Confidential Morbidity Report (Cmr) Form
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1
2REPORTABLE DISEASES AND CONDITIONS
City and County of San Francisco
San Francisco Department of Public Health
Title 17, California Code of Regulations (CCR) §2500, §2593, §2641-2643 and §2800-2812.
Every health care provider, knowing of or in attendance on a case or suspected case of any of the diseases or conditions listed below, must report to the local health officer for the
jurisdiction where the patient resides. Where no health care provider is in attendance, any individual having knowledge of a person who is suspected to be suffering from one of
the diseases or conditions listed below may make such a report to the local health officer for the jurisdiction where the patient resides.
§2500 (c) The Administrator of each health facility, clinic or other setting where more than one health care provider may know of a case, a suspected case or an outbreak of
disease within the facility shall establish and be responsible for administrative procedures to assure that reports are made to the local officer.
WHO TO REPORT TO
REPORT OUTBREAKS, DISEASES, AND CONDITIONS TO COMMUNICABLE DISEASE CONTROL UNIT UNLESS OTHERWISE INDICATED
COMMUNICABLE DISEASE CONTROL UNIT
AIDS OFFICE
ANIMAL BITES (mammals only)
PHONE: (415) 554-2830
PHONE: (415) 554-9050
PHONE: (415) 554-9422 FAX: (415) 864-2866
FAX: (415) 554-2848 M-F 8AM to 5PM
STD CLINIC
ENVIRONMENTAL HEALTH SERVICES
PHONE: (415) 487-5555 FAX: (415) 431-4628
PHONE: (415) 252-3862 FAX: (415) 252-3818
For urgent reports after hours, follow the prompts to
page the on-call MD
TUBERCULOSIS CLINIC
PHONE: (415) 206-8524 FAX: (415) 206-4565
DISEASE OR CONDITION / URGENCY REPORTING REQUIREMENTS
URGENCY REPORTING KEY
1
Report immediately by telephone
Report within one working day of identification
Report within seven calendar days by FAX, phone or mail
7
Acquired Immune Deficiency Syndrome (AIDS)
7
Giardiasis
7
Rickettsial Diseases (non-Rocky Mountain
7
to AIDS Office
Gonococcal infections (including disseminated) to
Spotted Fever), including Typhus and Typhus
7
Alzheimer’s Diseases and Related Conditions
STD Clinic
-like Illnesses
7
1
Amebiasis
Haemophilus influenzae invasive disease (less than
Rocky Mountain Spotted Fever
1
7
15 years of age)
Rubella (German Measles)
7
7
Anaplasmosis/Ehrlichiosis
Hantavirus infections
Rubella Congenital Syndrome
7
Animal bites (mammals only) to
7
Hemolytic Uremic Syndrome
Animal Care and Control
Salmonellosis (other than Typhoid Fever)
1
1
Hepatitis A, acute infection
Anthrax*, human or animal
Scombroid Fish Poisoning
7
Hepatitis B (specify acute case or chronic)
1
Babesiosis
Severe Acute Respiratory Syndrome (SARS)
7
Hepatitis C (specify acute case or chronic)
Botulism* (Infant, Foodborne, Wound, Other)
Shiga toxin (detected in feces)
7
Hepatitis D (Delta) (specify acute case or chronic)
Brucellosis, animal (except infections due to
7
Shigellosis
1
Brucella canis)
7
Hepatitis E, acute infection
Smallpox* (Variola)
Brucellosis*, human
7
Human Immunodeficiency Virus (HIV) to AIDS Office
Staphylococcus aureus infections, severe
1
Campylobacteriosis
1
7
Influenza, deaths in laboratory-confirmed cases for
(ICU/death) in a previously healthy person
age 0-64 years
Cancer,
7
including benign and borderline brain tumors
Streptococcal infections, outbreaks of any
1
(except (1) basal and squamous skin cancer unless
7
Influenza, novel strains (human)
type and individual cases in food handlers
occurring on genitalia, and (2) carcinoma in-situ and
and dairy workers only
7
Legionellosis
CIN III of the cervix)
1
Syphilis to STD Clinic
7
7
Chancroid to STD Clinic
Leprosy (Hansen Disease)
Taeniasis
7
7
Leptospirosis
1
Chickenpox (only hospitalizations and deaths)
Tetanus
7
1
Listeriosis
Chlamydia trachomatis infections to STD Clinic
7
Toxic Shock Syndrome
7
7
Lyme Disease
Cholera
Transmissable Spongiform Encephalopathies
7
7
Lymphogranuloma Venereum (LGV) to STD Clinic
Ciguatera Fish Poisoning
(TSE)
1
Malaria
Coccidioidomycosis
7
Trichinosis
1
Measles (Rubeola)
7
Creutzfeldt-Jakob Disease (CJD)
1
Tuberculosis to Tuberculosis Clinic
1
Meningitis (specify etiology)
Cryptosporidiosis
1
Tularemia, animal
7
Meningococcal infections
7
Cyclosporiasis
Tularemia*, human
Mumps
7
Cysticercosis
7
Typhoid Fever (cases and carriers)
1
Paralytic Shellfish Poisoning
Dengue
Vibrio infections
1
Pelvic Inflammatory Disease (PID) to STD Clinic
7
Diphtheria
Viral Hemorrhagic Fevers*, human or animal
Pertussis (Whooping Cough)
7
Disorders Characterized by Lapses
1
(e.g. Crimean-Congo, Ebola, Lassa and Mar-
of Consciousness
burg viruses)
Pesticide-related illness or injury (known or sus-
7
pected cases) to Environmental Health Services
Domoic Acid Poisoning (Amnesic
1
West Nile Virus (WNV) Infection
Shellfish Poisoning)
Plague*, human or animal
Yellow Fever
7
Ehrlichiosis/Anaplasmosis
1
Poliovirus infection
Yersiniosis
1
1
Encephalitis, infectious (specify etiology)
1
Psittacosis
ANY UNUSUAL DISEASES
Escherichia coli shiga toxin producing (STEC)
Q Fever
1
NEW DISEASE OR SYNDROME
including E. coli O157
NOT PREVIOUSLY RECOGNIZED
Rabies, human or animal
Foodborne illness
1
OUTBREAKS OF ANY DISEASE
Relapsing Fever
(2 or more cases from different households)
Effective July 5, 2011 Revised September 2011
*
Potential Bioterrorism Agents
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