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Other links concerning Notifiable Conditions |
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Posters |
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Associated Programs |
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Notifiable Conditions
Glossary
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Blood Lead
Level |
A measurement of lead content in
whole blood. Elevated blood lead level means blood lead levels
equal to or greater than 25 micrograms per deciliter for persons
aged fifteen years or older, or equal to or greater than 10
micrograms per deciliter in children less than fifteen years of
age. |
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Carrier |
A person or animal that harbors a
specific infectious agent without discernible clinical disease
and serves as a potential source of infection. The carrier
state may exist in an individual with an infection that is
inapparent throughout its course (commonly known as health or
asymptomatic carrier), or during the incubation period,
convalescence and postconvalescence of an individual with a
clinically recognizable disease (commonly known as an incubatory
or convalescent carrier). Under either circumstance the carrier
state may be of short or long duration (temporary or transient
carrier, or chronic carrier). |
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Case-Fatality
Rate |
Usually expressed as the
percentage of persons diagnosed as having a specified disease
who die as a result of that illness within a given period. |
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Chemoprophylaxis |
The administration of a chemical,
including antibiotics, to prevent the development of an
infection or the progression of an infection to active manifest
disease, or to eliminate the carriage of a specific infectious
agent to prevent transmission and disease in others.
Chemotherapy, on the other hand, refers to use of a chemical to
treat a clinically manifest disease or to limit its further
progression. |
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Communicable
Disease |
An illness due to a specific
infectious agent or its toxic products that arises through
transmission of that agent or its products from an infected
person, animal or inanimate reservoir to a susceptible host;
either directly or indirectly through an intermediate plant or
animal host, vector or the inanimate environment (synonym:
infectious disease). |
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Communicable
Disease Cluster |
Two or more cases of a confirmed
or suspected communicable disease with a suspected common source
diagnosed or exposed within a twenty-four hour period. |
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Communicable
Period |
The time during which an
infectious agent may be transferred directly or indirectly from
an infected person to another person, from an infected animal to
humans, or from an infected person to animals, including
arthropods.
In diseases such as diphtheria and
streptococcal infection, in which mucous membranes are involved
from the initial entry of the infectious agent, the period of
communicability is from the date of first exposure to a source
of infection until the infecting microorganism is no longer
disseminated from the involved mucous membranes, i.e., from the
period before the prodromata until termination of a carrier
state, if the latter develops. Some diseases are more
communicable during the incubation period than during the actual
illness (e.g., hepatitis A, measles).
In diseases such as tuberculosis,
leprosy, syphilis, gonorrhea and some of the salmonelloses, the
communicable state may exist over a long and sometimes
intermittent period when active chronic lesions permit the
discharge of infectious agents from the surface of the skin or
through any of the body orifices.
In diseases transmitted by
arthropods, such as malaria and yellow fever, the periods of
communicability (or more properly infectivity) are those during
which the infectious agent occurs in the blood or other tissues
of the infected person in sufficient numbers to permit infection
of the vector. A period of communicability (transmissibility) is
also to be noted for the arthropod vector, namely, when the
agent is present in the tissues of the arthropod in such form
and locus (infective state) as to be transmissible. |
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Contact |
A person or animal that has been
in such association with an infected person or animal or a
contaminated environment as to have had an opportunity to
acquire the infection. |
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Contamination |
The presence of an infectious
agent on a body surface, in clothes, bedding, toys, surgical
instruments or dressings, or other inanimate articles or
substances including water and food. Pollution is distinct from
contamination and implies the presence of offensive, but not
necessarily infectious, matter in the environment. Contamination
of a body surface does not imply a carrier state. |
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Disease Of Suspected Bioterrorism Origin |
A disease caused by viruses,
bacteria, fungi, or toxins from living organisms that are used
to produce death or disease in humans, animals, or plants. Many
of these diseases may have nonspecific presenting symptoms. The
following situations could represent a possible bioterrorism
event and should be reported immediately to the local health
department:
- A single diagnosed or
strongly suspected case of disease caused by an uncommon agent
or a potential agent of bioterrorism occurring in a patient
with no known risk factors;
- A cluster of patients
presenting with a similar syndrome that includes unusual
disease characteristics or unusually high morbidity or
mortality without obvious etiology; or
- Unexplained increase in a
common syndrome above seasonally expected levels.
