DEPARTMENT OF COMMUNITY HEALTH  
BUREAU OF EPIDEMIOLOGY  
COMMUNICABLE AND RELATED DISEASES  
(By authority conferred on the department of community health by sections 2221, 2226(d),  
2231(1), 2233, 5111, 5125 and 9227 of 1978 PA 368 and Executive Reorganization Order  
Nos.1996-1 and 1997-4, MCL 333.2221, 333.2226(d), 333.2231(1), 333.2233, 333.5111,  
333.5125, 333.9227, 330.3101, 333.26324, 333.5114, and MCL 16.109)  
R 325.171 Definitions.  
Rule 1. (1) As used in these rules:  
(a) "Appropriate local health department" means the local health department that has  
jurisdiction where an individual who has a disease or condition that is required to be  
reported resides or the local health department of the county in which the service facility  
is located.  
(b) "Code" means 1978 PA 368, MCL 333.1101 to 333.25211.  
(c) "Communicable" means capable of being transmitted from individual to individual,  
from animal to individual, or from an inanimate reservoir to an individual.  
(d) "Department" means the Michigan department of community health.  
(e) "Director" means the state director of community health or his or her designee.  
(f) "Epidemic" means any increase in the number of cases, above the number of expected  
cases, of any disease, infection, or other condition in a specific time period, area, or  
demographic segment of the population.  
(g) "Local health officer" means the health officer, or his or her designee, in the  
appropriate local health department.  
(h) "Medical and epidemiological information" means any of the following:  
(i) Medical histories.  
(ii) Results of examinations.  
(iii) Findings on laboratory tests.  
(iv) Diagnoses.  
(v) Treatments employed.  
(vi) Outcomes.  
(vii) Description and source of suspected causative agents.  
(viii) Any other information that is pertinent to an investigation which is requested by the  
local health department or the department in the course of that investigation.  
(i) "Novel influenza" means any strains or subtypes of influenza viruses not included in  
the current year influenza vaccine formulation.  
(k) "Venereal disease" means any of the following:  
(i) Syphilis.  
(ii) Gonorrhea.  
(iii) Chancroid.  
(iv) Lymphogranuloma venereum.  
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(v) Granuloma inguinale.  
(2) Unless the context requires otherwise or as further clarified in these rules, terms  
defined in the code have the same meanings when used in these rules.  
History: 1993 AACS; 1999 AACS; 2009 AACS; 2014 AACS.  
R 325.172 Disease reporting.  
Rule 2. (1) The department, as required in MCL 333.5111 (1), annually review, maintain,  
and publish a list of reportable diseases, infections, and disabilities on the department’s  
website.  
(2) Physicians and laboratories shall report the unusual occurrence, outbreak, or epidemic  
of any condition, including healthcare-associated infections, to the local health department  
and to the department as required in R 325.173.  
History: 1993 AACS; 1999 AACS; 2005 AACS; 2009 AACS; 2014 AACS.  
Editor's Note: An obvious error in R 325.172 was corrected at the request of the promulgating agency,  
pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the  
error was published in Annual Administrative Code Supplement 2014. The memorandum requesting the  
correction was published in Michigan Register, 2026 MR 18.  
R 325.173 Reporting and surveillance requirements.  
Rule 3. (1) A physician shall report each case of a serious communicable disease that is  
listed and maintained by the department as required in, MCL 333.5111(1), except for  
human immunodeficiency virus infection and acquired immunodeficiency syndrome,  
within 24 hours of diagnosis or discovery, to the appropriate health department. Reporting  
requirements for human immunodeficiency virus infection and acquired  
immunodeficiency syndrome are set out in MCL 333.5114 and subrules (12) to (14) of this  
rule.  
(2) A physician shall report the unusual occurrence of any disease, infection, or condition  
that threatens the health of the public, within 24 hours of diagnosis or discovery, to the  
appropriate local health department.  
(3) A physician shall report noncommunicable diseases that are listed and maintained by  
the department as required in MCL 333.5111(1) within 3 days of diagnosis or discovery,  
to the appropriate local health department.  
(4) A physician may report any disease, infection, or condition that is not included in  
subrule (1), (2), or (3) of this rule to the appropriate local health department according to  
the physician's medical judgment.  
(5) A laboratory shall report, within 24 hours of discovery, both of the following to the  
appropriate local health department:  
(a) Laboratory evidence of any serious infection that is listed and maintained by the  
department as required in MCL333.5111(1), except for human immunodeficiency virus  
which is governed by MCL 333.5114.  
