STATE OF FLORIDA

DEPARTMENT OF HEALTH

CHAPTER 64D-3, FLORIDA ADMINISTRATIVE CODE

CONTROL OF COMMUNICABLE DISEASES AND

CONDITIONS WHICH MAY SIGNIFICANTLY AFFECT MAN

AMENDING SECTIONS 64D-3.002, 64D-3.003, 64D-3.004,

64D-3.006, 64D-3.013, 64D-3.015, AND 64D-3.016

CREATING SECTION 64D-3.027

 

64D-3.002 Notifiable Diseases or Conditions To Be Reported, Human.

(1) The following notifiable diseases or conditions are declared as dangerous to the public’s health or of public health significance. The occurrence or suspected occurrence of these diseases listed in Rule 64D-3.002, or the suspected occurrence with the exception of cancer, congenital anomalies, and HIV infection carriers of certain diseases listed in Rule 64D-3.013 in any person, including persons who at the time of death were so affected, shall be reported by licensed the attending practitioners as defined in s.381.0031, F.S., Rule 64D-3.076 to the local county public health department director or administrator or to their designated representative in the county of the patient’s residence. Such reports shall be made within 72 48 hours of recognition by telephone, or other electronic means, or in writing, except for certain specified diseases as indicated below by a (T) which shall be reported immediately by telephone. Telephone reports shall be followed by a subsequent written report. Exceptions to the reporting time frames required as defined by this rule are provided for by syphilis, as indicated in 64D-3.016(3), and AIDS, as indicated in 64D-3.016(1)(a)098(1)(a)1.,2., and congenital anomalies, as indicated in 64D-3.025(4). Cancer cases treated or diagnosed by licensed practitioners as defined in s.381.0031, F.S., in medical facilities licensed under Chapter 395, F.S., and in each freestanding radiation therapy center as defined in s.408.07, F.S., shall be reported to the Florida Cancer Data System as required by s.385.202, F.S., and by 64D-3.006.

(a) Acquired Immune Deficiency Syndrome (AIDS)

(b) Amebiasis

(c) Animal bite to humans only by a potentially rabid animal

(d) Anthrax (T)

(e) Botulism (T)

(f) Brucellosis

(g) Campylobacteriosis

(h) Cancer (except non melanoma skin cancer)

(i) Chancroid

(j) Chlamydia trachomatis

(k) Ciguatera

(l) Congenital anomalies Cryptosporidiosis

(m) Cryptosporidiosis Cyclosporosis

(n) Cyclosporiasis Dengue

(o) Dengue Diphtheria (T)

(p) Diphtheria (T) Ehrlichiosis, human

(q) Ehrlichiosis, human Encephalitis

(r) Encephalitis Enteric disease due to Escherichia coli 0157:H7

(s) Enteric disease due to Escherichia coli O157:H7 (T) Enteric disease due to other pathogenic Escherichia coli (including enterotoxigenic, enteroinvasive, enteropathogenic, enterohemorrhagic, and enteroaggregative strains)

(t) Enteric disease due to other pathogenic Escherichia coli (including enterotoxigenic, enteroinvasive, enteropathogenic, enterohemorrhagic, and enteroaggregative strains) Giardiasis (acute)

(u) Giardiasis (acute) Gonorrhea

(v) Gonorrhea Granuloma Inguinale

(w) Granuloma Inguinale Haemophilus Influenzae Type b invasive disease

(x) Haemophilus influenzae type b invasive disease Hansen’s Disease (Leprosy)

(y) Hansen’s Disease (Leprosy) Hantavirus infection

(z) Hantavirus Infection (T) Hemolytic Uremic Syndrome

(aa) Hemolytic Uremic Syndrome Hemorrhagic Fever (T)

(bb) Hemorrhagic Fever (T) Hepatitis

(cc) Hepatitis, viral A (T), B, C, non-A non-B, and other including unspecified Histoplasmosis

(dd) Hepatitis, viral, positive B surface antigen in a pregnant woman or in a child <25 months of age Kawasaki

(ee) Human Immunodeficiency Virus (HIV) Lead Poisoning

(ff) Lead Poisoning Legionnaire’s Disease

(gg) Legionellosis Leptospirosis

(hh) Leptospirosis Lyme Disease

(ii) Listeriosis (T) Lymphogranuloma Venereum

(jj) Lyme Disease Malaria

(kk) Lymphogranuloma Venereum Measles (T)