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Disinfection |
Killing of infectious agents
outside the body by direct exposure to chemical or physical
agents. High-level disinfection may kill all microorganisms with
the exception of high numbers of bacterial spores; it requires
extended exposure to ensure killing of most bacterial spores. It
is achieved, after thorough detergent cleaning, by exposure to
specific concentrations of certain disinfectants (e.g., 2%
glutaraldehyde, 6% stabilized hydrogen peroxide and up to 1%
peracetic acid) for at least 20 minutes. Intermediate-level
disinfection does not kill spores; it can be achieved by
pasteurization (75» C [167» F] for 30 minutes) or by appropriate
treatment with EPA-approved disinfectants.
Concurrent disinfection is the
application of disinfective measures as soon as possible after
the discharge of infectious material from the body of an
infected person, or after the soiling of articles with such
infectious discharges; all personal contact with such discharges
or articles should be minimized prior to such disinfection.
Terminal disinfection is the
application of disinfective measures after the patient has been
removed by death or to a hospital, or has ceased to be a source
of infection, or after hospital isolation or other practices
have been discontinued. Terminal disinfection is rarely
practiced; terminal cleaning generally suffices, along with
airing and sunning of rooms, furniture and bedding. Disinfection
is necessary only for diseases spread by indirect contact; steam
sterilization or incineration of bedding and other items is
recommended after a disease such as Lassa fever or other highly
infectious diseases.
Sterilization involves
destruction of all forms of life by heat, irradiation, gas
(ethylene oxide or formaldehyde) or chemical treatment. |
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Endemic |
The constant presence of a disease
or infectious agent within a given geographic area; it may also
refer to the usual prevalence of a given disease within such
area. Hyperendemic expresses a constant presence at a high level
of incidence, and holoendemic a high level of prevalence with
infections beginning early in life and affecting most of the
population, e.g., malaria in some places. |
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Epidemic |
The occurrence in a community or
region of cases of an illness (or an outbreak) with a frequency
clearly in excess of normal expectancy. The number of cases
indicating presence of an epidemic will vary according to the
infectious agent, size and type of population exposed, previous
experience or lack of exposure to the disease, and time and
place of occurrence; epidemicity is thus relative to usual
frequency of the disease in the same area, among the specified
population, at the same season of the year. A single case of a
communicable disease long absent from a population or the first
invasion by a disease not previously recognized in that area
requires immediate reporting and epidemiologic investigation;
two cases of such a disease associated in time and place are
sufficient evidence of transmission to be considered an
epidemic. |
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Health Education |
Health education is the process by
which individuals and groups of people learn to behave in a
manner conducive to the promotion, maintenance or restoration of
health. Education for health begins with people as they are,
with whatever interests they may have in improving their living
conditions. Its aim is to develop in them a sense of
responsibility for health conditions, as individuals and as
members of families and communities. In communicable disease
control, health education commonly includes an appraisal of what
is known by a population about a disease, an assessment of
habits and attitudes of the people as they relate to spread and
frequency of the disease, and the presentation of specific means
to remedy observed deficiencies. |
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Herd Immunity |
The immunity of a group or
community. The resistance of a group to invasion and spread of
an infectious agent, based on the resistance to infection of a
high proportion of individual members of the group. |
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Host |
A person or other living thing
animal, including birds and arthropods, that affords subsistence
or lodgment to an infectious agent under natural (as opposed to
experimental) conditions. Some protozoa and helminths pass
successive stages in alternate hosts of different species. Hosts
in which the parasite attains maturity or passes its sexual
stage are primary or definitive hosts; those in which the
parasite is in a larval or asexual state are secondary or
intermediate hosts. A transport host is a carrier in which the
organism remains alive but does not undergo development. |
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Immune Individual |
A person or animal that has
specific protective antibodies and/or cellular immunity as a
result of previous infection or immunization, or is so
conditioned by such previous specific experience as to respond
in such a way that prevents the development of infection and/or
clinical illness following reexposure to the specific infectious
agent. Immunity is relative: a level of protection that could be
