Reporting of Diseases, Emergency Illnesses, Health Conditions, and Laboratory Findings

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Disease reporting and surveillance are important functions to monitor the status of the public's health. It allows the Connecticut Department of Public Health (DPH) to determine the epidemiology of diseases, see trends, and establish preventive measures. The DPH and an advisory committee consisting of public health officials, clinicians, and laboratorians, contribute to the process of selecting diseases for surveillance.

In accordance with Sections 19a-36-A3 and 19a-36-A4 of the Public Health Code and Sections 19a-2a and 19a-215 of the Connecticut General Statutes, diseases on the lists of reportable diseases, emergency illnesses and health conditions, and laboratory reportable significant findings are required to be reported to the DPH and the Local Health Director of the town in which the patient resides. These lists are reviewed annually and revised when necessary. They are outlined in the January issue of the Connecticut Epidemiologist newsletter.

The DPH is transitioning to electronic laboratory reporting (ELR). Laboratory reports in electronic format require special arrangements to assure accurate transfer of information and protect patient confidentiality. For additional information about ELR, please visit the Electronic Laboratory Reporting page. 

Disease Specific Reporting Forms

The primary disease reporting form for providers is the Reportable Disease Confidential Case Report Form PD-23. Laboratories use the Reportable Laboratory Findings Form OL-15C to report diseases related to public health. Disease specific forms are also available for the diseases listed below. All forms are found on the DPH "Forms" page and most of them are fillable PDF.

 

Please use the on-line forms as much as possible. Copies of the 3-ply PD-23 and OL-15C can be ordered by calling the Epidemiology and Emerging Infections Program at 860-509-7994. Please call the programs below directly with any questions concerning their form or reporting.

The DPH HAI Program uses the National Healthcare Safety Network (NHSN) for Connecticut mandated health reporting of HAI. NHSN is an online disease surveillance system for healthcare facilities and public health HAI programs developed and maintained by the Centers for Disease Control and Prevention.

  • HIV/AIDS - 860-509-7900    Adult HIV/AIDS Case Report Form
  • Influenza - 860-509-7994    Hospitalized and Fatal Cases of Influenza Case Report Form
  • Occupational Diseases - 860-509-7740    Physician's Report Form
  • Other Reportable Diseases - 860-509-7994     PD-23 and OL-15C Forms
  • Sexually Transmitted Diseases - 860-509-7920    STD-23 Report Form
  • Tuberculosis  - 860-509-7722    Report Forms and Laboratory Testing Forms
  • Varicella - 860-509-7929    Case Report Form

 

DPH Infectious Diseases Program Contact Information

When appropriate, completed forms can be mailed in envelopes marked "Confidential" or faxed to the DPH at:

Connecticut Department of Public Health
410 Capitol Avenue, MS#11FDS
P.O. Box 340308
Hartford, CT 06134-0308

Phone: 860-509-7994 for immediate reporting of Category 1 diseases

             860-509-8000 for after hours, weekends, and holidays

FAX:     860-509-7910