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§ 11.03 Diseases and Conditions of Public Health Interest That Are Reportable.
   (a)   Cases and carriers affected with any of the following diseases and conditions of public health interest, and persons who at the time of their death were apparently so affected, shall be reported to the Department as specified in this article:
      Alpha-gal syndrome, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Amebiasis
      Anaplasmosis (Human granulocytic anaplasmosis)
      Animal bite, or exposure to rabies
      Anthrax
      Arboviral infections, acute (including but not limited to the following viruses: chikungunya virus, Zika virus, dengue virus, Eastern equine encephalitis virus, Jamestown Canyon virus, Japanese encephalitis virus, La Crosse virus, Powassan virus, Rift Valley fever virus, St. Louis encephalitis virus, Western or Venezuelan equine encephalitis virus, West Nile virus and yellow fever)
      Babesiosis
      Blood lead level of three and a half micrograms per deciliter or higher (see also 24 RCNY Health Code § 11.09(a))
      Botulism (including infant, foodborne and wound botulism)
      Brucellosis (undulant fever)
      Campylobacteriosis
      Carbapenem-resistant organisms, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Chancroid
      Chlamydia trachomatis infections
      Cholera
      Creutzfeldt-Jakob Disease
      Cryptosporidiosis
      Cyclosporiasis
      Diphtheria
      Drownings, defined as the process of experiencing respiratory impairment from submersion/immersion in liquid whether resulting in death or not
      Ehrlichiosis (Human monocytic ehrlichiosis)
      Encephalitis
      Escherichia coli 0157:H7 infections
      Falls from windows in multiple dwellings by children sixteen (16) years of age and under
      Food poisoning occurring in a group of two or more individuals, including clusters of diarrhea or other gastrointestinal symptoms; or sore throat which appear to be due to exposure to the same consumption of spoiled, contaminated or poisonous food, or to having eaten at a common restaurant or other setting where such food was served. Also includes one or more suspected cases of neurologic symptoms consistent with foodborne toxin-mediated, including but not limited to botulism, combroid or ciguatera fish poisoning, or neurotoxic or paralytic shellfish poisoning.
      Giardiasis
      Glanders
      Gonococcal infection (gonorrhea)
      Granuloma inguinale
      Hantavirus disease
      Hemolytic uremic syndrome
      Hemophilus influenzae (invasive disease)
      Hepatitis A; B; and C
      Herpes simplex virus, neonatal infections (in infants 60 days or younger)
      Hospital associated infections as defined in Title 10 New York Codes, Rules and Regulations (NYCRR) Section 2.2 (New York State Sanitary Code) or its successor law, rule or regulation
      Influenza, novel strain with pandemic potential
      Influenza, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Influenza-related deaths of a child less than 18 years of age
      Legionellosis
      Leprosy
      Leptospirosis
      Listeriosis
      Lyme disease
      Lymphocytic choriomeningitis virus
      Lymphogranuloma venereum
      Malaria
      Measles (rubeola)
      Melioidosis
      Meningitis, bacterial causes (specify type)
      Meningococcal, invasive disease
      Monkeypox
      Mumps
      Norovirus, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Pertussis (Whooping cough)
      Plague
      Poisoning by drugs or other toxic agents, including but not limited to carbon monoxide poisoning and/or a carboxyhemoglobin level above 10%; and including confirmed or suspected pesticide poisoning as demonstrated by:
         (1)   Clinical symptoms and signs consistent with a diagnosis of pesticide poisoning; or
         (2)   Clinical laboratory findings of blood cholinesterase levels below the normal range; or
         (3)   Clinical laboratory findings or pesticide levels in human tissue above the normal range.
