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THE SANITARY CODEOF THE

STATE OF FLORIDA

CHAPTER XXXIV

RULES AND REGULATIONS FOR THECONTROL OF COMMUNICABLE

DISEASES

ADOPTED BYTHE FLORIDA STATE BOARD OF HEALTH

Under Authority ol Chapter 381. Florida Statutes 1941.Sections 381.49 • 381.59, Inclusive

FLORIDA STATE BOARD OF HEALTHWilson T. Sowder, M.D., State Health Oiiicer

Jacksonville1948

THE SANITARY CODEOF THE

STATE OF FLORIDA

RULES AND REGULATIONSFOR THE

CONTROL OF COMMUNICABLEDISEASES

Revised and Effective, February 10, 1948

FLORIDA ($TATE BOARD OF HEALTHWilson T. Sowder, M.D., M.P.H., State Health Officer

Compiled by Bureau of Preventable DiseasesR. F. Sondag, M.D., Director

FLORIDA STATE BOARD OF HEALTH

Herbert L. Bryans, M.D., President

Pensacola

William Parr, Ph.G., Vice PresidentTampa

Mark F. Boyd, M.D.,Member

TallahasseeJ. Ernest Edwards, D.D.S., Member

MiamiRobert B. Mclver, M.D., Member

Jacksonville

At a session of the Florida State Board ofHealth held at its headquarters in the City ofJacksonville on February 10, 1948, a quorumof members being present, the Board did bymotion duly carried adopt the following rulesand regulations contained in Sections I to VII,inclusive, and by the same motion repealed allformer rules and regulations for the controlof communicable diseases previously adoptedand in force prior to the date of said meeting.

By the Board

PresidentFlorida State Board of Health

Attested:

State Health Officer andSecretary, State Board of Health

5

TABLE OF CONTENTSRULES AND REGULATIONS FOR THE CONTROL OF

COMMUNICABLE DISEASESPage

Chapter 381, Florida Statutes 7- 9

Section I, Reportable Diseases 10-11

Section II, Defining the Responsibility of PracticingPhysicians 12-13

Section III, Duties of Local Health Officers 14

Section IV, Definition of Terms 15-20

Section V, General Management of Patients withCommunicable Diseases 21-29

A. Isolation _____ 21

B. Quarantine 21

C. Removal of Patients Under Quarantine 22

D. Closure of Premises 22E. Placarding

_, 22F. Disinfection 23

G. Control of Milk, Milk Products, and OtherFood Stuffs 25

H. Schools 26

I. Release Specimens 26

J. Isolation in Hospitals 26’ K. Conduct of Funerals 27

L. Agreement Releasing Chronic Carrier 29

Section VI, Detailed Procedure for Control of Com-municable Diseases — — 30-57

Section VII, Control of Venereal Diseases —_ 58-60

Appendix I — 61

Appendix II _—- -—62

Index - -69

7CHAPTER 381, FLORIDA STATUTES 1941

Sections 381.49 - 381.59, InclusiveAN ACT to authorize the State Board of Health to adopt,promulgate, and enforce rules and regulations for thebetterment and protection of the public health.

381.49 Rules and Regulations of State Board of Health.The State Board of Health may make, adopt, promulgate,enforce, and from time to time, amend, and repeal, rulesand regulations covering sanitation and quarantine as maybe necessary for the protection of the public health. Theregulation so established shall be called and known as thesanitary code of the State of Florida. The sanitary codemay deal with any matters affecting the security of lifeor health or the preservation and improvement of publichealth in the State of Florida.

381.50. The Sanitary Code. The sanitary code mayinclude regulations covering drinking water either sold inpipe systems, bottled, or in any manner made accessibleto the public; watersheds used for public water supplies;the disposal of excreta, sewage, or other wastes; the pro-duction, handling and sale of foods and drinks; the disposalof garbage and refuse; the pollution of sewage, industrial orother wastes, of streams, lakes and other waters; drainagein connection with mosquito breeding control; plumbing;sanitation of state, county or municipal institutions or pri-vate institutions serving the public; the sanitation of publicbuildings; the sanitation of schools, publicly or privatelyowned and operated; tourist and trailer camps; swimmingpools and bathing beaches; road side service stations; foodcanning plants; shell-fish dealing and handling establish-ments; restaurants and all places where food is handled,sold or served; places of entertainment where food or drinkis sold or accommodations are provided for the public; dairiesand milk plants; the sanitation and disinfection of all pass-enger cars, sleeping cars, dining cars, steamboats and otherpublic vehicles of transportation in this state; the sanitationof all convict camps, jails, penitentiaries, factories, hotels,summer camps and recreation camps, and the sanitary regu-lation of any other condition, practice, establishment orinstitution as may be necessary for the control of communi-cable disease or the protection of public health; providedthat the state board of education and the State Board ofHealth shall jointly prescribe regulations relating to thesanitation of schools.

381.51. Segregation, Practice of Midwifery. The sani-tary code may provide for the care, segregation, and isola-tion of persons having, or suspected of having, any communi-cable, contagious, or infectious disease; and for the treat-

8 Florida Statutes

ment, segregation, isolation, and disinfection of all animalsor birds, having or suspected of having, diseases communi-cable to man. Also the sanitary codu may include provi-sions regulating the practice of midwifery in the state.

381.52. Regulating Milk, Water and Sewage Plants. TheState Board of Health may prescribe by regulations in-corporated in and as a part of the sanitary code, the quali-fications of milk plant operators, operators of water purifi-cation plants and operators of sewage treatment plants.

381.53. Regulations and Ordinances Superseded. Theprovisions of the sanitary code, as to public health mattersto which it relates, supersede all regulations heretoforeor hereafter enacted by other state departments, boards, orcommissions, or by local ordinances heretofore or hereafterenacted by incorporated villages, towns, or cities. Each city,town or village may, in manner prescribed by law, enactsanitary regulations not inconsistent with the sanitary codeestablished by the State Board of Health.

381.54. Presumptions. The actions, proceedings, andauthority, of the State Board of Hualth and the state healthofficer, in enforcing the provisions of the sanitary codeapplying them to specific cases, shall at all times be regardedas in their nature judicial and shall be treated as primafacie, just, and legal.

381.55. Study of Causes of Diseases. The State Boardof Health shall provide for the thorough investigation andstudy of the causes of all diseases, epidemic and otherwise,in this state and the means for prevention, and the publica-tion and distribution of such information as may contributeto the preservation of the public health and prevention ofdisease.

381.56. Regulations for Municipal and County Sanita-tion. The State Board of Health shall supervise and regu-late municipal and county sanitation and shall exercise gen-eral supervision over the work of local health authorities.Local health officials and other appropriate local offi-cials, concurrently with the State Board of Health, shal 1

enforce the provisions of tho state sanitary code and of suchlocal ordinances and sanitary regulations as may be con-sistent with it.

381.57. Construction of Sections 381.49 - 381.59. Nothingcontained in Sections 381.49 - 381.59 shall be construed as inany wise limiting any duty, power, or powers now possessedor heretofore granted to the said State Board of Health, bythe statutes of this state, or as affecting, or repealing anyrule or regulation heretofore adopted by said Board.

