<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.06.02.03" title_num="10" subtitle_num="06" chapter_num="02" heading="Human Rabies.">
  <paragraph num="A.">
    <text>Reporting.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>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.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Immunization; Preexposure.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The local health officer shall:</text>
      <paragraph num="(a)">
        <text>Report to the Public Health Veterinarian at least every 3 months, the number of preexposure immunizations administered; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>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.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The local health officer shall administer rabies preexposure immunizations according to the recommendations developed by the Public Health Veterinarian and the State Epidemiologist.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Treatment; Postexposure.</text>
    <paragraph num="(1)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A local health officer shall report to the Public Health Veterinarian:</text>
      <paragraph num="(a)">
        <text>At least every 3 months, the number of postexposure treatments administered;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At the completion of treatment, for each individual administered treatment, the individual’s:</text>
        <paragraph num="(i)">
          <text>Name;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Address;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Age;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Sex;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>County of residence; and</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Occupation; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Other information as directed by the Public Health Veterinarian.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>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.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>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:</text>
      <paragraph num="(a)">
        <text>Based on the current ability-to-pay schedule of the Department; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Only after all available benefits and discounts are applied.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>