Department of Public Health & Human Services

Public Health & Safety Division             

Questions & Answers Regarding Disease Reporting in Montana

Title 50, Section 1-202 of the Montana Code Annotated (MCA) outlines the general powers and duties of the Montana Department of Public Health & Human Services (DPHHS). Although this law lists twenty items, two primary duties serve as a foundation for all of the activities undertaken by the department. These two items state that the department shall:

  • study conditions affecting the citizens of the state by making use of birth, death, and sickness records;
  • make investigations, disseminate information, and make recommendations for control of diseases and improvement of public health to persons, groups, or the public;

In order to meet these obligations, DPHHS works closely with county health departments to collect and analyze disease reports. Although anyone may report a case of communicable disease, such reports are submitted primarily by health care providers and facilities. Unfortunately, the system does not always work as well as it should. Reporting is often seen as an unnecessary burden or an academic exercise without a clear purpose. In other instances, it is assumed to be the responsibility of someone else, or the last thing on the mind of an already very busy clinician.

Regardless of the reasons, the incomplete data resulting from the occasional breakdown of the reporting system hinders efforts to define and combat health threats to the public. As a result, already scarce resources may be misallocated, or worse - preventable diseases strike those who are vulnerable.

In this document, we address the most common questions concerning reporting- the why, what and hows. In the process, many of the common misconceptions concerning reporting are clarified.

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Why are diseases reported?
The immediate use of data collected by a disease surveillance system is to trigger disease-control efforts; the long-term use is to assess trends and patterns in disease prevalence. Without accurate and timely data, it is difficult for health officials to implement and evaluate disease control measures, detect outbreaks or identify those individuals at risk for infection. With accurate and timely information, health officials can control or prevent the spread of disease much more effectively.

The dissemination of disease information to those who need to know is an integral part of any surveillance system. At the local level, use of such information may allow providers to recognize and respond to disease patterns occurring in the community. This heightened awareness, often results in earlier diagnosis and treatment of patients with similar symptoms.

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Who is required to report?
The Administrative Rules of Montana (ARM 16.28.201) state that any person who knows or has reason to believe that a case of reportable disease exists shall report the required information to the designated health authorities. Although public and private health care providers, school administrators and laboratorians are specifically mentioned in this section, health departments rely primarily on physicians or nurses for disease reports. Individuals submitting reports do not need to worry the possibility of multiple reports being submitted, mechanisms at the state and local level automatically take care of duplicate reports.

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What diseases are reportable?
A list of reportable diseases is maintained in ARM 16.28.202 and is enclosed in this packet. The list continues to evolve, changing as health threats are identified, or are eliminated. Recent additions included E.Coli 0157:H7 and Hantavirus Pulmonary Syndrome, and plans for removing smallpox, chickenpox and others are in progress. In addition to the diseases listed, unusual outbreaks of any communicable disease are to be reported. Every case is important, and may provide the information necessary to identify and prevent a health threat.

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What Information must be reported?
The contents of a report are outlined in ARM 16.28.204. In most cases, the report must include the following:

  • name and age of the case (names are not to be provided in the case of HIV+ tests),

  • dates of onset of disease and date reported,
  • whether or not the case is confirmed or suspected,
  • name and address of the case's physician and a contact person who can provide additional information if required.

In order to make the collection of the above information as convenient as possible, case reporting cards designed to collect the necessary information are available from your health department. In some instances, health care providers may be contacted for additional information regarding cases of particular interest. For example, cases of AIDS, viral hepatitis and pertussis require a supplemental form to be completed. Such forms collect information to increase our understanding and control of particular diseases.

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What about confidentiality?
Title 37, Section 2-301 of MCA requires physicians and other health care practitioners to report diseases specified by DPHHS. As a complement to this requirement, Montana's statute governing the release of health care information (the Uniform Health Care Information Act, 50-16 Part 5 MCA) allows the release of information, without patient consent, to public health authorities when such information is required by law.

Once information is in possession of your local or state health department, subsequent release of the information is governed by the Government Health Care Information Act (50-16, Part 6 MCA). Proper release of information by a health department is only allowed if the strict circumstances outlined in this act.

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How and to whom are reports submitted?
Reports may be submitted, in a variety of ways, to your local county health department. Generally, reporting cards designed to collect the necessary information are mailed to a designated individual at the local health department as soon as possible after a diagnosis is made. However, some diseases require immediate notification due to their serious nature. Diseases such as botulism and diphtheria are a few of those listed on the enclosed list requiring an immediate telephone report to the proper authorities.

Please refer to the list of reportable diseases and the list of local health authorities to see what to report and to whom reports should be directed. The contact person designated by your local health department can be a valuable resource!

Additional reporting requirements for laboratories performing specific tests are "on the books." Such requirements require the submission of reports and/or specimens directly t

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For more information or reporting supplies...
Additional information regarding reporting can be obtained by contacting your county health department or the DPHHS' Epidemiology Program at 444-0273. Case reporting cards and lists of the reportable diseases may also be obtained from the same sources.

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