REPORTABLE LABORATORY FINDINGS
July 1, 1999The following list of reportable lab findings is up-to-date as of July 1, 1999. It cannot be entirely complete or static, as the technology of laboratory diagnosis continues to evolve. Thus, any finding that is highly suggestive (even if not confirmatory) of one of the reportable diseases, but does not appear on this list, should generate a report. Some of the findings on this list are from procedures carried out in only very specialized laboratories, such as reference labs, while others are the results of quite widely performed tests.
DISEASE |
FINDING(S) |
| Amebiasis | Identification of Entamoeba histolytica
in stool or in tissue biopsy specimen, or demonstration of specific antibody by specific immunodiagnostic tests |
| Anthrax | Isolation of Bacillus anthracis from a clinical specimen, demonstration of the organism in a clinical specimen by immunofluoresence (IF), or anthrax electrophorectic immunotransblot (EITB) reaction in one or more serum samples |
| Botulism | Detection of botulinal toxin in serum, stool or epidemiologically incriminated food, or isolation of Clostridium botulinum from a clinical specimen |
| Brucellosis | Isolation of Brucella sp. from a clinical specimen or detection by IF, or four-fold or greater rise in Brucella agglutination serum antibody |
| Campylobacteriosis | Isolation of Campylobacter from any clinical specimen |
| Cholera | Isolation of Vibrio cholerae O1 or O139 from a clinical specimen, or detection of specific serum antibody |
| Ciguatera Poisoning | Detection of ciguatoxin in epidemiologically implicated fish |
| Cryptosporidiosis | Identification of Cryptosporidium in stool, intestinal fluid or small bowel biopsy specimens, or detection of Cryptosporidium antigen in stool by an immunodiagnostic test, such as enzyme-linked immunosorbent assay (ELISA) |
| Cyclosporiasis | Identification of Cyclospora cayetanensis in stool, or detection of Cyclospora antigen by polymerase chain reaction (PCR) in clinical specimens |
| Dengue Fever | Isolation of dengue virus from serum or tissue, demonstration of four-fold or greater rise in specific serum antibody, or detection of dengue virus antigen in tissue or serum by immunofluorescence (IF) or by hybridization probe |
| Diphtheria | Isolation of Corynebacterium diphtheriae from a clinical specimen |
| Ehrlichiosis | Detection of four-fold or greater rise in serum antibody by IFA or EIA, detection of specific antigen in serum or CSF by PCR, or demonstration or intracytoplasmic morulae in clinical specimens |
| Encephalitis, arboviral | Detection of serum or cerebrospinal fluid (CSF) antibody to Eastern Equine, St. Louis, or other mosquito-borne encephalitis agents by serologic assay such as HAI, CF, IF, SN, or EIA |
| Encephalitis, post-infectious | Detection of measles, mumps, chicken pox, herpes, or influenza viral antibody in CSF |
| Escherichia coli O157 | Isolation of E. coli O157:H7, or detection of Shiga toxin-producing E. coli O157:NM from a clinical specimen |
| Giardiasis | Identification of Giardia Iamblia trophozooites or cysts in stool, duodenal fluid or small bowel biopsy, or detection of G. lamblia antigen in stool by specific immunodiagnostic tests |
| Hemophilus influenzae type b invasive disease | Isolation of H. influenzae type b (HIB) from blood, CSF or other sterile site (not including sputum), or detection of HIB antigen in CSF |
| Hansen’s Disease (Leprosy) |
Demonstration of acid fast bacilli in biopsy specimens from lepromatous lesions |
| Hantavirus Infection | Detection of hantavirus-specific serum antibody, or detection of antigen in clinical specimens by IF or hybridization probe |
DISEASE |
FINDINGS (continued) |
| Hemorrhagic Fever | Isolation of Junin, Machupo, Hantaan, Seoul, or Puumala viruses from blood, detection of four-fold or greater rise in specific antibody, or detection of specific serum IgM antibody |
| Hepatitis A | Detection of IgM antibody to hepatitis A virus (anti-HAV) |
| Hepatitis B | Detection of IgM antibody to hepatitis B core antigen (anti-HBc) or detection of hepatitis B surface antigen (HbsAg) |
| Hepatitis C | Detection of antibody to HCV by EIA or recombinant immunoassay (RIBA) or other assay or detection of HCV ribonucleic acid (RNA) by PCR or other assay |
| Lead Poisoning | Demonstration of a blood lead value of >10 ug/dL with venous or capillary specimen type specified |
| Legionellosis | Isolation of Legionella pneumophila from any normally sterile site, demonstration of a four-fold or greater rise in L. pneumophila serogroup 1 serum antibody by IFA, detection of L. pneumophila serogroup 1 in respiratory secretions, lung tissue or pleural fluid by direct fluorescent antibody (DFA), or detection of L. pneumophila serogroup 1 antigen in urine by RIA or ELISA |
