report notifiable diseasephdistrict2.org/pdfs/nd posters 8.04.pdf · 1-866-pub-hlth...
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REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Northwest Georgia Health District Serving: Bartow, Catoosa, Chattooga, Dade, Floyd, Gordon, Haralson, Paulding, Polk, and Walker counties.
Epidemiology Section706-295-6656or1-866-PUB-HLTH(1-866-782-4584) Epidemiology Section, Northwest Georgia Health District
1305 Redmond Circle, Bldg. 614, Rome, GA 30165or Fax to: 706-802-5342
Form 3096:1-1 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Infectious Disease Department706-272-2342or1-866-PUB-HLTH(1-866-782-4584) North Georgia Health District, Infectious Disease Department
100 West Walnut Ave., Suite 92, Dalton, GA 30720or Fax to: 706-272-2929
North Georgia Health District | Serving: Cherokee, Fannin, Gilmer, Murray, Pickens, and Whitfield counties.
North GeorgiaHealth District
Form 3096:1-2 (8-04).
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
North Health District Serving: Banks, Dawson, Forsyth, Franklin, Hall, Habersham, Hart, Lumpkin, Rabun, Stephens, Towns, Union and White counties.
North Health District770-535-5743or1-866-PUB-HLTH(1-866-782-4584) North Health District, 1280 Athens Street
Gainesville, GA 30507or Fax to: 770-535-5958
Form 3096:2-0 (8-04)
North Health District
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Cobb and Douglas Public Health | Serving: Cobb and Douglas counties.
Center for Health Assessment770-514-2432or1-866-PUB-HLTH(1-866-782-4584) Cobb and Douglas Public Health, Center for Health Assessment
1650 County Services Parkway, SW, Marietta, Georgia 30008-4010or Fax to: 770-514-2313
Form 3096:3-1 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Fulton County Department of Health and Wellness
Office of Epidemiology404-730-1391or1-866-PUB-HLTH(1-866-782-4584) Fulton County Department of Health and Wellness, Office of
Epidemiology, 99 Jesse Hill Jr. Drive, SE, Atlanta, GA 30303-3045or Fax to: 404-730-1397
Form 3096:3-2 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Clayton Health District | Serving Clayton county
Clayton County Board of HealthAdministrative Office770-961-1330or1-866-PUB-HLTH(1-866-782-4584)
Clayton County Board of Health, Administrative Office1380 Southlake Plaza Drive, Morrow, GA 30260or Fax to: 770-961-8370
Form 3096:3-3 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
East Metro Health District | Serving: Gwinnett, Newton and Rockdale counties.
Epidemiology & CommunicableDisease UnitAfter hours 404-323-1910770-339-4260or1-866-PUB-HLTH(1-866-782-4584)
East Metro Health District, Epi. & Communicable Disease Unit324 W. Pike Street, P.O. Box 897, Lawrenceville, GA 30046or Fax to: 770-339-5971
Form 3096:3-4 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
DeKalb Health District | Serving DeKalb county.
Office of Infectious Diseases404-508-7851or1-866-PUB-HLTH(1-866-782-4584) DeKalb Health District, Office of Infectious Diseases
P.O. Box 987, Decatur, GA 30031or Fax to: 404-508-7813
Form 3096:3-5 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
LaGrange Health District Serving: Butts, Carroll, Coweta, Fayette, Heard, Henry, Lamar, Meriwether, Pike, Spalding, Troup, and Upson counties.
LaGrange Health District706-845-4035or1-866-PUB-HLTH(1-866-782-4584) LaGrange Health District, 122 Gordon Commercial Drive
Suite A, LaGrange, GA 30240or Fax to: 706-845-4038
Form 3096:4-0 (8-04)
LaGrangeHealth District
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
South Central Health District478-275-6545or1-866-PUB-HLTH(1-866-782-4584) South Central Health District, 2121-B Bellevue Road
Dublin, GA 31021or Fax to: 478-275-6575
South Central Health District Serving: Bleckley, Dodge, Johnson, Laurens, Montgomery, Pulaski, Telfair, Treutlen, Wheeler and Wilcox counties.Form 3096:5-1 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Infectious Disease Unit478-751-6214or1-866-PUB-HLTH(1-866-782-4584) North Central Health District, Infectious Disease Unit Supervisor
811 Hemlock Street, Macon, GA 31201or Fax to: 478-752-1710
North Central Health District Serving: Baldwin, Bibb, Crawford, Hancock, Houston, Jasper, Jones, Monroe, Peach, Putnam, Twiggs, Washington and Wilkinson counties.Form 3096:5-2 (8-04)
North CentralHealth District
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
East Central Health District706-667-4342or1-866-PUB-HLTH(1-866-782-4584) East Central Health District, 1916 North Leg Rd.
