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10.06.01.00.htm 10.06.01.00. Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle 06 DISEASES Chapter 01 Communicable Diseases and Related Conditions of Public Health Importance Authority: Health-General Article, §2-104(b) 18-102, 18-103, 18-105, 18-201, 18-201.1, 18-202, 18-205, 18-208, 18-214.1, 18-307, 18-337, and 24-101―24-110, Annotated Code of Maryland
10.06.01.01.htm 10.06.01.01. 01 Scope.. A. This chapter does not apply to human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) surveillance, reporting, record maintenance, or confidentiality, which are covered by COMAR 10.18.02 and 10.18.03.B. This chapter applies to human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) control.C. This chapter provides regulations for coordinated control efforts for communicable diseases and r
10.06.01.01-1.htm 10.06.01.01-1. 01-1 Incorporation by Reference.. A. In this chapter, the following document is incorporated by reference.. B. Document Incorporated. "Control of Communicable Diseases Manual (Nineteenth Edition, 2008).
10.06.01.02.htm 10.06.01.02. 02 Definitions.. A. The definitions of terms used in the Control of Communicable Diseases Manual are accepted as official and applicable to the control of diseases within this State under this chapter.B. Terms Defined.. 1) Body Fluid.. a) "Body fluid" means an excretion or fluid from a human body that contains visible blood and all other tissues, excretions or fluids including:i) Visible blood or any body fluid that is visibly contaminated with blood;.
10.06.01.03.htm 10.06.01.03. 03 Reportable Diseases, Conditions, Outbreaks, and Unusual Manifestations; Submitting Clinical Materials.A. A person, as set forth in Regulation .04 of this chapter, shall report the diseases or conditions listed in §C of this regulation, or any other condition as requested by the Secretary.B. Within 1 working day of a positive laboratory finding for a disease or condition listed in §C of this regulation, or upon request of the Secretary, the director of a medical laboratory shall:
10.06.01.04.htm 10.06.01.04. 04 Reporting Procedures.. A. Sources of Reports and to Whom to Report.. 1) An institution, as specified in Health-General Article, §18-202, Annotated Code of Maryland, and a health care provider who knows of a case of a reportable disease, condition, outbreak, or unusual manifestation shall report it to the health officer.2) A teacher at any public, private, or parochial school or a child care provider at any child care facility shall report an occurrence of a reportabl
10.06.01.05.htm 10.06.01.05. 05 Record Maintenance and Confidentiality.. A. The custodian of a report identifying an individual that was filed by a reporting source (Regulation .04A) in compliance with the provisions of Health-General Article, §18-201, 18-202, and 18-205, Annotated Code of Maryland:1) Shall keep the report and record confidential;. 2) May not open a report or record to public inspection;. 3) Shall release a report or record or respond to a subpoena for a report or record in criminal or c
10.06.01.06.htm 10.06.01.06. 06 General Control Measures.. A. Necessary Action. The Secretary or health officer shall:. 1) Take any action or measure necessary to prevent the spread of communicable disease or to control a reportable disease and condition; and2) Issue, when necessary, special instructions for control of a disease or condition.. B. Epidemiologic Investigations.. 1) A health officer shall respond to each reported outbreak or suspected outbreak of disease within the health officer's juri
10.06.01.07.htm 10.06.01.07. 07 Minimum Control Measures for Specific Diseases or Conditions.. A. The definitions of terms used in the text and the recommendations for control included in the Control of Communicable Diseases Manual are accepted as official and applicable to the control of disease within this State under the regulations of the Secretary, except in those instances in which the recommendations may be in conflict with the regulations of the Secretary, in which case the regulati
10.06.01.08.htm 10.06.01.08. 08 Amebiasis.. A. Control of a Case. A case may not participate in an occupation involving patient care, care of young children or the elderly, and food handling until chemotherapy is completed and 24 hours after diarrhea has ceased.B. Control of Contacts.. 1) The health officer shall investigate household and close contacts whose occupations involve food handling, patient care, and care of young children or the elderly.2) A contact who has diarrhea shall submit three f
10.06.01.08-1.htm 10.06.01.08-1. 08-1 Campylobacteriosis.. A. Control of a Case.. 1) A physician in attendance upon a case of campylobacteriosis with diarrhea shall instruct the case on the risks of transmission and the prevention of infection, especially proper:a) Handwashing;. b) Handling of raw meat; and. c) Cleaning of the food-preparation surfaces in contact with raw meat.. 2) A case may not attend a child care facility until the:. a) Case's fecal cultures are campylobacter-free on two consecutive specimen