(ll) Malaria Meningitis

(mm) Measles (T) Meningococcal Disease

(nn) Meningitis, bacterial and mycotic Mercury Poisoning

(oo) Meningococcal Disease (T) Mumps

(pp) Mercury Poisoning (T) Paralytic Shellfish Poisoning (T)

(qq) Mumps Pertussis

(rr) Neurotoxic Shellfish Poisoning (T) Pesticide Poisoning

(ss) Pertussis Plague (T)

(tt) Pesticide Poisoning Poliomyelitis (T)

(uu) Plague (T) Psittacosis

(vv) Poliomyelitis (T) Rabies

(ww) Psittacosis Rocky Mountain Spotted Fever R. rickettsia

(xx) Rabies Reye Syndrome

(yy) Rocky Mountain Spotted Fever, R. rickettsia Rubella, including congenital

(zz) Rubella, including congenital Salmonellosis

(aaa) Salmonellosis Shigellosis

(bbb) Shigellosis Streptococcal Disease, invasive, Grp A

(ccc) Smallpox (T) Streptococcal Toxic Shock Syndrome

(ddd) Staphylococcus aureus, glycopeptide (vancomycin) intermediate (GISA/VISA, MIC=8ug/ml) Streptococcus pneumoniae, drug resistant

(eee) Staphylococcus aureus, glycopeptide (vancomycin) resistant (GRSA/VRSA, MIC= >32mg/ml) (T) Syphilis

(fff) Streptococcal Disease, invasive, Group A Tetanus

(ggg) Streptococcus pneumoniae, invasive disease Toxic Shock Syndrome

(hhh) Syphilis Toxoplasmosis, acute

(iii) Tetanus Trichinosis

(jjj) Toxic Shock Syndrome, staphylococcal or streptococcal Tuberculosis

(kkk) Toxoplasmosis, acute Typhoid Fever

(lll) Trichinosis Typhus (T)

(mmm) Tuberculosis Vibrio cholera (T)

(nnn) Tularemia (T) Vibrio Infections

(ooo) Typhoid Fever Yellow Fever (T)

(ppp) Vibrio cholerae (T) Any disease outbreak in a community, a hospital, or other institution, or a foodborne, or waterborne outbreak as defined in Rule 10D-3.064.

(qqq) Vibrio Infections

(rrr) Yellow Fever (T)

(sss) Any disease outbreak in a community, a hospital, or other institution, or a foodborne, or waterborne outbreak (T)

(2) The Ddepartment periodically will periodically list additional diseases and conditions on its reporting forms for which reporting is encouraged but not required.

Specific Authority 381.0011(4), (13), 381.003(2), 381.0031(5), 384.33, 392.53, 392.66, FS. Law Implemented 154.01, 381.0011(4), 381.003(1), 381.0031 (1),(2),(5) (FL. Laws Chap 98-151), 384.23, 384.25, 385.202, 392.53, FS. History - New 12-29-77, Amended 6-7-82, 11-6-85, Formerly 10D-3.62, Amended 2-26-92, 9-7-93, 11-1-94, 7-21-96, Formerly 10D-3.062, Amended 11-2-98. Amended _______.

64D-3.003 Notification by Laboratories.

    1. Each laboratory director or designee in charge of a laboratory in which an examination of any specimen derived from a human body, or from an animal in the case of rabies or plague testing, yields evidence suggestive or diagnostic of diseases or conditions listed in 64D-3.002(1), shall report, or cause to be reported, such findings All laboratories that provide evidence suggestive of any notifiable disease shall be made available upon request to representatives of the county health department director or administrator or the State Health Officer or to either of their designated representatives or to other specifically-named representatives, of the county health department director or administrator or the State Health Officer. Exceptions to laboratory reporting as defined by this rule are provided for sexually transmitted diseases including AIDS, as indicated in 64D-3.017.

(2) All reports of cancer identified by laboratories licensed under Chapter 483, F.S., shall be submitted to the Florida Cancer Data System within six (6) months of diagnosis.

(3) The State Health Officer shall periodically, but no less than annually, issue a listing of laboratory test results that are to be reported. The March 1999 "Reportable Laboratory Findings," incorporated by reference in this rule, shall be updated to reflect changes in technology and practice and may be obtained from the Department of Health, Bureau of Epidemiology, 2020 Capital Circle S.E., Bin A12, Tallahassee, Florida 32399-1734.