Augusta, GA 30909or Fax to: 706-667-4728
East Central Health District Serving: Burke, Columbia, Emanuel, Glascock, Jefferson, Jenkins, Lincoln, McDuffie, Richmond, Screven, Taliaferro, Warren and Wilkes counties.
East CentralHealth District
Form 3096:6-0 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
West Central Health District Serving: Chattahoochee, Clay, Crisp, Dooly, Harris, Macon, Marion, Muscogee, Quitman, Randolph, Schley, Stewart, Sumter, Talbot, Taylor and Webster counties.
Epidemiology Unit706-321-6300or1-866-PUB-HLTH(1-866-782-4584) West Central Health District, Epidemiology Unit
2100 Comer Ave., P.O. Box 2299, Columbus, GA 31902-2299or Fax to: 706-321-6155
Form 3096:7-0 (8-04)
West CentralHealth District
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Epidemiology229-333-5290(Toll Free) 866-801-5360or1-866-PUB-HLTH(1-866-782-4584) South Health District, Epidemiology
312 N. Patterson Street, P.O. Box 5147, Valdosta, GA 31603-5147or Fax to: 229-259-5003
South Health District Serving: Ben Hill, Berrien, Brooks, Cook, Echols, Irwin, Lanier, Lowndes, Tift and Turner counties.Form 3096:8-1 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Southwest Health District Serving: Baker, Calhoun, Colquitt, Decatur, Dougherty, Early, Grady, Lee, Miller, Mitchell, Seminole, Terrell, Thomas and Worth counties.
Southwest Health District229-430-7870or1-866-PUB-HLTH(1-866-782-4584) Southwest Health District, 1306 S. Slappey Blvd., Suite L
Albany, GA 31701or Fax to: 229-430-2920
Form 3096:8-2 (8-04)
Southwest Health District
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
East Health District | Serving: Effingham and Chatham counties.
Epidemiology Unit912-353-3125or1-866-PUB-HLTH(1-866-782-4584) East Health District, Epidemiology Unit,
P.O Box 15879, Savannah, GA 31416-2579or Fax to: 912-353-5195
Form 3096:9-1 (8-04)
East Health District 9-1
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Southeast Health District Serving: Appling, Atkinson, Bacon, Brantley, Bulloch, Candler, Charlton, Clinch, Coffee, Evans, Jeff Davis, Pierce, Tattnall, Toombs, Ware and Wayne counties.
Office of Infectious Disease912-285-6022 - 24 hours a dayor1-866-PUB-HLTH(1-866-782-4584) Southeast Health District, Office of Infectious Disease
1115 Church Street, Suite A, Waycross, GA 31501or Fax to: 912-284-2522
Form 3096:9-2 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Coastal Health District | Serving: Bryan, Camden, Liberty, Long, Glynn and McIntosh counties.
