December 5, 2017
The opioid addiction crisis continues to take its toll on the people of Virginia. Thank you for your efforts to prevent and treat addiction, and manage its additional consequences. One of those serious consequences is the significant rise in cases of Neonatal Abstinence Syndrome (NAS), a condition characterized by clinical signs of withdrawal in neonates exposed in utero to prescribed or illicit drugs. I am writing today to update you on recent developments in our capability for receiving online web-based morbidity reporting as well as legislative mandates concerning NAS disease reporting:
As a result of the significant impact of opioid addiction on neonates, the 2017 General Assembly passed House Bill 1467, requiring the State Board of Health to add NAS to the list of conditions that must be reported to the health department. This amendment to the Regulations for Disease Reporting and Control became effective on November 27, 2017. Physicians and directors of medical care facilities must report when a newborn has been diagnosed with NAS in a Virginia facility. Reports must be submitted within one month of diagnosis using a web-based portal described below.
The Regulations for Disease Reporting and Control provide a list of conditions that physicians, directors of medical care facilities, and directors of laboratories are required to report to the health department, as well as instructions for how such reporting should transpire. The prompt reporting of these conditions to public health is essential to ensure that disease control and prevention actions can be implemented to protect the health of our communities.
Reporting of conditions on the reportable disease list has historically been done by completing a morbidity report form, known as the Epi-1 form. In recent years, many laboratories have converted to reporting through electronic means. The Virginia Department of Health (VDH) is now offering an option for providers to securely submit a confidential morbidity report by completing an electronic form available on an online, web-based portal accessible through the VDH internet clinician’s webpage. Information will be processed from a central VDH location and made available to the local health department serving the jurisdiction in which you practice, thus ensuring reporting is conducted according to the requirements of the disease reporting regulations. This web-based reporting is an option that can be used for reporting any condition on the reportable disease list. This web-based method must be used to report Neonatal Abstinence Syndrome (NAS), as described below.
Reporting NAS to the health department is for public health surveillance purposes only; that is, the data will provide a description of the magnitude and distribution of this problem in Virginia. Public health reporting will not lead to a referral for services. Therefore, it is important and required that all cases of NAS also be reported to the Virginia Department of Social Services (DSS) in accordance with the requirements of §63.2-1509 of the Code of Virginia. More information on the reporting of any substance-exposed infants, including those with NAS, to DSS can be found in Section 10 of the DSS Child and Family Services Manual.
Thank you in advance for complying with this new requirement and for contributing to our understanding of the impact this condition has on the health of our communities. We will be sure to provide you with feedback on the extent of NAS as we begin to receive and review your reports.
I hope that many of you will find disease reporting easier to accomplish through this new web-based reporting system. If you have any questions about disease reporting requirements or this new online morbidity reporting portal, feel free to contact your local health department or Diane Woolard, PhD, Director of the VDH Division of Surveillance and Investigation at firstname.lastname@example.org or by phone at (804) 864-8141.
Your reporting activates Virginia’s public health system. It is only through your reporting that we can effectively detect and work to control conditions of public health concern throughout our Commonwealth. Thank you for your partnership in these important efforts.
Marissa J. Levine, MD, MPH, FAAFP
State Health Commissioner