COMMITTEE SUBSTITUTE FOR ORDINANCE NO. 040206

Amending Chapter 34, Code of Ordinances, by repealing Section 34-53, Report of certain diseases and events required, and 34-56, Persons required to report diseases and conditions, and enacting new sections of like numbers and subject matters, and enacting a new Section 34-66, Adults Immunization Program and International Travel Immunization Program, to add certain disease and condition reporting requirements and authorizing the director of health to start an Adults Immunization Program and International Travel Immunization Program.

BE IT ORDAINED BY THE COUNCIL OF KANSAS CITY:

Section 1. That Chapter 34, Code of Ordinances of the City of Kansas City, Missouri, is hereby amended by repealing Section 34-53, Report of certain diseases and events required, 34-56, Persons required to report diseases and conditions, and enacting new sections of like numbers and subject matters, and enacting a new Section 34-66, Adults Immunization Program and International Travel Immunization Program, to read as follows:

Sec. 34-53. Report of certain diseases and events required.

(a) Upon laboratory or clinical confirmation the following diseases must be reported to the director: animal bites, blastomycosis, campylobacter, chancroid, chlamydia, Creutzfeldt-Jacob disease, cryptosporidiosis, Cyclospora infection, diphtheria, ehrlichiosis, Escherichia coli 015:H7, food poisoning (suspected or confirmed; infectious or toxic), giardia, gonorrhea (all manifestations including ophthalmia and pelvic inflammatory disease), Haemophilus influenzae (invasive disease and meningitis), hantavirus, hepatitis A, hepatitis B (including surface antigen positive pregnant women), hepatitis C, hepatitis D, hepatitis E, human immunodeficiency virus (HIV asymptomatic or symptomatic, AIDS, detection of HIV nuclei acid, HIV viral culture, or other test indicating HIV infection, T-helper (CD4+) lymphocyte count on any person with HIV infection, and viral load measurement including non-detectable results), influenza, legionellosis, leptospirosis, listeria, Lyme disease, malaria, measles, meningitis (aseptic), meningococcal disease (invasive and meningitis), mumps, mycobacterial infections (active disease and infection, tuberculosis and mycobacteria other than tuberculosis including leprosy, pulmonary and non-pulmonary, and positive Mantoux skin tests), nosocomial disease (outbreaks only), pertussis, poliomyelitis, psittacosis, rabies, Reyes syndrome, Rocky Mountain spotted fever, rubella, salmonellosis (including typhoid fever), shigellosis, Staphylococcus aureus (vancomycin resistant only), streptococcal Group A invasive disease, Streptococcus pneumoniae drug resistant disease, syphilis (all stages including congenital syndrome), tetanus, trichinosis, varicella infection (only deaths), vibrio, and yersinia; and others declared reportable by the director of health; and the occurrence of epidemics or outbreaks of any illness or disease which may be of public health concern.

(b) Upon suspicion of or confirmation the following diseases must be reported to the director: adult respiratory distress syndrome (ARDS) in patients under 50 years of age (without a contributing medical history), anthrax, botulism, brucellosis, cholera, encephalitis (arthropod-borne), food poisoning (infectious or toxic) with multiple cases or resulting in hospitalization, glanders,

hemorrhagic fevers, plague, Q fever, ricin poisoning, Severe Acute Respiratory Syndrome (SARS), smallpox or adverse reaction to smallpox vaccination, staphylococcal enterotoxin B, and T-2 mycotoxins, and tularemia and others declared reportable by the director of health; and the occurrence of epidemics or outbreaks of any illness or disease which may be of public health concern.

(c) Incidence of absenteeism of 20% greater than the daily norm in any public or private school must be reported to the director; the director shall provide assistance to schools in the calculation of baseline absenteeism rates and reporting thresholds.

(d) Unless otherwise specified, the report shall include the name, time and date of diagnosis, date of birth, sex, race, address or location, telephone number, name of the attending physician, name of the disease, condition or finding diagnosed or suspected, date of onset, name and address of treating facility (if any), any appropriate laboratory results and other such facts and information which may be available. For diseases listed in (a) the report shall be made and received by the director of health within two days of diagnosis in writing or by telephone, facsimile communication or other rapid communication. For diseases listed in (b) and (c) the report shall be made and received by the director within four hours of suspicion or confirmation by telephone, facsimile communication or other rapid communication.

Sec. 34-56. Persons required to report diseases and conditions.

(a) The following persons are required to file with the director of health the reports required in sections 34-53, 34-53.1 and 34-54:

(1) Duly licensed physicians;

(2) Physicians assistants;

(3) Advanced practice nurses;

(4) Every nurse, superintendent, or principal of a public or private school;

(5) Every owner or any person in charge of a child care facility;

(6) Administrator of each institution. The reports filed by such administrator shall not be considered the divulging of confidential information, and does not relieve the responsible physician or other person of the duty to report the same case.

(b) Any person in charge of a plasma center or blood donating center shall report when blood extracted from a person tests positive for the human immunodeficiency virus or hepatitis viruses by prevailing laboratory techniques.

(c) Any person in charge of a clinical laboratory shall report when a laboratory examination of any specimen derived from the human body yields microscopical, cultural, chemical, immunological, serological, or other evidence suggestive of those communicable diseases or disease conditions deemed reportable. This reporting requirement also applies to laboratory specimens sent to another laboratory for analysis or evaluation. Isolates of the following specimens must be submitted to the Missouri Department of Health Laboratory for epidemiological or confirmation purposes:

(1) anthrax

(2) cholera

(3) diphtheria

(4) Escherichia coli 0157:H7

(5) Haemophilus influenzae from invasive disease

(6) malaria

(7) measles

(8) tuberculosis

(9) Neisseria meningitidis from invasive disease

(10) pertussis

(11) plague

(12) salmonella, all species

(13) shigella, all species

(14) Staphylococcus aureus, vancomycin resistant strains only

(15) Severe Acute Respiratory Syndrome

Submission of specimens does not relieve the person in charge of a clinical laboratory from the reporting requirement.

(d) It shall be unlawful for any person to fail to make a report required in this article within the applicable reporting time.

Sec. 34-66. Adults Immunization Program and International Travel Immunization Program.

The director is authorized to establish an adult immunization program and an international travel immunization program to provide immunization for prevention of disease and for post-exposure prophylaxis in accordance with established guidelines and recommendations from the Centers for Disease Control and Prevention (CDC) and to set an appropriate fee schedule to offset the costs of the programs.

_____________________________________________

Approved as to form and legality:

___________________________________

James M. Brady

Assistant City Attorney