Communicable Diseases

A provider of health care who knows of, or provides services to, a person who has or is suspected of having a communicable disease.

A medical facility in which more than one provider of health care may know of, or provide services to, a person who has or is suspected of having a communicable disease.

A laboratory director, or if more than one medical laboratory is involved in testing a specimen, the laboratory that is responsible for reporting the results of the testing directly to the provider of health care for the patient shall also be responsible for reporting to the health authority.

NRS 441A.150 Reporting occurrences of communicable diseases to health authority; reporting drug overdoses to Chief Medical Officer. [Effective January 1, 2020.]

      1.  A provider of health care who knows of, or provides services to, a person who has or is suspected of having a communicable disease shall report that fact to the health authority in the manner prescribed by the regulations of the Board. If no provider of health care is providing services, each person having knowledge that another person has a communicable disease shall report that fact to the health authority in the manner prescribed by the regulations of the Board. A report of a pregnant woman who has or is suspected of having syphilis must include, without limitation, the fact that the case occurred in a pregnant woman and:
(a) If treatment was provided, the type of treatment that was provided; or
(b) If the pregnant woman refused treatment, the fact that the pregnant woman refused treatment.

      2.  A provider of health care who knows of, or provides services to, a person who has suffered or is suspected of having suffered a drug overdose shall report that fact and the information required by the Board pursuant to NRS 441A.120 to the Chief Medical Officer or his or her designee in the manner prescribed by the regulations of the Board. The Chief Medical Officer or his or her designee shall upload that information to the database of the program established pursuant to NRS 453.162 if the program allows for the upload of such information.

      3.  A medical facility in which more than one provider of health care may know of, or provide services to, a person who has or is suspected of having a communicable disease or who has suffered or is suspected of having suffered a drug overdose shall establish administrative procedures to ensure that the health authority or Chief Medical Officer or his or her designee, as applicable, is notified.

      4.  A laboratory director shall, in the manner prescribed by the Board, notify the health authority of the identification by his or her medical laboratory of the presence of any communicable disease in the jurisdiction of that health authority. The health authority shall not presume a diagnosis of a communicable disease on the basis of the notification received from the laboratory director.

      5.  If more than one medical laboratory is involved in testing a specimen, the laboratory that is responsible for reporting the results of the testing directly to the provider of health care for the patient shall also be responsible for reporting to the health authority.

      (Added to NRS by 1989, 295; A 2017, 4401; 2019, 166, effective January 1, 2020)

NAC 441A.225 General requirements for certain reports to health authority and rabies control authority; establishment of after-hours reporting system. (NRS 441A.120)

     1.  Except as otherwise provided in this section, a report of a case or suspected case, which is required to be made pursuant to the provisions of this chapter, must be made to the health authority during the regular business hours of the health authority on the first working day following the identification of the case or suspected case. The report may be made by:

     (a) Telephone;

     (b) Telecopy, in the form prescribed by the health authority; or

     (c) Any form of electronic communication identified by the health authority, in the form and manner specified by the health authority.

     2.  A report must be made immediately after identifying a case having or a suspected case considered to have:

     (a) Anthrax;

     (b) Foodborne botulism;

     (c) Botulism, other than foodborne botulism, infant botulism or wound botulism;

     (d) Extraordinary occurrence of illness;

     (e) Influenza that is known or suspected to be of a viral strain that the Centers for Disease Control and Prevention or the World Health Organization has determined poses a risk of a national or global pandemic;

     (f) Meningococcal disease;

     (g) Plague;

     (h) Rabies, human;

     (i) Poliovirus infection;

     (j) Severe acute respiratory syndrome (SARS);

     (k) Smallpox (variola);

     (l) Tularemia;

     (m) Viral hemorrhagic fever; or

     (n) Any infection or disease that is known or suspected to be related to an act of intentional transmission or biological terrorism, or that is or is considered possibly to be part of an outbreak or a suspected outbreak.

     3.  A report must be made to the health authority within 24 hours after identifying a case having:

     (a) Infant botulism;

     (b) Wound botulism;

     (c) Brucellosis;

     (d) Cholera;

     (e) Diphtheria;

     (f) Haemophilus influenzae type b;

     (g) Hepatitis A;

     (h) Hepatitis E;

     (i) Measles;

     (j) Mumps;

     (k) Pertussis;

     (l) Rubella;

     (m) Typhoid fever; or

     (n) Tuberculosis.

     4.  A report must be made to the health authority within 24 hours after identifying a suspected case considered possibly to have:

     (a) Diphtheria;

     (b) Measles;

     (c) Rubella; or

     (d) Tuberculosis.

     5.  A report to the health authority made pursuant to subsection 2, 3 or 4 must be made by telephone if it is made during the regular business hours of the health authority or using the after-hours reporting system if the report is made at any other time.

