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COVID-19 & Acute Respiratory Illness (ARI) Cluster Reporting

Instructions for Multiple Sectors

Overview

In Los Angeles County, all settings must report clusters of COVID-19 and Acute Respiratory Illness (ARI) to the LA County Department of Public Health (LAC DPH) within 24 hours, as mandated by the LA County Health Officer Order.

In healthcare settings, where the risk of adverse outcomes is higher, timely reporting of COVID-19 case clusters is essential. Specific reporting thresholds are established to ensure swift actions are taken to mitigate the virus's spread.

For non-healthcare community settings, where testing access may be limited, COVID-19 reporting is now incorporated into the existing Acute Respiratory Illness (ARI) symptom-based reporting protocol. This approach aims to facilitate early outbreak detection and management through proactive symptom monitoring.

See below for reporting requirements and information by type of setting.

If you are a representative from a laboratory or provider's office seeking information about mandated COVID-19 reporting, visit the Health Professional Mandatory Reporting webpage.

If you are looking to submit an anonymous report, call (888) 700-9995 or submit a complaint.

Healthcare Setting: Reporting Requirements
Definitions for Healthcare Settings
COVID-19 Case

For the purposes of communicable disease reporting in 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 patients or residents is defined as overlap on the same unit or ward, or other patient care location (e.g., radiology suite), or having the potential to have been cared 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 patients 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.

Healthcare Facilities
Refers to:
  • Skilled Nursing Facilities
  • Intermediate Care Facilities of all license types, including those for the Developmentally Disabled
  • Congregate Living Health Facilities
  • Adult Day Healthcare Centers (CBAS)
When to Report

These sites must report within 24 hours when:

  • For SNFs, ICFs, and CLHFs: There are ≥2 cases of confirmed COVID-19 among residents 7 or more days after admission for a non-COVID condition, with epi-linkage.
  • For SNFs: There are ≥2 cases of confirmed COVID-19 among HCP AND ≥1 case of confirmed COVID-19 among residents 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.
  • For CBASs, CDRHs, HFs and RCFs: 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

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.

Acute Care Hospital Settings
Refers to:
  • General Acute Care Hospitals
  • Acute Psychiatric Hospitals
  • Long-term Acute Care Hospitals
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.
How to Report

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

Community Settings: Reporting Requirements
Definitions for Community Settings
COVID-19 Case

For the purposes of communicable disease reporting, a COVID-19 case is defined as a person who:

  • Has a positive viral test (i.e., a PCR or antigen test, including self-administered and self-read tests) for COVID-19 and/or
  • Has a positive COVID-19 diagnosis from a licensed healthcare provider.

Acute Respiratory Illness Case

For the purpose of communicable disease reporting to LAC DPH, a case of acute respiratory illness (ARI) is defined as a person who:

  • Has the new onset of two or more of the following symptoms: fever or chills, cough, sore throat, runny or stuffy nose, difficulty breathing, and body aches; and/or
  • Has tested positive for a specific respiratory infection, such as COVID-19, Influenza, or RSV.
Epidemiologically Linked Group

Epidemiologically linked groups involve individuals who were together in the same location when at least one person was contagious. In educational settings, this could mean students and/or teachers in the same classroom or athletic team who become ill around the same time. In community congregate settings, such as community care facilities and homeless shelters, it might involve residents who use the same living space or dining area. In correctional/detention facilities, the link could be among inmates or detainees sharing common areas or on the same unit. These situations suggest that the disease spread among these people is due to their shared environment rather than random transmission from outside that setting.

Community Congregate Settings
Refers to:
  • 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
    • Long-Term Care Facilities
    • Residential Substance Use Treatment Facilities
    • Mental Health Treatment Facilities
  • Sites that provide housing for people experiencing homelessness such as:
    • Shelters
    • Recuperative care centers
    • Single room occupancy hotels (SRO)
  • Correctional/detention facilities
When to Report
Epidemiologically linked group (e.g., individuals sharing common areas or living space):
  • A minimum of 5 cases (at least 20% of the group) meets case definition for acute respiratory illness within a 7 day period, OR
Facility-wide (e.g., among residents or clients):
  • At least 10% of the average daily population are reporting new onset of symptoms of acute respiratory illness, with a minimum of 5* ill, within a 3-day period.

*In settings with groups smaller than 15 people, the minimum is reduced to 3 cases.

How to Report

SPOT: Spot.cdph.ca.gov


For additional assistance, contact the Community Outbreak Team.

Education Settings
Refers to:
  • Early Care and Education (ECE) Facilities
  • TK-12 Schools
  • Institutes of Higher Education (IHE), including colleges, universities, and trade and technical schools
  • Programs serving school-aged children, including day care, camps, and youth sports programs
When to Report
Epidemiologically linked group (e.g., classroom, sports team, after-school group):
  • A minimum of 5* cases (at least 20% of the group) meet case definition for acute respiratory illness within a 7-day period.
Facility-wide (e.g., entire school or center):
  • At least 10% of the average daily attendance are absent and/or reporting symptoms of acute respiratory illness, with a minimum of 5* ill, within a 3-day period.
*In settings with groups smaller than 15 people, the minimum is reduced to 3 cases.
How to Report

SPOT: Spot.cdph.ca.gov


For additional assistance, contact the Community Outbreak Team.

Workplace Settings
Refers to:

Places of employment as defined in Cal/OSHA COVID-19 Prevention Non-Emergency Regulations, section 3205(a)(2)(A)-(D).

When to Report

Employers are required to report within 24 hours when:

  • There are at least 3 linked COVID-19 cases among an exposed group of workers (employees, assigned or contracted workers, or volunteers) within a 7-day period.
  • For large workplaces with more than 100 on-site workers, employers must also report when 5% of the workers are COVID-19 cases within a 7-day period, even if they are unlinked to each other.

In addition to LAC DPH Requirements, workplace settings should follow all instructions found in the Cal/OSHA COVID-19 Prevention Non-Emergency Regulations.

How to Report

SPOT: Spot.cdph.ca.gov


For additional assistance, contact the Community Outbreak Team.



Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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