I 

118TH CONGRESS 

2D SESSION H. R. 9098 

To provide for surveillance of Clostridioides difficile, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 23, 2024 

Ms. CLARKE of New York introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL 

To provide for surveillance of Clostridioides difficile, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; FINDINGS AND PURPOSES. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Peggy Lillis Clostridioides difficile Inclusion Act’’. 

6 (b) FINDINGS.—Congress finds the following: 

7 (1) Clostridioides difficile (referred to in this 

8 section as ‘‘C.diff’’) is a bacterium that can cause a 

9 range of symptoms from diarrhea to life-threatening 

10 inflammation of the colon. 


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1 (2) C. diff infections are a significant public 

2 health concern, leading to substantial morbidity, 

3 mortality, and healthcare costs in the United States. 

4 An estimated 500,000 infections, including 20,000 

5 in children, occur in the United States each year, 

6 causing an estimated 30,000 deaths. Because C.diff 

7 infections is not mandatorily reported by outpatient 

8 facilities, skilled nursing facilities, and others, this 

9 number likely does not account for the full burden 

10 of C. diff infections. The estimated attributable cost 

11 of C.diff infections in the United States is 

12 $1,000,000,000. 

13 (3) Tracking and monitoring of C. diff cases is 

14 essential for understanding the disease epidemiology, 

15 implementing effective prevention and control strate16 gies, and ensuring public health and health care pro17 viders have to necessary resources to improve health 

18 outcomes, address health disparities, and reduce 

19 mortality. While C. diff is more commonly found in 

20 White patients, Black patients tend to have worse 

21 outcomes—including greater risk for severe C.diff in22 fections and greater risk for mortality. 

23 (c) PURPOSES.—The purpose of this Act is to require 

24 the Centers for Disease Control and Prevention to include 


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1 C.diff as a Nationally Notifiable Infectious Disease and 

2 Condition. 

3 SEC. 2. IMPROVING SURVEILLANCE OF CLOSTRIDIUM 

4 DIFFICILE. 

5 (a) INCLUSION AS NATIONALLY NOTIFIABLE DIS6 EASE OR CONDITION.—Not later than 180 days after the 

7 date of the enactment of this Act, the Secretary of Health 

8 and Human Services, acting through the Director of the 

9 Centers for Disease Control and Prevention (in this sec10 tion referred to as the ‘‘Secretary’’) shall add 

11 Clostridioides difficile (referred to in this section as 

12 ‘‘C.diff’’) to the list of nationally notifiable diseases or con13 ditions published by the Council of State and Territorial 

14 Epidemiologists and the Centers for Disease Control and 

15 Prevention. 

16 (b) REPORTING REQUIREMENTS.— 

17 (1) STATES.—The Secretary shall, pursuant to 

18 section 301 of the Public Health Service Act (42 

19 U.S.C. 241), issue regulations requiring each State 

20 to collect and report data on confirmed cases of 

21 C.diff to the Secretary. 

22 (2) REPORTING ENTITIES.—Any entity required 

23 to submit information to the Secretary, pursuant to 

24 such section 301, with respect to cases of a nation25 ally notifiable disease or condition, including a 


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1 health care facility or laboratory, shall submit such 

2 information to the Secretary with respect to cases of 

3 C.diff. 

4 (3) DATA ELEMENTS.—The Secretary shall es5 tablish standardized data elements, including demo6 graphic information, clinical information, and lab7 oratory results, for the reporting of cases of C.diff 

8 under this subsection. 

9 (c) SEVERABILITY.—If any provision of this Act, or 

10 the application thereof to any person or circumstances, is 

11 held invalid, the remainder of the Act and the application 

12 of the provisions to other persons or circumstances shall 

13 not be affected. 

14 (d) STATE DEFINED.—In this section, the term 

15 ‘‘State’’ means each of the several States, the District of 

16 Columbia, each territory or possession of the United 

17 States, and each federally recognized Indian Tribe. 

Æ 


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