Carbon Monoxide Poisoning
Reportable by Laboratories and ProvidersAbout this Reportable Disease
Agent: carbon monoxide (CO) an odorless, colorless, and deadly gas
Description of illness: CO poisoning often causes dizziness, headache, nausea, and shortness of breath. CO poisoning can cause death within minutes inside enclosed, semi-enclosed or poorly ventilated areas. All people are at risk for CO poisoning. Certain groups are more easily affected, including infants, children, pregnant women and those with chronic heart disease, anemia, or respiratory problems.
Common Sources: Carbon monoxide is the result of incomplete combustion. Therefore, just about anything that burns can make CO. Common sources are electric generators, vehicle tailpipes, boat motors, natural gas appliances and water heaters, charcoal grills, and fires.
NEW: As of 01/01/2024 Laboratories are required to report laboratory-confirmed CO cases (carboxyhemoglobin level of >12.0% as measured in a blood sample)
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Laboratory Reporting
Reporting requirements apply to all laboratories located within Tennessee, as well as laboratories outside of Tennessee that test residents of Tennessee, including laboratories located within healthcare facilities. Healthcare providers and laboratories in the same healthcare facility both have a duty to report. The type of organisms and analytes laboratories must report to TDH for 2026 are indicated, and there are several ways laboratories can report results to TDH.
- Manually report results to TDH by faxing or mailing a completed PH-1600 form to your local health department, or faxing to the state health office at (615) 741-3857
- Automatically submit results to TDH via electronic laboratory reporting (ELR), which automates the process of sharing data with TDH using interoperability standards.
- See the ELR Onboarding Handbook for details on the onboarding process, checklist, frequently asked questions, business rules, message format, and vocabulary.
- To initiate the ELR onboarding process with TDH, register in the Trading Partner Registration (TPR) system TPR provides documentation for Promoting Interoperability (PI) attestation and milestone letters to document onboarding progress. Contact MU.Health@tn.gov for assistance.
- Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
- Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for Healthcare Providers
Clinical Summary
- CO is an odorless, colorless, and potentially lethal gas produced by incomplete combustion of carbon‑containing fuels.
- Typical symptoms are non‑specific (e.g., headache, dizziness, weakness, nausea, vomiting, chest pain, confusion) and often mimic influenza.
- Pathophysiology involves formation of carboxyhemoglobin (COHb) which reduces oxygen delivery and disrupts cellular respiration, especially affecting brain and heart.
- Diagnosis is based on exposure history, compatible signs/symptoms, and elevated COHb levels (e.g., ≥ 5 % in non‑smokers) though levels don’t always correlate with severity.
- Treatment centers on prompt removal from exposure, administration of 100 % oxygen (via non‑rebreather) until symptoms resolve, and in selected cases hyperbaric oxygen therapy (especially for pregnancy, cardiac involvement, neurological signs).
Healthcare Provider Reporting
Healthcare reporting requirements apply to all providers located within Tennessee, as well as providers whose patients reside in Tennessee.
Providers must report cases of all diseases and conditions listed through one of these methods:
• Mail or fax a completed PH-1600 form to your local health department or fax to the state health office at (615) 741-3857
• Send automatically via electronic case reporting (eCR). See this TDH webpage for more information on eCR, register at the Trader Partner Registration website, or contact MU.Health@tn.gov for assistance.
• Submit online via NBS. NBS is TDH's reportable disease system. To request an NBS account for reporting Complete this user survey to request an NBS account for reporting.
• Blood lead levels can be sent via fax ( (615) 741-3857), entered online, or reported using the instructions at this link.
Information about this Reportable Disease for the Public
What it is
Carbon monoxide is a colorless, odorless gas produced by incomplete combustion of fuels; inhalation prevents oxygen delivery to tissues, causing hypoxia.
Types
There are no formal “types,” but exposures can be acute (sudden, high-level) or chronic/low-level (prolonged, mild exposure), both causing health effects.
Signs and Symptoms
Symptoms range from headache, dizziness, nausea, vomiting, and confusion to chest pain, loss of consciousness, or death in severe exposure.
Treatment
Immediate removal from CO source, administration of 100% oxygen (via mask or hyperbaric oxygen in severe cases), and supportive care are essential.
This Page Last Updated: March 25, 2026 at 8:53 PM