Florida Statutes 9

381.58. Punishment for Violations of Sanitary Code.Any person who shall violate, disobey, refuse, omit orneglect to comply with any of the rules and regulations ofthe sanitary code shall be guilty of a misdemeanor andupon conviction, shall be punished by imprisonment, notexceeding six month, or by fine not exceeding one thousanddollars.

381.59. Punishment for Obstructing State Board. Anyperson who shall interfere with, or hinder, or oppose, anyofficer, agent or member of the State Board of Health inthe performance of his duty as such, under Section 381.49 -

381.59, shall violate a quarantine regulation, or shall teardown, mutilate, deface, or alter any placard, or notice,affixed to premises in the enforcement of the sanitary code,shall be guilty of a misdemeanor and punishable upon con-viction, by imprisonment for not exceeding six months orby a fine not exceeding one thousand dollars.

10

Section IThe following diseases are dangerous to the public health

and must be reported to local health officers by practicingphysicians, regular and sectarian, licensed to practice in theState of Florida, and other persons as well.

A. The following named infectious diseases and carriersthereof, are declared to be contagious, communicable, anddangerous to the public health, and the names of personsill or infected therewith shall be reportable in accord*ance with the provisions of these regulations, viz.:

1. Actinomycosis2. Amebiasis (Dysentery,

Amebic)3. Anthrax (Human)4. Chancroid5. Chickenpox (Varicella)6. Cholera (Asiatic)7. Conjunctivitis of the

Newborn (Acute In-fectious — OphthalmiaNeonatorum)

8. Conjunctivitis (AcuteInfectious—In personsover one month of age.

9. Dengue10. Diarrhea of the New-

born (Epidemic)11. Diphtheria12. Dog and Other Animal

Bites13. Dysentery, Bacillary

(Shigellosis)14. Encephalitis (Acute

Infectious)15. Erysipelas16. Food Infections

(Salmonellosis)17. Food Poisonings

(StaphylococcusIntoxications)

18. German Measles(Rubella)

19. Glanders (Human)20. Gonorrhea21. Granuloma Inguinale

22. Hemorrhagic Jaundice(Ictero-hemorrhagicSpirochetosis; Weil’sDisease)

23. Hookworm Disease(Ancylostomiasis,Uncinariasis)

24. Hepatitis, Infectious(Acute CatarrhalJaundice)

25. Impetigo Contagiosa(In institutions)

26. Influenza27. Kerato-conjunctivitis,

Infectious (SuperficialPunctate Keratitis;Nummular Keratitis)

28. Leprosy29. Lymphopathia Venere-

um; LymphogranulomaVenereum; Lympho-granuloma Inguinale

30. Malariaa. Acquired outside U.S.b. Acquired within U.S.

31. Measles (Morbilli;Rubeola)

32. Meningococcal Menin-gitis and meningococ-cemia

33. Mumps (InfectiousParotitis)

34. Paratyphoid Fever35. Plague (Human)

Reportable Diseases 11

36. Pneumoniaa. Pneumococcalb. Primary bacterial

other thanpneumococcal

c. Primary atypicalor “virus”

37. Poliomyelitis (AcuteAnterior)

38. Psittacosis andOrnithosis

39. Rabies (Hydrophobia)a. Humanb. Animal

40. Ringworm of the Scalp41. Rocky Mountain

Spotted Fever42. Scarlet Fever and other

Hemolytic StreptococcalInfections of the UpperRespiratory Tract

43. Smallpox (Variola)44. Syphilis45. Tetanus46. Trachoma47. Tuberculosis,

Pulmonary48. Tularemia49. Typhoid Fever50. Typhus Fever (Brill’s

Fever; Murine Typhus)51. Undulant Fever

(Brucellosis)52. Vincent’s Infections

(Including Vincent’sAngina and UlcerativeStomatitis)

53. Whooping Cough(Pertussis)

54. Yellow Fever

B. Any person having knowledge of the occurrence ofany unusual or group expression of illness which may beof public concern, whether or not it is known to be ofa communicable nature, should promptly report thisinformation to the local health officer of the county inwhich occurring.

12

Section IIDefining the responsibility of practicing physicians and

others to report known or suspected cases of the diseasesenumerated in Section I, or carriers of the causative in-fectious agent thereof to the local health officer, and the re-sponsibility of the latter in relation to such reports.

A. Every physician of any school of practice, and everydentist, who diagnoses or recognizes or suspects theexistence of any reportable disease or carrier conditionenumerated in Section I, in a living patient or personrecently deceased seen in his practice, shall promptlyadvise the local health officer by telephone or writtenreport of such diagnosis or suspicion within twenty-fourhours of reaching such conclusion or forming such anopinion.B. If unattended by a physician, any person who recog-nizes that he or she is ill with a communicable disease;any parent or householder who recognizes that any mem-ber of his family or household is ill with a communicabledisease; any keeper of a rooming house, inn, motor courtor hotel who suspects that any patron domiciled on hispremises is ill with a communicable disease; or any prin-cipal or teacher in a public or private school who sus-pects that any pupil is ill with a communicable disease,shall promptly communicate the information by telephoneor writing to the local health officer.C. Any diagnostic laboratory making an objective diag-nosis of any reportable disease from specimens submittedby any physician or dentist, shall promptly report theresults to the local health officer, and such report may beaccepted in lieu of a direct report from the physician ordentist concerned.D. If the identity or office of the local health officer isnot known to the person possessing the knowledge orsuspicion described in “B”, above, the report may bemade to the mayor of the city or town, or to a countycommissioner, who shall promptly transmit the reportto the local health officer.E. Reports of quarantinable diseases made by telephoneshall be confirmed in writing within twenty-four hours.Such telephonic and written reports shall give the nameand place of residence of the patient (if a minor, that ofthe parent or guardian as well), the sex, color and ageof the patient, the definite or provisional diagnosis, thedate of onset, date of the report, and signature of theattending physician or other person making the report.

Responsibility of Physicians 13

Reports submitted by a clinical laboratory on behalf ofa physician or dentist, shall indicate the name of theprofessional attendant. Excepting the reports of venerealdiseases, which must be enclosed and sealed in a frankedenvelope provided by the State Board of Health (SectionVII, “C”, Page 58). Written reports may be made onthe franked post card forms furnished to practicing phy-sicians by the State Board of Health.F. The local health officer shall, at the end of eachweek, mail to the epidemiologist of the State Board ofHealth, a transcript of all reports received during thatweek from the physicians practicing in his jurisdiction ona form to be prescribed by the epidemiologist. In addition,should any local health officer receive report of any realor suspected cases of Cholera, Encephalitis, Plague, Polio-myelitis, Smallpox, Typhoid, or Yellow Fever, a supple-mental report shall be immediately sent to the epidemi-ologist by long distance telephone or telegraph, at the costof the State Board of Health.

