Rare Disease of Public Health Significance

 

Rare diseases of public health significance are defined as diseases or conditions of general public health concern not listed elsewhere which are not commonly diagnosed in Washington residents.

Diseases and Agents that Should Be Reported

The 2011 revision of WAC 246-101-010 states “‘Other rare diseases of public health significance' means a disease or condition, of general or international public health concern, which is occasionally or not ordinarily seen in the state of Washington including, but not limited to, spotted fever rickettsiosis, babesiosis, tick paralysis, anaplasmosis, and other tick borne diseases. This also includes public health events of international concern and communicable diseases that would be of general public concern if detected in Washington.”

Included are conditions requested for immediate reporting nationally in accordance with International Health Regulations, which address reporting of any public health emergency of international concern (infectious, chemical, biological, or radiological). Exposures may be endemic or outside the state or country.

Conditions that should be reported through PHIMS to Communicable Disease Epidemiology (CDE) as Rare Diseases of Public Health Significance include:

  • African tick bite fever^
  • African sleeping sickness^
  • Amoebic meningitis
  • Anaplasmosis
  • Babesiosis*
  • Burkholderia infection (Melioidosis or Glanders)
  • Chagas disease
  • Coccidioidomycosis*
  • Cryptococcus gattii*
  • Ehrlichiosis^
  • Histoplasmosis^
  • Monkeypox
  • Paragonimiasis^
  • Prion disease*
  • Severe acute respiratory syndrome-associated coronavirus disease (SARS)
  • Shellfish poisoning: Paralytic, Domoic Acid or Diarrhetic*
  • Smallpox
  • Tickborne rickettsioses (including Rocky Mountain spotted fever)*
  • Tick paralysis*
  • Typhus
  • Vaccinia transmission*
  • Varicella death*
  • Viral hemorrhagic fevers
  • Highly antibiotic resistant organisms including vancomycin resistant S. aureus
  • Any emerging condition with outbreak potential

* Indicates condition endemic to the state recently identified in a Washington State resident

^ Indicates condition not endemic to the state recently identified in a Washington State resident

Purpose of Reporting and Surveillance

  • To understand the epidemiology of emerging and uncommon diseases in Washington State residents and to inform public health and health care about conditions that have been diagnosed in residents
  • To assist in the diagnosis and treatment of cases
  • If applicable, to identify potentially exposed close contacts, health care workers, and laboratory personnel and to provide counseling
  • To identify sources of transmission and to prevent further transmission
  • To raise the index of suspicion of a possible bioterrorism event if no natural exposure source is identified

Legal Reporting Requirements

  • Health care providers: Burkholderia, emerging condition with outbreak potential, novel influenza, monkeypox, SARS, smallpox, or viral hemorrhagic fever immediately notifiable to local health jurisdiction, influenza-associated death or varicella-associated death notifiable in 3 business days, other rare diseases notifiable in 24 hours.
  • Health care facilities: Burkholderia, emerging condition with outbreak potential, novel influenza, monkeypox, SARS, smallpox virus, or viral hemorrhagic fever agents immediately notifiable to local health jurisdiction, influenza-associated death or varicella-associated death notifiable in 3 business days, other rare diseases notifiable in 24 hours.
  • Laboratories: Burkholderia, novel influenza virus, SARS-asociated coronavirus, or smallpox immediately notifiable to the local health jurisdiction.
  • Veterinarians: Suspected human cases notifiable immediately to the local health jurisdiction; animal cases of some conditions notifiable to Washington State Department of Agriculture (see: https://app.leg.wa.gov/WAC/default.aspx?cite=16-70).
  • Local health jurisdictions: emerging condition with outbreak potential, novel influenza, SARS, smallpox or viral hemorrhagic fever immediately notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE)