RULES ANDREGULATIONS

of the

State DepartmentOf Health

for the

CONTROL OFCOMMUNICABLE DISEASES

ADOPTED APRIL 11, 1943

RULES AND REGULATIONS OF THE STATE DEPARTMENT OFHEALTH FOR THE CONTROL OF COMMUNICABLE DISEASES

Words and Terms Defined

Regulation I.—Certain words and terms used in these rules andregulations are defined as follows;

(a) Communicable Disease.—A communicable disease is a dis-ease incited by the entrance into a body and the multiplication there-in of disease-producing organisms capable of being transmitted,directly or indirectly, to other persons or animals. The term com-municable disease embraces the common term contagious and in-fectious disease.

(b) Report of a Disease.—By report of a disease is meant thenotification to the State and local health department that a case ofreportable disease exists or is suspected of existing in a specifiedperson or persons at a given address.

(c) Infectious Agent.—An infectious agent is a living micro-organism, capable, under favorable conditions, of inciting a com-municable disease.

The words, germ, organism, microorganism and infectious agentare used interchangeably.

(d) Incubation Period.—The incubation period of a communi-cable disease is the interval which usually elapses between the en-trance into the body of the disease-producing organism and themanifestation of the first symptoms of the disease.

(e) Period of Communicability.—The period of communicabilityis the time during which a person affected with a communicabledisease is capable of transmitting the infectious agent to others.

(f) Susceptibles.—A susceptible is a person or animal who isnot known to be immune to a communicable disease.

(g) Immunes.—An immune is a person who is not susceptibleto the influence of a particular infectious agent. Immunity usuallyfollows recovery from an attack of a disease or successful vaccineor serum treatment.

(h) Contacts.—A contact is a person or animal that has beensufficiently near to an infected person, animal or thing to makeprobable the transmission of the infectious agent to him.

(i) Carriers.—A carrier is one who harbors in his body, themicroorganisms of a communicable disease, but who at the time isapparently in good health. A carrier may convey the infectiousagent to another person and, under favorable conditions, the germsmay incite the disease in his own body.

(j) Cultures.—Cultures are growths of microorganisms propa-

gated in or upon artificial media for the purpose of determining thepresence of disease-producing organisms.

(k) Isolation.—lsolation consists of the limitation of the freedomof persons or animals who are presumably affected with, or car-riers of, or who have been exposed to, communicable disease, andthe taking of measures to secure the prompt and regular disinfec-tion of all infected body secretions and excretions and of all in-fected or presumably infected materials.

(1) Placards.—A placard is an official notice, written or printed,posted as a warning of the presence of a communicable disease onthe premises or in the apartment or room so placarded.

(m) Disinfection.—Disinfection is the process of destroying thevitality of disease-producing organisms by physical or chemicalmeans.

(n) Concurrent Disinfection.—Concurrent disinfection signifiesthe immediate disinfection and disposal of body discharges, and theimmediate disinfection or destruction of all infected or presumablyinfected materials.

(o) Terminal Disinfection.—Terminal disinfection signifies theprecautions taken to destroy or remove infectious material after theremoval of the patient or the termination of isolation.

Diseases Declared ReportableRegulation 2.—The following list of diseases are declared to be

reportable to the State and the local health departments:ActinomycosisAnthraxChancroidChickenpox (varicella)CholeraCoccidioidomycosis (coccidioidal

granuloma, "Valley fever")Conjunctivitis, acute infectious

(of the newborn, not includingtrachoma). ..

DengueDiphtheriaDysentery, amebic (amebiasis)Dysentery, bacillaryEncephalitis, infectious (lethargic

and nonlethargic)German measles (rubella)GlandersGonorrheaGranuloma InguinaleHemorrhagic jaundice (spiro-

chetosis icterohemorrhagic,

Weil's disease)Hookworm disease (ancylosto-

miasis)InfluenzaLeprosyLymphogranuloma venereum

(inguinale) (climatic bubo)MalariaMeasles (rubeola)Meningococcus meningitis(cerebrospinal fever)