     6.  A report of animal rabies or an animal bite by a rabies-susceptible animal must be made to the health authority or to the rabies control authority, if designated by the health authority, within 24 hours after identifying the case. The report must be made by telephone if it is made during the regular business hours of the health authority or rabies control authority, as applicable, or using the after-hours reporting system if the report is made at any other time.

     7.  Each health authority and rabies control authority shall establish and maintain an after-hours reporting system.

     (Added to NAC by Bd. of Health, eff. 1-24-92; A by R087-08, 1-13-2011)

 NAC 441A.230  Duty of health care provider to report case or suspected case; content of report. (NRS 441A.120)

     1.  Except as otherwise provided in NAC 441A.240, a health care provider who knows of, or provides services to, a case or suspected case shall report the case or suspected case to the health authority having jurisdiction where the office of the health care provider is located. The report must be made in the manner provided in NAC 441A.225.

     2.  The report must include:

     (a) The communicable disease or suspected communicable disease.

     (b) The name, address and, if available, telephone number of the case or suspected case.

     (c) The name, address and telephone number of the health care provider making the report.

     (d) The occupation, employer, age, sex, race and date of birth of the case or suspected case, if available.

     (e) The date of diagnosis of the communicable disease.

     (f) The date of onset of the communicable disease, if available.

     (g) Any other information requested by the health authority, if available.

     (Added to NAC by Bd. of Health, eff. 1-24-92; A by R087-08, 1-13-2011)

NAC 441A.235  Duty of director or other person in charge of medical laboratory to report findings of communicable disease, causative agent of communicable disease or immune response to causative agent; contents of report; submission of certain microbiologic cultures, subcultures, or other specimen or clinical material; required reporting of results of certain tests relating to human immunodeficiency virus. (NRS 439.200, 441A.120, 441A.167)

     1.  Except as otherwise provided in NAC 441A.240, the director or other person in charge of a medical laboratory in which a test or examination of any specimen derived from the human body yields evidence suggesting the presence of a communicable disease, a causative agent of a communicable disease or an immune response to a causative agent of a communicable disease shall:

     (a) If the medical laboratory is in this State, report the findings to the health authority having jurisdiction where the office of the health care provider who ordered the test or examination is located or to an electronic clearinghouse approved by the health authority.

     (b) If the medical laboratory performed the test or examination on specimens obtained in this State or from residents of this State, and the medical laboratory is located outside of this State, report the findings to the Chief Medical Officer.

The report must be made in the manner provided in NAC 441A.225.

     2.  The report must include:

     (a) The date and result of the test or examination performed.

     (b) The name, address and, if available, telephone number of the person from whom the specimen was obtained.

     (c) The sex, age and date of birth of the person from whom the specimen was obtained, if available.

     (d) The name of the health care provider who ordered the test or examination.

     (e) The name and the address or telephone number of the medical laboratory making the report.

     (f) Any other information requested by the health authority, if available.

     3.  The director or other person in charge of the medical laboratory shall also submit microbiologic cultures, subcultures, or other specimens or clinical material, if available, to the State Public Health Laboratory or other laboratory designated by the health authority for diagnosis, confirmation or further testing if:

     (a) Requested by the health authority;

     (b) The communicable disease is included on the list of diseases published by the health authority pursuant to subsection 4 and the health authority has provided the director or other person in charge of the medical laboratory with a copy of the list; or

     (c) The microbiologic cultures, subcultures, or other specimens or clinical material consist of:

          (1) Isolates of Bordetella pertussis or Bordetella parapertussis;

          (2) Isolates of non-motile and non-hemolytic Bacillus spp.;

          (3) Isolates of Brucella spp.;

          (4) Isolates of Burkholderia mallei or Burkholderia pseudomallei;

          (5) Isolates of Campylobacter spp.;

          (6) Isolates of Clostridium botulinum;

          (7) Isolates of Clostridium tetani;

          (8) Isolates of Corynebacterium diptheriae;

          (9) Isolates of Coxiella burnetii;

          (10) Isolates of E. coli O157:H7;

          (11) Isolates of Francisella tularensis;

          (12) Isolates of Haemophilus influenza (invasive only);

          (13) Isolates of Legionella spp.;

          (14) Isolates of Listeria monocytogenes;

          (15) Isolates of Mycobacterium spp.;

          (16) Isolates of Neisseria meningitidis from a sterile site;

          (17) Blood smears containing Plasmodium spp.;

          (18) Isolates of Salmonella spp.;

          (19) Isolates of, or broth positive results for, Shiga-toxin producing E. coli;

          (20) Isolates of Shigella spp.;

          (21) Isolates of Vibrio spp.;

          (22) Isolates of Vancomycin-intermediate Staphylococcus aureus;

          (23) Isolates of Vancomycin-resistant Staphylococcus aureus;

          (24) Isolates of Yersinia pestis; or

          (25) Isolates of Yersinia spp., other than Yersinia pestis.

