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of the Commonwealth of Pennsylvania

    The .gov means it's official.

    Local, state, and federal government websites often end in .gov. Commonwealth of Pennsylvania government websites and email systems use "pennsylvania.gov" or "pa.gov" at the end of the address. Before sharing sensitive or personal information, make sure you're on an official state website. 

    Cases (28 Pa. Code § 27.3)

    Report to PA-NEDSS:

    • All positive influenza and RSV tests, including positive point-of-care (POC) tests performed in a health care setting, are required to be reported to PA-NEDSS. (28 Pa. Code § 27.3)
      • Tests performed at a lab are generally reported to PA-NEDSS via electronic lab reporting.
    • Voluntary positive COVID-19 reporting is strongly recommended statewide.
      • Reporting of cases of COVID-19 is still required in some counties, please check with your local or municipal health department regarding local reporting requirements.

    Severe outcomes

    Report to PA-NEDSS:

    • All influenza- and RSV- related hospitalizations.
    • All influenza- and RSV- related deaths.
    • Pediatric COVID-19 deaths are also reportable.

    Additional requirements:

    • Pediatric influenza- and COVID-19- related deaths are also reported to the CDC by the DOH
    • DOH may contact facilities to complete a pediatric death case report form.

    Outbreaks

    Healthcare facilities are required to report all respiratory virus outbreaks.

    • In health care settings other than LTCFs: an outbreak = any unusual cluster or increase above baseline.
    • LTCFs should follow the guidance in “Section 2: Outbreak Response and Control” of the Respiratory Virus Outbreak Toolkit.                 

    Rare or Unusual Disease Occurrences

    If an emerging or rare respiratory virus is suspected, call DOH for assistance at 1-877-787-3350. This assistance is available 24/7 days a week. 

    Examples include clinical suspicion for:

    • Middle East Respiratory Syndrome (MERS)
    • Avian (bird) influenza (see section on avian influenza below).
    • Variant influenza (e.g., A/H3N2v)
    • SARS (SARS-CoV-1)
    • Any  unusual respiratory disease which routine testing does not provide a diagnosis

    NOTE: Other local, state, and federal programs may have different or additional reporting requirements.

    Cases

    Report cases to PA-NEDSS by:

    • Manual entry
    • Aggregate reporting
      •  Do not include hospitalized or death cases in the aggregate reporting module totals.
    • Spreadsheet upload
    • Electronic Laboratory Report (Laboratories only)

    Details about the available reporting options can be found in Preparedness for the 2025-2026 Respiratory Season.

    Important:

    NOTE: Tests sent to hospital or commercial labs are usually reported by the laboratory performing the test.  These do not need to be manually reported.

    If using a smaller lab, or an out-of-state lab, please confirm they report to PA-NEDSS.  If not, your facility must report manually. 

    Hospitalizations and Deaths

    • Report hospitalizations and deaths to PA-NEDSS via manual entry ONLY.
      • DOH may contact your facility to complete a pediatric death case report form.

    Outbreaks

    NOTE: Other state and federal programs may have different or additional reporting requirements.

    Avian and Variant influenza (immediate notification required)

    When to suspect avian or variant influenza

    Consider in patients with:

    • A positive influenza A specimen with no subtype test performed or with subtype test negative and/or
    • Respiratory symptoms plus occupational or recreational exposure risk

    Occupational or Recreational Exposures to Consider (within 10 days before symptom onset)

    • Commercial poultry workers/depopulation workers (who cull infected poultry flocks)
    • Dairy farm workers
    • Live-bird market workers/shoppers
    • Backyard flock owners
    • People who consume or handle raw milk
    • Game-bird hunters
    • Members of agricultural clubs such as 4-H or FFA
    • Veterinary workers (especially those who handle poultry or livestock)
    • Slaughterhouse workers

    Important:
    Properly prepared meat does not transmit avian or variant influenza. Eating poultry, beef, or pork is not considered an exposure.

    How to screen for avian or variant influenza exposures:

    Ask symptomatic patients the following questions to determine risk:

    • What is your occupation?
    • Have you had a known exposure to bird flu?
    • Have you had any contact with sick/dead birds or cows in the last 10 days?

