TITLE 7 HEALTH
CHAPTER 4 DISEASE
CONTROL (EPIDEMIOLOGY)
PART 3 CONTROL
OF DISEASE AND CONDITIONS OF PUBLIC HEALTH SIGNIFICANCE
7.4.3.1 ISSUING
AGENCY: New Mexico Department of
Health.
[7.4.3.1 NMAC - Rp, 7.4.3.1 NMAC, 04/30/2009]
7.4.3.2 SCOPE: All physicians, laboratories, health care
professionals, and other persons having knowledge of diseases or conditions
covered by these regulations.
[7.4.3.2 NMAC - Rp, 7.4.3.2 NMAC, 04/30/2009]
7.4.3.3 STATUTORY
AUTHORITY: These provisions set
forth herein are promulgated by the secretary of the department of health by
authority of NMSA 1978 Section 9-7-6(E) and in conformity with the Public
Health Act, particularly NMSA 1978 Sections 24-1-3C, 24-1-7, and 24-1-15 and
pursuant to the Hospital-Acquired Infection Act, NMSA 1978, Sections 24-29-1
through 24-29-6. Administration and
enforcement of these rules are the responsibility of the epidemiology and
response division of the department of health.
[7.4.3.3 NMAC - Rp, 7.4.3.3 NMAC, 04/30/2009; A, 02/29/2012]
7.4.3.4 DURATION: Permanent.
[7.4.3.4 NMAC - Rp, 7.4.3.4 NMAC, 04/30/2009]
7.4.3.5 EFFECTIVE
DATE: April 30, 2009, unless a later
date is cited at the end of a section.
[7.4.3.5 NMAC - Rp, 7.4.3.5 NMAC, 04/30/2009]
7.4.3.6 OBJECTIVE: The essential objective of these rules is the
control of disease and conditions of public health significance through the
prompt identification of disease, notification of responsible health
authorities, and institution of preventive and ameliorative measures.
[7.4.3.6 NMAC - Rp, 7.4.3.6 NMAC, 04/30/2009]
7.4.3.7 DEFINITIONS: As used in these provisions, the following
terms shall have the meaning given to them, except where the context clearly
requires otherwise.
A. “Acute care hospital” means a
hospital providing emergency services, in-patient medical and nursing care for
acute illness, injury, surgery or obstetrics; ancillary services such as
pharmacy, clinical laboratory, radiology, and dietary are required for acute care
hospitals.
B. “Cancer” means all malignant
neoplasms and in situ neoplasms and all intracranial neoplasms, regardless of
the tissue of origin.
C. “Carrier” means an infected person
or animal that harbors a specific infectious agent without clinical symptoms
and that serves as a potential source of infection for humans.
D. “Condition of public health
significance” means a condition dangerous to public health or safety.
E. “Designee” means an agency or
instititution designated by the department of health to receive reports of
notifiable conditions on its behalf for the purpose of public health
surveillance.
F. “Disease” means an illness,
including those caused by infectious agents or their toxic products which may
be transmitted to a susceptible host.
G. “Division” means the epidemiology
and response division of the department of health, P.O. Box 26110, Santa Fe, NM
87502-6110.
H. “Health care professional” means any
licensed doctor of medicine or osteopathy, nurse, physician’s assistant,
midwife, veterinarian or other licensed health care provider unless the context
clearly requires otherwise.
I. “Isolation, detention or
quarantine” means the complete separation or partial restriction of movement
and association in such manner and for such period as will prevent the direct
and indirect transmission of the infectious agent.
J. “Laboratory” means the scientific
laboratory division of the department of health or any other laboratory which
performs diagnostic tests on specimens obtained from New Mexico sources for
diseases and conditions covered by these rules.
K. “Notifiable condition” means a
disease or condition of public health significance required by statute or these
rules to be reported to the division.
L. “Other person” includes but is not
limited to: laboratory staff; an official in charge of any health facility;
hospital records or administrative personnel; the principal or person in charge
of any private or public school, or child care center; teachers and school
nurses; and a householder or any other person, in the absence of a health care
professional having direct knowledge of a disease or condition of public health
significance.
M. “Regional or local public health
office” means a public health office designated by the public health division
of the department of health.
N. “Report” means a notification to the
division pursuant to these rules.
O. “Specimen” means any material
derived from humans or animals for examination for diagnosis, prevention or
treatment of any disease or condition of public health significance.
