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Communicable Diseases - Why Report?

Some 250 years ago, the tavern keepers were required to report contagious diseases among their patrons to the local authorities. Today, the majority of U.S. states and territories mandate reporting of the more common communicable diseases by health care providers. Beyond the basic public health functions of identifying patterns of disease occurrence in the population and implementing preventive measures, surveillance information can provide valuable clinical feedback to health care team members. For example, during the 1995 E. coli incident in Washington State, the state health department performed bacteria sub-typing to identify the specific strain of organism responsible for the disease affecting those eating under-cooked hamburger that had been contaminated. This assisted locating the specific source of the contamination, and the curtailment of a more possibly widely spread epidemic.

Local health departments are charged with preventing the spread of communicable diseases in the community. Rapid reporting by providers is critical to the process of identifying exposures, particularly common-source exposures in clustered cases, and implementing interventions to reduce or eliminate them (as in child care centers or restaurants). Health care providers are required to report most of the reportable communicable diseases (Washington Administrative Code 246-100-021 & 246-100-206). However, laboratories and other sources are often relied upon by providers to do the required reporting. Unfortunately, non-provider sources often provide incomplete information, particularly in regard to patient demographics and public health concerns such as attendance in child care programs or employment in sensitive occupation (direct patient or child care and food handling). Although some diseases are "laboratory-reportable", the primary health care provider is also required to report these diseases.

Studies of why providers do not report have identified several factors, including:
    1) the assumption that others are reporting,
    2) concerns about confidentiality,
    3) lack of knowledge of how and what to report, and
    4) the sentiment that reporting is too time consuming.

In an effort to address some of these points, Island County Public Health (ICPH) provides a list of notifiable diseases and forms to facilitate reporting. Reports can be made by calling 679-7351, available 24 hours a day, or by submitting a disease report form. Use the same telephone number to order additional reporting materials. To find out how the information you provide is utilized locally, call 679-7351 and ask to be put on the epiTrends mailing list. On a national level, subscribe to Morbidity and Mortality Weekly Report (MMWR); Epidemiology Program Office, Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia, 30333.