Long-Term Care-Related

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Disease Reporting Line:
(808) 586-4586

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AUW 2-1-1

Per the Hawaii Administrative Rules, Title 11, Chapter 156, Exhibit A, the Hawaii Department of Health (HDOH) requires all physicians, laboratory directors, and health care providers in institutions to report laboratory confirmed cases and outbreaks of COVID-19, influenza, and influenza-like illness immediately.

The Council for Outbreak Response: Healthcare-Associated Infections and Antimicrobial Resistant Pathogens (CORHA) and the Council of State and and Territorial Epidemiologist (CSTE) thresholds and Outbreaks definitions for COVID-19 in Healthcare Settings (updated January 2, 2024) found here.

COVID-19 Outbreaks

COVID-19 DiseaseWhen to reportReport toAction by the Facility
COVID-19 symptoms may change with new SARS-CoV-2 variants and can vary depending on vaccination status. Symptoms may include fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea.


Source: Symptoms of COVID-19 | CDC
≥2 cases of COVID-19 among residents identified within 7 days

OR

≥2 cases of COVID-19 among Health Care Personnel AND ≥1 case of COVID-19 among residents

OR

≥3 cases of acute illness compatible with COVID19 among residents with onset within a 72h period
To report COVID-19 activity to HDOH please call the island District Health Office:

Oahu- 808-586-4586
Maui- 808-984-8213
Kauai- 808-241-3563
Hawaii- 808-933-0912
Download and fill out the Long term care COVID-19 excel line list (attached)

Influenza-like Illness (ILI) / Influenza (FLU) Outbreaks

Influenza-like Illness (ILI) / Influenza (FLU)When to reportReport toAction by the Facility
ILI symptoms include cough or sore throat accompanying a fever or history of fever. Some people may feel tired, muscle aches, headaches, and chills. Symptoms can last up to a week, sometimes longer, especially in people who are immunocompromised.Long-term care facilities (LTCFs) are required to report flu-like activity to the HDOH when:
  • Three (3) or more cases of ILI are detected on a single unit* during a period of 48 to 72 hours.

*A unit is defined as any configuration that the facility divides their building, be it rooms, floors, or wards.
To report ILI activity to HDOH, please call (808) 586-4586.Download and fill out the following forms to the best of your ability:

Long Term Care Facility Flu/ILI Outbreak Form

Long Term Care Facility Flu/ILI Line List Excel Sheet

Fax it to (808) 586-4595 or email it to [email protected]
If emailing, please password protect the Excel file and send the password in a separate email for confidentiality and privacy purposes.
If you are not sure if the flu or ILI activity in your facility needs to be reported, please contact the Disease Investigation Branch at (808) 586-4586. Flu and ILI activity in healthcare facilities are immediately reportable, so please do not hesitate to call. HDOH personnel will assist you in determining how to proceed with your particular situation.

During the outbreak, HDOH personnel will be able to assist you in preventing further spread of infection in your facility. Testing kits are available from your partner clinical laboratories to test for influenza and other respiratory viruses at the State Laboratories Division of HDOH.

Once the specimens have been tested, we will know if your facility has a confirmed outbreak. HDOH personnel provides you with materials you may need to encourage proper infection control, workplace restriction, and other spread prevention practices. Our goal is to prevent further spread of the current outbreak and prevent other outbreaks from happening.

Gastrointestinal (GI) or suspected norovirus outbreaks

Gastrointestinal (GI) or suspected norovirus outbreaksWhen to reportReport toAction by the Facility
A Gastrointestinal Illness (GI) is an illness with symptoms of vomiting, diarrhea (≥3 stools in 24 hours), and/or abdominal pain. Illness is confirmed when an individual has a positive culture for a bacteria or virus in stool.

Norovirus symptoms include acute onset of vomiting and/or diarrhea, nausea, and stomach cramps. Some people may have a mild fever, chills, headache, muscle aches, and a general sense of tiredness. The illness usually begins suddenly, and the infected person may become dehydrated. The duration of the illness is usually about 1 to 3 days.
Long-term care facilities (LTCFs) should report GI or suspect norovirus activity to HDOH when:
  • Two (2) or more cases of suspect GI or norovirus are detected on a single unit* during a period of 24 hours.

*A unit is defined as any way that the facility divides their building, be it rooms, floors, or wards.
To report GI or suspect norovirus activity to HDOH, please call (808) 586-4586.Download and fill out the following forms to the best of your ability:

Long Term Care Facility Noro Outbreak Form

Long Term Care Facility Noro Line List Excel Sheet

Fax it to (808) 586-4595.
If you are not sure if the GI or suspect norovirus outbreaks in your facility needs to be reported, please contact the Disease Investigation Branch at (808) 586-4586. GI activity and suspect norovirus outbreaks in healthcare facilities are immediately reportable, so please do not hesitate to call. HDOH personnel will assist you in determining how to proceed with your situation.

During the outbreak, HDOH personnel will be able to assist you in preventing further spread of infection in your facility. Testing kits are available from your partner clinical laboratories to test for norovirus and other GI pathogens at the State Laboratories Division of HDOH.

Once the specimens have been tested, we will know if your facility has a confirmed outbreak. HDOH personnel provides you with materials you may need to ensure proper infection control, workplace restriction, and other prevention practices. Our goal is to prevent further spread of the current outbreak and prevent other outbreaks from happening.

Report an Infectious Disease

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To report an illness, please contact the Department of Health at these numbers:

Oahu (Disease Reporting Line): (808) 586-4586
Maui District Health Office: (808) 984-8213
Kauai District Health Office: (808) 241-3563
Hawaii Health Office: (808) 933-0912
After hours (Physician’s Exchange): (808) 600-3625 or Toll Free 1-800-360-2575

Last reviewed February 12, 2024