Clinical Laboratory Disease Reporting and Specimen Submission Requirements

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Page last updated 5/30/2025.

For more information, contact the Epidemiology Unit at (619) 692-8499 or the Public Health Laboratory at (858) 325-6400.

This page outlines how and when laboratories must report specific diseases to the San Diego County of San Diego Public Health Laboratory, per the Title 17, California Code of Regulations Section 2505.

• This includes local requirements for submitting specimens and laboratory test results suggestive of diseases of public health importance to the local health department. 
  • Laboratory findings for these diseases are those that satisfy the most recent communicable disease surveillance case definitions established by the Centers for Disease Control and Prevention (CDC), unless otherwise specified.

All laboratory notifications are acquired in confidence. The confidentiality of patient information is always protected. 

On this page:

• How to Report
• When to Report
  • Immediate Report (Within 1 hour)
  • Report Within 1 Day
    • STD Program
    • Tuberculosis Control and Refugee Health
• Additional Requirements
• How to Submit Specimens
  • Forms
  • Packaging and Shipping
• Resources    

How to Report

Laboratory reports must be made in writing and give the following information:

• Date the specimen was obtained.
• Patient identification number.
• Specimen accession number or another unique specimen identifier.
• Specimen Sites.
• Diagnosis Code(s).
• Laboratory findings for the test performed.
• Date that any positive laboratory findings were identified.
• Name, gender, address, telephone number (if known), pregnancy status, race, ethnicity, and date of birth of the person from whom the specimen was obtained.
• Name, address, and telephone number of the health care provider who ordered the test.

Submit this information via a laboratory report or by completing a Confidential Morbidity Report (CMR). Please attach the laboratory report to the CMR.

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When to Report

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Subsection (e)(2) List – Report to the Epidemiology Unit via Fax to (858) 715-6458.

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Additional Reporting Requirements

Malaria
If a clinical laboratory identifies malaria parasites in a patient’s blood smear:

• The laboratory must immediately send one or more blood film slides (and an EDTA blood tube, if available) to the local public health laboratory in the jurisdiction where the patient lives.
• Upon request, all submitted blood slides will return to the original sender. 

Salmonella
Per California Code of Regulations, Title 17, Section 2612, if a laboratory confirms a diagnosis of salmonellosis, the culture of the organism must be:

• Submitted to the local public health laboratory; and
• Forwarded to the California Department of Public Health’s Microbial Diseases Laboratory (MDL) for final identification. 

Tuberculosis (TB) and Acid-Fast Bacillus (AFB)
If a laboratory isolates Mycobacterium tuberculosis or identifies the Mycobacterium tuberculosis complex by molecular testing from a patient specimen, the culture must be submitted to the local public health laboratory for the jurisdiction where the patient lives.

• This should be done as soon as the primary isolate (used for TB diagnosis) becomes available.
• If a culture isolate is not available, the laboratory must submit a specimen that is available.
• The submission must include all the required information listed in the section “How to Report”.
• The San Diego County of San Diego Public Health Laboratory will keep one culture (per culture-positive patient) in a viable state for at least six (6) months.

Drug Susceptibility Testing:

Unless testing has already been done within the past three (3) months by the same or another laboratory, the clinical laboratory must do the following:

• Perform or refer for drug susceptibility testing on at least one (1) isolate per patient with Mycobacterium tuberculosis;
• Report the results of susceptibility testing, including molecular assays for drug resistance if performed, to the local health officer (in the patient’s jurisdiction) within one (1) working day of notifying the healthcare provider or authorized person who submitted the specimen; and
• If drug susceptibility testing determines the culture to be resistant to both isoniazid and rifampin (i.e., multidrug-resistant Mycobacterium tuberculosis complex), the laboratory must also submit one culture or subculture from that patient to the local public health lab as soon as possible.
  • The San Diego County Public Health Laboratory will forward it to the CDPH Microbial Diseases Laboratory. 

Additional AFB Testing Requirement:

If a patient with suspected or confirmed tuberculosis tests positive for AFB on a specimen and has not had a culture identifying the organism in the past 30 days, the laboratory must:

• Culture and identify the AFB organism, or
• Send a subculture to another laboratory. 

