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Epidemiology Program

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Epidemiology Program

Clinical Laboratory Reporting and Specimen Submission Guidelines

For more information, contact Epidemiology at 619-692-8499.

Note: This webpage describes the laboratory reporting requirements contained in the California Code of Regulations Title 17, including Section 2505, as well as local requirements for submitting specimens and laboratory test results suggestive of specified diseases of public health importance to the local health department. Laboratory findings for these diseases are those that satisfy the most recent communicable disease surveillance case definitions established by the Centers for Disease Control and Prevention (unless otherwise specified in this section). All laboratory notifications are acquired in confidence. The confidentiality of patient information is always protected. 

The information on this webpage is available for download by clicking this link Clinical Laboratory Reporting and Specimen Submission Guidelines (PDF).

NOTIFICATION BY LABORATORY

Section 2505 (a) To assist the health officer, the laboratory director, or the laboratory director’s designee, of a clinical laboratory, an approved public health laboratory or a veterinary laboratory in which a laboratory examination of any specimen derived from the human body (or from an animal, in the case of specified diseases) yields microscopical, cultural, immunological, serological, or other evidence suggestive of those diseases listed in subsections (e)(1) and (e)(2) below, shall report such findings to the health officer of the local health jurisdiction where the health care provider who first submitted the specimen is located.

HOW TO REPORT

Laboratory reports must be made in writing and give the following information:

  • Date the specimen was obtained
  • Patient identification number
  • Specimen accession number or other unique specimen identifier
  • Laboratory findings for the test performed
  • Date that any positive laboratory findings were identified
  • Name, gender, address, telephone number (if known), and date of birth of the patient
  • Name, address, and telephone number of the health care provider who ordered the test

Send laboratory reports to Epidemiology via fax 858-715-6458 or electronic laboratory reporting.

WHEN TO REPORT

These laboratory findings are reportable to the local health officer of the health jurisdiction where the health care provider who first submitted the specimen is located within one (1) hour (List (e)(1) diseases) or within one (1) working day (List (e)(2) diseases) from the time that the laboratory notifies that health care provider or other person authorized to receive the report. If the laboratory that makes the positive finding received the specimen from another laboratory, the laboratory making the positive finding shall notify the local health officer of the jurisdiction in which the health care provider is located within the time specified above from the time the laboratory notifies the referring laboratory that submitted the specimen. If the laboratory is an out-of-state laboratory, the California laboratory that receives a report of such findings shall notify the local health officer in the same way as if the finding had been made by the California laboratory.

Whenever the specimen, or an isolate there from, is transferred between laboratories, a test requisition with the patient and submitter information shall accompany the specimen. The laboratory that first receives a specimen shall be responsible for obtaining the patient and submitter information at the time the specimen is received by that laboratory.

The notification for List (e)(1) diseases shall be reported by telephone within one (1) hour, followed by a written report submitted by electronic facsimile transmission or electronic mail within one (1) working day, to the local health officer in the jurisdiction where the health care provider who submitted the specimen is located. 

(e)(1) Notification within 1 hour

Report to Public Health Services

Within 1 hour:
Call to Epidemiology 619-692-8499
After Hours 858-565-5255

Within 1 day:
Fax to Epidemiology 858-715-6458

Disease/Microorganism

Submit to Public Health Lab

Anthrax, animal (B. anthracis)

n/a

Anthrax, human (B. anthracis)

suspect isolate

Botulism

serum

Brucellosis, human (all Brucella spp.)

suspect isolate

Burkholderia pseudomallei and B. mallei (detection or isolation from a clinical specimen)

suspect isolate

Influenza, novel strains (human)

respiratory specimen in VTM

Plague, animal

n/a

Plague, human

suspect isolate

Smallpox (Variola)

scab, scab fluid, dry/wet swab of lesion

Tularemia, human (F. tularensis)

suspect isolate

Viral hemorrhagic fever agent, human (VHF),
(e.g., Crimean-Congo, Ebola, Lassa, and Marburg viruses)

serum

Whenever a laboratory receives a specimen for the laboratory diagnosis of a suspected human case of one of these List (e)(1) diseases, such laboratory shall communicate immediately by telephone with the Microbial Diseases Laboratory 510-412-3700 (or, for Influenza, novel strains, Smallpox or Viral Hemorrhagic Fevers, with the Viral and Rickettsial Disease Laboratory 510-307-8585) of the California Department of Public Health for instruction. The laboratory should also immediately contact the San Diego County Public Health Laboratory 619-692-8500.

The notification for List (e)(2) diseases shall be submitted by courier, mail, electronic facsimile transmission or electronic mail within one (1) working day to the local health officer in the jurisdiction where the health care provider who submitted the specimen is located. 

