Chapter 41 - Epidemiology Health







(a) The following named diseases and conditions are declared to be dangerous to the public health and are hereby made reportable within the time period specified after the disease or condition is reasonably suspected to exist:

(1) acquired immune deficiency syndrome (AIDS) 24 hours;

(2) acute flaccid myelitis 7 days;

(3) anaplasmosis 7 days;

(4) anthrax immediately;

(5) arboviral infection, neuroinvasive 7 days;

(6) babesiosis 7 days;

(7) botulism immediately;

(8) brucellosis 7 days;

(9) campylobacter infection 24 hours;

(10) Candida auris - 24 hours;

(11) Carbapenem-Resistant Enterobacteriaceae (CRE) 24 hours;

(12) chancroid 24 hours;

(13) chikungunya virus infection 24 hours;

(14) chlamydial infection (laboratory confirmed) 7 days;

(15) cholera 24 hours;

(16) Creutzfeldt-Jakob disease 7 days;

(17) cryptosporidiosis 24 hours;

(18) cyclosporiasis 24 hours;

(19) dengue 7 days;

(20) diphtheria 24 hours;

(21) Escherichia coli, shiga toxin-producing infection 24 hours;

(22) ehrlichiosis 7 days;

(23) foodborne disease, including Clostridium perfringens, staphylococcal, Bacillus cereus, and other and unknown causes 24 hours;

(24) gonorrhea 24 hours;

(25) granuloma inguinale 24 hours;

(26) Haemophilus influenzae, invasive disease 24 hours;

(27) Hantavirus infection 7 days;

(28) Hemolytic-uremic syndrome 24 hours;

(29) Hemorrhagic fever virus infection immediately;

(30) hepatitis A 24 hours;

(31) hepatitis B 24 hours;

(32) hepatitis B carriage 7 days;

(33) hepatitis C, acute 7 days;

(34) human immunodeficiency virus (HIV) infection confirmed 24 hours;

(35) influenza virus infection causing death 24 hours;

(36) legionellosis 7 days;

(37) leprosy 7 days;

(38) leptospirosis 7 days;

(39) listeriosis 24 hours;

(40) Lyme disease 7 days;

(41) Lymphogranuloma venereum 7 days;

(42) malaria 7 days;

(43) measles (rubeola) immediately;

(44) meningitis, pneumococcal 7 days;

(45) meningococcal disease 24 hours;

(46) Middle East respiratory syndrome (MERS) 24 hours;

(47) monkeypox 24 hours;

(48) mumps 7 days;

(49) nongonococcal urethritis 7 days;

(50) novel coronavirus infection causing death 24 hours;

(51) novel coronavirus infection immediately;

(52) novel influenza virus infection immediately;

(53) plague immediately;

(54) paralytic poliomyelitis 24 hours;

(55) pelvic inflammatory disease 7 days;

(56) psittacosis 7 days;

(57) Q fever 7 days;

(58) rabies, human 24 hours;

(59) rubella 24 hours;

(60) rubella congenital syndrome 7 days;

(61) salmonellosis 24 hours;

(62) severe acute respiratory syndrome (SARS) 24 hours;

(63) shigellosis 24 hours;

(64) smallpox immediately;

(65) spotted fever rickettsiosis 7 days;

(66) Staphylococcus aureus with reduced susceptibility to vancomycin 24 hours;

(67) streptococcal infection, Group A, invasive disease 7 days;

(68) syphilis 24 hours;

(69) tetanus 7 days;

(70) toxic shock syndrome 7 days;

(71) trichinosis 7 days;

(72) tuberculosis 24 hours;

(73) tularemia immediately;

(74) typhoid 24 hours;

(75) typhoid carriage (Salmonella typhi) 7 days;

(76) typhus, epidemic (louse-borne) 7 days;

(77) vaccinia 24 hours;

(78) varicella 24 hours;

(79) vibrio infection (other than cholera) 24 hours;

(80) whooping cough 24 hours;

(81) yellow fever 7 days; and

(82) zika virus 24 hours.