10.06.01.08-2.htm 10.06.01.08-2. 08-2 Escherichia coli O157:H7 and Other Shiga-Like Toxin Producing Enteric Bacteria.. A. Control of a Case.. 1) A case may not attend a child care facility until the:. a) Case's fecal cultures or stool Shiga-like toxin tests are free of E. coli O157:H7 and other Shiga-like toxin producing enteric bacteria on two consecutive specimens collected not less than 24 hours apart and not sooner than 48 hours following discontinuation of antibiotics, if antibiotics have been given; or
10.06.01.09.htm 10.06.01.09. 09 Foodborne and Waterborne Diseases.. A. Control of a Case or Contacts. If one of the following diseases is identified, the health officer shall follow the procedures detailed in this chapter for the specific disease:1) Campylobacteriosis;. 2) Hepatitis, viral type A;. 3) Salmonellosis;. 4) Shigellosis;. 5) Trichinosis; and. 6) Typhoid fever.. B. Investigation and Control Measures.. 1) A food establishment as defined in Health-General Article, §21-301, Annotated Code of Maryland, s
10.06.01.10.htm 10.06.01.10. 10 Hepatitis, Viral Type A.. A. Control of a Case. A case may not participate in an occupation involving food handling, patient care, or care of young children or the elderly for 1 week after onset of jaundice, or for 2 weeks after the onset of illness, if not jaundiced.B. Control of Contacts. For an individual who previously has not received hepatitis A vaccine, the physician in attendance or the health officer shall offer a single dose of single antigen hepatitis A
10.06.01.11.htm 10.06.01.11. 11 Hepatitis, Viral Type B.. A. Control of a Case. A physician in attendance upon a case having viral hepatitis type B shall educate that case on the:1) Risks of sexual transmission, household contact transmission, maternal-infant transmission, and transmission by the sharing of hypodermic needles and other drug paraphernalia; and2) Availability of hepatitis B vaccine and hepatitis B immune globulin for contacts who have had sexual contact with a case of hepatitis B within the
10.06.01.11-1.htm 10.06.01.11-1. 11-1 Hepatitis, Viral Type C.. A. Control of a Case. A physician in attendance upon a case of viral hepatitis type C shall educate that case on:1) The risks of transmission of viral hepatitis type C by:. a) Sharing hypodermic needles and other injecting drug paraphernalia;. b) Sexual transmission;. c) Maternal-child transmission;. d) Parenteral or permucosal exposure to blood or body fluids;. e) Chronic hemodialysis;. f) Transfusion; and. g) Transplantation;.
10.06.01.12.htm 10.06.01.12. 12 Measles (Rubeola). A. Control of a Case. A case may not attend a school or child care facility from the onset of the illness at least through the 4th day after the rash appears.B. Control of Contacts. The health officer may require all nonimmune individuals to be excluded from a school or child care facility when a case of measles is diagnosed or suspected in a student, employee, or volunteer of the school or facility. The health officer shall authorize readmission upon do
10.06.01.12-1.htm 10.06.01.12-1. 12-1 Pneumococcal Disease.. A. There is no control of a case or contacts.. B. Vaccinations of an Individual at Risk.. 1) An individual at increased risk of pneumococcal disease includes an individual:. a) With anatomic or functional asplenia;. b) With sickle cell disease;. c) With human immunodeficiency virus infection;. d) With chronic heart, lung, liver, or renal disease;. e) With diabetes mellitus;. f) Who is 65 years old or older; or.
10.06.01.13.htm 10.06.01.13. 13 Psittacosis.. A. There is no control of a human case or contacts.. B. Infection Control. A health care provider shall practice appropriate disinfection and disposal of respiratory discharges.C. The sale and distribution of exotic birds and handling of exotic birds which are cases or suspected cases of avian psittacosis are subject to Health-General Article, §24-101―24-110, Annotated Code of Maryland.D. The Department recommends that the Compendium of Measures To Control Chl
10.06.01.14.htm 10.06.01.14. 14 Rabies.. A. Control of a Case (Human) A health care provider shall apply contact isolation to the case for the period of communicability.B. Control of Contacts. A health officer or health care provider shall evaluate individually a close contact or hospital contact to determine the need for post-exposure rabies prophylaxis. A health care provider shall warn an immediate attendant of the hazard of infection.
10.06.01.15.htm 10.06.01.15. 15 Rubella (German Measles). A. Control of a Case.. 1) A health officer or health care provider shall recommend that a case be isolated from a woman of childbearing age who is not immune or is of unknown immunity, from the onset of illness through the 7th day after appearance of the rash.2) A case may not attend a school or child care facility from the onset of the illness through the 7th day after the appearance of the rash.B. Control of Contacts. The health officer:.
