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.  
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(iv) Lymphogranuloma venereum.  
(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 reviews,  
maintains, and publishes 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.  
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 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.  
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(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.  
(i) Any other information considered by the physician to be related to the health of  
the public.  
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(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.  
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(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  
epidemiologic, and other information pertaining to any of the following:  
(a) Individuals who have designated conditions or other conditions of public  
health significance.  
be  
provided  
with medical,  
(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.  
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  
Page 5  
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.  
Page 7  
(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) 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.  
Page 8  
(d) Three doses of any appropriate poliovirus vaccine.  
(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:  
Page 9  
(a) Have received 4 doses of any appropriate diphtheria vaccine - 3 doses if the first  
dose was received on or after the first birthday.  
(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  
Page 10  
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 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.  
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.  
R325.179 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 isolates of any of the following:  
(i) Bacillus anthracis.  
(ii) Brucella species.  
(iii) Burkholderia pseudomallei.  
(iv) Burkholderia mallei.  
(v) Clostridridium botulinum.  
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(vi) Coxiella burnetii.  
(vii) Francisella tularensis.  
(viii) Orthopox viruses, including smallpox and monkey pox.  
(ix) Yersinia pestis.  
(b) Specimens that contain and isolates 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.  
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.  
(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.  
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(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 2008" 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.  
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  
Page 14  
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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