G. The local health officer shall maintain a permanentfile of ail reports of infections with Leprosy, Syphilis, Tu-berculosis and Typhoid Fever. Reports of other communi-cable diseases may be discarded and burned 120 days aftertheir receipt. A card from permanent file may be discard-ed if and when information of death comes to the attentionof the local health officer, or the removal of such infectedperson to another health jurisdiction. Final dispositionshall be in accordance with instructions from the stateepidemiologist.

14

Section IIIDuties and responsibilities of local health officers in re-

lation to the morbidity reports received, and the initiationand supervision of isolation and quarantine of cases of com-municable diseases, as outlined in Sections V and VI.

A. When the placarding of premises or the initiation ofisolation of patients ill with any communicable disease,or the quarantine of susceptible contacts, is required byany of the provisions of Section VI, the local healthofficer shall, either in person or by a qualified assistant,cause the same to be done on the day on which thereport is received.B. The local health officer or his deputy shall visit asoften as in his judgment circumstances may require, allpremises on which cases of communicable diseases arein isolation or persons are in quarantine, to satisfy him-self that the regulations of the State Board of Healthare scrupulously observed.C. By deputization from the State Health Officer, thelocal health officer may order release from isolation orthe detention of quarantine when he is satisfied thatthe provisions of the regulations of the State Board ofHealth have met compliance.D. The local health officer, within five days of receivingreport of a case of any communicable disease which mayhave been acquired from the consumption of infectedwater, milk (or dairy products) or other food, shallcause to be made, on a form prescribed by the epidemi-ologist of the State Board of Health, a careful investi-gation of the movements of the patient in the monthpreceding the onset of his illness, and the source, natureand character of the usual and unusual water, milk andother foods consumed during this period. He shallfurnish the epidemiologist a weekly report of the datacollected pertaining to each such patient.

E. At the request of the attending physician, the localhealth officer shall undertake, with the consent of thepersons concerned, or of their parents or guardians ifminors, the immunization by appropriate means, of at-tendants, or of persons detained in quarantine. Providedthat the health officer shall not be prevented from ef-fecting such immunizations on his own initiative, if de-sired by the persons concerned, if the attending physicianhas neglected or refused to perform them earlier.

15

Section IVDefinitions.

1. An ADULT is a person who is sixteen years of age orolder, except under the circumstances noted in Defini-tion 5.

2. An AUTHENTIC RELEASE SPECIMEN is one collectedin such a manner and under such conditions as areapproved by the Florida State Board of Health, andwhich are described in greater detail under differentdiseases.

3. A CARRIER is a person who, without symptoms of agiven communicable disease, harbors and disseminatesthe specific microorganisms thereof. Such a conditionmay exist under the following circumstances:

a. An incubatory carrier is a person who withoutat the time manifesting symptoms of a specificdisease is found to be harboring microorganisms ofa specific communicable disease, and who latercomes down with the disease.b. A convalescent carrier is a person who has re-cently recovered from the clinical manifestations ofa specific communicable disease, and continues toharbor the microorganisms thereof.c. A contact carrier is a person who, without ex-hibiting signs of disease, passively harbors micro-organisms of a specific communicable disease, asa consequence of contact, direct or indirect, withanother case or carrier.d. A chronic carrier is a person who harbors with-in himself a focus of reproducing microorganismsof a specific communicable disease, and dissem-inates them either continuously or intermittentlywithout exhibiting further symptoms of the diseasein question. Chronicity is subsequently defined foreach disease in which it is significant.

4. A CASE is a single instance of a patient suffering froma given disease. There may be distinguished:

a. The typical case, which shows the usual signsand symptoms, and follows the usual course of thedisease in question.b. The atypical case, which does not present allof the usual signs and symptoms of the disease inquestion, and consequently is difficult to diagnose.(See Subclinical or Inapparent Infection)

16 Definition of Terms

c. The missed case is a patient in whom the exist-ence of a communicable disease has previously es-caped recognition. If recently ill, the symptomshave been mild and not readily recognizable, andthe attack probably of short duration. In this senseit has been atypical. The diagnosis is usually madein retrospect, and usually based on laboratoryexaminations.

5. A CHILD is a person under sixteen years of age. Ifage sixteen or over, and is in attendance at school, heshall be considered a school child after completionof the twelfth grade.

6. CLEANING is the removal, by scrubbing and washing,as with hot water and washing soda, or organic material.

7. A COMMUNICABLE DISEASE is an infection caused bya specific microorganism which is transmissible fromperson to person by various routes.

8. A CONTAGIOUS DISEASE is caused by a specificmicroorganism which is transmitted exclusively or near-ly so directly from person to person (i.e. by contagion).A contagious disease is communicable, but a communica-ble disease is not necessarily contagious.

9. The COMMUNICABLE PERIOD is a variable intervalduring which the microorganisms of a specific com-municable disease may be transferred directly or in-directly from the body of an infected person to the bodyof another person.

10. A CONTACT is any person or animal who or which hasbeen in close association with an infected person oranimal so as presumably to have been exposed to in-fection.

11. CONTACT TRANSMISSION means the transfer ofmicroorganisms from person to person through the ex-change of infective secretions or excretions with thelapse of but a short interval of time, during which themicroorganisms are subject to little or no attenuation.

12. CONTAMINATION of a surface (such as a wound), ofan article (such as a handkerchief) or matter (such aswater, milk, dairy products or other food), signifies thepresence of human or animal secretions or excretions.

13. DELOUSING is the process of treating a person andhis personal effects so that neither the eggs or adults ofthe human louse, Pediculus humanus, survive.

14. DISINFECTION is the destruction of pathogenic micro-organisms by the application of physical or chemicalmeans directly to the situations where they are present.

Definition of Terms 17

a. Chemical disinfection implies the application ofsubstances to the contaminated and infected materi-al or objects, which are directly lethal to the patho-genic microorganisms on contact after a short periodof exposure. These substances may all be regardedas poisons, and should be handled with care. Somecommonly employed are bichloride of mercury, car-bolic acid, chloride of lime and Liquor cresolis com-positus. They are all used in solution, must be usedin an effective concentration, and given a sufficientinterval of time to be effective.b. Concurrent disinfection is the application ofsome form of disinfection immediately after thedischarge of infectious material from the body ofan infected person, or after the soiling of objectswith such discharges, before an opportunity arisesfor other persons to come in contact with livingorganisms therein. This is a procedure of highestimportance.c. Terminal disinfection is the process of render-ing the immediate physical environment of thepatient free from the possibility of conveying in-fection to others, after the patient is no longer in-fectious. Terminal disinfection may be adequatelysecured by thorough cleaning in accordance withthe procedures later described.

15. DISINFESTATION is the application of any physical orchemical process by which insects or rodents capable ofconveying or transmitting infection, either living on thebody, or in and around human habitations, are destroyedupon the person, or clothing, or in the environment.The term insects as here employed, comprises ticks,mites, flies, mosquitoes, lice and fleas.

