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(a) The board shall identify each communicable disease or health condition that shall
be reported under this chapter.
(b) The board shall classify each reportable disease according to its nature and the severity of its effect on the public
health.
(c) The board shall maintain and revise as necessary the list of reportable diseases.
(d) The board may establish registries for reportable diseases and other communicable diseases and health conditions. The provision to the department of information relating to a communicable disease or health condition that is not classified as
reportable is voluntary only.
(e) Acquired immune deficiency syndrome and human immunodeficiency virus infection are reportable diseases under
this chapter for which the board shall require reports.
(f) In a public health disaster, the commissioner may require reports of communicable diseases or other health conditions
from providers without board rule or action. The commissioner shall issue appropriate instructions relating to complying with the reporting requirements of this section.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989. Amended
by Acts 2003, 78th Leg., ch. 198, § 2.170, eff. Sept. 1, 2003.

(a) A report under Subsection (b), (c), or (d) shall be made to the local health
authority.
(b) A dentist or veterinarian licensed to practice in this state or a physician shall report, after the first professional encounter, a patient or animal examined that has or is suspected of having a reportable disease.
(c) A local school authority shall report a child attending school who is suspected of having a reportable disease. The board
by rule shall establish procedures to determine if a child should be suspected and reported and to exclude the child from school pending appropriate medical diagnosis or recovery.
(d) A person in charge of a clinical or hospital laboratory, blood bank, mobile unit, or other facility in which a laboratory
examination of a specimen derived from a human body yields microscopical, cultural, serological, or other evidence of a
reportable disease shall report the findings, in accordance with this section and procedures adopted by the board, in the jurisdiction in which:
(1) the physician's office is located, if the laboratory examination was requested by a physician; or
(2) the laboratory is located, if the laboratory examination was not requested by a physician.
(e) The following persons shall report to the local health authority or the department a suspected case of a reportable
disease and all information known concerning the person who has or is suspected of having the disease if a report is not made as required by Subsections (a)-(d):
(1) a professional registered nurse;
(2) an administrator or director of a public or private temporary or permanent child-care facility;
(3) an administrator or director of a nursing home, personal care home, maternity home, adult respite care center, or adult day-care center;
(4) an administrator of a home health agency;
(5) an administrator or health official of a public or private institution of higher education;
(6) an owner or manager of a restaurant, dairy, or other food handling or processing establishment or outlet;
(7) a superintendent, manager, or health official of a public or private camp, home, or institution;
(8) a parent, guardian, or householder;
(9) a health professional;
(10) an administrator or health official of a penal or correctional institution; or
(11) emergency medical service personnel, a peace officer, or a firefighter.

Acts 1989, 71st Leg., ch. 678, § 1, eff. Sept. 1, 1989. Amended
by Acts 2003, 78th Leg., ch. 198, § 2.171, eff. Sept. 1, 2003;
Acts 2003, 78th Leg., ch. 1312, § 7, eff. June 21, 2003.

(a) A person commits an offense if the person knowingly fails to report a reportable disease or health condition under this subchapter.
(b) An offense under this section is a Class B misdemeanor.

Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97 COMMUNICABLE DISEASES
SUBCHAPTER A CONTROL OF COMMUNICABLE DISEASES
RULE §97.2 Who Shall Report

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(a) A physician, dentist, veterinarian, chiropractor, advanced practice nurse, physician assistant, or person permitted by law to attend a pregnant woman during gestation or at the delivery of an infant shall report, as required by these sections, each patient (person or animal) he or she shall examine and who has or is suspected of having any notifiable condition, and shall report any outbreak, exotic disease, or unusual group expression of illness of any kind whether or not the disease is known to be communicable or reportable. An employee from the clinic or office staff may be designated to serve as the reporting officer. A physician, dentist, veterinarian, or chiropractor who can assure that a designated or appointed person from the clinic or office is regularly reporting every occurrence of these diseases or health conditions in their clinic or office does not have to submit a duplicate report.

