1. A. Control of a Case.

   1. (1) For a case with diarrhea due to or presumed due to cholera, a health officer shall restrict or exclude a case from:

      1. (a) Attending a child care facility; or

      2. (b) Participating in an occupation involving;

         1. (i) Food handling;
         2. (ii) Patient care; or
         3. (iii) Care of young children or the elderly.

   2. (2) For a case who has been without diarrhea for at least 48 hours, unless a health officer otherwise restricts or excludes the case based on Regulation .06D of this chapter, the case may:

      1. (a) Attend a child care facility; and

      2. (b) Participate in an occupation involving:

         1. (i) Food handling;
         2. (ii) Patient care; or
         3. (iii) Care of young children or the elderly.

   3. (3) If a health officer has restricted or excluded a case under §A(1) of this regulation or Regulation .06D of this chapter, the health officer shall approve resumption of child care attendance or occupational duties when:

      1. (a) The case's fecal cultures are Vibrio-free on two consecutive specimens collected:

         1. (i) Not less than 24 hours apart; and
         2. (ii) If antibiotics have been given, not sooner than 48 hours following discontinuation of antibiotics; or
      2. (b) The health officer determines that the likelihood of disease transmission is low.

2. B. Control of Contacts at Increased Risk of Transmitting Cholera.

   1. (1) A health officer shall restrict or exclude from child care or an occupational setting a contact who has diarrhea, until at least 48 hours after diarrhea ceases, if the contact is in the household of a case or is a close contact who:

      1. (a) Attends a child care facility; or

      2. (b) Participates in an occupation involving:

         1. (i) Food handling;
         2. (ii) Patient care; or
         3. (iii) Care of young children or the elderly.

   2. (2) If an individual is a contact of a case as specified in §B(1) of this regulation, and that individual has diarrhea at the time of the health department's investigation of the case, then the contact shall submit for examination two fecal specimens taken at:

      1. (a) Not less than 24 hours apart; and
      2. (b) If antibiotics have been given, not sooner than 48 hours following discontinuation of antibiotics.
   3. (3) If either of the specimens referred to in §B(2) of this regulation is positive for Vibrio cholera, a health officer shall consider the contact to be a case, and the control measures specified in §A of this regulation apply.

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

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. 1257); emergency status expired October 21, 1983

Regulations .02A and .03B amended effective October 24, 1983 (10:21 Md. R. 1901)

Regulation .14D amended as an emergency provision effective March 17, 1981 (8:7 Md. R. 639); emergency status expired August 1, 1981; adopted permanently effective August 17, 1981 (8:16 Md. R. 1365)

Regulation .31 adopted as an emergency provision effective September 2, 1980 (7:20 Md. R. 1872); adopted permanently effective February 6, 1981 (8:3 Md. R. 227)

Regulations .01—.22, .31, .55, and .58 repealed effective August 7, 1989 (16:15 Md. R. 1650)

Regulations .01—.17 and .19—.24 adopted effective August 7, 1989 (16:15 Md. R. 1650)

Regulation .18 adopted effective February 19, 1990 (17:3 Md. R. 297)

Chapter revised effective July 5, 1993 (20:13 Md. R. 1049)

Regulation .02 amended and Regulation .06G adopted as an emergency provision effective December 3, 1996 (23:26 Md. R. 1856); amended permanently effective March 24, 1997 (24:6 Md. R. 484)

Regulation .17D amended as an emergency provision effective December 5, 1997 (24:26 Md. R. 1751); amended permanently effective January 26, 1998 (25:2 Md. R. 76)

Chapter revised effective January 20, 2003 (30:1 Md. R. 24)

Regulation .01B amended as an emergency provision effective October 1, 2003 (30:22 Md. R. 1574); amended permanently effective March 1, 2004 (31:4 Md. R. 315)

Regulation .02B amended as an emergency provision effective October 1, 2003 (30:22 Md. R. 1574); amended permanently effective March 1, 2004 (31:4 Md. R. 315)

Regulation .02B amended as an emergency provision effective July 12, 2007 (34:17 Md. R. 1505); emergency status extended at 35:3 Md. R. 285; amended permanently effective January 14, 2008 (35:1 Md. R. 17)

Regulation .02B amended as an emergency provision effective November 5, 2007 (34:24 Md. R. 2154); amended permanently effective March 24, 2008 (35:6 Md. R. 698)

Regulation .03B amended as an emergency provision effective October 1, 2003 (30:22 Md. R. 1574); amended permanently effective March 1, 2004 (31:4 Md. R. 315)

Regulation .03B amended effective March 13, 2006 (33:5 Md. R. 519)

Regulation .03B amended as an emergency provision effective November 5, 2007 (34:24 Md. R. 2154); amended permanently effective March 24, 2008 (35:6 Md. R. 698)

Regulation .04 amended effective March 13, 2006 (33:5 Md. R. 519)

Regulation .07B amended as an emergency provision effective October 1, 2003 (30:22 Md. R. 1574); amended permanently effective March 1, 2004 (31:4 Md. R. 315)

Regulation .08-2A, B amended as an emergency provision effective November 5, 2007 (34:24 Md. R. 2154); amended permanently effective March 24, 2008 (35:6 Md. R. 698)

Regulation .17-1 adopted as an emergency provision effective July 12, 2007 (34:17 Md. R. 1505); emergency status extended at 35:3 Md. R. 285; adopted permanently effective January 14, 2008 (35:1 Md. R. 17)

Chapter revised as an emergency provision effective October 1, 2008 (35:22 Md. R. 1946); emergency status extended at 36:10 Md. R. 714; revised permanently effective April 6, 2009 (36:7 Md. R. 522)

Regulation .01 amended effective April 24, 2017 (44:8 Md. R. 403)

Regulation .01-1 amended effective April 6, 2009 (36:7 Md. R. 522)

Regulation .02B amended effective March 28, 2016 (43:6 Md. R. 406); April 24, 2017 (44:8 Md. R. 403)

Regulation .03C amended effective April 23, 2018 (45:8 Md. R. 420)

Regulation .17 amended effective April 24, 2017 (44:8 Md. R. 403)

Regulation .17-1 repealed effective March 28, 2016 (43:6 Md. R. 406)

Regulation .18 amended effective April 24, 2017 (44:8 Md. R. 403)

Chapter revised effective May 18, 2020 (47:10 Md. R. 516)

Regulation .01C amended effective July 12, 2021 (48:14 Md. R. 538)

Regulation .01-1 amended effective July 12, 2021 (48:14 Md. R. 538)

Regulation .13D amended effective July 12, 2021 (48:14 Md. R. 538)