16. A FOOD HANDLER is a person who produces, prepares,packages, or sells food which is not stored and dis-tributed in a tightly closed container, and which is com-monly or usually eaten without proper cooking equiva-lent to boiling, or from which the outside peeling orcovering is not usually or commonly removed. All per-sons handling milk, cream, cheese and similar dairyproducts, or whose occupation is that of cook, waiter orhelper in a kitchen or dining room, shall be consideredfood handlers.

17. FOMITES are objects upon which microorganisms caus-ing communicable diseases may survive or retain theirvitality for protracted periods of time, without findingthe conditions favorable for their multiplication.


18. FUMIGATION as a procedure is now limited to the de-struction of insects or rats in confined spaces. Since thesubstances used, such as sulphur dioxide, cyanide, carbonmonoxide, carbon bisulphide, etc., are highly toxic to awide variety of life, the operation should only be per-formed by a skilled operator.

19. The INCUBATION PERIOD is the interval between theinfection or inoculation of a susceptible person with themicroorganisms of a specific communicable disease, andthe appearance in him of the symptoms characteristic ofthe disease in question.

20. The term INFECTED PERSON comprises patients typi-cally ill with a specific communicable disease, personsatypically ill with subclinical or inapparent infection, aswell as carriers.

21. INFECTION signifies the entry and multiplication of apathogenic microorganism in the body of man or animal.

22. An INFECTIOUS AGENT is a microorganism capable ofestablishing itself and multiplying within the body of aperson or animal, with or without producing symptomsof disease as a result of such invasion. Illness may shortlyarise therefrom if the invaded person or animal is sus-ceptible, but if possessing some degree of immunity, theinvasion will not be productive of many or any symp-toms. Infectious agents are living organisms, usuallymicroscopic (microorganisms), representative of a widevariety of living forms, and comprise (a) viruses; (b)unicellular vegetable forms (bacteria); (c) multicellularvegetable forms (fungi); (d) unicellular animal .forms(protozoa); and (e) multicellular animal forms (worms,arthropods).

23. An INFECTIOUS DISEASE is produced as the result ofthe invasion of the tissues by a living organism; i.e., aninfectious agent. It is usually communicable, and may becontagious.

24. INFESTATION OF THE PERSON, OR ANIMALS,ARTICLES, OR PREMISES. The infestation of personsor animals implies the lodgement, development, and re-production of parasitic insects on the surface of the bodyor in the clothing. By infestation of articles or premisesis meant the harborage or sheltering of insects or rodentscapable of carrying disease.

25. ISOLATION is the separation, for the period of com-municability, of infected persons from other persons, insuch places and under such conditions as will preventthe direct or indirect conveyance of the infectious agentfrom such infected persons to other persons.

Definition of Terms 19

26. A MICROORGANISM, in the sense of these regulations,is a specific infectious agent, rarely visible to the nakedeye (worms, arthropods, some fungi), more commonlyrequiring a high magnification by a microscope for ob-servation, (bacteria, fungi, protozoa, certain worms),or even too small for observation by ordinary micro-scopes (viruses).

27. The PATIENT OR SICK PERSON is a person sufferingfrom a clinically recognizable or suspected attack of acommunicable disease.

28. PLACARDING is an official procedure executed understate or local authority which consists of posting a warn-ing notice upon the door or entrance to living quartersof persons isolated because of communicable disease.

29. PREMISES are defined as:

a. The room or rooms, suite of rooms, or apart-ment, either in a detached dwelling, duplex, orapartment building, occupied by one family.b. In a building containing two or more apartments,only the immediate suite of rooms occupied by thepatient and his household.c. In a hotel, the room or suite of rooms occupiedby the case, his attendants and family contacts.d. In an institution, the entire institution or thatphysical portion designated as the premises by theState Health Officer, or his authorized representa-tive.

30. QUARANTINE is the limitation of freedom of move-ment of susceptible persons or animals who or whichhave been exposed to communicable disease, for a periodof time equal to the longest usual incubation period ofthe disease to which they have been exposed.

31. ROUTES OF TRANSMISSION OR TRANFERENCE arethe channels by which infectious agents are transferredfrom person to person, and comprise: (a) air; (b) con-tact (mouth spray, hands and fingers contaminated withsecretions and excretions, direct approximation of bodysurfaces of two persons); (c) foods (including water,ice, milk and dairy products, meat and shell fish, variousother foods); (d) insects (arthropods); (e) soil; and (f)fomites.

32. SEGREGATION applies to the separation, for specialconsideration, control, or observation, of some part of agroup of persons from others, to facilitate the controlof some- communicable disease, particularly for the pur-pose of separating susceptible from immune persons.


33. A SOURCE OF INFECTION is a person or animal whoor which is harboring the specific infectious agent ca-pable of inducing, on their transmission, a communicabledisease in the person or animal to whom they may be-come transferred through the contamination of anappropriate route of infection. In the case of certainmicroorganisms, the sources of infection are exclusivelyother human beings, in the case of others, the sources areexclusively or commonly various species of lower ani-mals, either domesticated or wild.

34. A SUBCLINICAL OR INAPPARENT INFECTION oc-curs in a person in whom the infecting organism, follow-ing the period of incubation, acts in so mild or atypicalmanner that even though the infection is present it islikely to be unrecognized. (See atypical case.)

35. A SUSCEPTIBLE is a person or animal who or whichis not known to have become immune to a particulardisease or infection by natural or artificial processes.It is presumed that should opportunity for exposurearise, transmission will be successful, and the personwill acquire the infection.

36. A SUSPECT is a person whose medical history andsymptoms suggest that he may now have or be develop-ing an attack of some communicable disease.

37. A VECTOR is an insect or arthropod which conveysthe microorganisms of certain communicable diseasesfrom a person or animal to another person or animal.The conveyance may be effected either by contact of theinsect with the skin or mucous membrances of the per-son, or by inoculation of the microorganisms into orthrough the skin or mucous surface in the course ofbiting the person.

21

Section VThe general management of patients suffering from a

communicable disease, subject to such modification with re-spect to any individual disease as is described in Section VI.

A. Establishment, conditions, duration and terminationof isolation.

1. Upon being informed of the existence of a casecarrier or suspected case or carrier of a communicabledisease for which isolation is required, the local healthofficer having jurisdiction in the area in which the pa-tient is situated, shall establish isolation of the patientin accordance with the provisions of these regulations.

2. Isolation at home can only be effective if throughoutthis period the patient is completely separated from allother members of his household, by detention in a roomor suite from which all, excepting his nurse or attendant,are excluded. All superfluous furnishings should be re-moved, leaving only the pieces essential for the care andcomfort of the patient. If the services of one or moretrained nurses cannot be provided, the attendant, if oneof the household, shall be relieved from all other do-mestic responsibilities, and under no circumstances shallprepare food to be consumed by persons other than thepatient, and shall not have access to the general familysupplies of food. The attendant, if not already enjoying anaturally acquired immunity to the disease in question,should immediately receive passive or active immuni-zation.3. Isolation shall be maintained for the minimum periodrequired in Section VI for the specific disease in ques-tion.4. Isolation may be terminated only by the local healthofficer having jurisdiction in the area in which thepatient is situated, or by the State Health Officer, whenthe provisions of the regulations of the State Board ofHealth have met compliance.

