Outbreak Reporting Requirements for Facilities and Programs

What are the legal requirements for facilities and programs to report outbreaks?

Section 32.1-37 of the Code of Virginia requires certain facilities and programs to report the presence or suspected presence of an outbreak to the local health department (LHD). Additional information about those required to report can be found in the Administrative Code under 12VAC5-90-90.

Who is required to report?

Those who are required to report certain diseases in Virginia are listed in 12-VAC5-90-90. This includes, but is not limited to, the person in charge of:

• Any residential or day program, service, or facility licensed or operated by any agency of the Commonwealth;
• A school, child care center, or summer camp as defined in § 35.1-1 of the Code of Virginia; or 
• Assisted living facilities, correctional or other detention facilities, mental health programs, and other group settings where outbreaks of illness might occur.

Anyone required to report in accordance with 12-VAC5-90-90 is also required to report suspected outbreaks to the LHD.

What diseases should be reported?

The lists of diseases that shall be reported in Virginia are listed in 12VAC5-90-80. The LHD shall be notified immediately when an outbreak is suspected, even if no specific disease has yet been diagnosed. An increase in any illness or an unusual disease presentation should be reported. The diseases that most commonly cause outbreaks in group settings are respiratory illnesses, such as influenza; gastrointestinal illnesses that cause vomiting or diarrhea; and rash illnesses, such as chickenpox or scabies. Acute environmental exposures (e.g., carbon monoxide poisoning, pesticide intoxication) can also cause illness in group settings and should be reported.

What is an outbreak?

An outbreak happens when more people than usual get sick with the same illness in a certain area or group over a short period of time. You should monitor illnesses occurring within your facility or program and contact your LHD if you notice:

• A sudden increase in people getting sick at the same time; or
• Two or more people who are showing similar symptoms and share things in common, such as activities, living areas, or class schedules.

If you are unsure whether an incidence of illness in your facility or program is considered an outbreak, please contact your LHD for guidance.

Which health department should be contacted? How should it be contacted?

Immediately contact the LHD serving the city or county where your facility or program is located. Contact information for Virginia’s LHDs is available at the VDH Local Health Districts page. You may also report through VDH’s Suspected Outbreak Reporting Portal.

When you reach out to your LHD to report an illness of concern or an outbreak, be prepared to share the signs of illness you are observing, dates of illness onset, and your contact information. Per 12VAC5-90-90.H, you must also report additional information, including identifying and contact information for individuals with communicable diseases of public health concern or individuals who are involved in outbreaks that occur in their facilities, as necessary to facilitate public health investigation and disease control. Identifying and contact information, at a minimum, shall include a name and telephone number.

What will the health department do when they receive an outbreak report?

LHD staff will collect and assess information about each ill person, such as the date illness began, symptoms experienced, and exposure history. Specimens might be collected for laboratory testing. The LHD might interview people at the facility or program, both those who are ill and those who are well, to identify factors associated with illness.  Most importantly, the LHD will recommend actions that will prevent spread of disease/illness and stop the outbreak.

How can I get more information?

• Call your LHD. A directory of LHDs is located at https://www.vdh.virginia.gov/local-health-districts/ 
• Visit the VDH Disease Reporting webpage: https://www.vdh.virginia.gov/clinicians/disease-reporting-and-control-regulations/