Office of Infectious Diseases912-262-3092or1-866-PUB-HLTH(1-866-782-4584) Coastal Health District, Office of Infectious Diseases
777 Gloucester, Brunswick, GA 31522or Fax to: 912-261-1964
Form 3096:9-3 (8-04)
REPORT IMMEDIATELYany cluster of illnessesanimal bitesanthraxall acute arboviral infections:
-Eastern Equine Encephalitis (EEE)-LaCrosse Encephalitis (LAC)-St. Louis Encephalitis (SLE)-West Nile Virus (WNV)
botulismbrucellosischoleradiphtheriaE. coli O157:H7Haemophilus influenzae (invasive)*hantavirus pulmonary syndromehemolytic uremic syndrome (HUS)hepatitis A (acute)measles (rubeola)meningitis (specify agent)meningococcal diseasepertussisplaguepoliomyelitisQ feverrabies (human & animal)severe acute respiratory syndrome (SARS)shiga toxin positive testsS. aureus with vancomycin MIC > 4µg/mlsmallpoxsyphilis (congenital & adult)tuberculosislatent TB infection, under age 5tularemia
AIDS (see below, to report)aseptic meningitiscampylobacteriosischancroidChlamydia trachomatis (genital
infection)Creutzfeldt-Jakob Disease
(CJD), suspected cases,under age 55
cryptosporidiosiscyclosporiasisehrlichiosisgiardiasisgonorrheaHIV (see below, to report)hearing impairment (perma-
nent, under age 5)†
hepatitis B-acute hepatitis B-newly identified HBsAg+
carriers**-HBsAg+ pregnant women
hepatitis C virus infection (pastor present)
influenza-associated death(under age 18)
lead blood level > 10µg/dL
REPORT WITHIN 7 DAYS
(Refer to the web site http://health.state.ga.us/programs/gccr/reporting.asp)benign brain and central nervous system tumorscancer
Potential agent of bioterrorism.* Invasive = isolated from blood, bone, CSF, joint, pericardial fluid, peritoneal fluid, or
pleural fluid.† Hearing impairment is reportable to the Children 1st Program.
(http://health.state.ga.us/epi/disease/hearing.asp).** HBsAg+ = hepatitis B surface antigen positive.*** L. monocytogenes isolated from any site. Infant mortality is reportable to Vital Records.# Resulting in severe illness or death.## Maternal deaths during pregnancy or within one year of birth are reportable to Mater-
nal and Child Epidemiology (http://health.state.ga.us/epi/mch/publications.asp).‡ Birth defects are reportable to the Georgia Birth Defects Reporting and Information
System (http://health.state.ga.us/epi/disease/birthdefects.asp).
Poster Key
To Report Within 7 DaysReport cases electronically through the State Electronic NotifiableDisease Surveillance System at http://sendss.state.ga.usor mail a Notifiable Disease/Condition Report Form #3095(http://health.state.ga.us/epi/disease/report.asp) in an envelopemarked CONFIDENTIAL to:
To Report ImmediatelyCall:
To Report HIV & AIDSComplete the CDC form 50.42A (available athttp://health.state.ga.us/epi/aidsunit.asp or by calling1-800-827-9769) and mail in an envelope markedCONFIDENTIAL to:Georgia Division of Public Health, Epidemiology Branch2 Peachtree St. NW, 14th floor - Office 460Atlanta, GA 30303-3189
All Georgia physicians, laboratories, and other health care providers are required by law to reportpatients with the following conditions. Both lab-confirmed and clinical diagnoses are reportablewithin the time interval specified below.Reporting enables appropriate public health follow-up for your patients, helps identify outbreaks,and provides a better understanding of disease trends in Georgia. For the latest information fromthe DHR, Division of Public Health, visit their web site at: www.health.state.ga.us
REPORTNOTIFIABLE DISEASE
legionellosisleptospirosislisteriosis***Lyme diseaselymphogranuloma venereummalariamethicillin-resistant S. aureus
(community-associated)#
mumpspsittacosisRocky Mountain spotted feverrubella (including congenital)salmonellosisshigellosisstreptococcal disease, Group A
or B (invasive)*Streptococcus pneumoniae
(invasive)*-report with antibiotic-
resistance informationtetanustoxic shock syndrometoxoplasmosistyphoidVibrio infectionsyersiniosis
REPORT WITHIN 4-6 MONTHS
REPORT WITHIN 1 MONTHbirth defects‡
maternal death##
(Report electronically or call Maternal & Child Health Epidemiology Section, 404-657-6448)
Northeast Health District | Serving: Barrow, Clarke, Elbert, Greene, Jackson, Madison, Morgan, Oconee, Oglethorpe and Walton counties.
Epidemiology Section706-583-2868or1-866-PUB-HLTH(1-866-782-4584) Northeast Health District, Epidemiology Section
220 Research Drive, Athens, GA 30605or Fax to: 706-369-5640
Form 3096:10-0 (8-04)