(b) The chief administrative officer of a hospital shall appoint one reporting officer who shall be responsible for reporting each patient who is medically attended at the facility and who has or is suspected of having any notifiable condition. Hospital laboratories may report through the reporting officer or independently in accordance with the hospital's policies and procedures.

(c) Except as provided in subsection (b) of this section, any person who is in charge of a clinical laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of any specimen derived from a human body yields microscopic, bacteriologic, virologic, parasitologic, serologic, or other evidence of a notifiable condition, shall report as required by this section.

(d) School authorities, including a superintendent, principal, teacher, school health official, or counselor of a public or private school and the administrator or health official of a public or private institution of higher learning should report as required by these sections those students attending school who are suspected of having a notifiable condition. School administrators who are not medical directors meeting the criteria described in §97.132 of this title (relating to Who Shall Report Sexually Transmitted Diseases) are exempt from reporting sexually transmitted diseases.

(e) Any person having knowledge that a person or animal is suspected of having a notifiable condition should notify the local health authority or the department and provide all information known to them concerning the illness and physical condition of such person or persons.

(f) Sexually transmitted diseases including HIV and AIDS shall be reported in accordance with §97.132 of this title.

(g) Failure to report a notifiable condition is a Class B misdemeanor under the Texas Health and Safety Code, §81.049.

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Source Note: The provisions of this §97.2 adopted to be effective March 16, 1994, 19 TexReg 1453; amended to be effective March 5, 1998, 23 TexReg 1954; amended to be effective January 1, 1999, 23 TexReg 12663; amended to be effective March 26, 2000, 25 TexReg 2343; amended to be effective December 20, 2000, 25 TexReg 12426; amended to be effective August 5, 2001, 26 TexReg 5658

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(a) Humans.

(A) The most current edition of the Texas Department of Health's (department) publication titled "Identification, Confirmation, and Reporting of Notifiable Conditions" shall be reported under these sections based on a specific diagnosis, test procedure, and/or confirmatory test. Copies are available upon request to the Materials Acquisition and Management Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756. Copies are filed in the Infectious Disease Epidemiology and Surveillance Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756 and are available for public inspection during regular working hours.

(B) Repetitive test results from the same patient do not need to be reported except those for mycobacterial infections.

(A) Confirmed and suspected human cases of the following diseases/infections are reportable: acquired immune deficiency syndrome (AIDS); amebiasis; anthrax; botulism-adult and infant; brucellosis; campylobacteriosis; chancroid; chickenpox (varicella); Chlamydia trachomatis infection; Creutzfeldt-Jakob disease (CJD); cryptosporidiosis; cyclosporiasis; dengue; diphtheria; ehrlichiosis; encephalitis (specify etiology); Escherichia coli, enterohemorrhagic infection; gonorrhea; Hansen's disease (leprosy); Haemophilus influenzae type b infection, invasive; hantavirus infection; hemolytic uremic syndrome (HUS); hepatitis A, B, D, E, and unspecified (acute); hepatitis C (newly diagnosed infection, effective 1/1/00); hepatitis B, (chronic) identified prenatally or at delivery as described in §97.135 of this title (relating to Serologic Testing during Pregnancy and Delivery; human immunodeficiency virus (HIV) infection; legionellosis; listeriosis; Lyme disease; malaria; measles (rubeola); meningitis (specify type); meningococcal infection, invasive; mumps; pertussis; plague; poliomyelitis, acute paralytic; Q fever; rabies; relapsing fever; rubella (including congenital); salmonellosis, including typhoid fever; shigellosis; smallpox; spotted fever group rickettsioses (such as Rocky Mountain spotted fever); streptococcal disease: invasive group A, invasive group B, or invasive Streptococcus pneumoniae; syphilis; tetanus; trichinosis; tuberculosis; tularemia; typhus; Vibrio infection, including cholera (specify species); viral hemorrhagic fevers; yellow fever; yersiniosis; and Severe Acute Respiratory Syndrome (SARS) as defined by the United States Centers for Disease Control and Prevention.