B. Establishment, conditions, duration and terminationof quarantine.

1. Quarantine of persons who have been in contact witha case, carrier or suspected case or carrier of a communi-cable disease shall immediately be established by thelocal health officer having jurisdiction in the area inwhich the contacts reside when such quarantine is re-quired for the specific disease in question by Section VI.2. The conditions of quarantine shall be specified by thelocal health officer.

22 General Procedure For Control

3. Quarantine of contacts shall be maintained for the mini-mum period of time required for the specific disease bySection VI.4. Quarantine may be terminated only by the localhealth officer having jurisdiction in the area in which thequarantined contact resides, or by the State HealthOfficer, or when the provisions of the regulations of theState Board of Health have met compliance.

C. Conditions under which patients subject to isolationor quarantine may be removed or transported.

1. Removal of a person under isolation or quarantine toanother dwelling or a hospital, may be made only withthe permission of the local health officer.2. Removal of a patient under isolation or quarantinefrom one health jurisdiction to another within Floridamay be made only with the permission of the StateHealth Officer.3. Interstate removal may be made only with the per-mission of the State Health Officer.4. Transportation of a person under isolation or quar-antine shall be made by private conveyance or as other-wise ordered by the local health officer or the StateHealth Officer, due care being taken to prevent thespread of the disease.5. Isolation or quarantine shall be immediately re-sumed upon arrival of the patient at the point of destina-tion, for the period of time required for the specificdisease by Section VI.

D. Closure of stores or places of business if satisfactoryisolation cannot be effected on premises.

1. Whenever a case, carrier, or suspected case or carrierof a communicable disease resides on premises connectedwith any store or place of business, such store or place ofbusiness shall be closed, unless isolation of the patientand quarantine of the contacts can be established andmaintained in a manner satisfactory to the State HealthOfficer or his duly authorized representative, either onthe premises or by removal of the patient elsewhere toa satisfactory location.

E. Placarding.

1. Whenever the provisions of Section VI require thatthe residence or domicile of a case, carrier or suspectedcase, or carrier of a communicable disease be placarded,the local health officer having jurisdiction over the area

General Procedure For Control 23

in which said case, carrier or suspected case or carrieris isolated, shall post a placard in a conspicuous place ateach outside entrance of the premises wherein the patientis isolated; provided, however, that if the patient isisolated in a general hospital in the manner prescribedby these regulations, the placard need only be posted atthe door of the particular room or ward wherein thepatient is isolated and need not bear the name of the dis-ease.

2. Whenever the rules of Section VI require that con-tacts with a case, carrier, or suspected case or carrierof a communicable disease be quarantined, the premiseswherein the contacts reside for the duration of the quar-antine period, shall be placarded by the local healthofficer having jurisdiction over the area where the con-tact is under quarantine.3. Placards shall not be removed or concealed frompublic view, shall not be mutilated or defaced, and shallremain posted until the requirements of Section VI rela-tive to the duration of the period of isolation or quaran-tine for the specific disease have been satisfied.

F. Concurrent and Terminal disinfection.1. Concurrent disinfection of the secretions and excre-tions of any person in isolation or quarantine, or theobjects contaminated by such secretions or excretions,shall be disinfected in accordance with the provisionsof the different sections of this rule.2. Normal and abnormal discharges from the eyes,ears, nose, throat, sputum, skin lesions and glands shallbe collected in or bn pieces of cloth, cotton, paper ortissue, and either burned at once, or if allowed to accu-mulate in disposable containers, be burned not less thantwice daily.3. In handling vessels containing body discharges andother infected materials, the nurse or attendant shallavoid touching or allowing any object which is not to beimmediately disinfected, to touch the contaminated sur-face.4. The waste bath water shall be either boiled or dis-infected by adding a sufficient quantity of Liquor cre-solis compositus to make a 2 per cent solution. However,if the bath water is disposed of in a drain connected witha sanitary sewer, such water need not be disinfected.5. Bedclothes, pillow slips, sheets, nightgowns, towels,washcloths, or any other cloth or clothing of similarkind, shall be disinfected either by being boiled with

General Procedure For Control24

soap and water for ten minutes, or allowed to soak in a2 per cent solution of Liquor cresolis compositus for 15minutes before removal from the isolation room, andsubsequently boiled for 10 minutes.6. Dishes, glassware, knives, forks, spoons, or any othereating utensils used in feuding the patient shall be boiledfor 10 minutes before washing, and shall not be used byany other member of the family, but shall be set asidefor the exclusive use of the patient.

7. Food left overs from the sick room shall be collectedand burned.8. Rectal tubes, douche nozzles, etc., shall be soaked forone hour in a 2 per cent solution of Liquor cresolis com-positus, after each use, and when not in use shall be keptimmersed in 70 per cent alcohol. Thermometers shall bekept immersed in 70 per cent alcohol.9. Bowel and bladder discharges (feces and urine) shallbe collected in a bed pan or urinal and disinfected byadding a solution of 2 per cent Liquor cresolis compositusof equal volume, and stirring the mixture until all partshave been thoroughly brought in contact with the dis-infectant. This mixture shall be allowed to stand, pro-tected from flies, for one hour before being dischargedinto a sewer or privy vault. A solid stool shall have onepint of water added and then treated as previously de-scribed in this Section.10. Bed pans and urinals when emptied shall bethoroughly cleaned with a solution of disinfectant aftereach use, and left containing a small amount of the dis-infectant. These receptacles shall, be screened from flies.11. A wash basin shall be kept near the door of theisolation room in which all persons, before leaving theroom, shall wash their hands thoroughly with soap andwater.12. Washable gowns shall be worn by the attendantswhile in the isolation room, which shall be removed justprior to leaving and hung within the room just priorto washing the hands.13. Whenever terminal disinfection is required by therules of Section VI, it shall be carried out at the termina-tion of the period of isolation, or applied to the quartersvacated when the patient is removed to other quartersto continue isolation. All the furniture, floors, walls,windows and woodwork shall be scrubbed with soap andwater and all washable articles shall be thoroughly boiledfor 10 minutes. Clothing which cannot be boiled, mat-


tresses and pillows, shall be placed out of doors in fullsunlight on successive days until they have had an ex-posure of at least 24 hours. Milk bottles or food con-tainers shall be boiled for 10 minutes before they arereturned to the dairyman or grocer. Soiled library andschool books shall be destroyed. Those which are notsoiled shall be cleaned and sunned for a total of 24hours, and subsequently should not be handled or usedfor a period of one week, after which they may be re-turned to use. After the cleaning described in the firstsentence of this section, the former isolation room and itscontents should be given as thorough a sunning as cir-cumstances permit for several days.

