WAC 246-101-201. Notifiable conditions — Laboratories

(1) For the purposes of Table Lab-1: (a) "At least annually" means deidentified negative screening results may be submitted in a single report no less than once per year, but may be submitted more frequently as a single report or as individual screening results. (b) "Deidentified negative screening result" means an initial test result that indicates the absence of disease, and that has personally identifiable information removed from it using the Health Insurance Portability and Accountability Act of 1996 Safe Harbor method defined in 45 C.F.R. 164.514. A deidentified negative screening result does not include a negative test result associated with a previous positive test result, such as a negative nucleic acid or viral load test that is performed after a positive antibody or antigen test. (c) "LHJ" means where the patient resides, or, in the event that patient residence cannot be determined, the local health jurisdiction in which the ordering health care provider practices, or the local health jurisdiction in which the laboratory operates. (d) "Within two business days" means specimens must be in transit to the Washington state public health laboratories within two business days of: (i) Completing a test and the specimen being ready for packaging; or (ii) Receiving a request from a local health jurisdiction or the department, provided the specimen is still available at the time of the request. (2) This chapter does not require a laboratory to: (a) Test for agents (conditions) or speciate if the laboratory does not perform the test as part of its normal work. A laboratory director shall only report a condition if it is identified as part of their normal testing protocols; or (b) Retain specimens indefinitely in anticipation of a request from a local health jurisdiction or the department. (3) The agents (conditions) in Table Lab-1 are notifiable by a laboratory director as indicated in Table Lab-1 and this chapter. Table Lab-1 (Conditions Notifiable by Laboratory Directors) Agent (Condition) Notification of Results Specimen Submission to the Washington State Public Health Laboratories What to Submit in a Laboratory Report When and Whom to Notify Upon Receiving Presumptive or Final Test Result What to Submit When to Submit Amebic meningitis Positive result by any method Immediately to LHJ Specimen associated with positive result, if available Within 2 business days Anaplasma species (Anaplasmosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result, if available Within 2 business days of request by LHJ or DOH Babesia species (Babesiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result, if available Within 2 business days of request by LHJ or DOH Bacillus anthracis (Anthrax) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Bacillus cereus , biovar anthracis only Confirmed positive result by any method Immediately to LHJ Do not ship specimen Do not ship specimen Baylisascaris (Baylisascariasis) Positive result by any method Within 24 hours to LHJ Specimen associated with positive result, if available Within 2 business days Blood lead level Results equal to or greater than 5 micrograms per deciliter for: RST Venous Within 2 business days to DOH N/A N/A Results less than 5 micrograms per deciliter for: RST Venous Within 30 days to DOH Bordetella pertussis (Pertussis) Positive results by: Culture or Nucleic acid detection ((nucleic acid testing (NAT)) or (nucleic acid amplification testing (NAAT)) Within 24 hours to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Borrelia burgdorferi or Borrelia mayonii (Lyme disease) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Borrelia hermsii , parkeri , turicatae , miyamotoi , or recurrentis (Relapsing fever, tick- or louse-borne) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Brucella species (Brucellosis) Positive result by any method excluding Immunoglobulin G (IgG) Within 24 hours to LHJ Isolate, excluding confirmed positive B. melitensis, B. abortus, or B. suis Within 2 business days If no isolate available, specimen associated with positive result Burkholderia mallei (Glanders) Positive result by any method excluding IgG Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Burkholderia pseudomallei (Melioidosis) Positive result by any method excluding IgG Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result California serogroup viruses, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Campylobacter species (Campylobacteriosis) Positive result by: Culture, Nucleic acid detection (NAT or NAAT), or Antigen detection Within 2 business days to LHJ Isolate Within 2 business days of request by LHJ or DOH If no isolate available, specimen associated with positive result Candida auris Positive result by any method Within 24 hours to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Carbapenem-resistant Enterobacteriaceae: Klebsiella species E. coli Enterobacter species Positive for known carbapenemase resistance gene (including, but not limited to, KPC, NDM, VIM, IMP, OXA-48) demonstrated by nucleic acid detection (NAT or NAAT), or whole genome sequencing Positive on a phenotypic test for carbapenemase production including, but not limited to, Metallo-B-lactamase test, modified Hodge test (MHT) (for E. coli and Klebsiella