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COVID-19 & Acute Respiratory Illness (ARI) Reporting

Instructions for Multiple Sectors

In Los Angeles County, ongoing COVID-19 surveillance necessitates mandatory reporting from healthcare facilities and community settings as required by Title 17 California Code of Regulations § 2500 and the LA County Health Officer Order.

Click the buttons to the left for reporting requirements by type of setting.

If you are looking to submit an anonymous report, call (888) 700-9995 or submit a complaint. For information about other reporting requirements, visit the reportable diseases and conditions list and the health professional mandatory reporting hub.

Acute healthcare facilities

In Los Angeles County, hospitals are required to report COVID-19 and influenza hospitalizations, as mandated by the LA County Health Officer Order. Use the navigation below to view the specific reporting details.

Aggregate COVID-19 & flu hospitalization reporting

Hospitals are required to report weekly COVID-19 & influenza hospitalizations and bed capacity to the CDC National Healthcare Safety Network.

How to report

Hospitalizations must be reported online at https://sams.cdc.gov/.

Additional reporting guidance (including data elements and definitions) is available here.

When to report

Hospitals must report weekly by Tuesday 11:59 local time. Data from the previous week (defined as previous Sunday through Saturday) should be included.

Patient-level COVID-19 hospitalization reporting

All general acute care hospitals are required to report patient-level COVID-19 hospitalizations to the LACDPH data portal. Long-term acute care hospitals are exempt from this requirement.

How to report

Hospitalizations must be reported online by one of the following methods:

Additional reporting guidance (including data elements, definitions and reporting instructions) is available here.

When to report

Hospitals must report COVID hospitalizations on the second Monday of each month. Data from the previous three months should be included (e.g., include hospitalization data from 4/1/2024 through 6/30/2023, if submitting on 7/8/2024).

COVID-19 cluster reporting for acute care hospital settings
How to report

Any suspected COVID-19 outbreak must be reported to LAC DPH using one of the following methods:

When to report

These sites must report within 24 hours when:

  • There are ≥2 cases of confirmed COVID-19 among patients 4 or more days after admission for a non-COVID condition, with epi-linkage, OR
  • There are ≥2 cases of confirmed COVID-19 among HCP AND ≥1 case of confirmed COVID-19 among patients 4 or more days after admission for a non-COVID condition, with epi-linkage**, AND no other more likely sources of exposure for at least 1 of the cases.
Fatality Reporting for Influenza & RSV
How to report

Sites must contact the Communicable Disease Reporting System within 7 days of the death occurring.

  • By phone:
    (888) 397-3993 or (213) 240-7821 (M-F 8am-5pm)
    (213) 974-1234 (afterhours, weekends, holidays)
  • By fax:
    (888) 397-3778 or (213) 482-5508
  • By email:
    ACDC-MorbidityUnit@ph.lacounty.gov
When to report

Providers are required to report deaths meeting the following criteria in patients with a laboratory confirmed influenza or RSV infection.

  • Influenza-associated deaths: reportable in patients under the age of 18
  • RSV-associated deaths: reportable in patients under the age of 5

For both conditions, there should be laboratory confirmed infection in the 30 days before death with no return to baseline health between the acute illness and death. Infection preventionists should have clinical laboratory reserve respiratory specimens associated with these deaths for 1 week after reporting, or arrange to have specimen sent to PHL is facility has a regular courier pick-up.

Long-Term Care Facilities

In non-acute healthcare settings, where the risk of adverse outcomes may be high, timely reporting of COVID-19 and other respiratory virus case clusters is essential. Specific reporting thresholds are established to ensure swift actions are taken to mitigate transmission.

Definitions
COVID-19 case

For the purposes of communicable disease reporting in non-acute healthcare settings, a COVID-19 case is defined as a person who:

  • A positive laboratory-based molecular test, also known as nucleic acid amplification tests (NAAT), including RT-PCR tests, OR
  • A positive antigen test, including facility supervised point of care tests and laboratory-based tests.

Please see CDC’s Overview of Testing for SARS-CoV-2 in the healthcare setting for more details on both molecular and antigen tests.

Epi-links

Epi-linkage among residents is defined as overlap on the same unit or ward, or other resident care location (e.g., radiology suite), or having the potential to have been cared for by common HCP within a 7-day time period of each other. Determining epi-linkages requires judgment and may include weighing evidence whether or not residents had a common source of exposure.

Epi-linkage among HCP is defined as having the potential to have been within 6 ft for 15 minutes or longer while working in the facility during the 7 days prior to the onset of symptoms; for example, worked on the same unit during the same shift, and no more likely sources of exposure identified outside the facility. Determining epi-linkages requires judgment and may include weighing evidence whether or not transmission took place in the facility, accounting for likely sources of exposure outside the facility.

Non-COVID-19 Respiratory Virus Case

These refer to any other virus causing respiratory disease that is not SARS-CoV-2 (COVID-19). Case clusters of influenza, respiratory syncytial virus (RSV), and more are reportable (please see the Reportable Diseases and Conditions List). Even if a virus is not listed here, it is better to report than not when there are multiple cases and the virus is spreading.

Skilled nursing facilities
How to report COVID-19 Cases

Any suspected new COVID-19 outbreak must be reported to LAC DPH using one of the following methods (NOTE: Individual COVID-19 cases among residents and staff are not reportable):

For reporting questions or assistance, email LACSNF@ph.lacounty.gov.

Sites must report within 24 hours when:

  • ≥ 2 cases of lab-confirmed COVID-19 (i.e., PCR or supervised in-facility Ag, or testing done at another facility) within a 7-day period among residents living in the facility 7 or more days after admission for a non-COVID condition, with epi-linkage*; OR
  • ≥ 2 cases of lab-confirmed COVID-19 (i.e., PCR or supervised in-facility Ag or testing done at another facility) among HCP AND ≥ 1 case of lab-confirmed COVID-19 among residents within a 7-day period, residents having lived in the facility 7 or more days after admission for a non-COVID condition, with epi-linkage*, AND no other more likely sources of exposure for at least 1 of the cases. HCP who are already excluded from work due to symptoms/positivity on home test should not report back to facility to be tested but should continue exclusion from work per guidance.

*For epi-linkage description, see the Definitions section.

How to report Influenza and non-COVID-19, non-Influenza cases
Report by email (rpu@ph.lacounty.gov) or by phone at 888-397-3993 or 213-240-7821 when:
  • At least one case of laboratory-confirmed influenza in a resident in the setting of a cluster (≥2 cases) of influenza-like illness (ILI)* within a 72-hour period; OR
    • *ILI is defined as fever (≥100°F or 37.8°C) plus cough and/or sore throat, in the absence of a known cause other than influenza. Persons with ILI often have fever or feverishness with cough, chills, headache, myalgia, sore throat, or runny nose. Some persons, such as the elderly, may have atypical clinical presentations, including the absence of fever.
  • At least one case of a laboratory-confirmed respiratory pathogen, other than influenza or COVID-19, in the setting of a cluster (≥2 cases) of acute respiratory illness (ARI)* within a 72-hour period.
    • *ARI is defined as an illness characterized by any two of the following: fever, cough, rhinorrhea (runny nose), nasal congestion, sore throat, or muscle aches.
  • Additionally, sudden increases in acute respiratory illness cases over the normal background rate, in the absence of a known etiology, must be reported to LAC DPH.
    • Report to both LAC DPH and CDPH Licensing & Certification (Health Facilities Inspection Division) district office.
Provide the following information when reporting suspected/confirmed Outbreak:
  • # of symptomatic residents and staff, total residents, or current census in the facility.
  • Detailed symptoms, hospitalizations, deaths, and lab testing information.
  • Actions taken to contain the infection.
  • Contact information – point of contact person’s name, job title, phone number, email address, reporting facility name, and address.
Intermediate care facilities
How to report COVID-19 cases

Any suspected COVID-19 outbreak must be reported to LAC DPH using one of the following methods:

For reporting questions or assistance, email LACSNF@ph.lacounty.gov.

Sites must report within 24 hours when:

  • ≥ 2 cases of lab-confirmed COVID-19 (i.e., PCR or supervised in-facility Ag, or testing done at another facility) within a 7-day period among residents living in the facility 7 or more days after admission for a non-COVID condition, with epi-linkage*.

*For epi-linkage description, see the Definitions section.