    Notify public health of a suspected avian or variant influenza case

    Health care facilities in any of the following counties or cities should notify their local health department of the suspected avian or variant case:

    • Allegheny County, Bucks County, Chester County, Delaware County, Erie County, Montgomery County, and Philadelphia County
    • Allentown, Bethlehem, Wilkes-Barre, and York City

    For a facility not located in the above jurisdictions, contact the Bureau of Epidemiology 24/7 at 1-877-PA-HEALTH. Public health will review the risk factors and relevant test results. If appropriate, public health will organize rush shipping to our state public health laboratory for testing at no cost to the patient or provider.

    Please be ready to provide the following information:

    • Testing already performed and results
    • Risk factors
    • Patient name, DOB
    • Facility name and address
    • Pick-up location
    • Point-of-contact: name, email, and phone number
    • Number of packages
    • Time packages will be ready for pickup
    • Hours available for pickup
    known exposure to sick/dead birds or swine
    no exposure to sick/dead birds or swine

    Additional details can be found below:

    Laboratories

    Hospital and commercial laboratories performing influenza testing with Universal or Viral Transport Media should follow the guidance below for submitting specimens. ILINet participants should refer to the guidance on ILINet | Department of Health | Commonwealth of Pennsylvania

    Specimens that can be sent without prior notification:

    • Influenza and COVID-19 Specimens
      • Label: “Flu/COVID Surveillance”
    • Influenza A positive specimens of severely ill hospitalized patients when subtyping is not performed or available at the lab
      • Label: “Need Subtype”
    • Influenza A positive specimens that are subtype negative and have no suspected or known exposure to sick/dead birds or swine
      • Label: “Subtype Negative”

    Specimens that need BOE notification BEFORE shipping to BOL:

    • Influenza A positive specimens of patients with an exposure to swine or sick/dead birds in the 10 days prior to symptoms starting
      • Shipping instructions and specimen label provided by BOE
      • BOE Contact information:
        • Mon-Fri 8-5: 717-787-3350
        • After hours, weekends, holidays: 1-877-PA-HEALTH

    This step should ideally be done by the ordering provider or infection preventionist. The patient needs to be screened to determine exposure to H5.

    How to ship specimens that do not require prior notification to BOL:

    Follow the instructions on the specimen collection and shipping information. Use the appropriate labelling as directed in the above sections.

    Maintain the specimen at ≤8 °C if it will be delivered to BOL within 72 hours. Please take shipping time into consideration. Keep specimen at ≤0 °C if it will not arrive at BOL within 72 hours of collection. Pack with multiple frozen ice packs or dry ice. Failure to meet these conditions will result in immediate rejection.

    Specimens should NOT be sent on Fridays, weekends, or the day before/on holiday. Courier must be requested for same day pick up by noon. Specimens collected after 12 PM should be sent the next day.

    • BOL Contact information: 1-610-280-3464

    Infection Control in Health Care Facilities

    DOH encourages health care facilities, including LTCFs, to follow the guidance in the Frequently Asked Questions about Fall 2025 Respiratory Viral Illness Guidance Changes for Health Care . This guidance may differ from CDC; we recommend facilities defer to DOH guidance where guidance differs. Additional resources for LTCFs can be found here: LTCF | Department of Health | Commonwealth of Pennsylvania.

    To prevent the transmission of respiratory infection in health care settings, including influenza, RSV, and COVID-19, the following infection control measures should be incorporated into standard procedures:

    • Optimize the use of administrative and engineering controls
    • Communicate about recommended infection control practices
    • Practice respiratory hygiene and cough etiquette
    • Consider broader use of source control
    • Use appropriate transmission-based precautions based on suspected diagnosis
    • Monitor and manage iII health care personnel

    For more details on each measure, please visit Preventing Transmission of Viral Respiratory Pathogens in Healthcare Settings | Infection Control | CDC and Work Exclusion Guidance for Health Care Personnel with Viral Respiratory Illness or Exposure (Updated).

    Additional health care facility resources for respiratory viruses

    Testing resources for respiratory viruses

    Influenza and RSV

    COVID-19