(B) In addition to individual case reports, any outbreak, exotic disease, or unusual group expression of disease which may be of public health concern should be reported by the most expeditious means.

(C) The following organisms shall be reported: Enterococcus species; vancomycin resistant Enterococcus species; vancomycin resistant Staphylococcus aureus; vancomycin resistant coagulase negative Staphyloccoccus species; Streptococcus pneumoniae; and penicillin-resistant Streptococcus pneumoniae.

(3) Minimal reportable information requirements. The minimal information that shall be reported for each disease is as follows:

(A) AIDS, chancroid, Chlamydia trachomatis infection, gonorrhea, HIV infection, and syphilis shall be reported in accordance with §§97.132-97.135 of this title (relating to Sexually Transmitted Diseases, including AIDS and HIV infection);

(B) for tuberculosis disease - complete name, date of birth, physical address and county of residence, information on which diagnosis was based or suspected. In addition, if known, radiographic or diagnostic imaging results and date(s); all information necessary to complete the most recent versions of forms TB 400 A & B (Report of Case and Patient Services), TB 340 (Report of Contacts) and TB 341 (Continuation of Report of Contacts); laboratory results used to guide prescribing, monitoring or modifying antibiotic treatment regimens for tuberculosis to include, but not limited to, liver function studies, renal function studies, and serum drug levels; pathology reports related to diagnostic evaluations of tuberculosis; reports of imaging or radiographic studies; records of hospital or outpatient care to include, but not limited to, histories and physical examinations, discharge summaries and progress notes; records of medication administration to include, but not limited to, directly observed therapy (DOT) records, and drug toxicity and monitoring records; a listing of other patient medications to evaluate the potential for drug-drug interactions; and copies of court documents related to court ordered management of tuberculosis.

(C) for contacts to a known case of tuberculosis - complete name; date of birth; physical address; county of residence; and all information necessary to complete the most recent versions of forms TB 400 A & B (Report of Case and Patient Services), TB 340 (Report of Contacts), and TB 341 (Continuation of Report of Contacts);

(D) for other persons identified with latent TB infection - complete name; date of birth; physical address and county of residence; and all information necessary to complete the most recent versions of forms TB 400 A & B (Report of Case and Patient Services);

(E) for hepatitis B, (chronic and acute) identified prenatally or at delivery - mother's name, address, telephone number, age, date of birth, sex, race and ethnicity, preferred language, hepatitis B laboratory test results; estimated delivery date or date and time of birth; name and phone number of delivery hospital or planned delivery hospital; name of infant; name, phone number, and address of medical provider for infant; date, time, formulation, dose, manufacturer, and lot number of hepatitis B vaccine and hepatitis B immune globulin administered to infant;

(F) for chickenpox - name, date of birth, sex, race and ethnicity, address, date of onset, and varicella vaccination history;

(G) for all other notifiable conditions listed in paragraph (2)(A) of this subsection - name, address, telephone number, age, date of birth, sex, race and ethnicity, disease, type of diagnosis, date of onset, and physician name, address, and telephone number;

(H) for all isolates of Enterococcus species and all isolates of Streptococcus pneumoniae regardless of resistance patterns - numeric totals at least quarterly;

(I) for vancomycin resistant Enterococcus species; penicillin resistant Streptococcus pneumoniae; vancomycin resistant Staphylococcus aureus; vancomycin resistant coagulase negative Staphylococcus species, - name, city of submitter, date of birth or age, sex, anatomic site of culture, and date of culture; and

(J) for Hansen's disease - name; date of birth; sex; race and ethnicity; social security number; disease type; place of birth; address; telephone number; date entered Texas; date entered U.S.; education/employment; insurance status; location and inclusive dates of residence outside U.S.; date of onset and history prior to diagnosis; date of initial biopsy and result; date initial drugs prescribed and name of drugs; name, date of birth and relationship of household contacts; and name, address, and telephone number of physician.

