Ariz. Admin. Code § R9-6-206 - Local Health Agency Responsibilities Regarding Communicable Disease Reports

A. The Department shall notify each local health agency of the format to be used by:

1. A health care provider required to report when making a report required under R9-6-202(A) and Table 2.1;

2. An administrator of a health care institution or correctional facility when making a report required under R9-6-202(B) and Table 2.1; and

3. An administrator of a school, child care establishment, or shelter when making a report required under R9-6-203(A) and Table 2.2.

B. A local health agency shall inform health care providers required to report and administrators of health care institutions, correctional facilities, schools, child care establishments, and shelters of the format to use when making a report, as specified in subsection (A).

C. Except as specified in Table 2.4 and Article 3, a local health agency shall provide to the Department the information contained in each report of a case, suspect case, or occurrence received by the local health agency under R9-6-202 or R9-6-203, including any report of disease in a nonresident of the jurisdiction who is or has been diagnosed or treated in the jurisdiction, within five working days after receipt and shall specify:

1. Which of the following best describes the individual identified in each report:

a. The individual meets the case definition for a case of the specific disease,

b. The individual is a suspect case,

c. The individual does not meet the case definition for a case or suspect case of the specific disease, or

d. The local health agency has not yet determined the status of the disease in the individual; and

2. The status of the epidemiologic investigation for each report.

D. Except as specified in Table 2.4 and Article 3, a local health agency shall submit to the Department a report, in a Department-provided format, of an epidemiologic investigation conducted by the local health agency:

1. In response to a report of a case, suspect case, or occurrence:

a. Submitted under R9-6-202 or R9-6-203, or

b. About which the local health agency was notified by the Department;

2. Within 30 calendar days after receiving the report submitted under R9-6-202 or R9-6-203 or notification by the Department;

3. If an epidemiologic investigation is required for the reported disease under Article 3; and

4. Including in the report of the epidemiologic investigation:

a. The information described in:

i. R9-6-202(C) for a report submitted under R9-6-202,

ii. R9-6-203(B) for a report submitted under R9-6-203, or

iii. R9-6-202(C) for a report about which the Department notified the local health agency;

b. A description of all laboratory or other test results, performed in addition to the laboratory tests described in R9-6-202(C) and contributing to the diagnosis;

c. A description of the case's symptoms of the disease and other signs that may be observed that indicate that the individual may have the disease, if applicable;

d. A classification of the case according to the case definition;

e. A description of the condition or status of the case at the end of the epidemiologic investigation;

f. A description of the case's specific risk factors for acquiring the disease or other epidemiologic evidence of how the case acquired the infection that resulted in the disease;

g. A description of how the local health agency provided or arranged for the case to receive health education about the nature of the disease and how to prevent transmission or limit disease progression;

h. A description of the case's specific risk factors for transmitting the disease considered by the local health agency when conducting an assessment of contacts;

i. A description of the control measures used by the local health agency to reduce the spread of the disease; and

j. The date the report of the case, suspect case, or occurrence was submitted or the Department notified the local health agency.

E. For each reported case or suspect case of unexplained death with a history of fever, the local health agency for the jurisdiction in which the death occurred shall:

1. Within one working day after receiving a report of unexplained death with a history of fever, submit to the Department in a format specified by the Department:

a. The following information about the deceased individual:

i. Name;

ii. Residential address;

iii. Date of birth;

iv. Race and ethnicity;

v. County of residence;

vi. If the individual was living on a reservation at the time of the individual's death, the name of the reservation;

vii. Gender;

viii. Whether the individual was pregnant and, if so, the result of the pregnancy; and

ix. Occupation;

b. The date of onset of symptoms;

c. The approximate date and time of death;

d. A description of the setting where the death occurred and of the circumstances leading up to the time of death;

e. The name, residential address, and telephone number of a family member of the deceased individual who may be contacted;

f. The name, address, and telephone number of the individual making the report to the local health agency; and

g. The name and address of the:

i. Health care provider required to report, if:

(1) The unexplained death with a history of fever was reported to the local health agency under R9-6-202(A), and

(2) The health care provider is different from the individual specified in subsection (E)(1)(f); or

ii. Health care institution or correctional facility, if the unexplained death with a history of fever was reported to the local health agency under R9-6-202(B); and

2. Within 30 calendar days after receiving the report of unexplained death with a history of fever, submit to the Department a written or electronic report of the epidemiologic investigation required under Article 3, in a format provided by the Department, including:

a. The name and date of birth of the deceased individual;

b. The date of each specimen collection;

c. Identification of each type of specimen collected;

d. Identification of each type of laboratory test completed;

e. A description of the laboratory test results, including quantitative results if available;

f. If an autopsy was completed, the autopsy results;

g. A hypothesis or conclusion as to the cause of death; and

h. Specific recommendations for preventing future deaths, if applicable.

F. E. For each instance when the local health agency receives a report or reports indicating an outbreak or possible outbreak, the local health agency shall:

1. Within 24 hours after receiving the report or reports, provide to the Department, in a Department-provided format, the following information:

a. The location of the outbreak or possible outbreak;

b. If known, the number of cases and suspect cases;

c. The date that the outbreak was reported or the dates that cases suggestive of an outbreak were reported;

d. The setting of the outbreak or possible outbreak;

e. The name of the disease suspected or known to be the cause of the outbreak or possible outbreak; and

f. The name and telephone number of an individual at the local health agency who can serve as a point of contact regarding the outbreak or possible outbreak; and

2. Within 30 calendar days after receiving the last report or reports associated with the outbreak, submit to the Department a report, in a Department-provided format, of the epidemiologic investigation conducted by the local health agency in response to the outbreak or possible outbreak, including:

a. A description of the outbreak location and setting;

b. The date that the local health agency was notified of the outbreak;

c. A description of how the local health agency verified the outbreak;

d. The number of individuals reported to be ill during the outbreak;

e. The number of individuals estimated to be at risk for illness as a result of the outbreak;

f. The specific case definition used;

g. A summary profile of the signs and symptoms;

h. An epidemiologic curve;

i. A copy of the laboratory evidence collected, including all laboratory test results, for all specimens submitted for testing to a laboratory other than the Arizona State Laboratory;

j. Hypotheses of how the outbreak occurred;

k. A description of the control measures used and the dates the control measures were implemented;

l. The conclusions drawn based upon the results of the epidemiologic investigation;

m. Recommendations for preventing future outbreaks; and

n. The name, address, and telephone number of the individual making the report to the Department.

Notes

Ariz. Admin. Code § R9-6-206

Section renumbered from R9-6-203and amended by final rulemaking at 10 A.A.R. 3559, effective October 2, 2004 (Supp. 04-3). Amended by final rulemaking at 14 A.A.R. 1502, effective April 1, 2008 (Supp. 08-2). Amended by final rulemaking at 23 A.A.R. 2605, effective 1/1/2018.