[7.4.3.7 NMAC - Rp, 7.4.3.7 NMAC, 04/30/2009; A, 02/29/2012]
7.4.3.8 NOTIFIABLE
CONDITIONS:
A. Declaration of notifiable
conditions: The division shall periodically issue a list of notifiable
conditions according to reporting category designated as 7.4.3.13 NMAC. The list shall be reviewed on a regular basis
and revised as necessary. Diseases shown
in 7.4.3.13 NMAC are declared notifiable conditions as of the effective date.
B. Official listing: The list of
notifiable conditions shall be issued in a quick reference format and shall
show that it is the current official list and shall specify its effective
date. The division shall routinely
supply the current official list to health care professionals and health
facilities and to other persons or entities on request.
C. Reporting of notifiable conditions:
Reporting will be by means of the following:
(1) the division’s 24-hour
telephone number as listed in the report, “New
Mexico epidemiology,” the division’s newsletter or by direct telephone contact
with the regional or local public health office;
(2) the division’s toll-free
telephone receiving and recording system telephone number listed in the report
“New Mexico epidemiology”;
(3) for specified conditions,
reporting to the address/phone number published on the printed form of the
“list of notifiable conditions”;
(4) written report to the division; or
(5) electronic transmission,
which includes facsimile and computer data transfers.
D. Reporting requirements - health care
professionals: Every health care professional treating any person or animal having
or suspected of having any notifiable condition shall report the condition
within the time and in the manner set out in the list of notifiable conditions.
E. Reporting requirements -
laboratories: All laboratories performing diagnostic tests for any notifiable
condition shall report all positive findings within the time and in the manner
set out in the list. Reports shall
include the name of the reporting laboratory, the patient’s name, date of
birth/age, and address, the date of clinical diagnosis, if known, and the health
care professional or hospital requesting the test.
F. Reporting requirement - other
persons: Any other person, including all persons listed in Subsection L of
7.4.3.7 NMAC of these rules, having knowledge of any person having or suspected
of having a notifiable condition, shall immediately report the condition to the
division.
G. Conditions of public health
significance: Any person, including health care professionals and persons
listed in Subsection L of 7.4.3.7 NMAC of these rules, having knowledge of a
notifiable condition shall immediately report the condition to the division.
[7.4.3.8 NMAC - Rp, 7.4.3.8 NMAC, 04/30/2009; A, 02/29/2012]
7.4.3.9 CONTROL
OF DISEASE AND CONDITIONS OF PUBLIC HEALTH SIGNIFICANCE:
A. Responsibility for protection of
public health: The department of health may take such measures as are deemed
necessary and proper for the protection of the public health.
B. Coordination among agencies: The
department of health shall coordinate the efforts of other concerned or
interested federal, state and local agencies and shall cooperate with local
health care professionals and health care facilities.
C. Imposition of isolation or
quarantine: The department of health may establish or require isolation or
quarantine of any animal, person, institution, community or region.
D. Case incidence in schools or health
facilities: Where any case of communicable disease occurs or is likely to occur
in a public, private, or parochial school, child care facility, or in a health
care facility, the department of health may require:
(1) exclusion of infected
persons and non-immune persons, whether students, patients, employees or other
persons;
(2) closure and discontinuance
of operations if there is likelihood of an epidemic.
E. Refusal of voluntary treatment,
detention or observation: When a person who is actively infectious with a
threatening communicable disease refuses voluntary treatment, detention or
observation, the department of health may seek a court order to detain the
person pursuant to Section 24-1-15 NMSA 1978 of the Public Health Act until the
person is no longer a contagious threat to the public or the person voluntarily
complies with appropriate treatment and contagion precautions.
F. Other public health orders: The
department of health may issue orders for the testing of particular populations
or groups of persons or animals to identify carriers of disease, including
immigrants, travelers, students or preschoolers and others who have been at
risk of transmission or exposure. The
department of health may require that all tests be done under the control of
the scientific laboratory division or by a laboratory approved for that
purpose.
G. Enforcement of public health orders:
Any order issued by the department of health under the Public Health Act or
these rules shall be enforceable as provided by law and violation is punishable
in accordance with Section 24-1-21 NMSA 1978.