G. Application of isolation and quarantine practices todairymen or dairy employees or members of their house-holds.

1. Whenever a case, carrier, or suspected case or car-rier of Amebiasis, Diphtheria, Bacillary Dysentery(Shigellosis), Food Infection (Salmonellosis), Meningoc-cal Meningitis, Paratyphoid Fever, Poliomyelitis, ScarletFever or infections of the upper respiratory tract due othemolytic streptococci, Smallpox, Tuberculosis or Ty-phoid Fever occur on any farm or dairy producing milk,cream, butter, cheese or other foods likely to be con-sumed raw away from the premises, or in the home of adistributor thereof, no such foods shall be sold, ex-changed, removed, or distributed from such home ordairy during the period of isolation or quarantine, exceptunder the following conditions: A neighbor, tenantfarmer, or employee who has not been in contact withthe patient and who continues to reside in a differentdwelling or household, or a home contact who has beenreleased from quarantine in accordance with Section VIfor the specific disease, may take care of the milk orfood production, provided the following restrictions areobserved:

(a) During the period of isolation or quarantine,all milk or cream produced on the farm shall notleave the premises unless it is sent to a pasteuriza-tion plant where it shall be pasteurized prior to saleat wholesale or retail.(b) Neither the herd, the employees, the food pro-duced, the utensils, etc., may be permitted to haveany contact, direct or indirect, with the patient orhis attendant, the residence or household of the pa-tient, those residing in the sarnie household with thepatient, or with articles or utensils from such ahousehold.


(c) Upon agreement of the person or persons whowill handle production during the period of isolationor quarantine to observe the restrictions of thepreceding sentence, he or they may be issued a foodhandler’s permit by the Florida State Board ofHealth, which he or they may sign in testimony ofgood faith. The permit shall be countersigned by thelocal health officer having jurisdiction, who shallthereafter make inspections at least weekly to seethat this rule is observed.(d) Pasteurization of the milk shall be continuedfor one week following termination of isolation orquarantine.

2. The patient, after recovery, shall not assist in anydairy or food production operations until he has beenreleased from isolation.

H. The control of communicable diseases in school chil-dren when schools are in session.

1. Whenever the presence of communicable diseasein children or in the community renders school closureadvisable, the local health officer shall issue a supple-mentary order requiring all children of school age oryounger to remain upon their own residential premises.

2. Children infected with a communicable disease shallnot be permitted to attend school, unless specificallyexcepted by the rule for the specific disease in Section VI.3. School children suspected of being infected withcommunicable disease shall be refused admittance toschool by the teacher or principal.

I. Use of laboratory examinations to determine the dura-tion of isolation or quarantine.

1. Whenever the rules of Section VI require the sub-mission of laboratory specimens to be examined for tnepresence of specific microorganisms in order to controlthe duration of isolation and quarantine, or to determineeligibility for release therefrom, reports of such ex-aminations will not be accepted by a local health officerunless they have been examined in a laboratory of theFlorida State Board of Health or in another laboratoryapproved by the State Board of Health for the specifictests required.

J. Isolation in hospitals.1. Cases of communicable disease may be hospitalizedin a general hospital or a children’s hospital, providedthat the patient is isolated in a private room, a cubicle,or in a ward where none but patients with the same dis-


ease are segregated, and further provided that strict iso-lation technique is observed. The requirements of therule relating to the specific disease which the patientexperienced, as described in Section VI, must be observedbefore the patient leaves the hospital. However, theremoval of the patient to his home during the convales-cent period of isolation may be permitted, provided therequirements under “C” of this Section are observed.2. Nurses and attendants caring for communicable dis-ease patients shall not come in contact with obstetricalor surgical patients until a period of time equal to theincubation period of the particular disease has elapsedsince their last contact with such patients.

K. Conduct of funerals, and the transportation anddisinterment of dead bodies when death has occurred fromcertain communicable diseases.

1. A burial-removal-transit permit issued by the localregistrar, his deputy or sub-registrar of the registrationdistrict in which the death occurred, or the body wasfound, must accompany each dead body when trans-ported.

a. The burial-removal-transit permit must statethe place of death, name of the deceased, sex, color,or race, age, and the date of death, the date ofshipment, the point of shipment and destination,and shall bear the signature and title of the localregistrar who issued the burial-removal-transitpermit.b. The burial-removal-transit permit shall bearthe signature of the funeral director and show thelicense number of the funeral director issued bythe State Board of Funeral Directors and Em-balmers of Florida.

2. The bodies of those who died of Smallpox, BubonicPlague, Asiatic Cholera, Glanders, Anthrax, or EpidemicMeningitis, shall not be accepted for transportation un-less prepared in the following manner:

a. Arterial and cavity injection with an approveddisinfecting fluid.b. Disinfection and stopping of all orifices with ab-sorbent cotton.c. Washing the body with disinfectant.d. The body, after being prepared in the abovemanner, shall be encased in an airtight iron, steel,zinc, copper or lead lined coffin or casket, all joints


and seams hermetically sealed or sealed by gasketand all encased in a strong metal or wooden box; orthe body placed in a strong coffin or casket and en-cased in an airtight vault or outer wooden box linedwith not less than twenty-eight (28) gauge metallining.

3. The bodies dead from any cause not specified in “2”above, shall be accepted for transportation only whenencased in a sound coffin or casket and enclosed in astrong outside wooden box or metal vault; provided thatthe body will reach its destination within eighteen (18)hours from time of death. If the body cannot reach itsdestination within eighteen (18) hours from time ofdeath, then the body must be prepared as provided by“2, a and b,” above. The outside case may be omitted inall instances when the coffin or casket is transported inhearse, funeral director’s vehicle, private vehicle, pri-vate railroad car, or private airplane. A body to be trans-ported by common carrier must in all instances beencased in a sound coffin or casket and enclosed in astrong outside wooden box or metal vault.4. In the shipment of bodies dead from any of thediseases named in “2” above, such bodies shall not beaccompanied by persons or articles which have beenexposed to the infection of the disease, unless certifiedby the local or state health officer as having been prop-erly disinfected.5. No dead body shall be disinterred for transportationwithout the written consent of the State Health Officer.All disinterred remains shall be uncased in an airtightiron, steel, zinc, copper or lead lined coffin or casket,all joints and seams hermetically sealed or sealed bygasket and all encased in a strong metal or wooden box;or the body placed in a strong coffin or casket and en-cased in an airtight metal vault or outer wooden boxlined with not less than a twenty-eight (28) gaugemetal lining.6. When dead bodies are to be shipped by express, allof the preceding rules shall apply except the burial-removal-transit permit shall be attached to and accom-pany the waybill.7. Bodies deposited in vaults, public or private, shall beprepared in accordance with “2, d,” above.8. When a body has been held fifteen (15) days fromdate of death, permission of the State Health Officermust be obtained before the body is offered for trans-portation.


L. Agreement releasing chronic carrier of Typhoid, Para-typhoid, Bacillary Dysentery, and Amebic Dysenteryfrom the ordinary restrictions of quarantine.

State Health Officer DateJacksonville, FloridaDear Sir:

I,_____ _____

acknowledge an agreementmade with Dr. Health Officer of

County on this date, by which Iam to be permitted to remain in free communication withother persons as long as I comply with the following re-quirements:

(1) I will not handle food to be consumed by mem-bers of my family or other people.

