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Administrative (Non-Clinical) Policy
This administrative policy applies to the operations and staff of the University of Wisconsin Hospitals and
Clinics Authority as integrated effective July 1, 2015, including the legacy operations and staff of
University of Wisconsin Hospital and Clinics and University of Wisconsin Medical Foundation.
Policy Title: Communicable Disease Reporting
Policy Number: 13.04
Effective Date: March 1, 2016
Chapter: Infection Control
To establish a surveillance system that promotes timely and effective communicable disease reporting to
the Division of Public Health (DPH) for the purpose of controlling the spread of communicable diseases.
A. It is the obligation of the physician caring for the patient and the laboratory performing testing to
report communicable diseases and conditions of public health importance to the local health
officer or state epidemiologist, as required under Wisconsin Statute Chapter 252, and Department
of Health and Family Services Administrative Rule Chapter DHS 145. Diseases listed as
reportable are subject to periodic change by state statute.
B. Positive results for reportable diseases generated within the UW Health clinical laboratories are
automatically submitted to the Wisconsin Electronic Disease Surveillance System (WEDSS).
C. After receiving the electronic notification of a positive test result for a reportable disease, local
public health officers may seek additional information from medical staff at the location from
which the specimen was collected regarding duration of symptoms, treatment, etc.
1. Patient healthcare records relevant to the Division of Public Health’s statutory authority
to prevent communicable disease transmission may be released to authorized DPH staff
in specific circumstances as designated by Chapter 252 of the Wisconsin Statutes without
informed consent of the patient and as specified under Hospital Administrative policy
4.13-Using and Disclosing (or Releasing) Protected Health Information.
D. Laboratory results which suggest or confirm the presence of a communicable disease for which
immediate Infection Control intervention may be required to prevent further exposure must be
called or paged to the Infection Control Practitioner (ICP) on call via the paging operator. See
UW Health Clinical Policy 4.1.6-Communicable Disease Exposure Response for a defined list.
E. Infection Control is responsible for assisting the Wisconsin Department of Public Health on
various communicable diseases of interest for syndromic surveillance based upon the ordering of
various tests. This communicable disease surveillance includes but is not limited to Pertussis,
Measles and Mumps.
F. Physicians who suspect the presence of a reportable disease based on symptomatology, or notice
clustering of a syndrome consistent with an infectious disease of concern should contact the ICP
on call on pager #2570 for UW Health inpatients at University Hospital, American Family
Children’s Hospital or The American Center, or pager #7826 for patients in ambulatory locations,
even if diagnostic tests are still pending. Alternatively, the Infection Control Practitioner on call
can be reached via the paging operator at 608-262-2122.
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III. FORMS AND REPORTING
A. Cases which may represent potential bioterrorism caused by infectious agents or their toxins
should also be immediately reported to the on-call ICP via the paging operator. For detailed
specific information regarding recognition and response to potential bioterrorism, refer to the
CDC's bioterrorism webpage at: http://www.bt.cdc.gov/bioterrorism/
B. Reportable diseases are organized into three categories (categories I, II and III) based upon the
relative public health threat that the illness represents, and hence, the rapidity with which DPH
needs to be notified. DPH may make additions to reporting requirements in order to enhance
surveillance for diseases of epidemiologic concern (e.g., pandemic influenza). If there are any
questions about the reportability of a specific illness, contact the ICP on-call via the page operator
(608-262-2122). See the addendum to this policy for the current list of reportable diseases.
1. Category I diseases are of urgent public health importance. When a case is identified or
suspected on clinical grounds, even though confirmatory laboratory tests are pending, it
must be immediately reported (within 24 hours) to the local public health department in
the patient's county of residence.
2. Category II diseases are reported to the local public health officer in the patient's county
of residence within 72 hours of the identification of a case or suspected case.
3. Category III diseases are reported to the state epidemiologist within 72 hours of the
identification of a confirmed or suspected case. Category III disease case information is
faxed to the secure office of the Wisconsin Division of Public Health's AIDS/HIV
Program staff for reporting and completion of the confidential report form.
Wisconsin Statute Chapter 250
Wisconsin Statute Chapter 252.05
Administrative Rule Chapter HFS 145
UWHC Clinical Microbiology Departmental Policy-Microbiology Call Values
Sr. Management Sponsor: SVP, Chief Nursing Officer & Patient Care Services
Author: Infection Control Practitioner
Approval Committee(s): Infection Control Committee; UW Health Administrative Policy and Procedure
President, University of Wisconsin Hospitals
Chief of Clinical Operations
Previous revision: 032013
Next revision: 032019