(b) Laboratory evidence of any other disease, infection, or condition that is judged by the  
laboratory director to indicate that the health of the public is threatened. A laboratory in  
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this state that receives or processes specimens to be tested for the listed agents shall report  
a result confirming presence of a listed agent, even if the testing is not done on-site, for  
example, the specimen is shipped to an out-of-state reference laboratory for testing.  
(6) When a physician or laboratory director suspects the presence of a designated  
condition, but does not have sufficient information to confirm its presence, the physician  
or laboratory shall report the designated condition as suspect to the appropriate local health  
department. Upon confirmation of the designated condition, a physician or laboratory  
director shall report the condition as confirmed to the appropriate local health department.  
(7) A health facility infection control committee shall develop policies and procedures to  
ensure the appropriate reporting of designated conditions by physicians who treat  
individuals at that facility and by laboratories at that facility.  
(8) All of the following individuals may report to the appropriate local health department  
any designated condition or any other disease, infection, or condition which comes to their  
professional attention and which poses a threat to the health of the public:  
(a) An administrator, epidemiologist, or infection control professional from a health care  
facility or other institution.  
(b) A dentist.  
(c) A nurse.  
(d) A pharmacist.  
(e) A physician's assistant.  
(f) A veterinarian.  
(g) Any other health care professional.  
(9) A primary or secondary school, child day care center, or camp shall report, within 24  
hours of suspecting, both of the following to the appropriate local health department:  
(a) The occurrence among those in attendance of any of the serious communicable  
diseases listed and maintained by the department as required in MCL 333.5111(1), except  
for human immunodeficiency virus and acquired immunodeficiency syndrome which are  
governed by MCL 333.5131.  
(b) The unusual occurrence, outbreak, or epidemic of any disease, infection, or condition  
among those in attendance.  
(10) A report shall be directed to the appropriate local health department. A report may  
be written, oral, or transmitted by electronic media. A report shall be transmitted in a  
manner prescribed or approved by the appropriate local health department.  
(11) Except as provided in subrules (13) and (14) of this rule, a required report by a  
physician shall contain all of the following information:  
(a) The patient's full name.  
(b) The patient's residential address, including street, city, village or township, county,  
and zip code.  
(c) The patient's telephone number.  
(d) The patient's date of birth, age, sex, race, and ethnic origin.  
(e) The name of the disease, infection, or condition reported.  
(f) The estimated date of the onset of the disease, infection, or condition, where  
applicable.  
(g) The identity of the reporting person.  
(h) Pertinent laboratory results.  
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(i) Any other information considered by the physician to be related to the health of the  
public.  
(12) Acquired immunodeficiency syndrome (AIDS), human immunodeficiency virus  
(HIV) infection, tuberculosis, and venereal disease shall be reported by completing forms  
provided by the department.  
(13) In addition to reporting requirements under section 5114 of the code for acquired  
immunodeficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection, a  
physician shall report, if available, the ethnicity and country of birth, if known, of the test  
subject.  
(14) Nothing in these rules is intended to limit use or disclosure of information needed by  
the department or local health department to carry out its responsibilities under the code as  
authorized by, but not limited to, MCL 333.5131.  
(15) Viral influenza need only be reported by the number of cases identified during a  
specified time period or when influenza is suspected to have caused or contributed to  
mortality in a person aged less than 18 years, or if the infected individual traveled outside  
of North America within the 2 weeks prior to symptom onset.  
(16) A required report by a laboratory shall contain all of the following information,  
except for human immunodeficiency virus and acquired immunodeficiency syndrome,  
which are governed by MCL 333.5114:  
(a) The patient's full name.  
(b) The patient's residential address, including street, city, village or township, county,  
and zip code.  
(c) The patient's telephone number.  
(d) The patient's date of birth or age.  
(e) The patient's sex.  
(f) The specific laboratory test, date performed, and the results.  
(g) The name and address of the reporting laboratory.  
(h) The name, address, and telephone number of the ordering person.  
(17) To the extent that the information is readily available, a report of an unusual  
occurrence, outbreak, or epidemic of a disease, infection, or other condition shall include  
all of the following information:  
(a) The nature of the confirmed or suspected disease, infection, or condition.  
(b) The approximate number of cases.  
(c) The approximate illness onset dates.  
(d) The location of the outbreak.  
(18) Within 24 hours of receiving a report, a local health department shall communicate  
the report of an individual who has a serious communicable disease listed and maintained  
by the department as required in MCL 333.5111(1) or a serious infection listed and  
maintained by the department as required in MCL 333.5111(1) to the department and any  
other Michigan jurisdiction if the individual resides in that other jurisdiction.  
(19) Within 3 days of receiving a report, a local health department shall communicate the  
report of an individual who has a noncommunicable disease listed and maintained by the  
department as required in MCL 333.5111(1) to the department and another Michigan  
jurisdiction if the individual resides in that other jurisdiction.  