     4.  The health authority shall annually publish and post on its Internet website a list of communicable diseases for which microbiologic cultures, subcultures, or other specimens or clinical material, if available, must be submitted pursuant to subsection 3. For each communicable disease included on the list, the health authority must specify:

     (a) The microbiologic cultures, subcultures, or other specimens or clinical material to be submitted;

     (b) The justification for requiring the microbiologic cultures, subcultures, or other specimens or clinical material to be submitted;

     (c) The name of the medical laboratory to which the microbiologic cultures, subcultures, or other specimens or clinical material must be submitted; and

     (d) The process by which the microbiologic cultures, subcultures, or other specimens or clinical material must be submitted.

     5.  Except as otherwise provided in NAC 441A.240, the director or other person in charge of a medical laboratory shall report as required by this section the results of any test of any specimen derived from the human body, if the test is approved by the Food and Drug Administration of the United States Department of Health and Human Services, and:

     (a) The results of the test confirm the presence of the human immunodeficiency virus (HIV) or antibodies to the human immunodeficiency virus (HIV); or

     (b) The test was conducted to monitor the progression of a human immunodeficiency virus (HIV) infection, including, without limitation, all levels of CD4, and both detectable and undetectable viral loads.

     6.  With respect to a test described in subsection 5, if the interpretation of the laboratory diagnostic testing algorithm is positive, indicating the presence of infection with the human immunodeficiency virus (HIV), the laboratory must report to the health authority:

     (a) The overall result or conclusion of the algorithm; and

     (b) Results from all such tests, including, without limitation, negative, nonreactive or intermediate results, that are performed as part of the testing algorithm, including, without limitation:

          (1) Fourth-generation and third-generation tests for the human immunodeficiency virus (HIV);

          (2) Human immunodeficiency virus antibody differentiation tests (HIV-1/-2); and

          (3) Nucleic acid amplification tests (NAT) for the presence of the human immunodeficiency virus (HIV).

     (Added to NAC by Bd. of Health, eff. 1-24-92; A 11-1-95; R087-08, 1-13-2011; R121-14, 10-27-2015)

NAC 441A.240  Duty of director or other person in charge of medical facility to report communicable disease; report by infection preventionist; adoption of administrative procedures for reporting. (NRS 441A.120)

     1.  Except as otherwise provided in subsection 2, the director or other person in charge of a medical facility who knows of or suspects the presence of a communicable disease within the medical facility shall report the communicable disease to the health authority having jurisdiction where the medical facility is located. The report must be made in the manner provided in NAC 441A.225.

     2.  If a medical facility has a designated infection preventionist, administrative procedures may be established by which all communicable diseases known or suspected within the medical facility, including its laboratories and outpatient locations, are reported to the health authority through the medical facility’s infection preventionist or his or her representative. The report must be made in the manner provided in NAC 441A.225. Notwithstanding any other provision of this chapter, a director or other person in charge of a laboratory in a medical facility or a health care provider in a medical facility is not required to report a known or suspected communicable disease in the medical facility to the health authority if he or she makes a report to the infection preventionist in accordance with the provisions of this section.

     3.  Any administrative procedures adopted by a medical facility pursuant to subsection 2 must:

     (a) Require the designated infection preventionist to:

          (1) Submit to the health authority each report of a known or suspected communicable disease in the medical facility made to the infection preventionist by a director or other person in charge of a laboratory in the medical facility or a health care provider in the medical facility; and

          (2) Make the report in the manner provided in NAC 441A.225;

     (b) Require each director or other person in charge of a laboratory in the medical facility and each health care provider in the medical facility to:

          (1) Submit a report to the infection preventionist if he or she knows of or suspects the presence of a communicable disease in the medical facility; and

          (2) Make the report in a manner that enables the infection preventionist to submit the report to the health authority in the manner provided in NAC 441A.225; and

     (c) Establish specific procedures for, without limitation:

          (1) Submitting a report to the infection preventionist outside his or her regular business hours;

          (2) Submitting a report if the infection preventionist is not available; and

          (3) Ensuring that a report submitted to the infection preventionist is made in a manner that enables the infection preventionist to submit the report to the health authority in the manner provided in NAC 441A.225.

     4.  If a medical facility adopts administrative procedures pursuant to subsection 2, the director or other person in charge of the medical facility shall:

     (a) Ensure that the administrative procedures are revised or amended as necessary; and

     (b) Provide the administrative procedures, and each revision and amendment thereto, to:

          (1) The health authority having jurisdiction where the medical facility is located;

          (2) Each health care provider in the medical facility;

          (3) The director or other person in charge of a laboratory in the medical facility; and

          (4) The designated infection preventionist, his or her representative and any other person who assists the infection preventionist in carrying out his or her duties.

     5.  A report submitted to a designated infection preventionist pursuant to this section must:

     (a) If submitted by the director or other person in charge of a laboratory in the medical facility, comply with NAC 441A.235; or

     (b) If submitted by a health care provider in the medical facility, comply with NAC 441A.230.

     (Added to NAC by Bd. of Health, eff. 1-24-92; A by R087-08, 1-13-2011)