10.06.01.16.htm 10.06.01.16. 16 Salmonellosis.. A. Control of a Case.. 1) The health officer shall restrict or exclude a case with diarrhea due to or presumed due to salmonellosis from:a) Attending:. i) A child care facility; or. ii) A family day care home; or. b) Participation in an occupation involving the:. i) Handling of food; or. ii) Care of patients, young children, or the elderly.. 2) Unless the health officer restricts or excludes the case when the health officer determines the c
10.06.01.17.htm 10.06.01.17. 17 Syphilis and HIV.. A. Control of a Case.. 1) For an individual who appears to have or who has syphilis in a stage which is or may become communicable, or HIV, a physician shall instruct the individual in the use of any measure and render any treatment which may be necessary to prevent the spread of the disease.2) An individual under medical observation for diagnosis of syphilis or HIV shall remain under medical supervision until the:
10.06.01.18.htm 10.06.01.18. 18 Other Sexually Transmitted Infections.. A. Control of a Case.. 1) Hepatitis, viral type B ― see Regulation .11.. 2) A physician in attendance upon a person who appears to have, or who has a sexually transmissible disease in a stage which is or may become communicable, shall:a) Instruct the person on the modes of transmission and the prevention of transmission;. b) Render any necessary treatment to the case; and. c) Advise the case to inform a sexual partner or p
10.06.01.19.htm 10.06.01.19. 19 Shigellosis.. A. Control of a Case.. 1) A case may not attend a child care facility until the case's fecal cultures are Shigella-free on two consecutive specimens collected not less than 24 hours apart and not sooner than 48 hours following discontinuation of antibiotics, if antibiotics have been given, or until the health officer approves readmission based on the low likelihood of disease transmission.2) A case, with or without diarrhea, may not participate in occupations inv
10.06.01.20.htm 10.06.01.20. 20 Trichinosis.. A. There is no control of a case or contacts.. B. Environmental Control. The health officer shall:. 1) Collect the suspect food for laboratory examination;. 2) Determine and order the proper disposition of the product if it is a homemade product intended for home use only that has been implicated by epidemiologic or laboratory evidence; and3) Notify the Secretary, who shall have the product withdrawn from sale or distribution and shall order the proper dispositio
10.06.01.21.htm 10.06.01.21. 21 Tuberculosis.. A. Control of a Case.. 1) A health officer or health care provider shall isolate a patient who is in a communicable stage as long as the specific microorganism:a) Is excreted by the patient; or. b) Can be isolated by culture in the case of multidrug resistant tuberculosis (MDR-TB) or extremely drug resistant tuberculosis (XDR-TB)2) A patient fulfills the requirements of isolation as long as the patient receives adequate chemotherapy, is under medical s
10.06.01.22.htm 10.06.01.22. 22 Typhoid Fever.. A. Control of a Case.. 1) A case may not attend a child care facility until fecal specimens are Salmonella-free on three consecutive specimens collected not less than 24 hours apart and not sooner than 48 hours following discontinuation of antibiotics, or until the health officer approves readmission based on the low likelihood of transmission.2) A case may not participate in occupations involving food handling, patient care, or care of young
10.06.01.23.htm 10.06.01.23. 23 Sale and Distribution of Reptiles.. A. Scope.. 1) Pursuant to the authority conferred upon the Secretary by Health-General Article, §18-219, Annotated Code of Maryland, the Secretary has determined that reptiles and reptile eggs are dangerous to human health and safety in that human contact with reptiles and reptile eggs may spread disease to humans. With this regulation, the Secretary prohibits the sale or public distribution of turtles with a carapace length of less
10.06.01.24.htm 10.06.01.24. 24 Sale and Distribution of Pet Animals.. To help prevent the spread of a communicable disease, a seller or a group of sellers who prepares or causes to be prepared a pamphlet, flyer, or other printed information on the handling of one or more pet animals and who distributes this pamphlet, flyer, or other printed information, shall ensure that this pamphlet, flyer, or other printed information stresses the importance of handwashing after contact with a reptile or
10.06.01.25.htm 10.06.01.25. 25 Control of Communicable Diseases in Pet Stores.. A. A pet store shall utilize procedures to ensure prevention and control of diseases common to and shared among humans and animals.B. The Department recommends that pet stores utilize the Compendium of Animal Rabies Prevention and Control, the Compendium of Measures To Control Chlamydophila psittaci Infection Among Humans (Psittacosis) and Pet Birds (Avian Chlamydiosis) and the Compendium of Measures to Prevent Disease Associat
10.06.01.9999.htm 10.06.01.9999. Administrative History Effective date: March 30, 1944. Amended April 1, 1966. Regulation .55 effective May 15, 1953. Regulation .56 effective October 18, 1951. Regulation .57 effective April 1, 1966. Regulation .58 effective December 20, 1971 ―. Regulations .01―54, .56, and .57 repealed and new Regulations .01―22 adopted effective December 26, 1980 (7:26 Md. R. 2420)Regulations .02A and .03B amended as an emergency provision effective June 21, 1983 (10:14 Md. R. 12
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