(2) I will wash my hands with soap and water aftereach and every visit to the toilet.

(3) I will not bathe in any pool public or private.(4) I agree to advise the local health officer of

County of any change of residencewithin said County within thirty days of such change andshould I change my residence to another County, I willnotify the State Health Officer within the same intervalof time.

(5) I agree to submit such fecal specimens for lab-oratory examination as may be requested by the stateor local health officer.

(6) If my residential premises are not connectedwith a sewer I agree to install, maintain, and use, a flyproof toilet of a type approved by the State Board ofHealth.

I understand that failure to observe the above stipu-lations will justify the revocation of the privilege of freecommunication and that I may thereafter be subjected tothe provisions of quarantine applicable to persons in mycondition.

Signed:-

In witness of which agreement, I hereby grant per-mission to to be in free communica-tion with other persons as long as he complies with theabove stipulations.

Signed:(County Health Officer)

Address:

30

Section VIProcedure for the control of specific communicable dis-

eases.

1. ACTINOMYCOSIS

Control of Case:a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection of all discharges fromlesions and articles soiled therewith is required.d. Terminal disinfection by thorough cleaning is re-quired.e. Quarantine: None.f. Immunization: None.

Control of Contacts:

a. No restrictions are required.

2. AMEBIASIS (Dysentery, Amebic)

a. Placarding of premises is not required.b. Isolation is not required, but specimens of fecesmust be submitted from cases or carriers until threeconsecutive specimens, taken not less than one weekapart, are negative for trophozoites, or cysts ofEndamoeba Histolytica. Food handling by a case orcarrier is prohibited until the above requirementshave been fulfilled. (For chronic carrier agreementsee “L,” Section V, page 29.) All specimens must beexamined in a laboratory of the Florida State Boardof Health, or in one approved by it, for the diagnosisof Amebiasis.c. Concurrent disinfection of feces and washing ofthe hands after bowel evacuation is required.d. Terminal disinfection other than cleaning isnot required.e. Quarantine: None.f. Immunization: None.

Control of Contacts:a. Members of the same household or other inti-mate contacts shall submit at least two specimens

Amebiasis 31

of feces taken not less than four days apart, for ex-amination in a laboratory of the Florida State Boardof Health, or in one approved by it, for the diagnosisof Amebiasis.

Sale of Food, Milk, etc.:(See “G,” Section V, page 25).

3. ANTHRAX (Human)

Control of Case:

a. Placarding of premises is not required.b. Isolation is required until lesions have healed.Attendants must exercise extreme care for ownprotection.c. Concurrent disinfection of discharges fromlesions is required. (Spores can be killed only bymeasures such as incineration or steam under pres-sure.)d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine: None.f. Immunization: None.g. Cremation of corpses of fatal cases, without em-balming, is recommended. Local health officersshould advise embalmers of measures for their ownprotection.


a. No restrictions are required if patient is properly isolated.

4. CHANCROID

Rules applicable to venereal diseases are given in SectionVII, page 58.

5. CHICKENPOX (Varicella)

Control of Case:a. Placarding of premises is not required.b. Isolation is required until all crusts have dis-appeared from the skin.

32 Chickenpox

c. Concurrent disinfection of articles soiled by dis-charges from nose, throat, and other lesions is re-quired.d. Terminal disinfection may be limited to thoroughcleaning of the isolation room.e. Quarantine: None.f. Immunization: None advised.

Control of Contacts:a. No restrictions are required.

6. CHOLERA (Asiatic)

Control of Case:a. Placarding of premises is required.b. Isolation in a screened room is required untilthree consecutive specimens of feces and urine takennot less than twenty-four hours apart are negativefor the Vibrio Comma. Attendants must exerciseextreme care for own protection.c. Concurrent disinfection of all discharges is re-quired.d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine: Same as “b” above.f. Immunization: See “b” under Control of Contacts.

Control of Contacts:a. Quarantine of contacts is required for five daysfrom the last exposure or until two successive stooland urine cultures taken not less than twenty-fourhours apart are negative for the Vibrio Comma.

b. Prompt immunization of all contacts is required.

7. CONJUNCTIVITIS OF THE NEWBORN(Acute Infectious, Ophthalmia Neonatorum)

(Includes Gonorrheal and Pneumococcal Ophthalmia)

Control of Case;

a. Placarding of premises is not required.b. Isolation is required until clinical recovery.c. Concurrent disinfection of purulent secretions

Conjunctivitis of the Newborn 33

from conjunctivas and of articles soiled therewithis required.d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine; None.f. Immunization: None.


8. CONJUNCTIVITIS, ACUTE INFECTIOUS(In Persons Over One Month of Age)

Control of Case;

a. Placarding of premises is not required.b. No isolation is required if under proper care.c. Concurrent disinfection of purulent secretionsfrom conjunctivae and articles soiled therefrom isrequired.d. Terminal disinfection other than cleaning is notrequired.e. Quarantine: None.f. Immunization: None.

Control of Contacts;


9. DENGUE

Control of Case;

a. Placarding of premises is not required.b. Isolation in a screened room until complete re-covery is required.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.



34 Diarrhea of the Newborn

10, DIARRHEA OF THE NEWBORN (Epidemic)

Control of Case:a. Placarding of residential premises is not re-quired.

b. Isolation is required. The infected infant shall beimmediately removed from the nursery to isolationquarters where it shall be cared for by a separatenursing staff skilled in isolation technique, and whodo not come in contact with other infants or children.c. Concurrent disinfection of all discharges andarticles soiled therewith is required.d. Terminal disinfection by thorough cleaning ofnursery and equipment is required.

e. Quarantine: Closure of contaminated nursery tonew admissions, and suspension of maternity serv-ice. All exposed babies in the nursery should be caredfor by separate medical and nursing personnel,skilled in communicable disease techniques. Babiesshould be observed for at least two weeks followingthe removal of the last case from the contaminatednursery, and all new cases should be immediatelyremoved to isolation quarters. The maternity serv-ice may be renewed after discharge of all contacts,babies, and mothers.f. Immunization: None.

Control of Contacts:a. In addition to “e” above, bacteriologic examina-tion of stools is required of all sick and exposedbabies, mothers, and maternity service personnel.

11. DIPHTHERIA

Control of Case or Carrier:a. Placarding of premises is required.b. Isolation is required until two successive cul-tures from both nose and throat, taken not less thantwenty-four hours apart, are negative for Diphthe-ria bacilli, or when a virulence test proves the bacillito be avirulent. Cultures shall not be submitted forvirulence tests until at least twenty-one days afterthe onset of the disease.c. Concurrent disinfection of all articles whichhave been in contact with the patient and all articlessoiled by discharges of the patient is required.

DlPHTHEPUA 35

d. Terminal disinfection by thorough cleaning, air-ing and sunning of the sick room is required.e. Quarantine: All intimate contacts whetheradults or children whose occupation involves hand-ling of foods or close association with children, shallbe subjected to quarantine until shown by bacterio-logic examination not to be carriers.f. Immunization: Passive immunization with anti-toxin is rarely necessary for exposed persons overfive years of age, for whose protection daily ex-amination by a physician or nurse suffices. Infantsand young children exposed to Diphtheria in thefamily should receive a prophylactic dose of anti-toxin without prior Schick testing, unless they areknown to have been immunized.

