Notifiable Disease Rules Updated

Alabama Department of Public Health

Notifiable Disease Rules Updated Effective 04/14/2024

The Alabama Department of Public Health, Bureau of Communicable Disease, updated the Notifiable Diseases Rule (Chapter 420-4-1)

Notifiable Disease Rule Highlights

420-4-1-.02 Definitions

• List of definitions updated.

420-4-1-.03 Enumeration

• Clarification added that the reportable timeframe starts at the point of laboratory test result or diagnosis.

420-4-1-.04 Reporting

• Standard reporting reduced from 5 to 3 days.

• A separate list of test results to be reported has been added as an appendix.

• Laboratories must also report specimen source and specimen collection date.

• Adding section with Birth Defect reporting specifics, including additional reporting elements pertaining to mother.

420-4-1-.10 Notification of Public Health and Regulatory Authorities of the Presence of Lead

• Added the word “lead” for clarification when referring to blood level.

420-4-1-.11 Testing of Pregnant Women for Sexually Transmitted Diseases

• Adds detailed testing recommendations for chlamydia, gonorrhea, syphilis, hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infections to replace previous guidance.

• These recommendations are supported by CDC, especially considering Alabama’s sharp increase in congenital syphilis, which is 100 percent preventable.

• Also added Appendix IV for easy reference.

420-4-1-.12 Dispensing of Legend Drugs by Alabama Department of Public Health Registered Nurses

• Pregnant birthing parents are able to receive legend drugs through The Patient Delivered Partner Therapy Program if not contraindicated during pregnancy.  This change has approval by the Board of Pharmacy.


Appendix I - Alabama Notifiable Diseases/Conditions (Healthcare Providers and Other Required Reporters, Excluding Laboratories)

• Splitting the list to be non-laboratory specific, to focus on disease names and conditions/syndromes.

• Adds birth defects, primary amebic meningoencephalitis, perinatal hepatitis C, and latent tuberculosis infection.

• Timeframe for reporting some conditions changed.

• Limits COVID-19 cases reported by providers to only be cases known to reside in congregate living facilities.

• Conditions removed from individual case reporting: giardiasis, hantavirus pulmonary syndrome, other viral hepatitis, influenza-associated deaths in adults, leptospiriosis, psittacosis, toxic shock syndrome (non-streptococcal).

New Appendix II - Alabama Notifiable Laboratory Results (Laboratories Only)

• Lists the viruses, organisms, and/or specific laboratory tests/results that are reportable by laboratories because laboratorians do not assess disease status or assign diagnoses.

• Congenital cytomegalovirus test results added as a laboratory test that is reportable in babies less than 21 days old.

New Appendix III – Submission of Clinical Materials by Performing Laboratories

• This list supports the legislation passed in 2019 that specifies the isolates, clinical specimens, or associated aliquots (all grouped under the umbrella of clinical materials).

• The clinical materials shall be sent to the state laboratory for additional testing by the laboratory performing the test. 

New Appendix IV – Alabama Prenatal STD Testing Summary Table

• A table visually summarizing the recommendations in 420-4-1-.11.

Notifiable Disease Rules Flyers

Alabama Reportable Diseases and Conditions

Alabama Laboratory Test Result Reporting and Clinical Material Submission

Alabama Prenatal STD Testing

If you have any questions, please contact ADPH at the following:

Bureau of Clinical Laboratories 334-290-6130

Infectious Diseases & Outbreaks Division 334-206-5971 or 1-800-338-8374

Office of HIV Prevention & Care 334-206-5364 or 1-800-344-1153

Division of Immunization 334-206-5023 or 1-800-469-4599

Division of Sexually Transmitted Diseases 334-206-5350

Division of Tuberculosis Control 334-206-5330