      Poliomyelitis
      Psittacosis
      Q fever
      Rabies
      Respiratory syncytial virus, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Ricin poisoning
      Rickettsialpox
      Rocky Mountain spotted fever
      Rotavirus, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Rubella (German measles)
      Rubella syndrome, congenital
      Salmonellosis
      Severe or novel coronavirus
      Shiga toxin producing Escherichia coli (STEC) (which includes but is not limited to E. coli O157:H7)
      Shigellosis
      Smallpox (variola)
      Staphylococcal enterotoxin B poisoning
      Staphylococcus aureus, methicillin-resistant, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Staphylococcus aureus, vancomycin intermediate and resistant (VISA and VRSA)
      Streptococcus, Group A (invasive infections)
      Streptococcus, Group B (invasive infections)
      Streptococcus pneumoniae invasive disease
      Syphilis, all stages, including congenital
      Tetanus
      Toxic shock syndrome
      Trachoma
      Transmissible spongiform encephalopathy
      Trichinosis
      Tuberculosis, as demonstrated by:
         (1)   Positive culture for Mycobacterium tuberculosis complex; or
         (2)   Positive DNA probe, polymerase chain reaction (PCR), or other technique for identifying Mycobacterium tuberculosis from a clinical or pathology specimen; or
         (3)   Positive smear for acid-fast bacillus, with final culture results pending or not available, on either a microbacteriology or a pathology specimen; or
         (4)   Clinically suspected pulmonary or extrapulmonary (meningeal, bone, kidney, etc.) tuberculosis, such that the physician or other health care professional attending the patient has initiated or intends to isolate the patient or initiate treatment for tuberculosis, or to continue or resume treatment for previously incompletely treated disease, or, if the patient is not available, that the physician or other health care professional would initiate isolation or treatment if the patient were available; or
         (5)   Biopsy, pathology, or autopsy findings in lung, lymph nodes or other tissue specimens, consistent with active tuberculosis disease including, but not limited to presence of acid-fast bacilli, caseating and non-caseating granulomas, caseous matter, tubercles and fibro-caseous lesions; or
         (6)   Positive reaction to the tuberculin skin test administered using the Mantoux method, blood-based tests positive for tuberculosis infection, or other recognized diagnostic test positive for tuberculosis infection in a child less than five years of age, regardless of whether such child has had a BCG vaccination. This reporting requirement is applicable to healthcare providers only. The related reporting requirement for laboratories is set forth in paragraph (7) below.
         (7)   Blood-based test for tuberculosis infection, or other later developed diagnostic test for tuberculosis infection, for all persons regardless of age. This reporting requirement is applicable to laboratories only. The related reporting requirement for healthcare providers is set forth in paragraph (6) above.
      Tularemia
      Typhoid fever
      Vaccinia disease, defined as
         (1)   Persons with vaccinia infection due to contact transmission; and
         (2)   Persons with the following complications from smallpox vaccination: eczema vaccinatum, erythema multiforme major or Stevens-Johnson syndrome, fetal vaccinia, generalized vaccinia, inadvertent inoculation, myocarditis or pericarditis, ocular vaccinia, post-vaccinial encephalitis or encephalomyelitis, progressive vaccinia, pyogenic infection of the vaccination site, and any other serious adverse events (i.e., those resulting in hospitalization, permanent disability, life-threatening illness or death)
      Varicella, laboratory-confirmed (reporting requirement applicable to laboratories only)
      Vibrio species, non-cholera (including parahaemolyticus and vulnificus)
      Viral hemorrhagic fever
      Yersiniosis
   (b)   (1)   Suspected and confirmed cases or carriers of the following diseases or conditions of public health interest, and cases of persons who at the time of death were apparently so affected, shall be immediately reported to the Department by telephone and immediately in writing by submission of a report form via facsimile, mail or in an electronic transmission format acceptable to the Department, unless the Department determines that a written report is unnecessary.
