailored to best address unique populations and the vast range of languages of our residents. Materials are stored on our webpages by disease/condition or topic. Consult the LAC DPH topic A- Z Index for area of interest: http://publichealth.lacounty.gov/phcommon/public/AtoZTopics/AtoZpubDisplayAll.cfm?alpha=ALL PART 1: Communicable Disease Control Measures Page 7 of 7