1. A. Reporting.

   1. (1) A physician, medical authority, or another person having knowledge of or suspicion of a case of human rabies shall immediately report the facts to the local health officer.
   2. (2) A local health officer who has received a report of a case or suspected case of human rabies shall immediately notify, by telephone or other immediate communication medium, the State Epidemiologist or the Public Health Veterinarian of the case or suspected case.
2. B. Isolation. A physician or administrator of a health care facility providing medical care to an individual who is suspected of having been infected with rabies shall isolate the individual in accordance with the order of a local health officer or the State Epidemiologist.

3. C. Immunization; Preexposure.

   1. (1) The Department shall provide rabies vaccine free of charge and the local health officer shall provide for the administration of preexposure immunization against rabies for any employee of the Department, a local health department, or another individual who provides rabies control services at the request of the Department.
   2. (2) The local health officer may provide rabies preexposure immunization to other individuals who are determined by the Public Health Veterinarian to have a high risk of exposure to rabies infection.

   3. (3) The local health officer shall:

      1. (a) Report to the Public Health Veterinarian at least every 3 months, the number of preexposure immunizations administered; and
      2. (b) Maintain records of the name, address, age, sex, county of residence, occupation, and the results of any blood tests administered in conjunction with rabies preexposure immunization for each individual immunized.
   4. (4) The Public Health Veterinarian and the State Epidemiologist shall make and distribute to local health officers recommendations on the dose and schedule of administration of rabies vaccine for the purpose of preexposure immunization of individuals.
   5. (5) The local health officer shall administer rabies preexposure immunizations according to the recommendations developed by the Public Health Veterinarian and the State Epidemiologist.

4. D. Treatment; Postexposure.

   1. (1) The Public Health Veterinarian and the State Epidemiologist shall jointly issue and distribute to local health departments, physicians, hospitals, and other medical authorities, rabies postexposure treatment guidelines.

   2. (2) A local health officer shall report to the Public Health Veterinarian:

      1. (a) At least every 3 months, the number of postexposure treatments administered;

      2. (b) At the completion of treatment, for each individual administered treatment, the individual’s:

         1. (i) Name;
         2. (ii) Address;
         3. (iii) Age;
         4. (iv) Sex;
         5. (v) County of residence; and
         6. (vi) Occupation; and
      3. (c) Other information as directed by the Public Health Veterinarian.
   3. (3) The Department shall ensure no one is denied rabies postexposure treatment due to the inability to pay when the treatment is provided in accordance with the guidelines issued by the Public Health Veterinarian and the State Epidemiologist and recommended by a licensed health care provider.
   4. (4) The local health officer of the jurisdiction where the resident resides shall ensure access to rabies postexposure treatment provided in accordance with the guidelines issued by the Public Health Veterinarian and the State Epidemiologist.

   5. (5) When rabies postexposure treatment is provided in accordance with the guidelines issued by the Public Health Veterinarian and the State Epidemiologist, the Department shall pay the charge of the rabies biologics for persons unable to pay for them:

      1. (a) Based on the current ability-to-pay schedule of the Department; and
      2. (b) Only after all available benefits and discounts are applied.

Authority: Health-General Article, §§18-102, 18-312—18-320, and 18-604, Annotated Code of Maryland

Effective date: April 27, 1977 (4:9 Md. R. 714)

Preface and Regulation .01 recodified to Regulation .01 and Regulation .01-1, respectively, in July 1994

Regulation .09A, B amended effective February 14, 1994 (21:3 Md. R. 193)

Regulations .01—.14 repealed and new Regulations .01—.14 adopted effective November 16, 1998 (25:23 Md. R. 1696)

Regulation .01 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .02B amended as an emergency provision effective January 1, 2008 (35:3 Md. R. 286); emergency status extended at 35:9 Md. R. 892; amended permanently effective March 24, 2008 (35:6 Md. R. 698)

Regulation .02B amended effective February 15, 2016 (43:3 Md. R. 272); February 27, 2017 (44:4 Md. R. 253)

Regulation .03C, D amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .03D amended effective May 20, 2019 (46:10 Md. R. 485)

Regulation .03E repealed effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .04 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .04B, D amended effective February 27, 2017 (44:4 Md. R. 253)

Regulation .06E amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .07 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .09 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .10 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .10B amended as an emergency provision effective January 1, 2008 (35:3 Md. R. 286); emergency status extended at 35:9 Md. R. 892; amended permanently effective March 24, 2008 (35:6 Md. R. 698)

Regulation .11 amended effective September 14, 2015 (42:18 Md. R. 1174)

Regulation .13B amended effective September 14, 2015 (42:18 Md. R. 1174); February 27, 2017 (44:4 Md. R. 253)