         Animal bites, from vector species at higher risk for rabies (including raccoons, skunks, foxes and bats) or any other animal with illness suggestive of rabies
         Anthrax
         Acute arboviral infections, as defined in subdivision (a) of this section (other than dengue)
         Botulism
         Brucellosis
         Carbon monoxide poisoning
         Cholera
         Diphtheria
         Food poisoning, as defined in subdivision (a) of this section
         Glanders
         Hantavirus
         Hepatitis A in a food handler, or in an enrollee or attendee under the age of six or staff member who has contact with children under the age of six in a school, day care facility, camp or any other congregate setting with children under the age of six, or in a health care practitioner in a hospital or medical facility who provides oral care, or in an inmate of a correctional facility, or in a resident of a homeless facility or any other congregate residential setting
         Influenza, novel strain with pandemic potential
         Measles
         Melioidosis
         Meningococcal, invasive disease
         Monkeypox
         Plague
         Poliomyelitis
         Q fever
         Rabies
         Ricin
         Rubella (German measles)
         Severe or novel coronavirus
         Smallpox
         Staphylococcal enterotoxin B poisoning
         Staphylococcus aureus, vancomycin intermediate and resistant (VISA and VRSA)
         Tularemia
         Vaccinia disease
         Viral hemorrhagic fever
         Any enteric disease (amebiasis, campylobacteriosis, cryptosporidiosis, E. coli 0157: H7 and other shiga toxin producing Escherichia coli (STEC) infections, giardiasis, salmonellosis, shigellosis, typhoid fever or yersiniosis) occurring in a food handler, or in an enrollee or attendee under the age of six or staff member who has contact with children under the age of six in a school, day care facility, camp or any other congregate setting with children under six, or in a health care practitioner in a hospital or medical facility who provides oral care, or in an inmate of a correctional facility, or in a resident of a homeless facility or any other congregate residential setting.
      (2)   All other diseases or conditions of public health interest that are required to be reported in subdivision (a) shall be reported to the Department within 24 hours of a diagnosis confirmed by laboratory or clinical criteria, by telephone, or in writing by submission of the appropriate Departmental report form via facsimile, mail or in an electronic transmission format acceptable to and approved by the Department.
   (c)   (1)   An outbreak or suspected outbreak of any disease, condition of public health interest or syndrome of known or unknown etiology, that may be a danger to public health and occurs in three or more persons, or
      (2)   any unusual manifestation of a disease or condition of public health interest in an individual or
      (3)   an unusual disease defined as a newly apparent or emerging disease or a syndrome of uncertain etiology that could possibly be communicable, shall be reported to the Department immediately by telephone and in writing by submission of a report form via facsimile, mail or in an electronic transmission format acceptable to the Department within 24 hours after diagnosis unless the Department determines that a written report is unnecessary. An outbreak may be detected based on clinical, laboratory or epidemiologic evidence.
   (d)   Authority for syndromic surveillance. To ascertain the existence or monitor the progress of an outbreak, or the occurrence of unusual manifestations of disease, or of unusual diseases or conditions of public health interest, the Department may require reports by emergency departments, urgent care facilities, hospitals and clinics, and health information organizations which are comprised of such health care providers, as such terms are defined in Article 28 of the New York State Public Health Law or regulation promulgated thereunder, of all patient visits during each 24-hour period. Such reports shall be made electronically and in a form, manner and frequency as may be specified by the Department. Reports required by this subdivision may include age, gender, date and time of visit, ZIP code of residence, chief complaint, diagnosis or diagnosis code, disposition, radiographic results, laboratory results and a unique identification number adequate to access the patient's medical record if deemed necessary by the Department to investigate a suspected outbreak. In the event of a suspected or confirmed outbreak, and upon request by the Department, the identity of a patient shall be promptly reported to the Department.
   (e)   Information needed for investigations. Upon receipt of a report submitted pursuant to this section or any other provision of this article or other applicable law the Department may conduct such surveillance, epidemiologic and laboratory investigation activities as it shall deem necessary to verify the diagnosis, ascertain the source or cause of infection, injury or illness, identify additional cases, contacts, carriers or others at risk, and implement public health measures to control the disease or condition and prevent additional morbidity or mortality. Such investigations may include, but are not limited to, collecting or requiring collection of such clinical or environmental specimens for laboratory examination as the Department considers necessary, including the collection of specimens or isolates from clinical laboratories for testing by the Department or as designated by the Department. When deemed necessary for the protection of public health, in the course of conducting an investigation of a disease or condition made reportable to the Department by this article or other applicable law, the Department may require any person or any entity maintaining or managing health-related electronic records to provide reasonably necessary information including but not limited to information on household contact and non-household contact names and contact information, clinical signs and symptoms, treatment, including records of treatment, laboratory, radiological, or other diagnostic procedures as specified by the Commissioner or designee.