species only), CarbaNP, Carbapenem Inactivation Method (CIM) or modified CIM (mCIM) Resistant to any carbapenem including, but not limited to, doripenem, ertapenem, imipenem or meropenem Within 2 business days to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days CD4 + counts 1 , or CD4 + percents 2 , or both (patients aged thirteen or older) All results Within 30 days to DOH except in King County where this is notifiable to the LHJ N/A N/A Chikungunya virus, acute (Arbovirus) Positive result by any method excluding Immunoglobulin G (IgG) Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Chlamydia psittaci (Psittacosis) Positive result by any method excluding IgG Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Chlamydia trachomatis Positive and indeterminate result by any method Within 2 business days to LHJ N/A N/A Chlamydia trachomatis Deidentified negative screening result At least annually to DOH N/A N/A Clostridium botulinum (Botulism) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Coccidioides (Coccidioidomycosis) Positive result by any method Within 2 business days to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Coronavirus SARS-associated coronavirus MERS-associated coronavirus Novel coronavirus (SARS-CoV-2) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days of request by LHJ or DOH Corynebacterium diphtheriae (Diphtheria) Positive result by: Culture or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Coxiella burnetii (Q fever) Positive result by any method Within 24 hours LHJ Specimen associated with presumptive positive result Within 2 business days Crimean-Congo hemorrhagic fever virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Cryptococcus gattii or undifferentiated Cryptococcus species (i.e., Cryptococcus not identified as C. neoformans ) Positive results by any method excluding cryptococcal antigen Within 2 business days to LHJ Isolate If no isolate available, specimen associated with positive result (excluding serum) Within 2 business days Serum Within 2 business days of request by LHJ or DOH Cryptosporidium (Cryptosporidiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Cyclospora cayetanensis (Cyclosporiasis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Dengue virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH E. coli - Refer to "Shiga toxin-producing E. coli " Eastern and western equine encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result excluding specimens from viral culture Within 2 business days of request by LHJ or DOH Ebola virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive specimen Within 2 business days Echinococcus granulosus or E. multilocularis (Echinococcosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Ehrlichia species (Ehrlichiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Francisella tularensis (Tularemia) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Giardia duodenalis, G. lamblia, G. intestinalis (Giardiasis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Guanarito virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Haemophilus influenzae (children < 5 years of age) Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Hantavirus including, but not limited to: Andes virus Bayou virus Black Creek Canal virus Dobrava-Belgrade virus Hantaan virus Seoul virus Sin nombre virus Positive result by any method Within 24 hours to LHJ Specimen associated with positive result Within 2 business days Hepatitis A virus Positive results for: IgM or Nucleic acid detection (NAT or NAAT) Hepatocellular enzyme levels to accompany report, if available, for positive IgM results Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis B virus Positive results for: IgM anti-HBc, HBsAg, HBeAg, or HBV Nucleic acid detection (NAT or NAAT) either qualitative or quantitative, for example PCR or genotyping If associated with a positive result listed above, and available: Hepatocellular enzyme levels, Pregnancy status, and Negative IgM anti-HBc result Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis C virus Positive result by any method Positive and nonpositive results for: HCV nucleic acid detection (NAT or NAAT) for qualitative, quantitative, and genotype tests If associated with a positive result and available: Hepatocellular enzyme levels, Pregnancy status, Negative result for IgM anti-HAV, and Negative result for IgM anti-HBc Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis C virus Deidentified negative screening result At least annually to DOH N/A N/A Hepatitis D virus Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis E virus Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Histoplasma capsulatum (histoplasmosis) Positive result by any method Within 2 business days to LHJ Isolate Within 2 business days Serum Within 2 business days of request by LHJ or DOH Human immunodeficiency virus (HIV) Positive and indeterminate results and subsequent negative results associated with those positive or indeterminate results for the tests below: Antibody detection tests (including RST), Antigen detection tests (including RST), or Viral culture All HIV nucleic acid detection (NAT or NAAT) tests: Qualitative and quantitative Detectable and undetectable HIV antiviral resistance testing genetic sequences Within 2 business days to DOH