(4) Diseases requiring submission of cultures. For all Neisseria meningitides from normally sterile sites, all vancomycin resistant Staphylococcus aureus, and vancomycin resistant coagulase negative Staphylococcus species - pure cultures shall be submitted accompanied by a Specimen Submission Form G-1.

(5) Laboratory reports. Reports from laboratories shall include name, patient identification number, address, telephone number, age, date of birth, sex, race and ethnicity, specimen submitter name, address, and phone number, specimen type, date specimen collected, disease test and test result, normal test values, date of test report, and physician name and telephone number.

(1) Clinically diagnosed or laboratory-confirmed animal cases of the following diseases are reportable: anthrax, arboviral encephalitis, Mycobacterium tuberculosis infection in animals other than those housed in research facilities, plague, and psittacosis. Also, all non-negative rabies tests performed on animals from Texas at laboratories located outside of Texas shall be reported; all non-negative rabies tests performed in Texas will be reported by the laboratory conducting the testing. In addition to individual case reports, any outbreak, exotic disease, or unusual group expression of disease which may be of public health concern should be reported by the most expeditious means.

(2) The minimal information that shall be reported for each disease includes species and number of animals affected, disease or condition, name and phone number of the veterinarian or other person in attendance, and the animal(s) owner's name, address, and phone number. Other information may be required as part of an investigation in accordance with Texas Health and Safety Code, §81.061.

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Source Note: The provisions of this §97.3 adopted to be effective March 16, 1994, 19 TexReg 1453; amended to be effective July 26, 1996, 21 TexReg 6622; amended to be effective March 5, 1998, 23 TexReg 1954; amended to be effective January 1, 1999, 23 TexReg 12663; amended to be effective March 26, 2000, 25 TexReg 2343; amended to be effective December 20, 2000, 25 TexReg 12426; amended to be effective August 5, 2001, 26 TexReg 5658; amended to be effective December 12, 2002, 27 TexReg 11547; amended to be effective May 29, 2003, 28 TexReg 4151

Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97 COMMUNICABLE DISEASES
SUBCHAPTER A CONTROL OF COMMUNICABLE DISEASES
RULE §97.4 When to Report a Condition or Isolate; Where to Submit an Isolate; Where to Report a Condition or Isolate

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(a) Humans.

(1) The following notifiable conditions are public health emergencies and suspect cases shall be reported immediately by phone to the local health authority or the regional director of the Texas Department of Health (department): anthrax; botulism, foodborne; diphtheria; Haemophilus influenzae type b infection, invasive; measles (rubeola); meningococcal infection, invasive; pertussis; poliomyelitis, acute paralytic; plague; rabies; smallpox; viral hemorrhagic fevers; yellow fever. Vancomycin resistant Staphylococcus aureus and vancomycin resistant coagulase negative Staphylococcus species shall be reported immediately by phone to the Infectious Disease Epidemiology and Surveillance Division, Texas Department of Health, Austin at (800) 252-8239.

(2) The following notifiable conditions shall be reported within one working day of identification as a suspected case: brucellosis, hepatitis A (acute), Q fever, rubella (including congenital), tularemia, tuberculosis, and Vibrio infection (including cholera).

(3) AIDS, chancroid, Chlamydia trachomatis infection, gonorrhea, HIV infection, and syphilis shall be reported in accordance with §§97.132 - 97.135 of this title (relating to Sexually Transmitted Diseases including AIDS and HIV infection);

(4) Tuberculosis antibiotic susceptibility results should be reported by laboratories no later than one week after they first become available.

(5) For all other notifiable conditions not listed in paragraphs (1)-(3) of this subsection, reports of disease shall be made no later than one week after a case or suspected case is identified.

