Missouri Regulations
Department of Health and Senior Services/Division of Community and Public Health
REGISTER SOURCE: Code of State Regulations 2020-06-30
PUBLICATION DATE: 06/30/2020
ACTION DATE: 06/15/2020
EFFECTIVE DATE: 07/30/2020
PUBLICATION TYPE: Centralized Repository
REGISTER SOURCE: Vol. 45, No. 12, Missouri Register 2020-06-15 p.956
PUBLICATION DATE: 06/15/2020
ACTION DATE: 06/15/2020
EFFECTIVE DATE: 07/30/2020
PUBLICATION TYPE: Register
Vol. 45, No. 5, Missouri Register 2020-03-02 p.351
PUBLICATION DATE: 03/02/2020
ACTION DATE: 01/27/2020
EFFECTIVE DATE: 02/10/2020
EXPIRATION DATE: 08/07/2020
PUBLICATION TYPE: Register
REGISTER SOURCE: Vol. 45, No. 5, Missouri Register 2020-03-02 p.374
PUBLICATION DATE: 03/02/2020
ACTION DATE: 01/27/2020
COMMENT DEADLINE: 04/01/2020
PUBLICATION TYPE: Register
Office of the Secretary of State 2020-02-10
PUBLICATION DATE: 02/10/2020
ACTION DATE: 01/27/2020
EFFECTIVE DATE: 02/10/2020
EXPIRATION DATE: 08/07/2020
PUBLICATION TYPE: Agency

Title 19-DEPARTMENT OF HEALTH AND SENIOR SERVICES

Division 20-Division of Community and Public Health

Chapter 20-Communicable Diseases

EMERGENCY AMENDMENT

19 CSR 20-20.020 Reporting Infectious, Contagious, Communicable, or Dangerous Diseases. The department is amending section (1).

PURPOSE: This amendment adds the 2019 Novel Coronavirus (2019- nCoV) to the list of diseases or findings that must be immediately reported.

EMERGENCY STATEMENT: The Department of Health and Senior Services ("DHSS") determined that this emergency amendment is necessary to protect the public health, safety, and welfare of Missouri residents and visitors.

This emergency amendment is necessary to ensure that the 2019 Novel Coronavirus (2019-nCoV) is reported to the local health authority or DHSS immediately upon detection. The Center for Disease Control and Prevention (CDC) is closely monitoring an outbreak of respiratory illness caused by a novel coronavirus first identified in Wuhan, Hubei Province, China. There are currently over 2,900 estimated cases with at least 82 deaths linked to this novel coronavirus (2019-nCoV). As of January 26, 2020, five cases have been confirmed in the United States (Arizona, California, Illinois, and Washington) of individuals traveling from Wuhan. Due to its severity and the rapid increase in the number of cases of this novel coronavirus, it is imperative for the local health authority or DHSS to be notified immediately upon detection in order to take appropriate measures. Finally, since 19 CSR 20-20.040 assigns duties, responsibilities, and actions to the DHSS director as well as local health authorities that are explicitly triggered by the detection of a condition listed in 19 CSR 20-20.020, the 2019 Novel Coronavirus (2019-nCoV) must be immediately added to 19 CSR 20-20.020.

DHSS needs this emergency amendment to ensure that the presence of the 2019 Novel Coronavirus (2019-nCoV) is reported to the local health authority or it immediately upon detection. This emergency amendment designates the diseases which are infectious, contagious, communicable or dangerous and must be reported to the local health authority or the Department of Health and Senior Services. It also establishes when they must be reported.

DHSS finds that there is an immediate danger to the public health, safety or welfare, which requires this emergency action. The scope of this emergency amendment is limited to the circumstances creating the emergency and complies with the protections extended in the Missouri and United States Constitutions. DHSS believes this emergency amendment is fair to all interested persons and parties under the circumstances. This emergency amendment was filed January 27, 2020, becomes effective February 10, 2020, and expires August 7, 2020.

PUBLIC COST: This emergency amendment will not cost state agencies or political subdivisions more than five hundred dollars ($500) in the time the emergency is effective.

PRIVATE COST: This emergency amendment will not cost private entities more than five hundred dollars ($500) in the time the emergency is effective.

(1) The diseases within the immediately reportable disease category pose a risk to national security because they: can be easily disseminated or transmitted from person to person; result in high mortality rates and have the potential for major public health impact; might cause public panic and social disruption; and require special action for public health preparedness. Immediately reportable diseases or findings shall be reported to the local health authority or to the Department of Health and Senior Services immediately upon knowledge or suspicion by telephone (1 (800) 392-0272), facsimile, or other rapid communication. Immediately reportable diseases or findings are

(A) Selected high priority diseases, findings or agents that occur naturally, from accidental exposure, or as the result of a bioterrorism event:

2019 Novel Coronavirus (2019-nCoV)

Anthrax

Botulism

Paralytic poliomyelitis

Plague

Rabies (Human)

Ricin toxin

Severe Acute Respiratory syndromeassociated Coronavirus (SARS-CoV) Disease

Smallpox

Tularemia (suspected intentional release)

Viral hemorrhagic fevers, suspected intentional (e.g., Viral hemorrhagic fever diseases: Ebola, Marburg, Lassa, Lujo, new world Arenavirus (Guanarito, Machupo, Junin, and Sabia viruses), or Crimean-Congo);

(B) Instances, clusters, or outbreaks of unusual diseases or manifestations of illness and clusters or instances of unexplained deaths which appear to be a result of a terrorist act or the intentional or deliberate release of biological, chemical, radiological, or physical agents, including exposures through food, water, or air;

(C) Instances, clusters, or outbreaks of unusual, novel, and/or emerging diseases or findings not otherwise named in this rule, appearing to be naturally occurring, but posing a substantial risk to public health and/or social and economic stability due to their ease of dissemination or transmittal, associated mortality rates, or the need for special public health actions to control.

AUTHORITY: sections 192.006, 192.020, 210.040, and 210.050, RSMo 2016. This rule was previously filed as 13 CSR 50-101.020. Original rule filed July 15, 1948, effective Sept. 13, 1948. For intervening history, please consult the Code of State Regulations. Emergency amendment filed June 28, 2019, effective July 8, 2019, expired Feb. 27, terminated Jan. 30, 2020. Amended: Filed June 28, 2019, effective Jan. 30, 2020. Emergency amendment filed Jan. 27, 2020, effective Feb. 10, 2020, expires Aug. 7, 2020. An emergency amendment and a proposed amendment covering this same material will be published in the March 2, 2020, issue of the Missouri Register