except in King County where this is notifiable to the LHJ N/A N/A Human immunodeficiency virus (HIV) Deidentified negative screening result At least annually to DOH N/A N/A Human prion disease Positive result by any method excluding Tau protein Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Influenza virus, novel or unsubtypable strain Positive novel and unsubtypable result Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Japanese encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Junin virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days La Crosse encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Lassa virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Legionella species (Legionellosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available but respiratory specimen available and associated with a positive test (as in the case of a PCR positive), respiratory specimen associated with positive result Within 2 business days Leptospira species (Leptospirosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Listeria monocytogenes (Listeriosis) Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT) Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Lujo virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Machupo virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Marburg virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Measles virus - See "Rubeola (measles virus)" Mumps virus Positive result for: Culture, Nucleic acid detection (NAT or NAAT), or IgM Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Specimen associated with positive IgM Within 2 business days of request by LHJ or DOH Mycobacterium tuberculosis complex (Tuberculosis) Positive result for: Culture Nucleic acid detection (NAT or NAAT) Drug susceptibilities (molecular and culture based) Within 2 business days to DOH Mycobacterium tuberculosis complex positive isolate (earliest available isolate for the patient) Within 2 business days Neisseria gonorrhoeae (Gonorrhea) Positive and indeterminate result by any method Within 2 business days to LHJ N/A N/A Neisseria gonorrhoeae (Gonorrhea) Deidentified negative screening result At least annually to DOH N/A N/A Neisseria meningitidis (Meningococcal disease) Positive result for specimen from a normally sterile site by any method Immediately to LHJ Isolate from a normally sterile site Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Plasmodium species (Malaria) Positive results for: Nucleic acid detection (NAT or NAAT), Malaria-specific antigens by rapid diagnostic test, PCR, or Microscopy (thick or thin smear) Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Poliovirus (Poliomyelitis) IgM positivity; PCR positivity Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Powassan virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Rabies virus Positive result by any method Immediately to LHJ Specimen associated with positive result Within 2 business days Rickettsia species including, but not limited to: Rickettsia rickettsii Rickettsia africae Rickettsia conorii Rickettsia typhi Rickettsia parkeri Rickettsia philipii Positive results by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Rubella Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Other specimen Within 2 business days of request by LHJ or DOH Rubeola (measles virus) Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate and specimen associated with positive culture Isolate and specimen association with positive NAT or NAAT result Within 2 business days Specimen associated with positive IgM Other specimen Within 2 business days of request by LHJ or DOH Sabia virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Salmonella species (Salmonellosis, typhoid fever) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Shiga toxin-producing E. coli /enterohemorrhagic E. coli (STEC) Positive result by any method Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Shigella species (Shigellosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days St. Louis encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Taenia solium (Taeniasis or Cysticercosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Treponema pallidum (Syphilis) Positive and indeterminate result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days Treponema pallidum (Syphilis) Deidentified negative screening result At least annually to DOH N/A N/A Trichinella species (Trichinellosis) Positive serologic test for Trichinella Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Trypanosoma cruzi (Chagas disease) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days Vaccinia Any request for testing associated with a suspect case Immediately to LHJ Any specimen collected from a suspect case Immediately Vancomycin-resistant Staphylococcus aureus Resistance to vancomycin Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Variola virus (smallpox) Any request for testing associated with a suspect case Immediately to LHJ Specimen collected from a suspect case Immediately Vibrio cholerae O1 or O139 (Cholera) Positive result by any method Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Vibrio species (Vibriosis) not including Vibrio cholerae O1 or O139 (Cholera) See "Vibrio cholerae O1 or O139 (Cholera)" Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days