Regulations Governing the Reporting of Diseases, Exposures, and Sentinel Health Events

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4.1 Elevated Toxic Metal Levels: The health authority shall investigate, as appropriate, each report of a person having elevated levels of arsenic, lead, or mercury, as identified as a person with detectable levels of arsenic, lead, or mercury in blood, urine, or other clinically appropriate specimens upon testing by a medical laboratory, to:

4.1.1 Confirm the diagnosis; and

4.1.2 To identify the source of exposure.

4.2 Exposure to Toxic Metals: The health authority shall, investigate as appropriate, each report of a person being exposed to arsenic, lead, or mercury, to:

4.2.1 Verify the exposure; and

4.2.2 Describe the circumstances and cause of the exposure; and

4.2.3 Determine the severity and extent of the exposure; and

4.2.4 Make recommendations for the remediation and prevention of future exposures.

4.3 Drowning: The health authority shall investigate, as appropriate, each report of drowning, to:

4.3.1 Verify the drowning; and

4.3.2 Describe the circumstances, risk factors, and cause of the drowning; and

4.3.3 Determine the severity and outcome of the drowning.

4.4 Drug-Resistant Streptococcus pneumoniae Invasive Disease: The health authority shall investigate, as appropriate, each report of a case having Drug-Resistant Streptococcus pneumoniae Invasive Disease, as identified by the finding of a person with Streptococcus pneumoniae in the blood or cerebral spinal fluid, with intermediate or high-level resistance of the isolate to at least one antimicrobial agent, upon testing of a clinical specimen by a medical laboratory, to:

4.4.1 Confirm the diagnosis; and

4.4.2 To identify risk factors for the development of the disease.

4.5 Group A Streptococcal Invasive Disease: The health authority shall investigate, as appropriate, each report of a case having Group A Streptococcal Invasive Disease, as identified by the finding of a person with Group A Streptococcus in a normally sterile site, upon testing of a clinical specimen by a medical laboratory, to:

4.5.1 Confirm the diagnosis; and

4.5.2 To identify risk factors for the development of the disease.

4.6 Pediatric Streptococcus pneumoniae Invasive Disease: The health authority shall investigate, as appropriate, each report of a child less than 5 years of age having Streptococcus pneumoniae Invasive Disease, as identified by the finding of a child less than 5 years of age with Streptococcus pneumoniae in the blood or cerebral spinal fluid, upon testing of a clinical specimen by a medical laboratory, to:

4.6.1 Confirm the diagnosis; and

4.6.2 To identify risk factors for the development of the disease.

4.7 Vancomycin-intermediate Staphylococcus aureus (VISA) and Vancomycin-resistant Staphylococcus aureus (VRSA) Infection: The health authority shall investigate, as appropriate, each report of a case having VISA or VRSA, as identified by the finding of a person with Staphylococcus aureus, with intermediate or high-level resistance of the isolate to vancomycin, upon testing of a clinical specimen by a medical laboratory, to:

4.7.1 Confirm the diagnosis; and

4.7.2 Determine the extent of any outbreak; and

4.7.3 To identify risk factors for the development of the disease.

4.8 Vibriosis, non-Cholera: The health authority shall investigate, as appropriate, each report of a case having vibriosis, as identified by the finding of a person with or excreting pathogenic Vibrio spp. organisms, other than Vibrio cholerae, which is described in NAC 441A.495, upon testing of a stool or vomitus specimen by a medical laboratory, or by the identification of a Vibrio spp. organisms in a wound, blood, or other sterile site by a medical laboratory to:

4.8.1 Confirm the diagnosis; and

4.8.2 Determine the extent of any outbreak; and

4.8.3 To identify risk factors for the development of the disease.

4.9 Communicable Disease Outbreaks: The health authority shall investigate, as appropriate, each report of an outbreak or suspected outbreak of a disease to:

4.9.1 Confirm the existence of the outbreak; and

4.9.2 Identify the source of the outbreak; and

4.9.3 Institute measures to control the outbreak or suspected outbreak; and

4.9.4 To prevent future exposures.

4.10 Exposures of Groups of People: The health authority shall investigate, as appropriate, each report of an exposure of two or more people to:

4.10.1 Confirm the exposure; and

4.10.2 Describe, epidemiologically, the group of people exposed;

4.10.3 Determine the need for the control measure to prevent future exposures.