Subsection (m)(2) List, Submission to Public Health Laboratory

(m)(2) Isolates:

• Drug resistant Neisseria gonorrhoeae isolates (cephalosporin or azithromycin only)    
• Listeria monocytogenes isolates                                                                                        
• Mycobacterium tuberculosis isolates (see Tuberculosis)
• Neisseria meningitidis isolates from sterile sites                                                               
• Salmonella isolates (see Salmonella)                      
• Shiga toxin-producing Escherichia coli (STEC) isolates, including O157 and non-O157 strains                                                                                                                                   
• Shigella isolate

If a laboratory test result indicates infection with any one of the pathogens listed in (m)(2), the testing laboratory must attempt to obtain a bacterial culture isolate for submission to a public health laboratory in accordance with (m)(2). This requirement includes identification cases of where Shiga toxin is found in a clinical specimen. If latent tuberculosis infection is identified, an attempt to obtain a bacterial culture isolate is not required. The testing laboratory shall take necessary steps to obtain an isolate, including requesting the collection of additional specimens and promptly sending specimens to a laboratory capable of performing bacterial culture.

Subsection (r):                                                                                                                                                      Instructions for Submission of Candida auris isolates to Public Health Laboratory

If a Candida auris isolate(s) is identified from a sterile site, and the laboratory has obtained a fungal culture isolate, the isolate(s) must be submitted to a public health laboratory within ten (10) working days from the date the specimen was collected. 

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How to Submit Specimens

The following information should be submitted with the specimen:

• Name, address, and date of birth of the person from whom the specimen was obtained.
• Patient identification number.
• Isolate or specimen accession number or other unique identifier.
• Date the isolate or specimen was obtained from the patient.
• Name, address, and telephone number and laboratory director’s name of the laboratory submitting the isolate or specimen.
• Appropriate form (see Form List).
  • Special forms are required to be submitted for testing of the following diseases:
    • Avian Influenza
    • Botulism
    • Hantavirus
    • Influenza (Seasonal and 2009 Pandemic H1N1)
    • Hepatitis E
    • Malaria
    • Smallpox
    • West Nile Virus

Contact the San Diego County Public Health Laboratory at (858) 325-6400 to obtain forms.

Form List

• Confidential Morbidity Report
• Adult C. botulinum Toxin Detection Laboratory Request and Final Report Form
• Avian Influenza A (H5N1) Submittal Form
• CDC DASH Form 50.34
• Chlamydia/Gonorrhea Examination Form
• Chlamydia/Gonorrhea Examination Form (Juvenile Hall)
• Gonorrhea Culture Requisition Form
• Hepatitis Serology Form
• HIV Court Order Form
• HIV-1 Antibody Test Request Form
• Influenza Virus Culture Request Form
• Influenza Virus PCR Requisition Form (Seasonal and 2009 Pandemic H1N1)
• Interfering Substances with Botulism Testing
• Molecular Test Request Form
• Mycobacteria (TB) CI Form
• Mycobacteria (TB) Culture Form
• Public Health Laboratory Test Requisition Form (10/11/24)
• Quantiferon In-tube Lab Request Form
• Serologic Examination Form
• Smallpox Sample Submission Form
• Syphilis Serology Form
• Virus Isolation Request Form
• West Nile Virus Specimen Submittal Form

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Packaging and Shipping Information

All specimens submitted to the San Diego County Public Health Laboratory must comply with all applicable U.S. Postal Service, DOT or IATA requirements (i.e., packaged, labeled and documented, as per applicable regulations).

• San Diego County Public Health Laboratory:
• Phone Number: (858) 325-6400
• Fax Number: (858) 268-4102
• Mailing Address (with Mail Stop):

            San Diego County Public Health Laboratory

            5540 Overland Avenue

            San Diego, CA 92123

            MS P572

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Resources

• County of San Diego:
  • Epidemiology Unit
  • Public Health Lab
• CDPH:
  • California Reportable Diseases and Conditions
  • Infectious Diseases Laboratory Division
  • Microbial Diseases Laboratory Branch
  • Reportable Conditions: Notification by Laboratories to Public Health
• CDC:
  • Surveillance Case Definition for Current and Historical Conditions

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