West Nile virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Yellow fever virus (Arbovirus) Positive result by any method excluding IgG Immediately to LHJ Specimen associated with positive result Within 2 business days Yersinia enterocolitica, Y. pseudotuberculosis, Y. intermedia, Y. fredericksenii, or Y. kristensenii (Yersiniosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Yersinia pestis (Plague) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Zika virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Agent (Condition) Notification of Results Specimen Submission to the Washington State Public Health Laboratories What to Submit in a Laboratory Report When and Whom to Notify Upon Receiving Presumptive or Final Test Result What to Submit When to Submit Amebic meningitis Positive result by any method Immediately to LHJ Specimen associated with positive result, if available Within 2 business days Anaplasma species (Anaplasmosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result, if available Within 2 business days of request by LHJ or DOH Babesia species (Babesiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result, if available Within 2 business days of request by LHJ or DOH Bacillus anthracis (Anthrax) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Bacillus cereus , biovar anthracis only Confirmed positive result by any method Immediately to LHJ Do not ship specimen Do not ship specimen Baylisascaris (Baylisascariasis) Positive result by any method Within 24 hours to LHJ Specimen associated with positive result, if available Within 2 business days Blood lead level Results equal to or greater than 5 micrograms per deciliter for: RST Venous Within 2 business days to DOH N/A N/A Results less than 5 micrograms per deciliter for: RST Venous Within 30 days to DOH Bordetella pertussis (Pertussis) Positive results by: Culture or Nucleic acid detection ((nucleic acid testing (NAT)) or (nucleic acid amplification testing (NAAT)) Within 24 hours to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Borrelia burgdorferi or Borrelia mayonii (Lyme disease) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Borrelia hermsii , parkeri , turicatae , miyamotoi , or recurrentis (Relapsing fever, tick- or louse-borne) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Brucella species (Brucellosis) Positive result by any method excluding Immunoglobulin G (IgG) Within 24 hours to LHJ Isolate, excluding confirmed positive B. melitensis, B. abortus, or B. suis Within 2 business days If no isolate available, specimen associated with positive result Burkholderia mallei (Glanders) Positive result by any method excluding IgG Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Burkholderia pseudomallei (Melioidosis) Positive result by any method excluding IgG Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result California serogroup viruses, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Campylobacter species (Campylobacteriosis) Positive result by: Culture, Nucleic acid detection (NAT or NAAT), or Antigen detection Within 2 business days to LHJ Isolate Within 2 business days of request by LHJ or DOH If no isolate available, specimen associated with positive result Candida auris Positive result by any method Within 24 hours to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Carbapenem-resistant Enterobacteriaceae: Klebsiella species E. coli Enterobacter species Positive for known carbapenemase resistance gene (including, but not limited to, KPC, NDM, VIM, IMP, OXA-48) demonstrated by nucleic acid detection (NAT or NAAT), or whole genome sequencing Positive on a phenotypic test for carbapenemase production including, but not limited to, Metallo-B-lactamase test, modified Hodge test (MHT) (for E. coli and Klebsiella species only), CarbaNP, Carbapenem Inactivation Method (CIM) or modified CIM (mCIM) Resistant to any carbapenem including, but not limited to, doripenem, ertapenem, imipenem or meropenem Within 2 business days to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days CD4 + counts 1 , or CD4 + percents 2 , or both (patients aged thirteen or older) All results Within 30 days to DOH except in King County where this is notifiable to the LHJ N/A N/A Chikungunya virus, acute (Arbovirus) Positive result by any method excluding Immunoglobulin G (IgG) Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Chlamydia psittaci (Psittacosis) Positive result by any method excluding IgG Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Chlamydia trachomatis Positive and indeterminate result by any method Within 2 business days to LHJ N/A N/A Chlamydia trachomatis Deidentified negative screening result At least annually to DOH N/A N/A Clostridium botulinum (Botulism) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Coccidioides (Coccidioidomycosis) Positive result by any method Within 2 business days to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Coronavirus SARS-associated coronavirus MERS-associated coronavirus Novel coronavirus (SARS-CoV-2) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days of request by LHJ or DOH Corynebacterium diphtheriae (Diphtheria) Positive result by: Culture or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Coxiella burnetii (Q fever) Positive result by any method Within 24 