How to report Influenza and non-COVID-19, non-Influenza cases
Report by email (rpu@ph.lacounty.gov) or by phone at 888-397-3993 or 213-240-7821 when:
  • At least one case of laboratory-confirmed influenza in a resident in the setting of a cluster (≥2 cases) of influenza-like illness (ILI)* within a 72-hour period; OR
    • *ILI is defined as fever (≥100°F or 37.8°C) plus cough and/or sore throat, in the absence of a known cause other than influenza. Persons with ILI often have fever or feverishness with cough, chills, headache, myalgia, sore throat, or runny nose. Some persons, such as the elderly, may have atypical clinical presentations, including the absence of fever.
  • At least one case of a laboratory-confirmed respiratory pathogen, other than influenza or COVID-19, in the setting of a cluster (≥2 cases) of acute respiratory illness (ARI)* within a 72-hour period.
    • *ARI is defined as an illness characterized by any two of the following: fever, cough, rhinorrhea (runny nose), nasal congestion, sore throat, or muscle aches.
  • Additionally, sudden increases in acute respiratory illness cases over the normal background rate, in the absence of a known etiology, must be reported to LAC DPH.
    • Report to both LAC DPH and CDPH Licensing & Certification (Health Facilities Inspection Division) district office.
Provide the following information when reporting suspected/confirmed Outbreak:
  • # of symptomatic residents and staff, total residents, or current census in the facility.
  • Detailed symptoms, hospitalizations, deaths, and lab testing information.
  • Actions taken to contain the infection.
  • Contact information – point of contact person’s name, job title, phone number, email address, reporting facility name, and address.
Congregate living health facilities
How to report COVID-19 cases

Any suspected COVID-19 outbreak must be reported to LAC DPH using one of the following methods:

For reporting questions or assistance, email LACSNF@ph.lacounty.gov.

Sites must report within 24 hours when:

  • ≥ 2 cases of lab-confirmed COVID-19 (i.e., PCR or supervised in-facility Ag, or testing done at another facility) within a 7-day period among residents living in the facility 7 or more days after admission for a non-COVID condition, with epi-linkage*.

*For epi-linkage description, see the Definitions section.

How to report Influenza and non-COVID-19, non-Influenza cases
Report by email (rpu@ph.lacounty.gov) or by phone at 888-397-3993 or 213-240-7821 when:
  • At least one case of laboratory-confirmed influenza in a resident in the setting of a cluster (≥2 cases) of influenza-like illness (ILI)* within a 72-hour period; OR
    • *ILI is defined as fever (≥100°F or 37.8°C) plus cough and/or sore throat, in the absence of a known cause other than influenza. Persons with ILI often have fever or feverishness with cough, chills, headache, myalgia, sore throat, or runny nose. Some persons, such as the elderly, may have atypical clinical presentations, including the absence of fever.
  • At least one case of a laboratory-confirmed respiratory pathogen, other than influenza or COVID-19, in the setting of a cluster (≥2 cases) of acute respiratory illness (ARI)* within a 72-hour period.
    • *ARI is defined as an illness characterized by any two of the following: fever, cough, rhinorrhea (runny nose), nasal congestion, sore throat, or muscle aches.
  • Additionally, sudden increases in acute respiratory illness cases over the normal background rate, in the absence of a known etiology, must be reported to LAC DPH.
    • Report to both LAC DPH and CDPH Licensing & Certification (Health Facilities Inspection Division) district office.
Provide the following information when reporting suspected/confirmed Outbreak:
  • # of symptomatic residents and staff, total residents, or current census in the facility.
  • Detailed symptoms, hospitalizations, deaths, and lab testing information.
  • Actions taken to contain the infection.
  • Contact information – point of contact person’s name, job title, phone number, email address, reporting facility name, and address.
Adult day healthcare centers / CBAS
How to report

Any suspected COVID-19 outbreak must be reported to LAC DPH using one of the following methods:

For reporting questions or assistance, email LACSNF@ph.lacounty.gov.