(e)(2) Notification within 1 working day

Report to Public Health Services

Provide the following:

  • Date of specimen
  • Patient ID number
  • Specimen accession number
  • Laboratory findings
  • Date of any positive findings
  • Patient information
    • Name
    • Date of birth
    • Gender
    • Address
    • Telephone number
  • Ordering health care provider
    • Name
    • Address
    • Telephone number

Within 1 day:
Fax to Epidemiology
858-715-6458
 


This information may be submitted via a laboratory report or by completing a Confidential Morbidity Report (please attach the laboratory report to the CMR).

Disease/Microorganism

Submit to Public Health Lab

Acid-fast bacillus**

n/a

Anaplasmosis

n/a

Bordetella pertussis

n/a

Borrelia burgdorferi

n/a

Brucellosis, animal (Brucella spp. except Brucella canis)

n/a

Campylobacteriosis (Campylobacter spp.) (detection or isolation from a clinical specimen)

n/a

Chancroid

n/a

Coccidioidomycosis

n/a

Cryptosporidiosis

n/a

Cyclosporiasis (Cyclospora cayetenensis)

n/a

Dengue (dengue virus)

serum

Diphtheria

n/a

Encephalitis, arboviral

n/a

Escherichia coli: shiga toxin producing (STEC), including E. coli O157

isolate, broth

Ehrlichiosis 

n/a

Giardiasis (Giardia lamblia, intestinalis, or duodenalis)

n/a

Haemophilus influenzae (report an incident of less than 15 years of age, from sterile site)

n/a

Hantavirus Infections

serum

Hepatitis A, acute infection

n/a

Hepatitis B, acute or chronic infection (specify gender)

n/a

Hepatitis C, acute or chronic infection 

n/a

Hepatitis D (Delta), acute or chronic infection

n/a

Hepatitis E, acute infection (detection of hepatitis E virus RNA from a clinical specimen or positive serology)

n/a

Legionellosis (Legionella spp.) (antigen or culture) 

n/a

Leprosy (Hansen Disease) (Mycobacterium leprae)

n/a

Leptospirosis (Leptospira spp.)

n/a

Listeriosis (Listeria)

isolate

Malaria**

blood film slide, EDTA blood tube

Measles (Rubeola), acute infection

serum, urine, NP

Mumps (mumps virus), acute infection

serum

Neisseria meningitidis (sterile site isolate)

CSF, EDTA blood tube, isolate

Poliovirus 

n/a

Psittacosis (Chlamydophila psittaci)

n/a

Q Fever (Coxiella burnetii)

whole blood and serum

Rabies, animal or human 

n/a

Relapsing Fever (Borrelia spp.) (identification of Borrelia spp. spirochetes on peripheral blood smear)

n/a

Rickettsia, any species, acute infection (detection from a clinical specimen or positive serology)

n/a

Rocky Mountain Spotted Fever (Rickettsia rickettsii)

n/a

Rubella, acute infection

n/a

Salmonellosis (Salmonellaspp.)

isolate

Shiga toxin (detected in feces)

broth, feces

Shigellosis (Shigella spp.)

isolate

Trichinosis (Trichinella)

n/a

Tularemia, animal (F. tularensis)

n/a

Typhoid

isolate

Vibrio cholerae, V. parahaemolyticus, Vibrio if unable to speciate 

isolate

West Nile virus infection

CSF, serum

Yellow Fever (yellow fever virus)

serum

Yersiniosis (Yersinia spp., non-pestis) (isolation from a clinical specimen)

isolate

Report to Public Health Services

Within 1 day:
Fax to STD Program 619-692-8541

Disease/Microorganism

Submit to Public Health Lab

Chlamydia trachomatis infections, including Lymphogranuloma Venereum (LGV)

n/a

Gonorrhea

See Local Requests

Syphilis

n/a

Report to Public Health Services

Within 1 day:
Fax to TB Program 619-692-5516

Disease/Microorganism

Submit to Public Health Lab

Mycobacterium tuberculosis** (see additional requirements for drug susceptibility testing and reporting)

isolate

    **See additional instructions in the ADDITIONAL REPORTING REQUIREMENTS section
      n/a=not applicable

The County of San Diego requests that clinical laboratories also report the following:

Local Requests

Report to Public Health Services

Within 1 day:
Fax to STD Program 619-692-8541

Disease/Microorganism

Submit to Public Health Lab

Quinilone-resistant Neisseria gonorrhoae

isolate

ADDITIONAL REPORTING REQUIREMENTS

MALARIA
Any clinical laboratory that makes a finding of malaria parasites in the blood film of a patient shall immediately submit one or more such blood film slides (and EDTA blood tube, if possible) for confirmation to the local public health laboratory for the local health jurisdiction where the health care provider is located. When requested, all blood films will be returned to the submitter.

SALMONELLA
California Code of Regulations, Title 17, Section 2612 requires that a culture of the organisms on which a diagnosis of salmonellosis is established must be submitted to the local public health laboratory and then to the State's Microbial Diseases Laboratory for definitive identification.