hours LHJ Specimen associated with presumptive positive result Within 2 business days Crimean-Congo hemorrhagic fever virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Cryptococcus gattii or undifferentiated Cryptococcus species (i.e., Cryptococcus not identified as C. neoformans ) Positive results by any method excluding cryptococcal antigen Within 2 business days to LHJ Isolate If no isolate available, specimen associated with positive result (excluding serum) Within 2 business days Serum Within 2 business days of request by LHJ or DOH Cryptosporidium (Cryptosporidiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Cyclospora cayetanensis (Cyclosporiasis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Dengue virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH E. coli - Refer to "Shiga toxin-producing E. coli " Eastern and western equine encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result excluding specimens from viral culture Within 2 business days of request by LHJ or DOH Ebola virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive specimen Within 2 business days Echinococcus granulosus or E. multilocularis (Echinococcosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Ehrlichia species (Ehrlichiosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Francisella tularensis (Tularemia) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Giardia duodenalis, G. lamblia, G. intestinalis (Giardiasis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Guanarito virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate Within 2 business days If no isolate available, specimen associated with presumptive positive result Haemophilus influenzae (children < 5 years of age) Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Hantavirus including, but not limited to: Andes virus Bayou virus Black Creek Canal virus Dobrava-Belgrade virus Hantaan virus Seoul virus Sin nombre virus Positive result by any method Within 24 hours to LHJ Specimen associated with positive result Within 2 business days Hepatitis A virus Positive results for: IgM or Nucleic acid detection (NAT or NAAT) Hepatocellular enzyme levels to accompany report, if available, for positive IgM results Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis B virus Positive results for: IgM anti-HBc, HBsAg, HBeAg, or HBV Nucleic acid detection (NAT or NAAT) either qualitative or quantitative, for example PCR or genotyping If associated with a positive result listed above, and available: Hepatocellular enzyme levels, Pregnancy status, and Negative IgM anti-HBc result Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis C virus Positive result by any method Positive and nonpositive results for: HCV nucleic acid detection (NAT or NAAT) for qualitative, quantitative, and genotype tests If associated with a positive result and available: Hepatocellular enzyme levels, Pregnancy status, Negative result for IgM anti-HAV, and Negative result for IgM anti-HBc Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis C virus Deidentified negative screening result At least annually to DOH N/A N/A Hepatitis D virus Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Hepatitis E virus Positive result by any method If associated with a positive result and available: Hepatocellular enzyme levels Within 24 hours to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Histoplasma capsulatum (histoplasmosis) Positive result by any method Within 2 business days to LHJ Isolate Within 2 business days Serum Within 2 business days of request by LHJ or DOH Human immunodeficiency virus (HIV) Positive and indeterminate results and subsequent negative results associated with those positive or indeterminate results for the tests below: Antibody detection tests (including RST), Antigen detection tests (including RST), or Viral culture All HIV nucleic acid detection (NAT or NAAT) tests: Qualitative and quantitative Detectable and undetectable HIV antiviral resistance testing genetic sequences Within 2 business days to DOH except in King County where this is notifiable to the LHJ N/A N/A Human immunodeficiency virus (HIV) Deidentified negative screening result At least annually to DOH N/A N/A Human prion disease Positive result by any method excluding Tau protein Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Influenza virus, novel or unsubtypable strain Positive novel and unsubtypable result Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Japanese encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Junin virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days La Crosse encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Lassa virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Legionella species (Legionellosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available but respiratory specimen available and associated with a positive test (as in the case of a PCR positive), respiratory specimen associated with positive result Within 2 business days Leptospira species (Leptospirosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Listeria monocytogenes (Listeriosis) Positive result for specimen from a normally sterile site by: Culture or Nucleic acid detection (NAT or NAAT) Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Lujo virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Machupo virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Marburg virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Measles virus - See "Rubeola (measles virus)" Mumps virus Positive result for: Culture, Nucleic acid detection (NAT or NAAT), or IgM Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Specimen associated with positive IgM Within 2 business days of request by LHJ or DOH Mycobacterium tuberculosis complex (Tuberculosis) Positive result for: Culture Nucleic acid detection (NAT or NAAT) Drug susceptibilities (molecular and culture based) Within 2 business days to DOH Mycobacterium tuberculosis complex positive isolate (earliest available isolate for the patient) Within 2 business days Neisseria gonorrhoeae (Gonorrhea) Positive and indeterminate result by any method Within 2 business days to LHJ N/A N/A Neisseria gonorrhoeae (Gonorrhea) Deidentified negative screening result At least annually to DOH N/A N/A Neisseria meningitidis (Meningococcal disease) Positive result for specimen from a normally sterile site by any method Immediately to LHJ Isolate from a normally sterile site Within 2 business days If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Plasmodium species (Malaria) Positive results for: Nucleic acid detection (NAT or NAAT), Malaria-specific antigens by rapid diagnostic test, PCR, or Microscopy (thick or thin smear) Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Poliovirus (Poliomyelitis) IgM positivity; PCR positivity Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Powassan virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Rabies virus Positive result by any method Immediately to LHJ Specimen associated with positive result Within 2 business days Rickettsia species including, but not limited to: Rickettsia rickettsii Rickettsia africae Rickettsia conorii Rickettsia typhi Rickettsia parkeri Rickettsia philipii Positive results by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Rubella Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Other specimen Within 2 business days of request by LHJ or DOH Rubeola (measles virus) Positive result by: Culture, IgM, or Nucleic acid detection (NAT or NAAT) Immediately to LHJ Isolate and specimen associated with positive culture Isolate and specimen association with positive NAT or NAAT result Within 2 business days Specimen associated with positive IgM Other specimen Within 2 business days of request by LHJ or DOH Sabia virus (Viral hemorrhagic fever) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Salmonella species (Salmonellosis, typhoid fever) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Shiga toxin-producing E. coli /enterohemorrhagic E. coli (STEC) Positive result by any method Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Shigella species (Shigellosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days St. Louis encephalitis virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Taenia solium (Taeniasis or Cysticercosis) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Treponema pallidum (Syphilis) Positive and indeterminate result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days Treponema pallidum (Syphilis) Deidentified negative screening result At least annually to DOH N/A N/A Trichinella species (Trichinellosis) Positive serologic test for Trichinella Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Trypanosoma cruzi (Chagas disease) Positive result by any method Within 2 business days to LHJ Specimen associated with positive result Within 2 business days Vaccinia Any request for testing associated with a suspect case Immediately to LHJ Any specimen collected from a suspect case Immediately Vancomycin-resistant Staphylococcus aureus Resistance to vancomycin Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Variola virus (smallpox) Any request for testing associated with a suspect case Immediately to LHJ Specimen collected from a suspect case Immediately Vibrio cholerae O1 or O139 (Cholera) Positive result by any method Immediately to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days Vibrio species (Vibriosis) not including Vibrio cholerae O1 or O139 (Cholera) See "Vibrio cholerae O1 or O139 (Cholera)" Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days West Nile virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH Yellow fever virus (Arbovirus) Positive result by any method excluding IgG Immediately to LHJ Specimen associated with positive result Within 2 business days Yersinia enterocolitica, Y. pseudotuberculosis, Y. intermedia, Y. fredericksenii, or Y. kristensenii (Yersiniosis) Positive result by any method Within 24 hours to LHJ Isolate If no isolate available, specimen associated with positive result Within 2 business days of request by LHJ or DOH Yersinia pestis (Plague) Positive result by any method Immediately to LHJ Presumptive positive isolate If no isolate available, specimen associated with presumptive positive result Within 2 business days Zika virus, acute (Arbovirus) Positive result by any method excluding IgG Within 2 business days to LHJ Specimen associated with positive result Within 2 business days of request by LHJ or DOH 1 "CD4 + counts" means CD4 + (T4) lymphocyte counts. 2 "CD4 + percents" means CD4 + (T4) percents of total lymphocytes.