Mumps (infectious parotitis)Paratyphoid feverPlague, bubonic, septicemic,

pneumonicPneumonia, acute lobarPoliomyelitisPsittacosisPuerperal infection

(puerperal septicemia)RabiesRelapsing fever

Rheumatic feverRocky Mountain spotted (or tick)

feverScarlet fever (scarlatina)Septic sore throatSmallpox (variola)SyphilisTetanusTrachomaTrichinosis

Tuberculosis, pulmonaryTuberculosis, other than pul-

monaryTularemiaTyphoid feverTyphus feverUndulant fever (brucellosis)Whooping cough (pertussis)Yellow fever

The following diseases are reportable but not communicable:Botulism PellagraFood infections and poisonings

DISEASESDECLARED

COMMUNICABLE

Regulation3.—Thefollowinglistofdiseasesaredeclaredtobecommunicableandsubjecttothecontrol measuresgiven.Theincubationperiodandtheminimumperiodofcommunicabilitygivenarethose

generally

acceptedandofficially

adopted.

DISEASEINCUBATION PERIOD

MINIMUMPERIODOF COMMUNICABILITY

CONTROLMEASURES

PATIENT

CONTACTS

ActinomycosisUndetermined

Aslongasopen

lesions

remain

Noisolationifunder

medicalcare

None

‘AnthraxWithin7

daysUntil

openlesionsheal

Noisolationifunder

medicalcare

None

Chancroid3to14days

Untilalllesionsare

healed

SeeRegulation

11

SeeRegulation

11

Chickenpox2to3weeks

10days

afterfirst appearanceof

eruptionIsolation

Exclusionfrom

school

‘Cholera1

to5

days

Untilinfectiousorganism

isabsentfrom

boweldis-

charges

Isolationin

screenedroomduringcommuni-

cableperiod

Isolationfor5

days

fromlast

exposureplusstoolculture

negativeforcholera

vibrio

Conjunctivitis, acuteinfectious36to48hoursUntil

dischargescease

Isolationduringperiod

of

communicabilityNone

Dengue

3to15days

5

daysfromonsetof

disease

Patientisolatedin

screenedroomfor5

daysfromdateofonset

None

*

Diphtheria2to5

daysMSj

;

-(■

..'Ai-

Untilvirulentdiphtheria

bacillihave

disappearedfromall

secretionsand

lesions

Isolationuntil2

nose

andthroator

othercul-

turestakennotlessthan

24hoursapartfailto

showvirulent

diphtheriabacilli

to..

Isolated(same

as

forpatient)

Dysentery, amebic2

daysto4

weeks

Duringcourseof

infec-

tionasdetermined

by

microscopicexamination

ofstools

Restrictedfromfood

handlingduring

period

of

communicabilityNone

‘Dysentery, bacillary1

to7

days

Untilmicroorganismis

absentfrom

boweldis-

charges

Isolationduringstageof

disease

None

Encephalitis, infectious4to21days

Unknown

Isolationinscreened

roomfor1

weekafter

onset

None

Gonorrhea1

to8

days

Aslongas

thegonococ-

cuspersistsinanyofthe

discharges

SeeRegulation11

SeeRegulation

11

Granuloma inguinale2

weeksto

1

month

UndeterminedSee

Regulation11

SeeRegulation

11

Leprosy

1

toseveral years mrisUntil

diseaseis

arrestedfor6

months

Isolationuntil

releasedbyState

Departmentof

Health

None

‘Concurrentand

termindhdigirifectionrequired.■

DISEASEINCUBATION PERIODMINIMUM

PERIODOF COMMUNICABILITY

CONTROLMEASURES

PATIENT

CONTACTS

Lymphogran- ulomavenereum1

to4weeks

Aslongasthereareopen

lesionsupon

skinor

mucousmembranesSee

Regulation11

SeeRegulation11

MalariaVariesaccord-

ingtotype

Periodofinfection

Patientprotectedfrom

mosquitoes

None

Measles10to15days

From4to5

daysafter

appearanceofrash

Isolationfromonsetof

catarrhalsymptomuntil

5

daysafter

appearanceof

rash

None

Measles, German14to21days

4to7

days

None

None

Meningococcus meningitis(cere- brospinalfever)2to10days

Duringclinical

courseof

disease

Isolationfor14daysfrom

onset

Isolationfor10

days

fromdateoflast

knowncontact.