Sites must report within 24 hours when:

  • There are ≥ 5 cases of confirmed COVID-19 among participants within a 7-day period. These cases must be part of a group where members do not share a household and are not a close contact of each other outside of the facility. Epidemiological links require cases to be present in the same setting during the same time-period while infectious.
How to report Influenza and non-COVID-19, non-Influenza cases
Report by email (rpu@ph.lacounty.gov) or by phone at 888-397-3993 or 213-240-7821 when:
  • At least one case of laboratory-confirmed influenza in a resident in the setting of a cluster (≥2 cases) of influenza-like illness (ILI)* within a 72-hour period; OR
    • *ILI is defined as fever (≥100°F or 37.8°C) plus cough and/or sore throat, in the absence of a known cause other than influenza. Persons with ILI often have fever or feverishness with cough, chills, headache, myalgia, sore throat, or runny nose. Some persons, such as the elderly, may have atypical clinical presentations, including the absence of fever.
  • At least one case of a laboratory-confirmed respiratory pathogen, other than influenza or COVID-19, in the setting of a cluster (≥2 cases) of acute respiratory illness (ARI)* within a 72-hour period.
    • *ARI is defined as an illness characterized by any two of the following: fever, cough, rhinorrhea (runny nose), nasal congestion, sore throat, or muscle aches.
  • Additionally, sudden increases in acute respiratory illness cases over the normal background rate, in the absence of a known etiology, must be reported to LAC DPH.
    • Report to both LAC DPH and CDPH Licensing & Certification (Health Facilities Inspection Division) district office.
Provide the following information when reporting suspected/confirmed Outbreak:
  • # of symptomatic residents and staff, total residents, or current census in the facility.
  • Detailed symptoms, hospitalizations, deaths, and lab testing information.
  • Actions taken to contain the infection.
  • Contact information – point of contact person’s name, job title, phone number, email address, reporting facility name, and address.
Community settings

For non-healthcare community settings, where testing access may be limited, COVID-19 reporting is part of Acute Respiratory Illness (ARI) symptom-based reporting. Proactive symptom monitoring supports outbreak detection and early management.

Definitions
Definition of acute respiratory illness (ARI)

For communicable disease reporting to LAC DPH, a person with acute respiratory illness (ARI)* is defined as a person who either:

  • Has the new onset (ie, not better explained by chronic conditions such as seasonal allergies) of two or more of the following symptoms: fever or chills, cough, sore throat, runny or stuffy nose, difficulty breathing, body aches; and/or
  • Has tested positive for a specific respiratory infection, including COVID-19, influenza, RSV, or strep throat.

*Note: This definition excludes suspected or confirmed cases of chickenpox/varicella, measles/rubeola, mumps, pertussis, polio, rubella, smallpox, tetanus, and tuberculosis. See reporting requirements and instructions for these other illnesses here.

Exposed group

An exposed group (epidemiologically linked group) involves individuals in the same location when at least one person was contagious, indicating disease spread due to their shared environment.

What are community settings?

Community settings generally do not provide medical care to individuals, though medical staff such as nurses may be employed. Settings include:

  • Sites that provide housing for people experiencing homelessness
  • Community care facilities, including:
  • Adult Residential Care Facilities, all license types
    • Continuing Care Retirement Communities
    • Psychiatric Health Facilities, not including Acute Psychiatric Hospitals
    • Residential Care Facilities for the Elderly
    • Residential Facilities for the Chronically Ill
    • Social Rehabilitation Facilities
    • Residential Substance Use & Mental Health Treatment Facilities
    • Mental Health Treatment Facilities
  • Correctional/detention facilities
  • Education Settings, including Early Care and Education (ECE) settings, TK-12 schools, and other programs serving school-aged children
  • Workplace settings
When to Report

Facilities should contact LA DPH (using SPOT) if a concerning respiratory illness cluster* or situation is identified onsite. Examples of possible situations of concern include, but are not limited to:

  • Evidence indicating that standard respiratory illness control measures have been ineffective or difficult to implement without additional support from LA DPH.
  • An unusually high number of people are identified with acute respiratory illness (either by positive test or by symptoms) that may be linked in time or place to a certain area of the facility, or across the facility.
  • Increased severity of illness, such as hospitalizations or fatalities among cases.
  • Cases with recent exposure to animals known to transmit respiratory illnesses.
  • A concerning situation as determined by onsite leads.

*A cluster of ARI cases refers to a group of people ill with acute respiratory symptoms that appear to be linked. Generally, DPH will not initiate investigation on clusters with fewer than five cases.

How to Report

SPOT: Spot.cdph.ca.gov


For additional assistance, contact the Community Outbreak Team.