(20) Within 24 hours of receiving a report that concerns an individual who resides outside  
of this state, a local health department shall forward the report to the department.  
Page 4  
(21) Reports of designated conditions acquired by residents of a local health department's  
jurisdiction shall be recorded by the local health officer and shall be forwarded to the  
department in a format specified by the department.  
History: 1993 AACS; 2005 AACS; 2009 AACS; 2014 AACS.  
R 325.174 Investigation of diseases, infections, epidemics, and situations with  
potential for causing diseases.  
Rule 4. (1) The department or the local health department that has jurisdiction where an  
individual who has a reported condition resides or where an illness or infection is being or  
may be spread shall initiate an investigation as necessary.  
(2) An investigator who presents official identification of the local health department or  
the department shall promptly be provided with medical, epidemiologic, and other  
information pertaining to any of the following:  
(a) Individuals who have designated conditions or other conditions of public health  
significance.  
(b) Individuals, whether ill or well, who are part of a group in which an unusual  
occurrence, outbreak, or epidemic has occurred.  
(c) Individuals who are not known to have a designated condition but whose medical or  
epidemiological information is needed for investigation into the cause of the occurrence of  
the condition.  
(d) Individuals who were potentially exposed to a designated condition.  
(e) Individuals who may be a carrier or health threat to others under MCL 333.5201.  
(f) Any other information that may be relevant to an investigation under this rule.  
(3) Requests for individual medical and epidemiologic information to validate the  
completeness and accuracy of reporting are specifically authorized. Information released  
in response to a request made by type of disease, infection, or condition or diagnostic code  
category may include information about individuals who are not the primary focus of the  
request if it is not reasonably possible to delete it from the requested information.  
(4) A representative of the local health department or the department may obtain human,  
animal, environmental, or other types of specimens or cause such specimens to be obtained  
by appropriate means, including venipuncture, in the course of an investigation of a  
reported disease, infection, or condition.  
(5) The local health department shall transmit the results of its investigation of a report of  
an unusual occurrence of illness, outbreak, or epidemic to the department by an immediate  
informal report that shall be followed by progress reports and a final report. The reports  
shall be in a format that is acceptable to the department.  
History: 1993 AACS; 2014 AACS.  
Editor's Note: An obvious error in R 325.174 was corrected at the request of the promulgating agency,  
pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the  
error was published in Annual Administrative Code Supplement 2014. The memorandum requesting the  
correction was published in Michigan Register, 2026 MR 18.  
Page 5  
R 325.175 Procedures for physicians, local health officers, and schools for control of  
diseases and infections.  
Rule 5. (1) A physician or other person who attends to a case of communicable disease  
shall arrange for appropriate barrier precautions, treatment, or isolation if needed to prevent  
the spread of infection to other household members, patients, or the community. A  
physician or other person who seeks information on appropriate precautionary measures  
may request the local health officer or the department to provide the necessary information.  
Appropriate isolation or other barrier precautions may be instituted for a case or a suspected  
case of disease, infection, or other condition by the local health officer or the department  
as necessary to protect the public health.  
(2) When a school official reasonably suspects that a student has a communicable disease  
except for AIDS, HIV infection, and noncommunicable diseases, the official may exclude  
the student for a period sufficient to obtain a determination by a physician or local health  
officer as to the presence of a communicable disease.  
(3) The local health officer may initiate the exclusion from school or group programs of a  
student or individual who has a communicable disease. A student or individual may be  
returned to school or a group program when a physician or local health officer indicates  
that the excluded individual does not represent a risk to other individuals.  
(4) When a local health officer confirms or reasonably suspects that a student or individual  
attending school or a group program has a communicable disease, the health officer may,  
as a disease control measure, exclude from attendance any individuals lacking  
documentation of immunity or otherwise considered susceptible to the disease until such  
time as the health officer deems there to be no likely further risk of disease spread.  
History: 1993 AACS; 2014 AACS.  
R 325.176 Immunizations required of children attending group programs or entering  
school.  
Rule 6. (1) As used in this rule:  
(a) "Certificate of immunization" means a medical, health department, school, or personal  
record which indicates the dates when each dose of a vaccine was given to an individual  
and which is certified by a health professional or local health department.  
(b) "Exemption" means a temporary or permanent waiver of 1 or more of the specific  
immunization requirements for medical, religious, or other reasons.  
(c) "Medical exemption" means a written statement from a physician that a vaccination is  
medically contraindicated for a particular child for a specified period of time.  