adequate under ordinary conditions may be overwhelmed by an
excessive dose of the infectious agent or by exposure through an
unusual portal of entry; protection may also be impaired by
immunosuppressive drug therapy, concurrent disease or the aging
process. |
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Immunity |
That resistance usually associated
with the presence of antibodies or cells having a specific
action on the microorganism concerned with a particular
infectious disease or on its toxin. Effective immunity includes
both cellular immunity, which is conferred by T-lymphocyte
sensitization, and/or humoral immunity, which is based on
B-lymphocyte response. Passive immunity is attained either
naturally by transplacental transfer from the mother, or
artificially by inoculation of specific protective antibodies
(from immunized animals, or convalescent hyperimmune serum or
immune serum globulin [human]); it is of short duration (days to
months). Active humoral immunity, which usually lasts for years,
is attained either naturally by infection with or without
clinical manifestations, or artificially by inoculation of the
agent itself in killed, modified or variant form, or of
fractions or products of the agent. |
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Inapparent Infection |
The presence of infection in a
host without recognizable clinical signs or symptoms. Inapparent
infections are identifiable only by laboratory means such as a
blood test or by the development of positive reactivity to
specific skin tests. |
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Incidence Rate |
The number of new cases of a
specified disease diagnosed or reported during a defined period
of time, divided by the number of persons in a stated population
in which the cases occurred. This is usually expressed as cases
per 1,000 or 100,000 per annum. This rate may be expressed as
age- or gender-specific or as specific for any other population
characteristic or subdivision.
Attack rate, or case rate, is a
proportion measuring cumulative incidence often used for
particular groups, observed for limited periods and under
special circumstances, as in an epidemic; it is usually
expressed as percent (cases per 100 in the group). The secondary
attack rate is the number of cases among familial or
institutional contacts occurring within the accepted incubation
period following exposure to a primary case, in relation to the
total of exposed contacts; the denominator may be restricted to
susceptible contacts when determinable. Infection rate is a
proportion that expresses the incidence of all identified
infections, manifest and inapparent. |
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Incubation Period |
The time interval between initial
contact with an infectious agent and the first appearance of
symptoms associated with the infection. In a vector, it is the
time between entrance of an organism into the vector and the
time when that vector can transmit the infection. The period in
people between the time of exposure to a parasite and the time
when the parasite can be detected in blood or stool is called
the prepatent period. |
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Infected Individual |
A person or animal that harbors an
infectious agent and who has either manifest disease or
inapparent infection. An infectious person or animal is one from
whom the infectious agent can be naturally acquired. |
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Infection |
The entry and development (of many
parasites) or multiplication of an infectious agent in the body
of persons or animals. Infection is not synonymous with
infectious disease; the result may be inapparent or manifest.
The presence of living infectious agents on exterior surfaces of
the body, or on articles of apparel or soiled exterior surfaces
of the body, or on articles of apparel or soiled articles, is
not infection, but represents contamination of such surfaces and
articles. |
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Infectious Agent |
An organism (virus, rickettsia,
bacteria, fungus, protozoan or helminth) that is capable of
producing infection or infectious disease. Infectivity expresses
the ability of the disease agent to enter, survive and multiply
in the host; infectiousness indicates the relative ease with
which a disease is transmitted to other hosts. |
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Infectious Disease |
A clinically manifest disease of
humans or animals resulting from an infection. |
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Infestation |
For persons or animals, the
lodgment, development and reproduction of arthropods on the
surface of the body or in the clothing. Infested articles or
premises are those that harbor or give shelter to animal forms,
especially arthropods and rodents. |
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Isolation |
As applied to patients, isolation
represents separation, for the period of communicability, of
infected persons or animals from others in such places and under
such conditions as to prevent or limit the direct or indirect
transmission of the infectious agent from those infected to
those who are susceptible to infection or who may spread the
agent to others. In contrast, quarantine applies to restrictions
on the healthy contacts of an infectious case.
