Sec. 10.06.01.15. Rubella (German Measles)

A. Control of a Case. A health officer or health care provider shall recommend that a case:

(1) 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; and

(2) May not attend a school, workplace, or child care facility from the onset of the illness through the 7th day after the appearance of the rash.

B. Control of Contacts.

(1) Nonimmune Contacts.

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

(i) Have not received at least one dose of rubella 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 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 rubella.

(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 rubella is diagnosed or suspected in a student, employee, or volunteer of the school or facility; and

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

C. Infection Control. A health care provider shall practice droplet precaution for 7 days after onset of the rash.

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 either one dose of live rubella virus vaccination on or after becoming 1 year old or proof of immunity by blood test for antibody to rubella. The hospital shall keep the vaccine 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 rubella 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 rubella 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 rubella antibody test results.