(d) "Religious or other exemption" means a written statement which is signed by the  
parent, guardian, or person in loco parentis of a child, which certifies that immunization is  
in conflict with religious or other convictions of the signer, and which includes the name  
and date of birth of the child.  
(e) "Vaccine" means an agent for immunization against an infection or disease caused by  
an infectious agent.  
(2) A child who is 2 months through 3 months of age and who is registered in a program  
of group residence or care shall have received at least all of the following vaccines:  
(a) One dose of any appropriate diphtheria vaccine.  
(b) One dose of any appropriate tetanus vaccine.  
Page 6  
(c) One dose of any appropriate pertussis vaccine.  
(d) One dose of any appropriate poliovirus vaccine.  
(e) One dose of any appropriate Haemophilus influenzae type B vaccine.  
(f) One dose of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis B  
immunity or disease satisfies this requirement.  
(g) One dose of any appropriate pneumococcal conjugate vaccine.  
(3) A child who is 4 months through 5 months of age and who is registered in a program  
of group residence or care shall have received at least all of the following vaccines:  
(a) Two doses of any appropriate diphtheria vaccine.  
(b) Two doses of any appropriate tetanus vaccine.  
(c) Two doses of any appropriate pertussis vaccine.  
(d) Two doses of any appropriate poliovirus vaccine.  
(e) Two doses of any appropriate Haemophilus influenzae type B vaccine.  
(f) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(g) Two doses of any appropriate pneumococcal conjugate vaccine.  
(4) A child who is 6 months through 15 months of age and who is registered in a program  
of group residence or care shall have received at least all of the following vaccines:  
(a) Three doses of any appropriate diphtheria vaccine.  
(b) Three doses of any appropriate tetanus vaccine.  
(c) Three doses of any appropriate pertussis vaccine.  
(d) Two doses of any appropriate poliovirus vaccine.  
(e) Two doses of any appropriate Haemophilus influenzae type B vaccine.  
(f) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(g) Pneumococcal conjugate vaccine as shown by either of the following:  
(i) Three doses of any appropriate pneumococcal conjugate vaccine.  
(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal  
conjugate vaccine.  
(5) A child who is 16 months through 18 months of age and who is registered in a program  
of group residence, care, or camping shall have received at least all of the following  
vaccines:  
(a) Three doses of any appropriate diphtheria vaccine.  
(b) Three doses of any appropriate tetanus vaccine.  
(c) Three doses of any appropriate pertussis vaccine.  
(d) Two doses of any appropriate poliovirus vaccine.  
(e) Haemophilus Influenzae type B vaccine age as shown by either of the following:  
(i) Receipt of 1 dose of any appropriate haemophilus influenzae type B vaccine at or after  
15 months of age.  
(ii) Receipt of a complete series of any appropriate haemophilus influenzae type B  
vaccine.  
(f) One dose of any appropriate live measles vaccine at or after 12 months of age. A  
laboratory finding of measles immunity satisfies this requirement.  
(g) One dose of any appropriate live mumps vaccine at or after 12 months of age. A  
laboratory finding of mumps immunity satisfies this requirement.  
Page 7  
(h) One dose of any appropriate live rubella vaccine at or after 12 months of age. A  
laboratory finding of rubella immunity satisfies this requirement.  
(i) Two doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(j ) Pneumococcal conjugate vaccine as shown by either of the following:  
(i) Four doses of any appropriate pneumococcal conjugate vaccine.  
(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal  
conjugate vaccine.  
(6) A child who is 19 months through 4 years of age and who is registered in a program  
of group residence, care, or camping shall have received at least all of the following  
vaccines:  
(a) Four doses of any appropriate diphtheria vaccine.  
(b) Four doses of any appropriate tetanus vaccine.  
(c) Four doses of any appropriate pertussis vaccine.  
(d) Three doses of any appropriate poliovirus vaccine.  
(e) Haemophilus influenzae type B vaccine as shown by either of the following:  
(i) Receipt of 1 dose of any appropriate Haemophilus influenzae type B  
vaccine at or after 15 months of age.  
(ii) Receipt of a complete series of any appropriate Haemophilus influenzae type B  
vaccine.  
(f) One dose of any appropriate live measles vaccine at or after 12 months of age. A  
laboratory finding of measles immunity satisfies this requirement.  
(g) One dose of any appropriate live mumps vaccine at or after 12 months of age. A  
laboratory finding of mumps immunity satisfies this requirement.  
(h) One dose of any appropriate live rubella vaccine at or after 12 months of age. A  
laboratory finding of rubella immunity satisfies this requirement.  
(i) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(j) Have evidence of varicella immunity as shown by any of the following:  
(i) One dose of any appropriate varicella vaccine at or after 12 months of age.  