Mumps

12to26days

Aslongas

swellingof

salivaryglands

persistsIsolationuntilswelling

subsides

None

*Plague,bubonic septicemic pneumonic3

to7

days sometimes14

days

Pneumonic—during

acutestagesof

disease

Strictisolationof

pneu-

monictypeduring

acute

symptomof

diseasePneumonic—strict

isolationfor7

days

afterlastcontact

‘Pneumonia, acutelobar1

to3

days,not

welldetermined

Unknown

Isolationduring

febrile

periodof

disease

None

‘Poliomyelitis7to14days

UndeterminedIsolationfor2weeksfrom

onsetpreferablyin

screenedroom

Exclusionfromall

publicgatherings

for14days

‘Psittacosis6to15

days

Duringacuteillness

especiallywhencough-

ing

Strictisolationduring

febrilestage

None

Rabies

Usually2to6

weeks,maybe6

monthsor

longerUndetermined

Isolation

None

RockyMountain

spottedfever

3to

about10

days

Notcommunicablefrom

man

None

None Exclusionof

ex-

‘Scarletfever2to7

days

Usually3

weeksfrom

onsetof

diseaseand

un-

til

allabnormaldis-

chargescease

andle-

sionsheal

Isolationduring

periodof

communicabilityposedchildrenand

teachersfrom

school,foodhand-

lersfromworkfor

7

daysfromlast

ex-

posure

‘Septicsorethroat1

to3

days

Duringcontinuanceof

clinicalsymptoms

Isolationduring

periodof

communicabilityExclusionof

ex-

posedchildrenand

teachersfrom

school,foodhand-

lersfromworkfor

3

daysfrom

ex-

posure

‘Smallpox8to16days

Fromfirst

symptomsto

disappearanceof

all

scabsand

crusts

Isolationuntilallscabs

disappear

Isolationfor16days

fromlast

exposureor

untilevidenceof

successfulvaccina-

tionfollowing

ex-

posure

‘Concurrentand

terminaldisinfection

required.

10

DISEASEINCUBATION PERIODMINIMUM

PERIODOF COMMUNICABILITY

CONTROLMEASURES

PATIENT

CONTACTS

Syphilis

About3

weeks, occasionally longerAslongas

lesionsare

openuponmucousmem-

branesor

skin,practical-

lylimitedtothefirst2

yearsofdisease

SeeRegulation

11

SeeRegulation

11

TrachomaUndetermined

Duringpersistenceof

lesions

Exclusionfromschool

duringperiodof

com-

municability

None

‘Typhoidand Paratyphoid3to38days

Aslong

qsstoolor

urine

is

positive

Isolationin

fly

proof

roomuntil2

successivenegative

culturesofstool

andurinespecimens

col-

lectednotlessthan24

hoursapart

Recommendimmun-

izationofall

non-

immunecontacts

Typhusfever6to14days

In

presenceofliceuntil

36hoursafternormal

temperature

Isolationinvermin

free

roomduring

courseof

disease

None

Whoopingcough7to16days

3

weeksafteronsetof

typicalparoxysms

Isolationfor3weeksafter

typicalwhoopdevelops

None

Yellowfever3to6

days

2

dayspriortoonsetof

feverandfirst4

daysof

fever

Isolationfrom

mosquitoesduringacutestageofdis-

ease

None

‘Concurrentand

terminaldisinfection

required.

General Measures for Control of Communicable DiseasesRegulation 4.—The local health officer, in instituting measures

for the control of communicable diseases,(a) shall make, or cause to be made, such investigation as may

be necessary for the purpose of securing data regarding contactsand, if possible, the time, place, and source of infection;

(b) shall establish and maintain isolation or such other meas-ures for control as required by rules and regulations of the StateBoard of Health;

(c) shall provide, directly or indirectly, for the instruction ofpersons affected, and their attendants, in the proper methods ofconcurrent disinfection;

(d) shall introduce such other measures, consistent with therules and regulations of the State Board of Health, as may bedeemed advisable because of widespread infection or threatenedepidemic;

(e) suspected cases of communicable diseases shall be subjectto the administrative procedures specified for cases of the diseaseuntil the diagnosis is determined or laboratory tests required for therelease of cases have been found to be negative.