(6) For Enterococcus species; vancomycin resistant Enterococcus species; Streptococcus pneumoniae; and penicillin-resistant Streptococcus pneumoniae - reports shall be made no later than the last working day of March, June, September, and December.

(7) All Neisseria meningitides from normally sterile sites, all vancomycin resistant Staphylococcus aureus, and all vancomycin resistant coagulase negative Staphylococcus species shall be submitted as pure cultures to the Texas Department of Health, Bureau of Laboratories, 1100 West 49th Street, Austin, Texas 78756-3199 as they become available.

(1) Reportable conditions affecting animals shall be reported within one working day following the diagnosis.

(2) Reportable conditions in animals shall be reported to either the appropriate Texas Department of Health regional zoonosis control office or the Zoonosis Control Division office in Austin.

(3) Conditions in animals that are reportable to both the Texas Department of Health and the Texas Animal Health Commission can be reported to either one of the agencies which will forward the information to the other agency.

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Source Note: The provisions of this §97.4 adopted to be effective March 16, 1994, 19 TexReg 1453; amended to be effective July 26, 1996, 21 TexReg 6622; amended to be effective March 5, 1998, 23 TexReg 1954; amended to be effective January 1, 1999, 23 TexReg 12663; amended to be effective December 20, 2000, 25 TexReg 12426; amended to be effective August 5, 2001, 26 TexReg 5658; amended to be effective December 12, 2002, 27 TexReg 11547

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(a) A physician, dentist, veterinarian, chiropractor, reporting officer of a hospital and a person in charge of a hospital laboratory (if the laboratory reports independently), or person permitted by law to attend a pregnant woman during gestation or at the delivery of an infant, or school authority shall report to the local health authority where the office, clinic, hospital, or school is located. If there is no local health authority appointed for the jurisdiction where the office, clinic, hospital, or school is located, the report shall be made to the Texas Department of Health (department) regional director. Public health emergencies shall be reported to the department's central office if the local health authority or the department's regional director is not immediately accessible.

(b) The administrative officer of a clinical laboratory, blood bank, mobile unit, or other facility shall report a condition or submit an isolate as follows.

(1) If the laboratory examination was requested by a physician, notice shall be sent to the local health authority for the jurisdiction where the physician's office is located, to the department's regional director for the jurisdiction where the physician's office is located if no local health authority exists, or to the department's central office when the regional director or local health authority are unknown to the laboratory.

(2) If the laboratory examination was not requested by a physician, notice shall be sent to the local health authority for the jurisdiction where the laboratory is located, to the department's regional director for the jurisdiction where the laboratory is located if no local health authority has been appointed, or to the department's central office when the regional director or local health authority are unknown to the laboratory.

(3) For vancomycin resistant Staphylococcus aureus and vancomycin resistant coagulase negative Staphylococcus species immediately report by phone to the Infectious Disease Epidemiology and Surveillance Division at 1-800-252-8239. For Enterococcus species; vancomycin resistant Enterococcus species; Streptococcus pneumoniae; and penicillin resistant Streptococcus pneumoniae; reports shall be mailed to the Infectious Disease Epidemiology and Surveillance Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199, or faxed to the Infectious Disease Epidemiology and Surveillance Division at (512) 458-7616.

(4) All Neisseria meningitidis from normally sterile sites, all vancomycin resistant Staphylococcus aureus, and all vancomycin resistant coagulase negative Staphylococcus species shall be submitted as pure cultures to the Texas Department of Health, Bureau of Laboratories, 1100 West 49th Street, Austin, Texas 78756-3199.

(c) Sexually transmitted diseases including HIV and AIDS shall be reported in accordance with §§97.132 - 97.135 of this title (relating to Sexually Transmitted Diseases Including Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV)).

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Source Note: The provisions of this §97.5 adopted to be effective March 16, 1994, 19 TexReg 1453; amended to be effective March 5, 1998, 23 TexReg 1954; amended to be effective March 26, 2000, 25 TexReg 2343

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Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 97 COMMUNICABLE DISEASES
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