H. Medical records: To carry out its
duties to investigate and control disease and conditions of public health
significance, the department of health or designee shall have access to all
medical records of persons with, or suspected of having, notifiable diseases or
conditions of public health significance. The department of health is a “public
health authority” as defined by the Health Insurance Portability and
Accountability Act of 1996 (HIPAA) and the Privacy Rule. The department of health is authorized to
receive protected health information without patient authorization for purposes
of public health surveillance, investigation and interventions and as otherwise
required by law. The division or designee may periodically review medical
records to ensure the completeness and quality of reporting.
I. Confidentiality of reports: All
notifiable condition reports are confidential.
Disclosure to any person of report information, except for disclosure for the purpose of
prevention, treatment or control, is prohibited unless disclosure is required
by law.
J. Research use of notifiable
condition data: Researchers authorized by the division or its designee who
certify to the satisfaction of the division that confidentiality of data will
be maintained in accordance with applicable state and federal confidentiality
requirements, may conduct studies utilizing notifiable condition data,
including studies of the sources and causes of conditions of public health
significance, evaluations of the cost, quality, efficacy and appropriateness of
screening, diagnostic, therapeutic, rehabilitative and preventive services and
programs relating to conditions of public health significance and other
clinical or epidemiologic research.
[7.4.3.9 NMAC - Rp, 7.4.3.9 NMAC, 04/30/2009; A, 02/29/2012]
7.4.3.10 EMERGENCY
DEPARTMENT REPORTING:
A. Reporting requirements: Hospitals shall report all emergency
department visits electronically to the department of health in such a format,
with such data elements and in accordance with such standards of quality,
timeliness and completeness as established by the department of health.
B. Confidentiality: All emergency department visit reports are
confidential. Disclosure to any person
of report information, except for disclosure of a notifiable condition for the
purpose of prevention or control of diseases and other health conditions, is
prohibited unless disclosure is required by law.
[7.4.3.10 NMAC - Rp, 7.4.3.10 NMAC & 7.4.3.11 NMAC, 04/30/2009]
7.4.3.11 HEALTHCARE-ASSOCIATED
INFECTION REPORTING: Acute care hospitals will submit data to the
New Mexico department of health using the centers for disease control and
prevention national healthcare safety network (NHSN) and confer rights to access
the data to the New Mexico department of health for central line-associated
bloodstream infections and clostridium difficile infections.
[7.4.3.11 NMAC - N, 02/29/2012]
7.4.3.12 REPEALER: These requirements repeal and replace all
previous rules, particularly rules governing the control of communicable
disease of November 11, 1952, rules governing the reporting of notifiable
disease of June 29, 1974 and rules governing the control of disease and
conditions of public health significance of 1980.
[7.4.3.12 NMAC - Rp, 7.4.3.12 NMAC, 04/30/2009; 7.4.3.12
NMAC - Rn, 7.4.3.11 NMAC, 02/29/2012]
7.4.3.13 NOTIFIABLE DISEASES OR
CONDITIONS IN NEW MEXICO:
A. All reports including electronic
laboratory reports of notifiable conditions, must include:
(1) the disease or condition
being reported;
(2) patient’s name, date of
birth/age, gender, race/ethnicity, address, patient telephone numbers, and
occupation;
(3) physician or licensed
healthcare professional name and telephone number; and
(4) healthcare facility or
laboratory name and telephone number, if applicable.
B. Laboratory or clinical samples for
conditions marked with (*) are required to be sent to the scientific laboratory
division.
C. Emergency reporting of diseases or
conditions: The following diseases,
confirmed or suspected, require immediate reporting by telephone to the
epidemiology and response division at (505) 827-0006. If no answer, call 1-866-885-6485.
(1) Infectious diseases:
(a) anthrax*;
(b) avian or novel influenza*;
(c) bordetella species*;
(d) botulism (any type) *;
(e) cholera*;
(f) diphtheria*;
(g) haemophilus
influenzae invasive infections*;
(h) measles;
(i) meningococcal
infections, invasive*;
(j) plague*;
(k) poliomyelitis, paralytic and non-paralytic;
(l) rabies;
(m) rubella (including congenital);
(n) severe acute respiratory syndrome (SARS)*;
(o) smallpox*;
(p) tularemia*;
(q) typhoid fever*;
(r) yellow fever.
(2) Other conditions:
(a) suspected foodborne
illness in two or more unrelated persons*;
(b) suspected waterborne
illness or conditions in two or more unrelated persons*;
(c) illnesses or conditions
suspected to be caused by the intentional or accidental release of biologic or
chemical agents*;
(d) acute illnesses or
conditions of any type involving large numbers of persons in the same
geographic area;
(e) severe smallpox vaccine
reaction;
(f) other illnesses or
conditions of public health significance.