(4) To allow follow-up of laboratory findings by the local county health department director/administrator or their designee, all specimens submitted for laboratory tests or examinations related to a disease or condition listed in 64D-3.002(1) shall be accompanied by certain identifying information. In addition to the name and date of birth of the person from whom the specimen was obtained; the name, address and telephone number of the processing clinical laboratory; and the diagnostic test(s) performed, specimen type and result, the following information shall be provided:

(a) Address, telephone number, race, sex, and ethnicity of the person from whom the specimen was obtained or, if this is not available,

    1. Name, address and telephone number of the submitting physician, health care provider or other authorized person who submitted the specimen.

(5) The practitioner who first authorizes, orders, requests or submits a specimen shall be responsible for obtaining and providing the information required in (4) above at the time the specimen is sent to or received by the laboratory.

(6) Notification of test results shall be submitted by telephone, or other electronic means, or in writing on a form furnished by the laboratory. Reports shall be made within 72 hours of a test result. Any preliminary telephone communication must be followed up by a written report.

(7) If the laboratory that makes the positive finding received the specimen from another laboratory, the laboratory making the positive finding shall be responsible for reporting such results as defined in 64D-3.003(1).

(8) In addition to the reporting requirements pursuant to 64D-3.003(1), each laboratory that obtains a human isolate of Escherichia coli O157:H7, or Neisseria meningitidis or Haemophilus influenzae from a sterile site shall retain a subculture of the isolate on suitable media for at least six months after receipt of the specimen in the laboratory. In lieu of retaining this subculture, the laboratory is permitted to send the subculture to the Florida Department of Health State Central Laboratory, which will maintain a record indicating the date that these subcultures were submitted to the Central Laboratory.

(9) In addition to the reporting requirements pursuant to 64D-3.003(1), each laboratory that makes a finding, or suggestive finding, of malaria or cyclospora parasites in a specimen of a patient shall retain a stained permanent slide for at least six months after receipt of the specimen in the laboratory. In lieu of retaining the slide(s), the laboratory may send such slide(s) to the State of Florida Department of Health Central Laboratory, which will maintain a record indicating the date that these specimens were submitted to the Central Laboratory.

(10) Each laboratory licensed to perform tests for any reportable disease or condition shall make its records for such diseases or conditions available for on-site inspection by the department or its authorized representatives.

Specific Authority 381.0011(13), 381.003(1)(d), (2), 381.0031(5), 384.33 FS. Law Implemented 154.01, 381.0011(4), 381.003(1), 381.0031(1),(5), (Fl. Laws Chap.98-151), 384.25 FS. History—New 12-29-77, Amended 6-7-82, Formerly 10D-3.66, Amended 2-26-92, 7-21-96, Formerly 10D-3.066, Amended 11-2-98. Amended __________.

64D-3.004 Notifiable Disease Case Report Content.

All notifiable disease case reports required by Sections 64D-3.002 and 64D-3.003 shall contain the diagnosis, name, address, age, sex, and race and ethnicity if known, and age of each case.

Specific Authority 381.0011(4), (13), 381.003(1)(d), (2), 381.0031(1), (5), 384.25 FS. Law Implemented 381.0011(4), 381.003(1), 381.0031(1) FS. History – New 12-29-77, Amended 6-7-82, Formerly 10D-3.68, 10D-3.068. Amended ___________.

64D-3.006 Reports, Medical Facilities and Freestanding Radiation Therapy Centers

(1) No change

(2) Reporting of a case or suspected case of notifiable disease or condition by a facility or center fulfills the requirements of the licensed attending practitioner to report; however, it is the responsibility of the attending practitioner to ensure that the report is made as stipulated in Section 64D-3.002. Reports shall be made within 72 hours of diagnosis. Exceptions to medical facility and center reporting as defined by this rule are provided for sexually transmissible diseases, including HIV infection, as indicated in 64D-3.016, and for cancer, as indicated in 64D-3.006(3).

(3) Reporting of cancer cases by a licensed practitioner, a hospital facility licensed under Chapter 395, F.S., and freestanding radiation therapy centers, as defined in s.408.07, F.S., to the Florida Cancer Data System as required by Section 385.202, F.S., shall be accomplished within six (6) months of the date of each diagnosis and within six (6) months of the date of each treatment.

