Sec. 10.06.01.12. Measles (Rubeola)  


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  • A. Control of a Case. A health officer or health care provider shall recommend that a case may not attend a school, workplace, or child care facility from the onset of the illness at least through the 4th day after the rash appears.

    B. Control of Contacts.

    (1) Nonimmune Contacts.

    (a) Nonimmune individuals for measles, in general, are people who:

    (i) Have not received two doses of measles containing vaccine on or after the first birthday;

    (ii) Have no documentation of immunity or disease; or

    (iii) Were born in or after 1957.

    (b) A health officer or health care provider shall recommend that:

    (i) Nonimmune contacts receive measles vaccine within 72 hours of exposure if not medically contraindicated; and

    (ii) Nonimmune household or other close contacts, particularly contacts younger than 1 year old, pregnant women, persons with immunodeficiencies, or those for whom the vaccine is contraindicated, be given immune globulin within 6 days of exposure.

    (c) A health officer shall restrict or exclude a nonimmune contact from attending a school, health care facility, child care facility, or workplace until 21 days after the onset of rash in the last case of measles.

    (2) A health officer:

    (a) May require all nonimmune individuals to be excluded from a school, workplace, or child care facility when a case of measles is diagnosed or suspected in a student, employee, or volunteer of the school or facility; and

    (b) Shall authorize readmission upon documented proof of immunity in the form of immunization record, serologic test, or the low likelihood of disease transmission.

    C. Infection Control. Health care providers shall practice airborne precautions from the onset of illness at least through the 4th day after the rash appears.

    D. Proof of Immunity for Health Care Workers.

    (1) A worker born in or after 1957 working at least 20 hours each week who is newly retained as medical staff, a direct or contractual employee, or a volunteer of a hospital classified as a “general hospital” under Health-General Article, §19-307, Annotated Code of Maryland, shall have documentation of receipt of two doses of live measles virus vaccine after becoming 1 year old or proof of immunity by blood test for antibody to rubeola. The hospital shall keep the measles vaccination or immunity status of each worker on file.

    (2) Exemptions.

    (a) A hospital shall grant a medical exemption for any worker who presents a written statement from a licensed physician or a health officer indicating that immunization against measles is medically contraindicated or detrimental to the worker's health. The statement shall indicate whether the exemption should be permanent or temporary. If the exemption is temporary, the statement shall indicate the date on which the worker is to receive the immunization. A hospital shall withdraw a temporary medical exemption on the day following that date. If the exemption is permanent, the hospital shall maintain a record of the worker's measles antibody test results.

    (b) If a worker objects to an immunization upon the grounds that it conflicts with the worker's bona fide religious beliefs and practices, the hospital shall grant a religious exemption to the worker for the immunization. The hospital shall maintain a record of the worker's measles antibody test results.