The Wisconsin Department of Health Services (DHS) announces that revisions to Chapter 145 of DHS Administrative Code have received final legislative approval. Chapter DHS 145 was promulgated to establish a surveillance system for the purpose of controlling the incidence and spread of communicable diseases in Wisconsin. Revisions to this rule were published in the Administrative Register and became effective July 1, 2018.
What is changing?
References in Chapter DHS 145 to publications containing standards for the control of communicable diseases have been updated and are now contained in the “Note” for each applicable section. Details of the revised references are available in the approved Chapter DHS 145.
The most significant revisions to Chapter DHS 145 are in its list of Communicable Diseases and Other Notifiable Conditions in Appendix A. To improve clarity, causative agent names or synonyms were added to some diseases, specific conditions were alphabetized, and the general categories of Outbreaks, and Diseases Foreign to Wisconsin were separated from the other Category I conditions. Because Category I diseases are of urgent public health importance, the initial notification of a disease incident now requires speaking with a local health officer or their designee (e.g., local public health nurse, on-call staff, DHS epidemiologist). Fax, mail, or electronic reporting can then be used for subsequent reports of the same incident.
Diseases added to the Category I list are expected to be uncommon and include:
- Carbapenem-resistant Enterobacteriaceae (CRE)
- Middle Eastern Respiratory Syndrome-associated Coronavirus (MERS-CoV)
- Primary Amebic Meningoencephalitis (PAM)
- Viral Hemorrhagic Fever (VHF)
Diseases added to the Category II list include:
- Borreliosis (other than Lyme disease)
- Coccidioidomycosis (Valley Fever)
- Environmental and occupational lung diseases (asbestosis, silicosis, chemical pneumonitis, and diseases caused by bio-dusts and bio-aerosols)
- Free-living amebae infection
- Influenza-associated hospitalization
- Latent tuberculosis infection (LTBI)
- Rickettsiosis (other than spotted fever)
- Blue-green algae and Cyanotoxin poisoning
- Carbon monoxide poisoning
- Zika virus infection
The Category III description of reporting human immunodeficiency virus (HIV) infection has also been updated to reflect additional laboratory results that are required to be reported. Most laboratories are already complying with the requirements.
Details of revisions to Appendix A are highlighted in the preview of the approved rule. Subject matter experts at DHS are preparing case reporting and investigation protocols (EpiNets) for added diseases and conditions. The EpiNet and related guidance and forms for each disease can usually be found in the “For Health Professionals” section of the DHS disease-specific website. The DHS Disease Reporting webpage will be revised to include the updates.
Who do I contact for more information?
If you have any questions or need assistance implementing these disease reporting changes, please contact the disease-specific program at DHS, the Bureau of Communicable Diseases general line (608-267-9003), or the Bureau of Environmental and Occupational Health general line (608-266-1120).