CDC has recommended that Universal
Precautions be used consistently for all patients (in hospital
settings as well as outpatient settings) regardless of their
bloodborne infection status. This practice is based on the
possibility that blood and certain body fluids (any body
secretion that is obviously bloody, semen, vaginal secretions,
tissue, CSF, and synovial, pleural, peritoneal, pericardial and
amniotic fluids) of all patients are potentially infections for
HIV, HBV and other bloodborne pathogens. Universal precautions
are intended to prevent parenteral, mucous membrane and
nonintact skin exposures of healthcare workers to bloodborne
pathogens. Protective barriers include gloves, gowns, masks and
protective eyewear or face shields. A private room is indicated
if patient hygiene is poor. Waste management is controlled by
local and state authority. |
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Morbidity Rate |
An incidence rate used to include
all persons in the population under consideration who become
clinically ill during the period of time stated. The population
may be limited to a specific gender or age group, or to those
with certain other characteristics. |
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Mortality Rate |
A rate calculated in the same way
as an incidence rate by dividing the number of deaths occurring
in the population during the stated period of time, usually a
year, by the number of persons at risk of dying during the
period. A total or crude mortality rate utilized deaths from all
causes, usually expressed as deaths per 1,000. a
disease-specific mortality rate covers deaths due to only one
disease and is often reported on the basis of 100,000 persons.
The population base may be defined by gender, age or other
characteristics. The mortality rate must not be confused with
case-fatality rate. |
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Nosocomialo Infection |
An infection occurring in a
patient in a hospital or other healthcare facility in whom it
was not present or incubating at the time of admission; or the
residual of an infection acquired during a previous admission.
Includes infections acquired in the hospital but appearing after
discharge, and also such infections among the staff of the
facility. |
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Outbreak |
The occurrence of cases of a
disease or condition in any area over a given period of time in
excess of the expected number of cases. |
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Pathogenicity |
The property of an infectious
agent that determines the extent to which overt disease is
produced in an infected population, or the power of an organism
to produce disease. |
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Personal Hygeine |
In the field of infectious disease
control, those protective measures, primarily within the
responsibility of the individual, that promote health and limit
the spread of infectious diseases, chiefly those transmitted by
direct contact. Such measures encompass (1) washing hands in
soap and water immediately after evacuating bowel or bladder and
always before handling food or eating; (2) keeping hands and
unclean articles, or articles that have been used for toilet
purposes by others, away from the mouth, nose, eyes, ears,
genitalia and wounds; (3) avoiding the use of common or unclean
eating utensils, drinking cups, towels, handkerchiefs, combs,
hairbrushes and pipes; (4) avoiding exposure of other persons to
spray from the nose and mouth as in coughing, sneezing, laughing
or talking; (5) washing hands thoroughly after handling a
patient or the patient» s belongings; and (6) keeping the body
clean by frequent soap and water baths. |
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Pesticide Poisoning |
Disturbance of function, damage to
structure, or illness in humans resulting from the inhalation,
absorption, ingestion of, or contact with any pesticide. |
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Prevalence Rate |
The total number of persons sick
or portraying a certain condition in a stated population at a
particular time (point prevalence), or during a stated period of
time (period prevalence), regardless of when that illness or
condition began, divided by the population at risk of having the
disease or condition at the point in time or midway through the
period in which they occurred. |
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Quarantine |
Restriction of the activities of
well persons or animals who have been exposed to a case of
communicable disease during its period of communicability (i.e.,
contacts) to prevent disease transmission during the incubation
period if infection should occur.
