Minnesota Health Officials Propose Changes to Disease-Reporting Rules

MINNEAPOLIS -- The Minnesota Department of Health (MDH) is proposing changes to the states communicable disease reporting rules. These changes will improve MDHs ability to respond to new and re-emerging diseases and changes in health care practice.

The department published its notice of intent to adopt changes in the Communicable Disease Reporting Rules in the State Register on Dec. 27, 2004. The public has until Feb. 2, 2005 to comment on the proposed changes. If MDH receives 25 or more requests for a hearing, a public hearing on the proposed rules will be held on Feb. 14 at 9 a.m. in the Chesley Room at the Minnesota Department of Health, 717 Delaware St. SE, Minneapolis.

The rules have not undergone a thorough revision since 1985. In the intervening 19 years, new communicable diseases have appeared in the United States, such as Severe Acute Respiratory Syndrome (SARS) and West Nile virus, diseases that did not exist in 1985. In addition, threats of biological terrorism have put health departments on alert for communicable diseases that could be caused by intentional acts, including diseases that previously were declared eradicated, such as smallpox. Finally, the federal Health Insurance Portability and Accountability Act (HIPAA) has created a climate in which professionals who are required to report communicable diseases increasingly want explicit provisions on reporting to ensure they are protected when they give health information to MDH.

Revision of the rules is critical for us to do our job, Minnesota Health Commissioner Dianne Mandernach said. The new rules will enable us to continue to:

-- conduct effective surveillance and disease investigation, identify outbreaks and promptly respond to new and emerging communicable diseases;

-- implement outbreak control measures to stop the spread of disease;

-- keep Minnesotans healthy both medically and economically (SARS caused a multibillion dollar loss to Torontos economy); and

-- respond promptly to an act of bioterrorism through early detection of disease.

The rulemaking process began March 1, 2004 when MDH published the Request for Comments on the proposed rules. In addition, to ensure that MDH heard from affected parties, MDH created a communicable disease reporting rules advisory committee that met during the spring of 2004. Based on these meetings and comments received, MDH formulated its revisions of the rules.

Among the highlights of the substantive changes:

-- Adds SARS and smallpox (variola) to the list of those diseases that are required to be immediately reported to MDH.

-- Requires mandated reporters and medical laboratories to submit clinical materials rather than isolates to the MDH Public Health Laboratory. Medical laboratories are increasingly using new diagnostic tests that do not result in isolation of an organism. If the laboratory does not isolate an organism, material containing the viable infectious agent is still necessary in order for MDH to conduct molecular subtyping and other tests for purposes of monitoring and investigation.

-- Adds emerging drug resistance cases to the rule requiring physicians to report unusually high numbers of certain cases.

-- Adds a requirement to report unexplained critical illness in a previously healthy individual that may be caused by an infectious agent.

Written comments or questions, requests to receive a draft of the rules and the statement of need and reasonableness (SONAR) should be directed to Patricia Segal Freeman at P.O. Box 9441, Minneapolis, Minn. 55440, or e-mail: Commdisrule@health.state.mn.us or phone (612) 676-5414, (800) 657-3970, fax (612) 676-5689.

Source: Minnesota Department of Health