Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 06 - DISEASES
Chapter 10.06.01 - Communicable Diseases and Related Conditions of Public Health Importance
Section 10.06.01.02 - Definitions
Universal Citation: MD Code Reg 10.06.01.02
Current through Register Vol. 51, No. 19, September 20, 2024
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;
(ii) Died,
(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 Department of
Health and Mental Hygiene.
(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:
(a) Physicians;
(b) Physician assistants;
(c) Dentists;
(d) Chiropractors;
(e) Nurse practitioners;
(f) Nurses;
(g) Podiatrists;
(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;
(v) Nurses;
(vi) Nursing assistants;
(vii) Physicians;
(viii) Physician assistants;
(ix) Technicians;
(x) Therapists;
(xi) Pharmacists;
(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:
(i) Anthrax;
(ii) Botulism;
(iii) Cholera (imported or seafood
related);
(iv) Ciguatera
poisoning;
(v) Mushroom
poisoning;
(vi) Paralytic shellfish
poisoning and other neurotoxic shellfish poisoning;
(vii) Plague;
(viii) Rabies (human);
(ix) Smallpox;
(x) Scombroid poisoning; or
(xi) Trichinosis.
(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:
(i) Equids;
(ii) Cattle;
(iii) Goats;
(iv) Sheep; and
(v) Swine.
(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 and Mental Hygiene 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.
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