(b) For purposes of reporting, "confirmed human immunodeficiency virus (HIV) infection" is defined as a positive virus culture, repeatedly reactive EIA antibody test confirmed by western blot or indirect immunofluorescent antibody test, positive nucleic acid detection (NAT) test, or other confirmed testing method approved by the Director of the State Public Health Laboratory conducted on or after February 1, 1990. In selecting additional tests for approval, the Director of the State Public Health Laboratory shall consider whether such tests have been approved by the federal Food and Drug Administration, recommended by the federal Centers for Disease Control and Prevention, and endorsed by the Association of Public Health Laboratories.

(c) In addition to the laboratory reports for Mycobacterium tuberculosis, Neisseria gonorrhoeae, and syphilis specified in G.S. 130A-139, laboratories shall report using electronic laboratory reporting (ELR), secure telecommunication, or paper reports.

(1) Isolation or other specific identification of the following organisms or their products from human clinical specimens:

(A) Anaplasma spp., the causes of anaplasmosis.

(B) Any hantavirus.

(C) Any hemorrhagic fever virus.

(D) Arthropod-borne virus (any type).

(E) Babesia spp., the cause of babesiosis.

(F) Bacillus anthracis, the cause of anthrax.

(G) Bordetella pertussis, the cause of whooping cough (pertussis).

(H) Borrelia burgdorferi, the cause of Lyme disease (confirmed tests).

(I) Brucella spp., the causes of brucellosis.

(J) Campylobacter spp., the causes of campylobacteriosis.

(K) Candida auris.

(L) Carbapenem-Resistant Enterobacteriaceae (CRE).

(M) Chlamydia trachomatis, the cause of genital chlamydial infection, conjunctivitis (adult and newborn) and pneumonia of newborns.

(N) Clostridium botulinum, a cause of botulism.

(O) Clostridium tetani, the cause of tetanus.

(P) Coronavirus, novel human strain.

(Q) Corynebacterium diphtheriae, the cause of diphtheria.

(R) Coxiella burnetii, the cause of Q fever.

(S) Cryptosporidium spp., the cause of human cryptosporidiosis.

(T) Cyclospora cayetanensis, the cause of cyclosporiasis.

(U) Dengue virus.

(V) Ehrlichia spp., the causes of ehrlichiosis.

(W) Shiga toxin-producing Escherichia coli, a cause of hemorrhagic colitis, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura.

(X) Francisella tularensis, the cause of tularemia.

(Y) Hepatitis A virus.

(Z) Hepatitis B virus or any component thereof, such as hepatitis B surface antigen.

(AA) Human Immunodeficiency Virus, the cause of AIDS.

(BB) Legionella spp., the causes of legionellosis.

(CC) Leptospira spp., the causes of leptospirosis.

(DD) Listeria monocytogenes, the cause of listeriosis.

(EE) Measles virus.

(FF) Middle East respiratory syndrome virus.

(GG) Monkeypox.

(HH) Mumps virus.

(II) Mycobacterium leprae, the cause of leprosy.

(JJ) Plasmodium falciparum, P. malariae, P. ovale, and P. vivax, the causes of malaria in humans.

(KK) Poliovirus (any), the cause of poliomyelitis.

(LL) Rabies virus.

(MM) Rickettsia spp., the cause of spotted fever rickettsiosis.

(NN) Rubella virus.

(OO) Salmonella spp., the causes of salmonellosis.

(PP) Shigella spp., the causes of shigellosis.

(QQ) Smallpox virus, the cause of smallpox.

(RR) Staphylococcus aureus with reduced susceptibility to vancomycin.

(SS) Trichinella spiralis, the cause of trichinosis.

(TT) Vaccinia virus.

(UU) Varicella virus.

(VV) Vibrio spp., the causes of cholera and other vibrioses.

(WW) Yellow fever virus.

(XX) Yersinia pestis, the cause of plague.

(YY) Zika virus.

(2) Isolation or other specific identification of the following organisms from normally sterile human body sites:

(A) Group A Streptococcus pyogenes (group A streptococci).

(B) Haemophilus influenzae, serotype b.