(f) When a health officer has reasonable grounds to believethat a person or persons may have been exposed to a communicabledisease, he may control them as known contacts, making such ex-aminations and adopting such measures amhe. deems necessaryand proper for the'protection of public health arid the prevention ofthe spreading of disease.

(g) A placard may be used in the control of any communicabledisease at the discretion of the health officer.

RabiesRegulation s.—Whenever rabies is prevalent in any area or

locality in the state, the local City, or County health officer shallmake such examinations and adopt such measures as he deemsnecessary or proper for the protection of the public and the preven-tion of the spreading of the disease; and shall require the detention,isolation and examination of animals suspected of having rabies,and the isolation by the owner of all dogs in areas where rabidanimals have run at large. All unlicensed stray dogs should beimpounded and destroyed.

Restrictions on Food Handlers

Regulation 6.—No person can be employed to handle or pre-pare food until he has had a comprehensive examination by alicensed physician and surgeon and has been found free from anycommunicable disease in an infectious stage.

Removal to Hospital of Certain CasesRegulation 7.—When, in the opinion of the health officer or the

State superintendent of health, proper isolation of an affected per-son or persons, carrier, or contact is not or can not be effectivelymaintained on the premises occupied by such person or persons, hemay remove or require the removal of such person or persons to ahospital or other proper place designated by him.

Invasion of Isolation AreasRegulation 8.—No person other than the attending physicians

and authorized attendants shall enter or leave, and no one exceptthe health officer or his representative shall permit any other per-son to enter or leave any room, apartment, or premises where acommunicable disease is isolated.

No person shall remove any article from an isolated area with-out permission of the health officer.

Duty of Health Officer When Infected Person Leaves HisJurisdiction Without Permission

Regulation 9.—lt shall be the duty of the local health officerto report immediately to the State superintendent of health by tele-phone or telegraph the name, address, probable destination androute of departure of any person who is affected with a communica-ble disease, who has left his jurisdiction without his consent.

Method of Control of TuberculosisRegulation 10.—All cases of tuberculosis, regardless of type,

shall be reported to the local health officer and the State Departmentof Health.

When, in the opinion of the health officer or the State superin-tendent of health, proper isolation of a person affected with pulmon-ary tuberculosis in a communicable stage is not or can not be ef-fectively maintained on the premises occupied by such person orpersons, he may remove or require the removal of such person orpersons to a hospital or other place designated by him, there toremain in isolation for such a time as the health officer deems suchperson or persons to be a menace to the public health.

Method of Control of Venereal DiseasesRegulation 11.—Venereal diseases as referred to in this regu-

lation include syphilis, gonorrhea, chancroid, lymphogranulomavenereum and granuloma inguinale.

Where, in the opinion of the health officer or the State superin-tendent of health, proper isolation of a person affected or suspectedof being affected with a venereal disease is not or can not be ef-fectively maintained on the premises occupied by such person or

persons, he may remove or require the removal of such person orpersons to a hospital or other place designated by him, there to re-main in isolation for such a time as the health officer deems suchperson or persons to be a menace to the public health.

When a health officer has reasonable grounds to believe thata person or persons may have been exposed to a venereal diseasehe may control them as known contacts, making such examinationsand adopting such measures as he deems necessary and properfor the protection of public health and the prevention of the spread-ing of disease.

All information received by health officers in reports of venerealdisease cases and contacts shall be considered as confidential andshall not be revealed to any other person except when in the opinionof the health officer such revelation is necessary to protect the publichealth.

For the prevention of gonorrheal ophthalmia, the physician orperson attending the birth of a child shall drop two drops of onepercent aqueous solution of silver nitrate into the eyes of the babyimmediately after birth.

RepealAll rules and regulations of the State Board of Health for

the control of communicable diseases adopted and in force prior toApril 11, 1943, are repealed.

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