Specific Authority 381, 381.0011(13), 381.003(1)(d), (2), 381.0031(5), 384, 384.33 FS. Law Implemented 381.0011, 381.003, 381.0031(5) (Fl. Laws Chap. 98-151), 384.25, 385.202, 392.53 FS. History – New 12-29-77, Amended 6-7-82, Formerly 10D-3.77. Amended 2-26-92, 7-21-96, Formerly 10D-3.077, Amended 11-2-98. Amended ______________.

64D-3.013 Procedures for Control of Specific Communicable Diseases

    1. Psittacosis (Chlamydiosis)
    1. No Change
    2. Birds suspected of being infected or having been associated with infected birds shall not be removed from any premises until the county health department director or administrator, or the State Health Officer has investigated the situation and issued orders which may include quarantine, laboratory examination, or prescribed treatment according to recommendations of the National Association of State Public Health Veterinarians, Inc., published in the 1999 annual Compendium of Measures to Control Chlamydia psittaci Infection Among Humans and Pet Birds Psittacosis (Chlamydiosis) Control, incorporated by reference in this rule. This document may be obtained from the Department of Health, Bureau of Epidemiology, 2020 Capital Circle S.E., Bin A12, Tallahassee, Florida 32399-1734.
    1. Rabies
    1. No change

(b) Prevention in Humans – Persons bitten or otherwise exposed to suspect rabid animals shall be evaluated for post-exposure treatment by the county health department director/medical director or the Sstate Hhealth Oofficer according to recommendations of the Immunization Practices Advisory Committee published in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Rreport, No. RR-1, January 8, 1999, incorporated by reference in this rule. This document may be obtained from the Department of Health, Bureau of Epidemiology, 2020 Capital Circle S.E., Bin A12, Tallahassee, Florida 32399-1734.

    1. Rabies Control in Animals
    1. No change
    2. Capture, confinement, quarantine, humane euthanization, and laboratory examination of all suspected rabid animals, as well as animals involved in human exposure (bite and non-bite) and animals exposed to rabid animals, and other animals shall be administered by order of the county health department director or administrator or the State Health Officer according to current recommendations of the Florida Rabies Advisory Committee published in the "1999 Rabies Prevention and Control in Florida," incorporated by reference in this rule National Association of State and Public health Veterinarians, Inc. (NASPHV) published in the 1999 annual Compendium for Animal Rabies Control by order of the county health department director or administrator or the State Health Officer. This document may be obtained from the Department of Health, Bureau of Epidemiology, 2020 Capital Circle S.E., Bin A12, Tallahassee, Florida 32399-1734.
    1. Epizootic Rabies

1. The State Health Officer or his designated representative, with the current approval of the Secretary of the Department, or the county health department director or administrator or his designated representatives may declare an area wide quarantine when prevalence of rabies so indicates. The conditions of the quarantine may control the movement, sale, impoundment and required euthanization of animals in the quarantine vaccination area as defined by departmental policy and procedure guidelines, and CDC and NASPPHV recommended actions.

    1. Shigella and Salmonella Infections (for excluding typhoid fever, see Section 64D-3.013(4) 10D-3.093(5))

      2. (a) through (b) No change

    2. No change
    1. Perinatal Hepatitis B
    1. All pregnant women shall be routinely tested for the hepatitis B surface antigen (HBsAg) during an early prenatal visit in each pregnancy. This test shall be performed at the same time that other routine prenatal screening is ordered and all HBsAg-positive pregnant women shall be reported to the local county health department.
    2. Infants born to HBsAg-positive mothers shall receive hepatitis B immune globulin and hepatitis B vaccine once they are physiologically stable, preferably within 12 hours of birth and shall complete the hepatitis B vaccine series according to the recommended vaccine schedule. Testing infants for HBsAg and antibody to hepatitis B surface antigen (anti-HBs) six (6) months after the completion of the hepatitis B vaccine series is recommended to monitor the success or failure of therapy. A positive HbsAg result in any infant aged under 25 months shall be reported to the local county health department.
    3. through (d) No change.

(6) No change.

Specific Authority 120.535, 381.0011(8), (13), 381.003(2), 381.006, 384.25(2), 384.33, FS. Law Implemented 381.0011(4), (8), 381.003(1), 381.0031, 384.27, FS. History—New 12-29-77, Amended 6-14-78, 6-7-82, 11-6-85, Formerly 10D-3.91, Amended 7-5-87, 7-19-89, 2-26-92, 10-20-93, 11-1-94, 7-21-96, Formerly 10D-3.091. Amended _________.