Absolute or complete
quarantine: The limitation of freedom of movement of those
exposed to a communicable disease for a period of time not
longer than the longest usual incubation period of that disease,
in such manner as to prevent effective contact with those not so
exposed.
Modified quarantine: A
selective, partial limitation of freedom of movement of
contacts, commonly on the basis of known or presumed differences
in susceptibility and related to the danger of disease
transmission. It may be designed to accommodate particular
situations. Examples are exclusion of children from school,
exemption of immune persons from provisions applicable to
susceptible persons, or restriction of military populations to
the post or to quarters. It includes personal surveillance, the
practice of close medical or other supervision of contacts to
permit prompt recognition of infection or illness but without
restricting their movements; and segregation, the separation of
some part of a group of persons or domestic animals from the
others for special consideration, control or observation;
removal of susceptible children to homes of immune persons; or
establishment of a sanitary boundary to protect uninfected from
infected portions of a population. |
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Rare Diseases of Public Health
Significance |
A disease or condition, of general
public health concern, which is occasionally or not ordinarily
seen in the state of Washington including, but not limited to,
viral hemorrhagic fevers, Rocky Mountain Spotted fever, and
other tick borne diseases. This also includes a communicable
disease that would be of general public concern if detected in
Washington. |
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Report of a Disease |
An official report notifying an
appropriate authority of the occurrence of a specified
communicable or other disease in humans or in animals. Diseases
in humans are reported to the local health authority; those in
animals, to the livestock, sanitary, veterinary or agriculture
authority. Some few diseases in animals, also transmissible to
humans, are reportable to both authorities. Each health
jurisdiction declares a list of reportable diseases appropriate
to its particular needs. Reports should also list suspected
cases of diseases of particular public health importance,
ordinarily those requiring epidemiologic investigation or
initiation of special control measures.
When a person is infected in one
health jurisdiction and the case is reported from another, the
health authority receiving the report should notify the
jurisdiction where infection presumably occurred, especially
when the disease requires examination of contacts for infection,
or if food, water or other common vehicles of infection may be
involved.
In addition to routine report
of cases of specified diseases, special notification is required
of all epidemics or outbreaks of disease, including diseases not
listed as reportable. |
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Reservoir |
Any person, animal, arthropod,
plant, soil or substance (or combination of these) in which an
infectious agent normally lives and multiplies, on which it
depends primarily for survival, and where it reproduces itself
in such manner that it can be transmitted to a susceptible host. |
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Resistance |
The sum total of body mechanisms
that interpose barriers to the invasion or multiplication of
infectious agents, or to damage by their toxic products.
Inherent resistance » an ability to resist disease independent
of immunity or of specifically developed tissue responses; it
commonly resides in anatomic or physiologic characteristics of
the host and may be genetic or acquired, permanent or temporary. |
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Source of Infection |
The person, animal, object or
substance from which an infectious agent passes to a host.
Source of infection should be clearly distinguished from source
of contamination, such as overflow of a septic tank
contaminating a water supply, or an infected cook contaminating
a salad. |
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Surveillance of disease
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Surveillance of disease is the
continuing scrutiny of all aspects of occurrence and spread of a
disease that are pertinent to effective control. Included are
the systematic collection and evaluation of:
- Morbidity and mortality
reports;
- Special reports of field
investigations of epidemics and of individual cases;
- Isolation and identification
of infectious agents by laboratories;
- Data concerning the
availability, use and untoward effects of vaccines and toxoids,
immune globulins, insecticides and other substances used in
control;
- Information regarding
immunity levels in segments of the population; and
- Other relevant epidemiologic
data. A report summarizing the above data should be prepared
and distributed to all cooperating persons and others with a
need to know the results of the surveillance activities.