(Amended City Record 12/13/2016, eff. 1/12/2017; amended City Record 3/19/2018, eff. 4/18/2018; amended City Record 6/19/2019, eff. 7/19/2019; amended City Record 10/15/2019, eff. 11/14/2019; amended City Record 11/4/2022, eff. 12/4/2022; amended City Record 11/2/2023, eff. 12/2/2023)
§ 11.04 Report of First-Episode Psychosis.
   (a)   Required reports. A hospital must report to the Director of the Division of Mental Hygiene of the Department by telephone or in an electronic transmission format acceptable to the Department, the admission of any person at least 16 and younger than 31 years of age with a psychosis diagnosis as defined in paragraph (1) of this subdivision within 24 hours of such admission; except that such report shall not be required if such person was previously hospitalized with a psychosis diagnosis that was reported, pursuant to this section.
      (1)   Psychosis diagnosis shall mean:
         (A)   Schizophrenia (any type);
         (B)   Psychosis NOS (not otherwise specified);
         (C)   Schizophreniform Disorder;
         (D)   Delusional Disorder;
         (E)   Schizoaffective Disorder;
         (F)   Brief Psychotic Disorder;
         (G)   Shared Psychotic Disorder;
         (H)   Other Specified Schizophrenia Spectrum and Other Psychotic Disorder; or
         (I)   Unspecified Schizophrenia Spectrum and Other Psychotic Disorder.
      (2)   Reports must include patient's:
         (A)   Full Name;
         (B)   Gender;
         (C)   Date of birth;
         (D)   Address;
         (E)   Telephone;
         (F)   Hospital admission date;
         (G)   Diagnosis;
         (H)   Insurance type;
         (I)   Race;
         (J)   Ethnicity;
         (K)   Parent's or guardian's name if patient is a minor; and
         (L)   Parent's or guardian's contact information if patient is a minor.
   (b)   Reports to be confidential. Identifying information reported to the Department, pursuant to this section shall be confidential and shall not be subject to inspection by persons other than authorized personnel of the Division of Mental Hygiene. Other than to such authorized personnel, such information may not be disclosed without the consent of the person who is the subject of such report or someone authorized to act on such person's behalf, except, pursuant to a federal or state law that compels such disclosure.
(Amended City Record 9/20/2018, eff. 1/1/2019)
§ 11.05 Reports.
   (a)   Reports required by 24 RCNY Health Code § 11.03 shall be made by a physician; dentist; licensed chiropractor; doctor of osteopathy; physician's assistant; nurse practitioner; a person in charge of a hospital, clinic, or other institution providing care or treatment; a clinical laboratory in accordance with 24 RCNY Health Code Article 13; or such persons' designees unless otherwise specified. Individual cases of those diseases that subdivision (a) of 24 RCNY Health Code § 11.03 indicates are to be reported only through the Department's electronic reporting mechanism set forth in 24 RCNY Health Code § 13.03(c), shall be reported by clinical laboratories only and no additional reporting pursuant to said subdivision (a) shall be required of others specified herein, unless an outbreak is suspected or confirmed.
   (b)   Reports required by 24 RCNY Health Code § 11.03 shall contain all the information concerning the disease or condition of public health interest and all the information concerning the case, carrier or suspect case required by the Department for the protection of public health. Reports shall be made on forms furnished by the Department and shall contain all the information required by such forms.