(ii) Laboratory evidence of varicella immunity.  
(iii) A parent, guardian, person in loco parentis, or physician statement that the child has  
had varicella disease.  
(k) Pneumococcal conjugate vaccine as shown by either of the following:  
(i) Four doses of any appropriate pneumococcal conjugate vaccine.  
(ii) Receipt of an age appropriate complete series of any appropriate pneumococcal  
conjugate vaccine.  
(iii) Receipt of 1 dose of any appropriate pneumococcal conjugate vaccine at or after 24  
months of age.  
(7) A child who is 5 years of age and who is registered in a program of group residence,  
care, or camping shall have received at least all of the following vaccines:  
(a) Four doses of any appropriate diphtheria vaccine.  
(b) Four doses of any appropriate tetanus vaccine.  
(c) Four doses of any appropriate pertussis vaccine.  
(d) Three doses of any appropriate poliovirus vaccine.  
Page 8  
(e) One dose of any appropriate live measles vaccine at or after 12 months of age. A  
laboratory finding of measles immunity satisfies this requirement.  
(f) One dose of any appropriate live mumps vaccine at or after 12 months of age. A  
laboratory finding of mumps immunity satisfies this requirement.  
(g) One dose of any appropriate live rubella vaccine at or after 12 months of age. A  
laboratory finding of rubella immunity satisfies this requirement.  
(h) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(i) Have evidence of varicella immunity as shown by any of the following:  
(i) One dose of any appropriate varicella vaccine at or after 12 months of age.  
(ii) Laboratory evidence of varicella immunity.  
(iii) A parent, guardian, person in loco parentis, or physician statement that the child has  
had varicella disease.  
(8) A child who is 4 years through 6 years of age and who is entering school shall be in  
compliance with all of the following immunization requirements:  
(a) Have received 4 doses of any appropriate diphtheria vaccine and, if a dose was not  
received on or after the fourth birthday, a booster dose at school entry.  
(b) Have received 4 doses of any appropriate tetanus vaccine and, if a dose was not  
received on or after the fourth birthday, a booster dose at school entry.  
(c) Have received 4 doses of any appropriate pertussis vaccine and, if a dose was not  
received on or after the fourth birthday, a booster dose at school entry.  
(d) Have received 4 doses of any appropriate polio vaccine. If dose 3 was administered  
on or after the fourth birthday only 3 doses are required.  
(e) Have evidence of measles immunity as shown by either of the following:  
(i) Two doses of any appropriate live measles vaccine received after the first birthday, not  
less than 28 days apart.  
(ii) Laboratory evidence of measles immunity.  
(f) Have evidence of mumps immunity as shown by either of the following:  
(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not  
less than 28 days apart.  
(ii) Laboratory evidence of mumps immunity.  
(g) Have evidence of rubella immunity as shown by either of the following:  
(i) Two doses of any appropriate live rubella vaccine received after the first birthday, at  
least 28 days apart.  
(ii) Laboratory evidence of rubella immunity.  
(h) Three doses of any appropriate hepatitis B vaccine or a laboratory finding of hepatitis  
B immunity or disease satisfies this requirement.  
(i) Have evidence of varicella immunity as shown by any of the following:  
(i) Two doses of any appropriate live varicella vaccine at or after 12 months of age.  
(ii) Laboratory evidence of varicella immunity.  
(iii) A parent, guardian, person in loco parentis, or physician statement that the child has  
had varicella disease.  
(9) A child who is 7 through 18 years of age and who is entering school or enrolled in  
grade 7, shall be in compliance with all of the following immunization requirements:  
(a) Have received 4 doses of any appropriate diphtheria vaccine - 3 doses if the first dose  
was received on or after the first birthday.  
Page 9  
(b) Have received 4 doses of any appropriate tetanus vaccine - 3 doses if the first dose  
was received on or after the first birthday.  
(c) Have received a dose of Tdap vaccine for grades 7 and higher with children 11 years  
of age and older.  
(d) Have received 4 doses of any appropriate poliovirus vaccine. If dose 3 was  
administered on or after the fourth birthday only 3 doses are required.  
(e) Have evidence of measles immunity as shown by either of the following:  
(i) Two doses of any appropriate live measles vaccine received after the first birthday, not  
less than 28 days apart.  
(ii) Laboratory evidence of measles immunity.  
(f) Have evidence of mumps immunity as shown by either of the following:  
(i) Two doses of any appropriate live mumps vaccine received after the first birthday, not  
less than 28 days apart.  
(ii) Laboratory evidence of mumps immunity.  
(g) Have evidence of rubella immunity as shown by either of the following:  
(i) Two doses of any appropriate live rubella vaccine received after the first birthday, not  
less than 28 days apart.  