64D-3.015 Diseases Designated as Sexually Transmissible Diseases.

    1. The following diseases are designated as sexually transmissible diseases for the purposes of Chapter 384, F.S., and this rule:
    1. through (e) No change.

(f) Hepatitis B Human Immunodeficiency Virus Infection

(g) Human Immunodeficiency Virus Infection Lymphogranuloma Venereum

(h) Lymphogranuloma Venereum Syphilis

(i) Syphilis

(2) No change

Specific Authority 381.0011(4), (13), 381.003(1)(b), (c), (d), (2), 384.23, 384.25(2), 384.33 FS. Law Implemented 381.0011(4), (8), (13), 381.003(1), 384.21, 384.23 FS. History – New 7-5-87, Amended 9-7-93, 5-20-96, 1-1-97, Formerly 10D-3.096. Amended __________.

64D-3.016 Reporting Requirements for Physicians for sexually Transmissible Diseases (STDs), Including HIV and AIDS.

(1) No change

    1. Except for the special reporting requirements for AIDS, HIV infection and early syphilis listed below in 64D-3.016(1)(c) and (d), F.A.C., and for hepatitis B as indicated in 64D-3.002(1), 64D-3.004, and 64D-3.006, F.A.C., all reports shall be submitted within three (3) working days from diagnosis.

(b) Except for AIDS, and HIV and hepatitis B reports, all reports of sexually transmissible diseases shall be submitted on the Florida Confidential Report of Sexually Transmitted Diseases, DOH Form 720, effective 7-5-87. The form, incorporated by reference in this rule, will be furnished by the local county health department.

(c) through (d) No change

(2) through (4) No change.

Specific Authority 381.0011(13), 381.003(2), 381.0031(5), 384.25(2), 384.33 FS. Law Implemented 381.0011, 381.003(1), 384.25, 458, 459 FS. History – New 7-5-87, Amended 2-7-90, 2-26-92, 5-20-96, 1-1-97, Formerly 10D-3.097. Amended .

64D-3.027 Reporting of Congenital Anomalies.

    1. Congenital anomalies include major structural congenital defects, genetic disorders, and other congenital disorders. A complete list of notifiable congenital anomalies can be found in the Florida Birth Defects Registry Data Reporting Manual dated July 1, 1999, incorporated by reference in this rule. This manual is available from the Florida Department of Health, Bureau of Environmental Epidemiology, 2020 Capital Circle SE, Bin A08, Tallahassee, FL 32399-1712.
    2. Notifiable congenital anomalies include all those diagnosed in:
    1. Infants who are born alive and have the anomaly diagnosed before their first birthday, including infants who at the time of death are so diagnosed; or
    2. Fetuses that are not born alive, but completed 19 weeks of gestation. In the absence of a gestational age estimate, a congenital anomaly in a fetus that is not born alive must be reported if the fetus had a weight of at least 500 grams.

(3) The reporting of congenital anomalies shall apply to each infant or fetus born, expelled, or extracted in Florida on July 4, 1999, or later.

(4) A licensed hospital, or licensed practitioner as defined in s.381.0031(1), F.S., shall report information regarding each notifiable congenital anomaly according to the definitions, coding schemes, instructions, and reporting forms contained in the above referenced Data Reporting Manual.

(a) Each hospital licensed under Chapter 395, F.S., shall report to the Florida Birth Defects Registry each notifiable congenital anomaly occurring in an infant admitted to the hospital. If a hospital reports a congenital anomaly to the Agency for Health Care Administration in its inpatient discharge data report pursuant to Chapter 59E-7, F.A.C., then it need not comply with the reporting requirements of 64D-3.027 for that anomaly.

    1. Each licensed practitioner, as defined in Chapter 381.0031, F.S., who diagnoses a notifiable congenital anomaly shall report it to the Florida Birth Defects Registry, except if the anomaly occurs in an infant admitted to a hospital licensed under Chapter 395, F.S.

(c) Physician or hospital reports shall be made no sooner than the date of birth, expulsion, or extraction, and no later than 60 days after the date on which the diagnosis was made, or the date of birth, expulsion, or extraction, whichever is later, except as indicated in 64D-3.027(4)(a).

Specific Authority 381.0011(13), 381.0031(5),FS. Law Implemented 381.0011(7), 381.0031, FS. History – New .