| Leptospirosis | Isolation of Leptospira from a clinical specimen, demonstration of a four-fold or greater rise in Leptospira serum antibody, or detection of Leptospira in a clinical specimen by IFA |
| Listeriosis | Isolation of Listeria monocytogenes from any normally sterile site |
| Lyme Disease | Isolation of Borellia burgdorferi from a clinical specimen, or detection of IgG or IgM antibody in serum or CSF by EIA, IFA or Western Blot (WB) |
| Malaria | Identification of malaria parasites in blood films |
| Measles | Detection of measles IgM serum antibody, demonstration of significant rise in serum IgG antibody, or isolation of measles virus from a clinical specimen |
| Meningitis | Isolation of Streptococcus pneumoniae, Listeria monocytogenes, Streptococcus Group B, Haemophilus influenzae, or Streptococcus pneumoniae from CSF |
| Meningococcal Disease | Isolation of Niesseria meningitidis from CSF, blood or other normally sterile site, or detection of CSF antigen |
| Mercury Poisoning | Demonstration of mercury blood value of >5ug/dL |
| Mumps | Isolation of mumps virus from a clinical specimen, demonstration of four-fold or greater rise in serum IgG antibody, or detection of serum IgM antibody |
| Neurotoxic Shellfish Poisoning | Detection of neurotoxin from stool or from samples of epidemiologically implicated fish |
| Pertussis | Isolation of Bordetella pertussis from clinical specimen, detection of B. pertussis by PCR, or detection by direct fluorescent antibody (DFA) |
| Pesticide Poisoning | Detection of specific pesticide or its metabolic product in a clinical or biological specimen, or demonstration of abnormal cholinesterase levels in red blood cells or plasma |
| Plague | Isolation of Yersinia pestis from a clinical specimen or detection of serum antibody titer |
| Poliomyelitis | Isolation of wild poliovirus from throat or stool specimens, or demonstration of four-fold or greater rise in serum antibody |
| Psittacosis | Isolation of Chlamydia psittaci from a clinical specimen, demonstration of a four-fold or greater rise in microimmuno-fluoresence (MIF) or complement-fixation (CF) serum antibody, or detection of MIF IgM serum antibody |
| Rabies, Animal | Isolation of rabies virus or detection of antigen by IF in central nervous system tissue |
| Rabies, Human | Isolation of rabies virus from saliva, CSF, or central nervous system tissue, detection of antibody by DFA in clinical specimens, or demonstration of rabies-neutralizing serum antibody |
DISEASE |
FINDINGS (continued) |
| Rocky Mountain Spotted Fever | Isolation of Rickettsia rickettsii or demonstration of antigen by IF from a clinical specimen, demonstration of four-fold or greater rise in serum antibody by IFA, CF, LA, MA, or IHA test, or a positive PCR assay |
| Rubella | Isolation of Rubella virus, detection of serum IgM antibody, or demonstration of significant rise in serum IgG antibody |
| Salmonellosis | Isolation of Salmonella sp. from a clinical specimen |
| Shigellosis | Isolation of Shigella sp. from a clinical specimen |
| Smallpox | Isolation of Variola virus from clinical specimens, or detection of a rise in serum antibody |
| Staphylococcus aureus, glycopeptide intermediate (GISA/VISA) resistant | Isolation of S. aureus with an MIC of >8<32ug/mL for vancomycin from a clinical specimen |
| Staphylococcus aureus, glycopeptide (GRSA/VRSA) resistant | Isolation of S. aureus with an MIC of >32ug/mL for vancomycin from a clinical specimen |
| Streptococcal Disease, Group A Invasive | Isolation of group A Streptococcus (S. pyogenes) from a normally sterile site |
| Streptococcus pneumoniae, Invasive | Isolation of S. pneumoniae from a normally sterile site (e.g., blood or cerebrospinal fluid, or joint, pleural or pericardial fluid) |
| Toxoplasmosis | Identification of Toxoplasma gondii in a clinical specimen, or detection of four-fold or greater rise in serum antibody |
| Trichinosis | Identification of Trichinella spiralis larvae in tissue or a positive serologic test |
| Tularemia | Isolation of Francisella tularensis from a clinical specimen, demonstration of F. tularensis by IF, or detection of four-fold or greater change in serum antibody |
| Typhoid Fever | Isolation of Salmonella typhi from a clinical specimen |
| Vibrio Infections | Isolation of Vibrio sp. from a clinical specimen |
| Yellow Fever | Demonstration of yellow fever virus, antigen or genome in a clinical specimen, or four-fold rise in serum antibody |
Glossary: CF=complement fixation LA=latex agglutination
EIA=enzyme immunoassay MA=microagglutination
HAI=hemagglutination inhibition MIC=minimum inhibitory concentration
IFA=immunofluorescent antibody PCR=polymerase chain reaction
IgG=immunoglobulin G RIA=radioimmunoassay
IgM=immunoglobulin M RIBA=recombinant immunoassy
IHA=indirect hemagglutination SN=serum neutralization