(ii) Laboratory evidence of rubella immunity.  
(h) Receipt of a complete series of any appropriate hepatitis B vaccine or a laboratory  
finding of hepatitis b immunity or disease satisfies this requirement.  
(i) Have evidence of varicella immunity as shown by any of the following:  
(i) Two doses of any appropriate live varicella vaccine at or after 12 months of age.  
(ii) Laboratory evidence of varicella immunity.  
(iii) A parent, guardian, person in loco parentis, or physician statement that the child has  
had varicella disease.  
(j) Have received 1 dose of meningococcal conjugate vaccine for grades 7 and higher with  
children 11 years of age and older.  
(10) To satisfy the requirements in subrules (2) to (9) of this rule, each vaccine shall have  
been administered in accordance with the manufacturer's instructions. A 4-day grace  
leniency is allowed on the minimum ages and intervals for each vaccine.  
(11) If the requirements for immunization cannot be completed due to medical reasons  
within 4 months of admittance, a child may remain enrolled in a school or group program  
for a reasonable length of time that is consistent with good medical practice. A statement  
requesting the enrollment of the child beyond the exclusion date shall be signed by a  
physician or local health officer and shall certify that the child is in the process of  
complying with all immunization requirements. This medical exemption shall be filed with  
the child's school or group program immunization records until it can be replaced with  
proof that the vaccines for which an exemption was granted have been received. Upon  
completion of the required immunizations, a parent shall present the school or group  
program with a certificate of immunization.  
(12) When presented with a medical exemption, religious or other exemption, the  
administrator of a child's school or operator of a child's group program shall recognize the  
exemption status of the child. Each nonmedical exemption filed at the child’s school or  
group program of a child entering a program after December 31, 2014 shall be certified by  
the local health department that the individual received education on the risks of not  
receiving the vaccines being waived and the benefits of vaccination to the individual and  
Page 10  
the community. All waivers shall be submitted using the waiver form prescribed by the  
department.  
(13) A standard record of the immunizations required by this rule and exemptions shall  
be maintained by every school for every pupil on forms supplied by the department. When  
a pupil transfers to another school or school district, the record of immunization, or a true  
copy of the record, shall be sent to the new school by the original school.  
(14) All of the following information shall be provided to fulfill the requirements of  
section 9209(1) of the code:  
(a) A listing, by child, of the number of doses of each vaccine received.  
(b) The date of each immunization for each vaccine received in the series.  
(c) A listing, by type of exemption granted, of the children who have exemptions.  
(15) Not less than 95% of entering students in a school, less the entering students who  
have medical, religious, or other exemptions, shall have received vaccinations as outlined  
in subrules (8) and (9) of this rule.  
(16) A principal of a school or operator of a group program shall make immunization  
records available for inspection by authorized representatives of the department or the  
appropriate local health department. The local health officer shall also make public clinic  
immunization records available to local schools or group programs for the purpose of  
verifying pupil immunizations.  
(17) A requirement for immunization with a specific vaccine may be suspended  
temporarily at the request of the department director for reasons of inadequate vaccine  
supply.  
History: 1993 AACS; 1994 AACS; 1995 AACS; 1999 AACS; 2006 AACS; 2009 AACS; 2014 AACS.  
Editor's Note: An obvious error in R 325.176 was corrected at the request of the promulgating agency,  
pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the  
error was published in Annual Administrative Code Supplement 2014. The memorandum requesting the  
correction was published in Michigan Register, 2026 MR 18.  
R 325.177 Provision of care by local health departments for venereal disease;  
maintenance of test records after provision of pregnancy care.  
Rule 7. (1) As used in this rule, "venereal disease case" means an individual who is  
diagnosed or treated for venereal disease on the basis of symptoms, signs, or laboratory  
tests.  
(2) A local health department shall provide for the diagnosis, treatment, and case  
intervention of venereal disease cases within its jurisdiction. Through direct service or  
referrals, the local health department shall ensure that professional care and case follow-  
up are provided without regard to race, age, sex, national origin, or income. All of the  
following services shall be provided for the diagnosis, treatment, and case intervention of  
venereal disease cases:  
(a) Relevant medical history and physical examination.  
(b) Diagnostic tests.  
(c) Treatment utilizing guidelines provided by the department.  
(d) Follow-up examination and testing.  
(e) Patient education.  
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(f) Identification and notification of sexual contacts.  
(g) The examination and treatment of sexual contacts and other designated high-risk  
individuals exposed to venereal disease cases.  
(h) The maintenance of records for not less than 5 years after the last reactive test in  
syphilis cases and for not less than 1 calendar year, not including the present year, for other  
venereal diseases.  
