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;
(ii) Semen or vaginal secretions;
(iii) Amniotic, cerebrospinal, pericardial, peritoneal, pleural, or synovial fluids;
(iv) Saliva in dental procedures; and
(v) All body fluids in situations where it is difficult or impossible to differentiate between body fluids.
(b) “Body fluid” does not include stool, nasal secretions, sputum, tears, urine, or vomitus.
(2) “Case” means an individual who has laboratory or clinical evidence of being infected by an infectious agent.
(3) “Case of a condition” means an individual who suffers from a condition that is not caused by an infectious agent, including, but not limited to:
(a) An animal bite;
(b) An adverse reaction to pertussis vaccine;
(c) Harmful algal bloom related illness;
(d) Pesticide related illness; or
(e) Ricin toxin poisoning.
(4) “Case (or suspected case) of avian psittacosis” means that a bird has:
(a) Laboratory evidence of Chlamydophila psittaci infection consisting of:
(i) Culture isolation of Chlamydophila psittaci from a clinical specimen;
(ii) A positive fluorescent antibody test for Chlamydophila psittaci on a clinical specimen;
(iii) A fourfold, or greater, increase in Chlamydophila psittaci antibody in a serologic titer, in two serum specimens obtained at least 2 weeks apart and assayed simultaneously at the same laboratory; or
(iv) Identification of Chlamydophila psittaci within macrophages in smears stained with Gimenez or Macchiavellos stain or sections of the bird's tissues; or
(b) Clinical evidence of Chlamydophila psittaci infection consisting of an epidemiologic link to an avian case that has laboratory evidence of infection, and has:
(i) Exhibited one or more signs of psittacosis;
(iii) Been clinically diagnosed as having psittacosis by a licensed veterinarian; or
(iv) Had gross necropsy findings or histopathological evidence consistent with psittacosis as reported by a veterinary pathologist.
(5) Child Care Facility.
(a) “Child care facility” means a licensed, registered, or unlicensed facility, institution, establishment, or home where children receive care or supervision for which money is paid when the child's parent has given the child's care over to another on a regular basis for some portion of a 24-hour day as a supplement to the parent's primary care of the child.
(b) “Child care facility” includes child care center, day care center, nursery, family day care home, and babysitter.
(6) Clinical Material.
(a) “Clinical material” means:
(i) An organism isolated from a clinical specimen;
(ii) Material derived or prepared from a clinical specimen in which evidence of a communicable disease has been identified or detected; or
(iii) If the organism or material described in §B(6)(a)(i) and (ii) of this regulation is not available, material from an individual that has already been obtained by the medical laboratory, in the following order of preference: a patient specimen, microbial genetic material, or other laboratory material.
(b) “Clinical material” includes, for Mycobacterium tuberculosis, one culture obtained from the primary isolate on which the diagnosis of tuberculosis was established.
(7) “Colonization” means the proliferation of microorganisms on or within one or more body sites without detectable host immune response, cellular damage, or clinical expression.
(8) “Commissioner” means the Commissioner of Health of the Baltimore City Health Department.
(9) “Department” means the Maryland Department of Health.
(10) “Foodborne disease outbreak” means two or more epidemiologically related cases of illness following consumption of a common food item or items, or one case of botulism, cholera, mushroom poisoning, trichinosis, or fish poisoning such as ciguatera poisoning, scombroid poisoning, paralytic shellfish poisoning, and other neurotoxic shellfish poisoning.
(11) “Health care provider” includes, but is not limited to:
(b) Physician assistants;
(e) Nurse practitioners;
(h) Medical examiners;
(i) Hospital administrators;
(j) Clinic administrators;
(k) Dispensary administrators;
(l) Nursing home administrators; and
(m) Any other licensed health care providers.
(12) Health Care Worker.
(a) “Health care worker” means a paid or unpaid individual working in a health care setting who has the potential for exposure to:
(i) Infectious materials, including body substances;
(ii) Contaminated medical supplies and equipment;
(iii) Contaminated environmental surfaces; or
(iv) Contaminated air.