TUBERCULOSIS (AND ACID-FAST BACILLUS)
Any laboratory that isolates Mycobacterium tuberculosis from a patient specimen must submit a culture to the local public health laboratory for the local health jurisdiction in which the health care provider’s office is located as soon as available from the primary isolate on which a diagnosis of tuberculosis was established. The information listed under “HOW TO REPORT” below must be submitted with the culture. The San Diego County Public Health Laboratory shall retain the culture received (one culture from each culture-positive patient) in a viable condition for at least six months.

Unless drug susceptibility testing has been performed by the clinical laboratory on a strain obtained from the same patient within the previous three months or the health care provider who submitted the specimen for laboratory examination informs the laboratory that such drug susceptibility testing has been performed by another laboratory on a culture obtained from that patient within the previous three months, the clinical laboratory must do the following:

  • Perform or refer for drug susceptibility testing on at least one isolate from each patient from whom Mycobacterium tuberculosis was isolated,

  • Report the results of drug susceptibility testing to the local health officer of the city or county where the submitting physician’s office is located within one (1) working day from the time the health care provider or other authorized person who submitted the specimen is notified, and

  • If the drug susceptibility testing determines the culture to be resistant to at least isoniazid and rifampin, in addition, submit one culture or subculture from each patient from whom multidrug-resistant Mycobacterium tuberculosis was isolated to the local public health laboratory. The San Diego County Public Health Laboratory shall forward such cultures to the CDPH Microbial Disease Laboratory.

Whenever a clinical laboratory finds that a specimen from a patient with known or suspected tuberculosis tests positive for acid-fast bacillus (AFB) staining and the patient has not had a culture which identifies that acid-fast organism within the past 30 days, the clinical laboratory shall culture and identify the acid fast bacteria or refer a subculture to another laboratory for those purposes.

HOW TO SUBMIT SPECIMENS

The following information should be submitted with the specimen:

  • Name, address, and date of birth of the person from whom the specimen was obtained
  • Patient identification number
  • Specimen accession number or other unique specimen identifier
  • Date the specimen was obtained from the patient
  • Name, address, and telephone number of the health care provider who ordered the test
  • Appropriate form (see Form List)
    • A legible copy of a laboratory report containing all of the above information is satisfactory if you do not have the correct form.
    • Special forms are required to be submitted for testing of the following diseases:
      • Avian Influenza
      • Botulism
      • Hantavirus
      • Influenza (Seasonal and 2009 Pandemic H1N1)
      • Hepatitis E
      • Malaria
      • Smallpox
      • West Nile Virus
  • To obtain forms:

FORM LIST

Confidential Morbidity Report
Adult C. botulinum Toxin Detection Laboratory Request and Final Report Form
Avian Influenza A (H5N1) Submittal Form
Bacterial Culture for Identification Form
Blood Lead Request Form
CDC DASH Form 50.34
Chlamydia/Gonorrhea Examination Form
Chlamydia/Gonorrhea Examination Form (Juvenile Hall)
Clinical Laboratory Request Form
Enteric Culture Form
Gonorrhea Culture Requisition Form
Hepatitis Serology Form
HIV Court Order Form
HIV-1 Antibody Test Request Form
Influenza Virus Culture Request Form
Influenza Virus PCR Requisition Form (Seasonal and 2009 Pandemic H1N1)
Interfering Substances with Botulism Testing
Lab Supply Request Form – LAB (P1)
Medical Examiner Submittal Form
Molecular Test Request Form
Mycobacteria (TB) CI Form
Mycobacteria (TB) Culture Form
Mycology CI Form
Parasitology Requisition Form
Quantiferon In-tube Lab Request Form
Serologic Examination Form
Smallpox Sample Submission Form
Submittal Form for Methicillin Resistant Staphylococcus aureus (MRSA) isolates
Syphilis Serology Form
Virus Isolation Request Form
West Nile Virus Specimen Submittal Form

PACKAGING AND SHIPPING INFORMATION

All specimens submitted to the San Diego County Public Health Laboratory must comply with all applicable U.S. Postal Service, DOT or IATA requirements (i.e., packaged, labeled and documented, as per applicable regulations).

Laboratory Telephone Number:(619) 692-8500
Laboratory FAX Number:(619) 692-8558
Mailing Address (w/ Mail Stop):San Diego County Public Health Laboratory
3851 Rosecrans Street, Suite 716
San Diego, CA 92110-3115
MS P572

    

REFERENCES

California Reportable Diseases and Conditions
http://www.cdph.ca.gov/HealthInfo/Pages/ReportableDiseases.aspx

Clinical Laboratory Reporting and Specimen Submission Guidelines (PDF, New Window)

County of San Diego Public Health Laboratory
http://www.sdcounty.ca.gov/hhsa/programs/phs/phs_laboratory/index.html

County of San Diego Epidemiology Program
http://www.sdepi.org/

 

 Page last updated 11/21/2013