Disease Regulations Update

November 16, 2018

VDH would like to offer clarification to the November 16th, 2018 clinician letter. In that letter, it identified that “the requirement that physicians and directors of medical facilities report influenza by number of cases (report total number per week and by type of influenza, if known) has been removed from the regulations”. This statement was not accurate.  The only change regarding influenza reporting is that the list of conditions that shall be reported was modified to “Influenza, Confirmed”. 

Dear Colleague:

The State Board of Health has updated the Virginia Regulations for Disease Reporting and Control, specifically 12 VAC 5-90-80. The updates, which went into effect November 14, 2018, allow greater flexibility with respect to reporting requirements, in light of rapidly changing laboratory technologies and the emergence of new pathogens that are of public health concern.

The updated regulations and the online reporting portal can be found on the Virginia Department of Health (VDH) website. We have highlighted some important updates below:

  • Carbapenemase-producing organisms were added to the reportable disease list and conditions reportable by directors of laboratories.
    • Report suspected or confirmed carbapenemase-producing organisms, infection or colonization.
    • Submit carbapenem-resistant Enterobacteriaceae and carbapenem-resistant Pseudomonas aeruginosa isolates for further public health testing.  Include available antimicrobial susceptibility findings.  For further guidance, see: https://www.vdh.virginia.gov/surveillance-and-investigation/hai/reporting/
  • Candida auris was added to the reportable disease list and conditions reportable by directors of laboratories.
  • Tuberculosis (TB) infection or latent TB infection is now reportable among persons of any age and not just in children younger than four years of age. Diagnosing tuberculosis infection requires that active TB has been ruled out. Results of a test for TB infection (tuberculin skin test or interferon gamma release assay) should be reported. To assist in correctly classifying reports, chest x-ray results and a lack of active TB symptoms may be noted in morbidity reports. TB infection has also been added to the conditions reportable by directors of laboratories list.
  • Congenital syphilis was added to the reportable disease list as a rapidly reportable condition.
  • Acquired immunodeficiency syndrome and Creutzfeldt-Jakob disease were removed from the reportable disease list and the conditions reportable by directors of laboratories.
  • The names of the reportable organisms were added next to disease names on the reportable disease list, conditions reportable by directors of laboratories, and reportable diseases requiring rapid communication lists.
  • Specific laboratory methods (e.g., test types) were removed from the conditions reportable by laboratory directors and replaced with more general language requiring directors of laboratories to report based on any laboratory method if that method indicates the presence of a reportable organism.
  • Conditions reportable by directors of laboratories were updated and include:
    • Reporting of all lead blood levels,
    • Reporting viral loads for persons who test positive for hepatitis C virus,
    • Reporting liver enzyme results for persons who test positive for hepatitis B virus,
    • Reporting gram-negative diplococci under “Meningococcal disease (Neisseria meningitidis), invasive – including identification of gram-negative diplococci.”
  • Some language contained under 12 VAC 5-90-90, subsection B regarding submission of an initial isolate or other specimen for further public health testing has been moved to 12 VAC 5-90-80, as subsection D and updated.

We rely on you to identify and report conditions of public health concern and encourage you to review the Virginia Reportable Disease List to ensure your familiarity with all reportable conditions.  VDH is available to assist you in the management of conditions of public health concern and to investigate and control disease in the community.

Disease reports are submitted to the local health department serving the jurisdiction where your practice is located, or through the online reporting portal.  Your local health department is available to answer any questions you may have about reporting or to assist you with this process in any way.  We appreciate your continued collaboration in our mutual effort to protect the health of the people of Virginia.


M. Norman Oliver, MD, MA
State Health Commissioner