(C) Neisseria meningitidis, the cause of meningococcal disease.

(3) Positive serologic test results, as specified, for the following infections:

(A) Fourfold or greater changes or equivalent changes in serum antibody titers to:

(i) Any arthropod-borne virus associated with neuroinvasive disease.

(ii) Anaplasma spp., the cause of anaplasmosis.

(iii) Any hantavirus or hemorrhagic fever virus.

(iv) Chlamydia psittaci, the cause of psittacosis.

(v) Chikungunya virus.

(vi) Coxiella burnetii, the cause of Q fever.

(vii) Dengue virus.

(viii) Ehrlichia spp., the causes of ehrlichiosis.

(ix) Measles (rubeola) virus.

(x) Mumps virus.

(xi) Rickettsia rickettsii, the cause of Rocky Mountain spotted fever.

(xii) Rubella virus.

(xiii) Varicella virus.

(xiv) Yellow fever virus.

(B) The presence of IgM serum antibodies to:

(i) Any arthropod-borne virus associated with neuroinvasive disease.

(ii) Chikungunya virus.

(iii) Chlamydia psittaci.

(iv) Dengue virus.

(v) Hepatitis A virus.

(vi) Hepatitis B virus core antigen.

(vii) Mumps virus.

(viii) Rubella virus.

(ix) Rubeola (measles) virus.

(x) Yellow fever virus.

(4) Laboratory results from tests to determine the absolute and relative counts for the T-helper (CD4) subset of lymphocytes and all results from tests to determine HIV viral load.

(5) Identification of CRE from a clinical specimen associated with either infection or colonization, including all susceptibility results and all phenotypic or molecular test results.

(d) Laboratories utilizing electronic laboratory reporting (ELR) shall report in addition to those listed under Paragraph (c) of this Rule:

(1) All positive laboratory results from tests used to diagnosis chronic Hepatitis C Infection, including the following:

(A) Hepatitis C virus antibody tests (including the test specific signal to cut-off (s/c) ratio);

(B) Hepatitis C nucleic acid tests;

(C) Hepatitis C antigen(s) tests; and

(D) Hepatitis C genotypic tests.

(2) All HIV genotypic test results, including when available:

(A) The entire nucleotide sequence; or

(B) The pol region sequence (including all regions: protease (PR)/reverse transcriptase (RT) and integrase (INI) genes, if available).

(3) All test results for Interferon Gamma Release Assays.

(e) For the purposes of reporting, Carbapenem-Resistant Enterobacteriaceae (CRE) are defined as:

(1) Enterobacter spp., E.coli or Klebsiella spp positive for a known carbapenemase resistance mechanism or positive on a phenotypic test for carbapenemase production; or

(2) Enterobacter spp., E.coli or Klebsiella spp resistant to any carbapenem in the absence of carbapenemase resistance mechanism testing or phenotypic testing for carbapenemase production.


History Note: Authority G.S. 130A-134; 130A-135; 130A-139; 130A-141;

Amended Eff. October 1, 1994; February 1, 1990;

Temporary Amendment Eff. July 1, 1997;

Amended Eff. August 1, 1998;

Temporary Amendment Eff. February 13, 2003; October 1, 2002; February 18, 2002; June 1, 2001;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. November 1, 2003; May 16, 2003;

Amended Eff. January 1, 2005; April 1, 2004;

Temporary Amendment Eff. June 1, 2006;

Amended Eff. April 1, 2008; November 1, 2007; October 1, 2006;

Temporary Amendment Eff. January 1, 2010;

Temporary Amendment Expired September 11, 2011;

Amended Eff. July 1, 2013;

Temporary Amendment Eff. December 2, 2014;

Amended Eff. October 1, 2015;

Emergency Amendment Eff. March 1, 2016;

Temporary Amendment Eff. July 1, 2016;

Amended Eff. January 1, 2018; October 1, 2016;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 9, 2018;

Amended Eff. October 1, 2018;

Emergency Amendment Eff. February 17, 2020;

Temporary Amendment Eff. April 24, 2020;

Amended Eff. April 1, 2021; July 1, 2020.