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  • Technical Bulletin
  • Reportable Communicable Diseases in Nevada

Updates to NAC 441A, Regarding Reportable Communicable Diseases in Nevada

Background

On Dec. 10, 2023, the Nevada Legislative Commission approved amendments to Nevada Administrative Code (NAC) 441A that updated the conditions which are mandated to be reported in Nevada. These amendments were made to better align with the Centers for Disease Control and Prevention (CDC) nationally notifiable conditions. NAC 441A has been amended to prescribe requirements governing the investigation of and response to cases of newly reportable conditions. Official codification of NAC 441A is pending, however the draft approved amendments can be found online here.

This technical bulletin lists the conditions that were added or amended in the definition of communicable disease and describes regulation updates concerning Babesiosis, COVID-19, Cyclosporiasis, mpox (monkeypox), and Haemophilus influenzae. New regulations regarding Candida auris (C. auris) and updates for other conditions are described in separate technical bulletins.

Reportable Conditions (NAC 441A.040)

The definition of “communicable disease” has been expanded to include the following new conditions:

  • Any condition identified by CDC as a nationally notifiable condition
  • Babesiosis (parasite)
  • C. auris
  • Coronavirus disease 2019 (COVID-19)
  • Cyclosporiasis (parasite)
  • Mpox (also known as monkeypox)

The definition of “communicable disease” has been edited to include modifications to the following previously reportable conditions:

  • Haemophilus influenzae invasive disease
  • Hepatitis B
  • Hepatitis C
  • Human immunodeficiency virus infection (HIV) stage 3 (formerly AIDS)
  • Influenza deaths

Investigation and Response to Newly Reportable Conditions

Babesiosis

The health authority shall investigate each report of a case having babesiosis, as identified by finding the infectious agent in a clinical specimen through testing by a medical laboratory, to:

  1. Confirm the diagnosis;
  2. Determine the extent of any outbreak;
  3. Identify the source of the infection; and
  4. Determine the necessity of initiating measures to control vectors.

Coronavirus disease 2019 (COVID-19)

The health authority shall investigate each report of a case having coronavirus disease 2019 (COVID-19) or suspected case considered to have coronavirus disease 2019 (COVID-19) to:

  1. Confirm the diagnosis;
  2. Determine the extent of any outbreak; and
  3. Determine the need for measures to prevent, suppress and control the spread of the disease including, without limitation, the need to exclude, isolate or quarantine the case or suspected case and any close contacts of the case or suspected case.

Cyclosporiasis

The health authority shall investigate each report of a case having cyclosporiasis, as identified by the presence of Cyclospora cayetanensis parasites in a clinical stool specimen through testing by a medical laboratory, to:

  1. Confirm the diagnosis;
  2. Identify the source of the infection; and
  3. Determine if the case is employed in a sensitive occupation or is an infant or child attending a child care facility.

A person excreting Cyclospora cayetanensis parasites shall not work in a sensitive occupation until the person is authorized to do so by the health authority. A health authority may authorize the person to work in a sensitive occupation if the case has not experienced diarrhea for at least 24 hours and there is no indication of poor personal hygiene.

The health authority shall instruct a person excreting Cyclospora cayetanensis parasites of the need to wash his or her hands after defecation and the proper method of hand washing.

An infant or child excreting Cyclospora cayetanensis parasites shall not attend a child care facility until the infant or child has not experienced diarrhea for at least 24 hours. The health authority shall instruct a child care facility attended by an infant or child excreting Cyclospora cayetanensis parasites of the need to wash the hands of the infant or child after defecation, the proper method of hand washing and other practices to control the spread of the infection.

If a case having Cyclospora cayetanensis is in a medical facility, the medical facility shall provide care for the case in accordance with precautions established by the medical facility to prevent the spread of enteric communicable diseases or other disease-specific precautions.

Mpox (monkeypox)

The health authority shall investigate each report of a case having mpox or a suspected case considered to have mpox to:

  1. Confirm the diagnosis;
  2. Determine the extent of any outbreak;
  3. Identify the source of the infection;
  4. Identify any susceptible contacts; and
  5. Determine the need for measures to prevent, suppress and control the spread of the disease, including, without limitation, the need to:
    1. Isolate the case or suspected case in accordance with CDC guidelines; and
    1. Offer prophylactic treatment to susceptible contacts.

Medical facility staff having mpox or a suspected case considered to have mpox shall not have direct contact with a case unless the member of the staff uses appropriate personal protective equipment.

The health authority shall immediately notify the Chief Medical Officer or a designee thereof of a report of a case having mpox or a suspected case considered to have mpox.

Reporting change for Haemophilus influenzae invasive disease

The requirement to report Haemophilus influenzae invasive disease only if caused by Type B has been removed. Invasive disease caused by any type of Haemophilus influenzae is now reportable in Nevada.

Provider Reporting

Nevada’s Confidential Morbidity Report Form can be found online here.

Laboratory Reporting

Laboratories with HL7 capability should plan to report laboratory results through the electronic laboratory reporting (ELR) system. The Nevada Division of Public and Behavioral Health (DPBH), Office of State Epidemiology (OSE) will assist in onboarding laboratories and testing entities and can be reached at dpbhelronboarding@health.nv.gov to start the process. OSE will provide instructions on the best alternative mechanism to report for entities without HL7 capability.

Questions

For updated guidance, review the Division of Public and Behavioral Health Technical Bulletin web page regularly. Email outbreak@health.nv.gov for other questions regarding updated reporting requirements.