(b) “Health care worker” includes, but is not limited to:
(i) Emergency medical service personnel;
(ii) Dental personnel;
(iii) Laboratory personnel;
(iv) Autopsy personnel;
(vi) Nursing assistants;
(viii) Physician assistants;
(xii) Students and trainees;
(xiii) Contractual staff not employed by the health care facility; and
(xiv) Individuals not directly involved in patient care but potentially exposed to infectious agents, for example, clerical, dietary, housekeeping, maintenance, and volunteer personnel.
(13) “Health officer” means the health officer in each of the 23 counties and the Commissioner of Health in Baltimore City, or the duly designated representative of the health officer, or both.
(14) “Infectious” means capable of being transmitted in a manner that can cause a disease or abnormal condition in an individual.
(15) “Invasive disease” means a disease in which an organism is detected in a specimen taken from a normally sterile body site.
(16) “Normally sterile body site” means a body site except for skin, external ear, oronasopharynx, gastrointestinal tract, urethral meatus, and vagina.
(17) “Novel influenza A virus infection” means a human case of infection with an influenza A virus subtype that is suspected to be markedly different from currently circulating human influenza A viruses, including, but not limited to, H2, H5, H7, or H9 subtypes.
(18) “Outbreak” means:
(a) A foodborne disease outbreak;
(b) Three or more cases of a disease or illness that is not a foodborne outbreak and that occurs in individuals who are not living in the same household, but who are epidemiologically linked;
(c) An increase in the number of infections in a facility, such as a hospital, long-term care facility, assisted living facility, school, or child care center, over the baseline rate usually found in that facility;
(d) A situation designated by the Secretary as an outbreak; or
(e) One case of:
(iii) Cholera (imported or seafood related);
(iv) Ciguatera poisoning;
(v) Mushroom poisoning;
(vi) Paralytic shellfish poisoning and other neurotoxic shellfish poisoning;
(viii) Rabies (human);
(x) Scombroid poisoning; or
(19) Pet Animal.
(a) “Pet animal” means a live animal sold or distributed to the public with or without charge for pleasure or companionship and not for utility.
(b) “Pet animal” does not include domestic farm animals including, but not limited to:
(iv) Sheep; and
(20) Pet Store.
(a) “Pet store” means a facility that keeps, cares for, and houses animals classified as pet animals for the purpose of sale or distribution to the public.
(b) “Pet store” includes but is not limited to a:
(i) Commercial facility;
(ii) Feed store; or
(iii) Department store.
(21) “Physician” means an individual licensed to practice osteopathy or medicine by the State, or the physician's designee working under the supervision of the physician.
(22) “Reptile” means a cold blooded, air breathing vertebrate of the class Reptilia.
(23) “Secretary” means the Secretary of Health or the Secretary's designee.
(24) “Sell” means to sell, hold for sale, or offer for commercial or public distribution, a pet animal.
(25) “Seller” means a person who sells, holds for sale, or offers for commercial or public distribution, a pet animal.
(26) “Sexually transmitted infection” means an infection which may be spread by sexual intercourse, including oral, anal, or vaginal sexual contact with an infected individual.
(27) Skin-Penetrating Body Adornment Procedure.
(a) “Skin-penetrating body adornment procedure” means a process that involves piercing or entering the skin or the mucous membrane of an individual for the purpose of inserting pigmented patterns, jewelry, or other forms of body decoration.
(b) “Skin-penetrating body adornment procedure” includes body-piercing and tattooing.
(c) “Skin-penetrating body adornment procedure” does not include piercing of an earlobe using a properly disinfected ear-piercing gun and single-use sterile studs and clutches.
(28) Standard Precautions.
(a) “Standard precautions” means a group of infection prevention practices that apply to all patients, regardless of suspected or confirmed diagnosis or presumed infection status, given that all blood, body fluids, secretions, excretions except sweat, nonintact skin, and mucous membranes may contain transmissible infectious agents.
(b) “Standard precautions” includes:
(i) Hand hygiene and use of gloves, gown, mask, eye protection, or face shield depending on anticipated exposure; and
(ii) Handling equipment or items in the patient environment likely to have been contaminated with infectious fluids in a manner to prevent transmission of infectious agents.
(29) “Turtle” means an animal commonly known as a turtle, tortoise, or terrapin.