(3) Records of test results that are obtained under section 5123 of the code shall be  
maintained for not less than 3 calendar years after the termination of pregnancy.  
History: 1993 AACS.  
R 325.178 Rescinded.  
History: 1993 AACS; 1999 AACS; 2015 AACS.  
R 325.179 Submission of tuberculosis laboratory specimens and test results.  
Rule 9. (1) For the purpose of this rule, "preliminary result" includes, but is not limited  
to, results from nucleic acid amplification tests, nucleic acid or other genetic probe tests,  
chromatographic or other such tests that may be performed prior to final culture  
identification of a clinical specimen.  
(2) A laboratory that initially receives any clinical specimen which yields Mycobacterium  
tuberculosis complex, or yields a preliminary result indicative of Mycobacterium  
tuberculosis complex, is responsible for ensuring that the following are submitted:  
(a) All preliminary results and any interpretation of those results to the appropriate local  
health department.  
(b) The first Mycobacterium tuberculosis complex isolate, or subculture thereof, from the  
patient being tested for tuberculosis, to the department.  
(c) Any Mycobacterium tuberculosis complex isolate, or subculture thereof, from a  
follow-up specimen, collected 90 days or more after the collection of the first  
Mycobacterium tuberculosis complex positive specimen.  
History: 1993 AACS; 2009 AACS.  
R 325.179a. Submission of other designated conditions specimens.  
Rule 9a. A laboratory shall submit to the department the first isolate or subculture thereof,  
or specimen where appropriate, from the patient being tested, any of the following:  
(a) Specimens suspected to contain and suspect isolate of any of the following:  
(i) Bacillus anthracis.  
(ii) Brucella species.  
(iii) Burkholderia pseudomallei.  
(iv) Burkholderia mallei.  
(v) Clostridridium botulinum.  
(vi) Coxiella burnetii.  
(vii) Francisella tularensis.  
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(viii) Orthopox viruses, including smallpox and monkey pox.  
(ix) Yersinia pestis.  
(b) Specimens that contain and isolate any of the following:  
(i) Corynebacterium diphtheriae.  
(ii) Escherichia coli 0157:H7 and all other shiga toxin positive serotypes.  
(iii) Haemophilus influenza, only if isolate collected from a normally sterile site or if  
patient is less than 15 years of age.  
(iv) Legionella species.  
(v) Listeria monocytogenes.  
(vi) Neisseria meningtidis, only if isolate collected from a normally sterile site.  
(vii) Novel influenza.  
(viii) Salmonella species including Typhi.  
(ix) Severe Acute Respiratory Syndrome (SARS) coronavirus.  
(x) Shigella species.  
(xi) Staphylococcus aureus, only vancomycin intermediate and resistant.  
(xii) Vibrio cholera.  
(xiii) Vibrio paphemolyticus.  
(xiv) Vibrio vulnificus.  
History: 2009 AACS; 2015 AACS.  
Editor's Note: An obvious error in R 325.179a was corrected at the request of the promulgating agency,  
pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the  
error was published in Annual Administrative Code Supplement 2015. The memorandum requesting the  
correction was published in Michigan Register, 2026 MR 18.  
R 325.179b. Submission of HIV laboratory specimens.  
Rule 9b. (1) A laboratory that receives any clinical specimen which yields results  
indicative of infection with human immunodeficiency virus (HIV) is responsible for  
ensuring that specimens are submitted to the department or to a laboratory designated by  
the department. These specimens include any of the following:  
(a) Remnant specimens from all positive western blot (WB) or immunofluorescent  
antibody (IFA) confirmed tests.  
(b) Remnant specimens from viral detection or quantitation tests upon request by the  
department within 3 months from specimen collection date, if available.  
(c) Remnant specimens from multiple reactive rapid enzyme immunoassay (EIA) tests  
that together constitute an HIV diagnosis.  
History: 2009 AACS.  
R 325.180 Procedures for control of rabies; disposition of rabid animals.  
Rule 10. (1) For the purposes of this rule, animals that are subject to rabies testing are any  
nonhuman mammals, except for rabbits or hares and rodents other than woodchucks.  
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(2) As used in this rule, "owner" means a person who has a right of property ownership  
of an animal, who keeps or harbors an animal, who has custody of an animal, or who  
permits an animal to remain on or about any premises occupied by the person.  
(3) Any laboratory in this state that conducts examinations of animals for rabies shall  
report all of the following data to the department within 7 days after examination:  
(a) Species of animal.  
(b) Name and address of the owner of the animal.  
(c) Name and address of the person who submits the specimen.  
(d) Name and address of the individuals who have been exposed to the animal or the name  
and address of the owner of the pet that has been exposed to the animal.  