   (c)   In addition to any other requirement to report set forth in this Code, when no physician or other person specified in subdivision (a) is in attendance, it shall be the duty of the head of a private household or of the person in charge of any institution, including but not limited to a day care or other congregate care setting with children under the age of six, school, college, university, hotel, shelter, correctional facility or camp, having knowledge of an individual likely to be affected with a disease or condition reportable under 24 RCNY Health Code § 11.03, to report the name and address of such individual to the Department,
§ 11.07 Immunization Registry.
   (a)   (1)   All immunizations administered to any individual age eighteen and under shall be reported to the Department, within 14 days of such immunization, by any person authorized by law to administer an immunization, or a person in charge of a hospital, clinic or other institution where such immunization is administered. Upon application of a person required to report pursuant to this section, the Department in its discretion and when deemed necessary may extend the period of time within which such a person shall report immunizations. Any person required to report pursuant to this section shall also report to the Department any occurrences or matters which are reportable to the Secretary of Health and Human Services pursuant to the Vaccine Adverse Event Reporting System established by 42 U.S.C. § 300aa-25(b) or any successor statute and any rules adopted pursuant thereto. The reporting of such occurrences or matters to the Department shall be made at the same time as made to the Secretary of Health and Human Services.
      (2)   Reports submitted to the Department pursuant to this section shall contain the name, address, and any other information required by the Department for the proper identification of the individual, demographic and epidemiological information and the immunization record, including past immunizations administered to the individual, in the possession of the person required to report pursuant to this section. Such reports shall be made in an electronic transmission format acceptable to the Department or, with the specific approval of the Department, in writing on a form prescribed by the Department via facsimile or by mail.
      (3)   Reports of an immunization administered to any individual age nineteen and above may be submitted to the Department provided that the person administering the immunization or the person in charge of the hospital, clinic or other institution where the immunization is administered, has obtained consent to report such immunization from the person to whom such immunization information relates.
   (b)   All records of immunization created or received by the Department shall be maintained in an immunization registry and shall be subject to the confidentiality provisions of 24 RCNY Health Code § 11.11(d).
(Amended City Record 12/13/2016, eff. 1/12/2017)
§ 11.09 Blood Lead Reporting and Children's Blood Lead Registry.
   (a)   In addition to the reports of blood lead levels made pursuant to 24 RCNY Health Code § 11.03, results of blood lead analyses that are less than three and a half micrograms per deciliter for any resident of the City of New York shall be reported as follows:
      (1)   Except as provided in Paragraph (2), clinical laboratories shall report blood lead test results that are less than three and a half micrograms per deciliter to the Department.
      (2)   A clinical laboratory that reports blood lead test results less than three and a half micrograms per deciliter electronically to the New York State Department of Health shall not be required to make any additional report to the Department of such test results.
      (3)   A person or entity who orders or performs blood lead tests but does not submit the specimen to a clinical laboratory for analysis shall report results of less than three and a half micrograms per deciliter to the Department.
      (4)   Results required to be reported pursuant to this section shall be submitted to the Department in an electronic transmission format acceptable to the Department or in writing via facsimile or by mail, within five (5) business days after such results are known by such person or entity. Reports required pursuant to this section shall contain all the information required by the Department for the protection of public health, and shall be made on forms furnished by the Department or shall contain all the information required by such forms.
   (b)   Children's blood lead registry. All records of blood lead tests created or received by the Department pursuant to 24 RCNY Health Code § 11.03 and this section for children shall be maintained in a registry in accordance with and subject to the limitations on disclosure of 24 RCNY Health Code § 11.11(d).
(Amended City Record 6/19/2019, eff. 7/19/2019; amended City Record 11/4/2022, eff. 12/4/2022)
§ 11.10 Neonatal Herpes Simplex.
At or before initiating treatment for a suspected case of herpes simplex virus infection occurring in a child aged 60 days or less, the health care provider ordering treatment shall collect specimens from one or more vesicles or from any skin lesions suggestive of herpetic disease. Unless otherwise directed by the Department, all such specimens shall be sent by the provider to the New York State Department of Health Wadsworth Center laboratories for diagnostic testing using molecular methods, and reports of positive and negative results shall be forwarded to the Department by the Wadsworth Center laboratories.
