Outbreak Reporting

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 or programs to report the presence or suspected presence of an outbreak to the local health department. The most recent amendment to this requirement went into effect on October 20, 2016.

Who is required to report?

The person in charge of any residential or day program, service or facility licensed or operated by any agency of the Commonwealth, school, or summer camp is required to report. This includes child care facilities, assisted living facilities, correctional or other detention facilities, mental health programs, and other group settings where outbreaks of illness might occur. Facilities licensed by the health department (hospitals and nursing homes) as well as physicians and directors of laboratories have always been required to report diseases and outbreaks to the health department.

What diseases should be reported?

An unusual level of activity of any illness that might be spread from one person to another or that might be caused by a common exposure 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. Other conditions, such as acute environmental exposures (e.g., carbon monoxide poisoning, pesticide intoxication) might also cause outbreaks. The local health department should be notified when an outbreak is suspected, even if no specific disease has yet been diagnosed.

What is an outbreak?

An outbreak is the occurrence of more cases of disease than expected. There is no strict definition of an outbreak or specific number of cases that need to occur to be considered an outbreak. If an outbreak is suspected, it should be reported.

How does a facility/program director know if an outbreak is occurring?

If people who work in a facility or program sense that more people are sick with similar symptoms than is usually seen, then an outbreak should be reported to the local health department. Many facility directors have already been doing this, even prior to the 2016 law going into effect.

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

The local health department serving the city or county in which the facility or program is located should be telephoned immediately if an outbreak is occurring. Contact information for Virginia’s health districts and their component city or county health departments is available at https://www.vdh.virginia.gov/local-health-districts/.

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

Health department 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 health department might need to interview people at the facility or program, both those who are ill and those who have not been ill, to identify factors that might be associated with illness. Under 12VAC5-90-90.d of the Virginia Regulations for Disease Reporting and Control, it has been clarified that persons reporting an outbreak may report identifying and contact information for individuals included in the outbreak. Most importantly, the health department will recommend steps to follow to stop the outbreak and reduce the risk of disease.

How can I get more information?

September 2018