(e) Date and results of the examination.  
(4) A physician who performs a postmortem on the body of an individual who died of  
rabies or who was suspected of dying of rabies shall immediately submit nonpreserved  
portions of the hippocampus major and spinal cord to the department for rabies  
examination. A history of the case shall accompany the specimens.  
(5) An animal that has bitten an individual or otherwise potentially exposed an individual  
to rabies shall be handled pursuant to the provisions of the publication entitled  
"Compendium of Animal Rabies Control, 2011" issued by the national association of state  
public health veterinarians (NASPHV). The provisions of the publication entitled  
"Compendium of Animal Rabies Control, 2011 or most recent version, are adopted by  
reference in these rules. Copies of this publication may be obtained from the State Public  
Health Veterinarian, Communicable Disease Division, Bureau of Disease Control,  
Prevention & Epidemiology, Michigan Department of Community Health, 201 Townsend  
Street, 5th Floor, Lansing, Michigan 48909 at no cost as of the time of adoption of these  
rules.  
(6) Any person who has knowledge of an animal bite where rabies is suspected shall,  
within 24 hours of the biting incident, report the bite to the appropriate local health  
department and to the local health department where the bite occurred. The report shall  
include all of the following information:  
(a) Animal species inflicting the bite.  
(b) Animal owner's name, address, and telephone number.  
(c) Vaccination status of the animal.  
(d) Date and location of the biting incident.  
(e) Name, address, and telephone number of the individual bitten.  
(f) Site of the bite on the body.  
(g) Name of the reporter of the bite.  
(7) Upon request by the department or local health department, any person who has  
information regarding the identity, whereabouts, or vaccination status of an animal that that  
has bitten an individual or otherwise potentially exposed an individual to rabies, or  
information about the owner of the animal, shall provide information about the animal or  
the animal's owner to the department or local health department.  
History: 1993 AACS; 1999 AACS; 2009 AACS; 2015 AACS.  
Editor's Note: An obvious error in R 325.180 was corrected at the request of the promulgating agency,  
pursuant to Section 56 of 1969 PA 306, as amended by 2000 PA 262, MCL 24.256. The rule containing the  
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error was published in Annual Administrative Code Supplement 2015. The memorandum requesting the  
correction was published in Michigan Register, 2026 MR 18.  
R 325.181 Confidentiality of reports, records, and data pertaining to testing,  
diagnosis, care, treatment, reporting, and research.  
Rule 11. (1) This rule applies to the communicable, serious communicable, chronic and  
noncommunicable diseases, infections, and disabilities listed and maintained by the  
department as required in MCL 333.5111 (1), except for human immunodeficiency virus  
(HIV) infection and acquired immunodeficiency syndrome (AIDS).  
(2) Medical and epidemiological information that identifies an individual and that is  
gathered in connection with an investigation is confidential and is not open to public  
inspection without the individual's consent or the consent of the individual's guardian,  
unless public inspection is necessary to protect the public health as determined by a local  
health officer or the director.  
(3) Medical and epidemiological information that is released to a legislative body shall  
not contain information that identifies a specific individual.  
History: 1993 AACS; 2015 AACS.  
R 325.182 Newborn eye prophylaxis.  
Rule 182. The following prophylaxes against ophthalmia neonatorum are approved:  
(a) Erythromycin (0.5%) ophthalmic ointment in single-use tubes or ampules.  
(b) A substance for which written approval has been given by the director of the Michigan  
department of community health.  
History: 2010 AACS.  
R 325.199 Rescissions.  
Rule 99. (1) R 325.763 to R 325.773, R 325.775, R 325.781 to 325.784, R 325.786, R  
325.801 to R 325.818, R 325.820 to R 325.898, and R 325.901 of the Michigan  
Administrative Code, appearing on pages 1763 to 1775 of the 1979 Michigan  
Administrative Code, are rescinded.  
(2) R 325.3401 to R 325.3409 of the Michigan Administrative Code, appearing on pages  
284 to 286 of the 1981 Annual Supplement to the 1979 Michigan Administrative Code, are  
rescinded.  
(3) R 325.3501 to R 325.3513 of the Michigan Administrative Code, appearing on pages  
2012 to 2015 of the 1979 Michigan Administrative Code and page 286 of the 1981 Annual  
Supplement to the Code, are rescinded.  
(4) R 325.9001 to R 325.9011 of the Michigan Administrative Code, appearing on pages  
290 to 292 of the 1981 Annual Supplement to the 1979 Michigan Administrative Code and  
pages 195 to 197 of the 1984 Annual Supplement to the Code, are rescinded.  
History: 1993 AACS.  
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