§ 11.11 Confidentiality of Reports and Records.
   (a)   (1)   Epidemiological and surveillance reports and records of cases, contacts, carriers, suspect cases or suspect contacts of diseases and conditions of public health interest that are reported to the Department, including but not limited to additional information it may obtain, develop or prepare in the course of an epidemiological investigation, shall be confidential and shall not be subject to inspection by persons other than authorized personnel or agents of the Department or by the State Department of Health pursuant to the State Sanitary Code. The disclosure of such reports, records or information shall not be compelled. No individual's medical or individually identifiable information shall be disclosed from any epidemiological report or record, and no disclosure thereof may be compelled, regarding any individual who is the subject of, or identified in, such a report, or regarding an individual or entity that has made such a report.
      (2)   Epidemiological or surveillance information that is disseminated as aggregated statistical data shall be prepared as determined by the Department in a manner that does not reasonably enable re-identification of any person whose personal health or individually identifiable information is contained in such data.
   (b)   Notwithstanding subdivision (a) hereof, to the extent permissible under applicable law and in accordance with the provisions of 24 RCNY Health Code § 3.25, the person to whom any such epidemiological and surveillance report or record relates, or in the case of a minor or incompetent such person's parent, legal guardian or custodial guardian, may sign a written consent authorizing the Commissioner to disclose such person's own patient information or records of diagnosis or treatment. The consensual disclosure of such information shall only be made to the person to whom the information relates, or to such person's current treating medical provider, or to a court upon receipt of such a written consent and a court order from that court. A disclosure pursuant to this subdivision shall not include the identity of persons who reported the case, investigative or epidemiological information related to the case or the identities and epidemiologic, surveillance and laboratory information on the person's contacts or other suspect or confirmed cases, contacts or carriers associated with the same epidemiologic investigation.
   (c)   Subdivisions (a) and (b) of this section shall not prevent the Commissioner or authorized personnel of the Department from furnishing what the Department determines to be appropriate information to a physician or institution providing examination or treatment to a person suspected of or affected with a disease or condition of public health interest, to an agency approved by the Department for prevention, treatment or social service, or to any person when necessary for the protection of public health. Only the minimum information necessary for the intended purpose shall be disclosed. A person, institution or agency to whom such information is furnished or to whom access to records has been given shall not divulge any part thereof so as to disclose the identity of the person to whom such information or record relates, except insofar as such disclosure is necessary for the treatment of a case or carrier or for the protection of the health of others.
   (d)   1)   Information contained in the immunization registry created pursuant to 24 RCNY Health Code § 11.07 and the children's blood lead registry established pursuant to 24 RCNY Health Code § 11.09 shall be confidential and not subject to inspection by persons other than authorized personnel or agents of the Department and persons or agencies authorized herein. The Department may disclose information contained in said immunization registry in accordance with the provisions of § 2168 of the New York State Public Health Law, and the regulations promulgated pursuant thereto. Information contained in the children's blood lead registry may be disclosed and the Department may permit access to such information by a person, authorized by law to administer or order a blood test, who is treating or testing the individual to whom said information relates, or to a public health agency for the protection of health. The Department may also disclose what it considers appropriate and necessary information from such immunization or children's blood lead registries to a person or agency concerned with immunization or blood lead testing of children authorized by the Department when (i) such person or agency provides sufficient identifying information satisfactory to the Department to identify the individual to whom such information relates and (ii) such disclosure is in the best interests of such individual and, in the case of a child, his or her family, or will contribute to the protection of the public health. Notwithstanding the foregoing, the person to whom any immunization or blood lead test record relates, or his or her custodial parent, guardian, or other person in parental or custodial relation to such person, may, by signing a written consent, authorize the Commissioner to disclose such record.
      (2)   A person, institution or agency to whom such immunization or blood lead registry information is furnished or to whom access to records or information has been given, shall not divulge any part thereof so as to disclose the identity of the person to whom such information or record relates, except insofar as such disclosure is necessary for the protection of the health of the person or other person.
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