Instances, clusters, or outbreaks of unusual diseases or manifestations of illness and clusters or instances of unexplained deaths which appear to be a result of a terrorist act or the intentional or deliberate release of biological, chemical, radiological, or physical agents, including exposures through food, water or air are a Category 1(B) disease and shall be reported to the local health authority or to DHSS immediately upon first knowledge or suspicion.

Instances, clusters, or outbreaks of unusual, novel, and/or emerging diseases or findings not otherwise named in 19 CSR 20-20.020, appearing to be naturally occurring, but posing a substantial risk to public health and/or social and economic stability due to their ease of dissemination or transmittal, associated mortality rates, or the need for special public health actions to control are a Category 1(C) disease and shall be reported to the local health authority or to the DHSS immediately upon first knowledge or suspicion.

Outbreaks (including nosocomial) or epidemics of any illness, disease or condition that may be of public health concern, including illness in a food handler that is potentially transmissible through food, are a Category 2(A) disease and shall be reported to the local health authority or to DHSS within one (1) calendar day of first knowledge or suspicion.