(3) Infectious diseases in
animals:
(a) anthrax;
(b) plague;
(c) rabies;
(d) tularemia.
D. Routine reporting of diseases or conditions:
(1) Infectious diseases
(report case within 24 hours to epidemiology and response division at
505-827-0006; or contact the local health office).
(a) brucellosis;
(b) campylobacter infections*;
(c) clostridium difficile*;
(d) coccidioidomycosis;
(e) Colorado tick fever;
(f) cryptosporidiosis;
(g) cysticercosis;
(h) cyclosporiasis;
(i) dengue
(j) E. coli 0157:H7
infections*;
(k) E. coli, shiga-toxin
producing (STEC) infections*;
(l) encephalitis, other;
(m) giardiasis;
(n) Group A streptococcal
invasive infections*;
(o) Group B streptococcal
invasive infections*;
(p) hantavirus pulmonary syndrome;
(q) hemolytic uremic syndrome;
(r) hepatitis A, acute;
(s) hepatitis B, acute or
chronic;
(t) hepatitis C, acute or chronic;
(u) hepatitis E, acute;
(v) influenza-associated
pediatric death
(w) influenza, laboratory confirmed
hospitalization only;
(x) legionnaires’ disease;
(y) leptospirosis;
(z) listeriosis*;
(aa) lyme disease;
(bb) malaria;
(cc) mumps;
(dd) necrotizing fasciitis*;
(ee) psittacosis;
(ff) q fever;
(gg) relapsing fever;
(hh) Rocky Mountain spotted
fever;
(ii) salmonellosis*;
(jj) shigellosis*;
(kk) St. Louis encephalitis infections;
(ll) streptococcus pneumoniae,
invasive infections*;
(mm) tetanus;
(nn) trichinellosis;
(oo) toxic shock syndrome;
(pp) varicella;
(qq) vibrio infections*;
(rr) west nile virus infections;
(ss) western equine encephalitis infections;
(tt) yersinia infections*.
(2) Infectious diseases in
animals (report case within 24 hours to epidemiology and response division at
505-827-0006; or contact the local health office).
(a) arboviral, other;
(b) brucellosis;
(c) psittacosis;
(d) west nile virus
infections.
(3) Tuberculosis* or other nontuberculous
mycobacterial infections (including Mycobacterium avium complex or leprosy).
Report suspect or confirmed cases within 24 hours to tuberculosis program, NM
Department of Health, P. O. Box 26110, Santa Fe, NM 87502-6110; or call (505-827-2471)
or 505-827-2473.
(4) Sexually transmitted
diseases. Report to infectious disease bureau - STD program, NM Department of
Health, P.O. Box 26110, Santa Fe, NM 87502-6110, fax 505-476-3638; or call
505-476-3636.
(a) chancroid;
(b) chlamydia trachomatis
infections;
(c) gonorrhea;
(d) syphilis.
(5)
HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency
syndrome). Report to HIV and hepatitis epidemiology program, 1190 St. Francis
Dr., N1350, Santa Fe, NM 87502, fax 505-476-3544 or call 505-476-3515.
(a) all confirmed positive HIV antibody tests (screening
test plus confirmatory test);
(b) all tests for HIV RNA or
HIV cDNA (‘-viral load tests-’);
(c) all tests to detect HIV proteins;
(d) all positive HIV cultures;
(e) all HIV genotype tests;
(f) all CD4 lymphocyte tests
(count and percent);
(g) opportunistic infections, cancers and any
other test or condition indicative of HIV or AIDS.
(6) Occupational illness and
injury. Report to epidemiology and
response division, NM Department of Health, P.O. Box 26110, Santa Fe, NM
87502-6110; or call 505-827-0006.
(a) asbestosis;
(b) coal
worker’s pneumoconiosis;
(c) hypersensitivity pneumonitis;
(d) mesothelioma;
(e) noise
induced hearing loss;
(f) occupational asthma;
(g) occupational burn
hospitalization;
(h) occupational injury death;
(i) occupational pesticide
poisoning;
(j) occupational traumatic
amputation;
(k) silicosis;
(l) other illnesses or injuries related to
occupational exposure.
