Changes to Reportable Disease Regulations in Virginia
September 24, 2025
Dear Colleague,
The Virginia Regulations for Disease Reporting and Control (12VAC5-90) have recently been updated to bring the regulations into compliance with changes in the field of communicable disease detection and control and to conform the regulations to Chapter 375 of the 2024 Virginia Acts of Assembly.
State Board of Health amendments to 12VAC5-90, effective September 10, include the following highlights. Please see the Regulations for Disease Reporting and Control for the complete details.
- Clarified which influenza laboratory tests are reportable by defining ‘influenza, laboratory-confirmed’ as “culture, antigen detection by direct fluorescent antibody (DFA), or nucleic acid detection”. Influenza rapid antigen tests are not reportable.
- Clarified that blood lead levels are to be submitted when reporting lead.
- Expanded the Genuses and species included in the definition of “Tubercle bacilli” to include: Mycobacterium canetti, Mycobacterium microti, and Mycobacterium caprae.
- Added Monkeypox virus to the list of reportable Orthopoxviruses.
- Added a timeframe in which positive cultures or other positive test results listed in subsection B shall have the initial isolate (preferred; within five days) or other initial specimen (within two days) forwarded to the Division of Consolidated Laboratory Services or other public health laboratory.
- Clarified that for SARS-CoV-2 laboratory reporting, positive SARS-CoV-2 test results shall be reported within 3 days.
- Added required reporting of identifying and contact information, including name and telephone number, for those reporting a communicable disease of public health concern or facility outbreak.
- Updated the procedure for preventing ophthalmia neonatorum.
- Clarified that “dangerous microbes and pathogens” will be known as “select agents and toxins” to align with 42 CFR Part 73.
- Established that by January 31 of every year, the responsible official at a laboratory as designated by the Federal Select Agent Program, shall provide a written report to the VDH Division of Surveillance and Investigation in the Office of Epidemiology (DSI-OEPI) with specific information, including the name and address of the laboratory. This can be done by emailing select_agent@vdh.virginia.gov.
- Established that in the event of a suspected release, loss, or theft of a select agent or toxin, the responsible official as designated by the Federal Select Agent Program shall submit a report immediately to DSI-OEPI. This can be done by calling (804) 864-8141.
Additionally, effective September 24, 2025, Alpha-gal Syndrome (AGS) was added to the lists of diseases that shall be reported in the Virginia Regulations for Disease Reporting & Control (12VAC5-90).
- Physicians, persons in charge of medical care facilities, and local health directors are now required to report suspected or confirmed cases of AGS to the Virginia Department of Health (VDH) as outlined in 12VAC5-90-90(A, C, E).
- Additionally, directors of laboratories are now required to report alpha-gal-specific IgE test results with a value of ≥0.1 IU/ml or ≥0.1 kU/L as outlined in 12VAC5-90-80(B) and 12VAC5-90-90(B).
- Clinicians should report AGS cases within three days of suspected or confirmed diagnosis via the Confidential Morbidity Report (Epi-1) (preferred) or directly to the local health department serving the jurisdiction where your practice is located (by telephone, fax, or mail).
- When reporting, clinicians need to provide the patient’s name, date of birth, race, sex, residential address, AGS-related laboratory results, and the reporter’s information.
- Directors of laboratories should report AGS laboratory results (per the AGS values above) within three days of suspected or confirmed diagnosis to the local health department (LHD) serving the jurisdiction where your laboratory is located, or through automatic triggering of electronic laboratory reports (ELR). Means of laboratory reporting include ELR sent via HL7 2.5.1 or flat file standard to VDH through our state health information exchange (preferred), telephone, fax, or mail. Information on ELR onboarding can be found on the VDH webpage. If your facility is already sending ELR, please start to include reportable AGS results in your feed starting 9/24/2025.
- When reporting, laboratories should include specimen source, lab method and result, patient’s name, date of birth, race, sex, residential address, phone number of the provider, and the medical facility where the patient was examined and order initiated.
- Additional AGS resources for clinicians are available at:
- VDH: Clinician Resources for Tick-borne Diseases page (includes a patient information sheet and link to a CDC continuing education opportunity) and Tick Prevention page
- CDC: Alpha-gal Syndrome page and Preventing Tick Bites page
More information on disease reporting in Virginia can be found on VDH’s Disease Reporting and Control Regulations webpage.
Thank you for your continued efforts to improve and maintain the health of all people in Virginia.
Sincerely,
Karen Shelton, MD
State Health Commissioner