The procedure applies to all
jurisdictional levels of public health from local to
international. Serologic surveillance identifies patterns of
current and past infection using serologic tests. |
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Susceptible |
A person or animal not possessing
sufficient resistance against a particular pathogenic agent to
prevent contracting infection or disease when exposed to the
agent. |
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Suspect |
In infectious disease control,
illness in a person whose history and symptoms suggest that he
or she may have or be developing a communicable disease. |
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Suspected Case |
A person whose diagnosis is
thought likely to be a particular disease or condition with
suspected diagnosis based on signs and symptoms, laboratory
evidence, or both. |
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Transmission of Infectious
Agent |
Any mechanism by which an
infectious agent is spread from a source or reservoir to a
person. These mechanisms are as follows:
- Direct transmission:
direct and essentially immediate transfer of infectious agents
to a receptive portal of entry through which human or animal
infection may take place. This may be by direct contact such
as touching, biting, kissing or sexual intercourse, or by the
direct projection (droplet spread) of droplet spray onto the
conjunctiva or onto the mucous membranes of the eye, nose or
mouth during sneezing, coughing, spitting, singing or talking
(usually limited to a distance of about 1 m or less).
- Indirect transmission:
- Vehicle-borne »
contaminated inanimate materials or objects (fomites) such
as toys, handkerchiefs, soiled clothes, bedding, cooking or
eating utensils, surgical instruments or dressings; water,
food, milk, and biological products including blood, serum,
plasma, tissues, or organs; or any substance serving as an
intermediate means by which an infectious agent is
transported and introduced into a susceptible host through a
suitable portal of entry. The agent may or may not have
multiplied or developed in or on the vehicle before being
transmitted.
- Vector-borne » mechanical:
includes simple mechanical carriage by a crawling or flying
insect through soiling of its feet or proboscis, or by
passage of organisms through its gastrointestinal tract.
This does not require multiplication or development of the
organism. Biological: propagation (multiplication), cyclic
development, or a combination of these (cyclopropagative) is
required before the arthropod can transmit the infective
form of the agent to humans. An incubation period
(extrinsic) is required following infection before the
arthropod becomes infective. The infectious agent may be
passed vertically to succeeding generations (transovarian
transmission); transstadial transmission indicates its
passage from one stage of life cycle to another, as nymph to
adult. Transmission may be by injection of salivary gland
fluid during biting, or by regurgitation or deposition on
the skin of feces or other material capable of penetrating
through the bite wound or through an area of trauma from
scratching or rubbing. This transmission is by an infected
nonvertebrate host and not simple mechanical carriage by a
vector as a vehicle. However, an arthropod in either role is
termed a vector.
- Airborne: the
dissemination of microbial aerosols to a suitable portal of
entry, usually the respiratory tract. Microbial aerosols are
suspensions of particles in the air consisting partially or
wholly of microorganisms. They may remain suspended in the air
for long periods of time, some retaining and others losing
infectivity or virulence. Particles in the 1- to 5-μm range
are easily drawn into the alveoli of the lungs and may be
retained there. Not considered as airborne are droplets and
other large particles that promptly settle out.
- Droplet nuclei » usually
the small residues that result from evaporation of fluid
from droplets emitted by an infected host. They may also be
created purposely by a variety of atomizing devices, or
accidentally as in microbiology laboratories or in
abattoirs, rendering plants or autopsy rooms. They usually
remain suspended in the air for long periods of time.
- Dust » the small particles
of widely varying size that may arise from soil (as, e.g.,
fungus spores separated from dry soil by wind or mechanical
agitation), clothes, bedding or contaminated floors.
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Unexplained Critical Illness or
Death |
Cases of illness or death with
infectious hallmarks but no known etiology, in previously
healthy persons one to forty-nine years of age excluding those
with chronic medical conditions (e.g., malignancy, diabetes,
AIDS, cirrhosis). |
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Virulence |
The degree of pathogenicity of an
infectious agent, indicated by case-fatality rates and/or the
ability of the agent to invade and damage tissues of the host. |
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Zoonosis |
An infection or infectious disease
transmissible under natural conditions from vertebrate animals
to humans. May be enzootic or epizootic (see Endemic and
Epidemic.) |
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