(7) Health conditions related
to environmental exposures and certain injuries. Report to epidemiology and response division,
NM Department of Health, P.O. Box 26110, Santa Fe, NM 87502-6110; or call
505-827-0006.
(a) Environmental exposures:
(i) all
pesticide poisoning;
(ii) arsenic in urine greater than 50
micrograms/liter;
(iii) carbon monoxide
poisoning;
(iv) infant methemoglobinemia;
(v) lead (all blood levels);
(vi) mercury
in urine greater than 3 micrograms/liter or mercury in blood greater than 5
micrograms/liter;
(vii) uranium
in urine greater than 0.2 micrograms/liter or 0.2 micrograms/gram creatinine;
(viii) other suspected environmentally-induced
health conditions.
(b) Injuries:
(i) drug overdose;
(ii) firearm injuries;
(iii) traumatic brain
injuries.
(8) Adverse vaccine
reactions. Report to vaccine adverse
events reporting system, http://www.vaers.hhs.org. Send copy of report to immunization program
vaccine manager, NM Department of Health, P.O. Box 26110, Santa Fe, NM
87502-6110; fax 505-827-1741.
(9) Healthcare-associated
infections. Central line-associated bloodstream infections (CLABSI) events.
(10) Cancer. Report to designee. Report all malignant and in situ neoplasms
and all intracranial neoplasms, regardless of the tissue of origin, using the
prevailing standards promulgated by the national cancer institute, the centers
for disease control and prevention, the North American association of central cancer
registries, and the American college of surgeons.
(11) Human papillomavirus (HPV). Laboratories report the following tests to designee
(a) papanicolaou test results
(all results);
(b) cervical, vulvar and
vaginal pathology results (all results);
(c) HPV test results (all results).
(12) Birth defects.
(a) Report to epidemiology and
response division, NM Department of Health, P.O. Box 26110, Santa Fe, NM
87502-6110; or call 505-827-0006.
(b) All birth defects
diagnosed by age 4 years, including:
(i) defects diagnosed during
pregnancy;
(ii) defects diagnosed on
fetal deaths;
(iii) defects
found in chromosome testing on amniotic
fluid, chorionic villus sampling and products of conception for Trisomy
13, Trisomy 18 and Trisomy 21.
(13) Genetic and congenital
hearing screening. Report to children’s medical services, 2040 S. Pacheco,
Santa Fe, NM 87505; or call 505-476-8868.
(a) Neonatal screening for
congenital hearing loss (all results).
(b) Suspected or confirmed congenital hearing
loss in one or both ears.
(c) All conditions identified
through statewide newborn genetic screening.
[7.4.3.13 NMAC - Rn & A, 7.4.3.12 NMAC, 02/29/2012]
HISTORY OF 7.4.3
NMAC:
Pre-NMAC History: The material in this part was derived from
that previously filed with the commission of public records - state records center
and archives:
HSSD 72-3, Regulations Governing The Reporting Of Notifiable
Diseases, filed 10/4/72.
HSSD 74-16, Regulations Governing The Reporting Of
Notifiable Diseases, filed 7/30/74.
HED-79-4 (HSD), Regulations Governing The Control Of Disease
And Conditions Of Public Health Significance, filed 12/20/79.
History of Repealed
Material: 7 NMAC 4.3, Control of
Disease and Conditions of Public Health Significance (filed 10/31/96), repealed
8/15/2003.
7.4.3 NMAC, Control of Disease and Conditions of Public
Health Significance (filed July 31, 2003), repealed 04/30/2009.
Other History:
HED-79-4 (HSD), Regulations Governing The Control Of Disease
And Conditions Of Public Health Significance (filed 12/20/79) was renumbered,
reformatted, and amended into the first version of the New Mexico
Administrative code as 7 NMAC 4.3, Control of Disease and Conditions of Public
Health Significance, effective 10/31/96.
7 NMAC 4.3, Control of Disease and Conditions of Public
Health Significance, filed 10/16/96 was replaced by the second version of the New Mexico Administrative code as 7.4.3
NMAC, Control of Disease and Conditions of
Public Health Significance, effective 8/15/2003.
7.4.3 NMAC, Control of Disease and Conditions of Public
Health Significance (filed July 31, 2003) was replaced by 7.4.3 NMAC, Health,
Disease Control (Epidemiology), Control of Disease and Conditions of Public
Health Significance, effective 04/30/2009.