Control of Contacts:a. See “e” above.

Sale of Food, Milk, etc.:See “G,” Section V, page 25.

12. DOG AND OTHER ANIMAL BITES

Reports:Every instance in which a person is bitten, scratchedby the teeth or otherwise wounded by a dog or othercarniverous animal, domestic or wild, or every in-stance in which a person has handled a known orsuspected rabid animal, shall be reported promptlyto the local health officer. Dog bites are to be re-ported on franked cards as employed for reportingcommunicable diseases.

Investigations:All instances of animal bites shall be investigatedpromptly by the local health officer, to determine, ifpossible, whether or not the animal in question hadrabies and if the person bitten is in need of prophy-lactic vaccination.

Control of Dogs:Any dog or other animal known to have bitten ahuman being shall be captured alive, if possible, andshall be quarantined under observation for a periodof fourteen days. If the animal is killed, the headshould be detached without mutilation and for-warded to one of the State Board of Health labora-tories where examination for rabies can be made.

36 Dysentery, Bacillary

13. DYSENTERY, BACILLARY (Shigellosis)

Control of Case:a. Placarding of premises is not required except inthe presence of an epidemic.b. Isolation in a screened room is required of allclinically active cases, until two consecutive speci-mens of feces, taken not less than seventy-two hoursapart, are negative for dysentery organisms. Allspecimens for release purposes must reach an ap-proved laboratory within twenty-four hours afterpassage. Clinically recovered cases, whose specimensare still positive, may be granted the same modifiedquarantine privileges as described for chronic car-riers. (See “L,” Section V, page 29.)c. Concurrent disinfection of bowel discharges isrequired.d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine: None.f. Immunization: No method of immunization hasas yet proved satisfactory.

Control of Carrier:See “L,” Section V, page 29.

Control of Contacts:a. All household contacts shall submit two succes-sive specimens of feces taken not less than twenty-four hours apart.b. No other restrictions are required of home con-tacts unless they are food handlers, in which casethey must not engage in thir usual occupation aslong as they reside on the premises where the patientis in isolation.

Sale of Food, Milk, etc.;See “G,” Section V, page 25.

14. ENCEPHALITIS, ACUTE INFECTIOUS

Control of Case:a. Placarding of premises is not required.b. Isolation in a screened room during the febrileperiod is required.c. Concurrent disinfection of all secretions andexcretions is required.

Encephalitis 37

d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.

Control of Contacts;a. No restrictions are required.

15. ERYSIPELAS

Control of Case:a. Placarding of premises is not required.b. Isolation is required until inflamation has sub-sided and all purulent discharges have ceased.c. Concurrent disinfection of all purulent dis-charges and careful disposal of all dressings is re-quired.d. Terminal disinfection by thorough cleaning is re-quired.e. Quarantine: None.f. Immunization: None. t


16. FOOD INFECTIONS (Salmonellosis)

Control of Case or Carrier:a. Placarding of premises is not required.

b. Isolation is not required, but specimens of fecesof cases or carriers must be submitted until twoconsecutive specimens taken not less than twenty-four hours apart are negative for salmonella organ-isms. Food handling or occupations involving thecare of children by a case or carrier are prohibited,until above requirements have been fulfilled. If caseor carrier refuses to submit specimens as requiredabove he shall be placed in isolation and the prem-ises placarded.c. Concurrent disinfection of all bowel dischargesand articles soiled by them is required.d. Terminal disinfection other than thorough clean-ing is not required.e. Quarantine: None.f. Immunization; None.

38 Food Infections


a. No restrictions are required.Suspected Food:

a. Samples of food suspected of being the source offood infections shall be obtained by the local healthofficer and sent for examination to a laboratory ofthe State Board of Health or one approved by it forsuch examinations.


17. FOOD POISONING (Staphylococcus Intoxications)

Control of Case:a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None,

Suspected Food:a. Samples of food suspected of being the sourceof food infection shall be obtained by the localhealth officer and sent for examination to a labora-tory of the State Board of Health or one approvedby it for such examinations.

18. GERMAN MEASLES (Rubella)

Control of Case:

a. Placarding of premises is not required.b. Isolation is required from onset of catarrhalsymptoms until five days after the appearance of therash.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization; None.


Glanders 39

19. GLANDERS (Human)

Control of Case:

a. Placarding of premises is not required.b. Isolation is required until all lesions have healed.(Attendants must exercise extreme care for theirown protection.)c. Concurrent disinfection of all purulent discharges or articles soiled therewith is required. Skincontacts with the lesions in the living or dead bodyis to be scrupulously avoided.d. Terminal disinfection of stable and contents isrequired.e. Quarantine: Of all horses in an infected stableuntil all have been tested by specific reaction, andthe removal of infected horses and terminal disin-fection of stable have been accomplished.f. Immunization: None accepted.g. Cremation of corpses of fatal cases is recom-mended. The local health officer should advise em-balmers of measures for own protection.


a. No restrictions are required.20. GONORRHEA

Rules applicable for venereal diseases are given inSection VII, page 58.

21. GRANULOMA INGUINALE

Rules applicable for venereal diseases are given inSection VII, page 58.

22. HEMORRHAGIC JAUNDICE

(Icterohemorrhagic Spirochetosis; Weil’s Disease)Control of Case:

a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection of urine and other dis-charges of patient is required.d. Terminal disinfection is not required.

40 Hemorrhagic Jaundice

e. Quarantine: None.f. Immunization: None practical.


23. HOOKWORM DISEASE(Ancylostomiasis; Uncinariasis)

Control of Case:a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection of bowel discharges andsanitary disposal to prevent contamination of soiland water is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


24. HEPATITIS, INFECTIOUS(Acute Catarrhal Jaundice)

Control of Case:a. Placarding of premises is not required.b. Isolation is required during the first week of ill-ness.c. Concurrent disinfection of discharges of nose,throat, bladder and bowels is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


25. IMPETIGO CONTAGIOSA (In Institutions)

Control of Case:a. Placarding of premises is not required.b. Isolation from other children is required untilall vesicles are healed.

Impetigo Contagiosa 41

c. Concurrent disinfection: Careful disposal ofdressings and moist discharges from the patient, andsterilization of underclothes and towels before laun-dering; care should be taken to avoid reinfectionfrom contaminated washcloths, combs, etc.d. Terminal disinfection of all toilet articles is re-quired.e. Quarantine: None.f. Immunization: None.


26. INFLUENZA

Control of Case:a. Placarding of premises is not required, butvisiting should be discouraged.b. Isolation is inquired during the acute stage ofthe illness.c. Concurrent disinfection of discharges from mouthand nose is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: A single subcutaneous injectionof 1 cc (Types A and B) is recommended for com-plete immunization and should be given in the faceof an epidemic. This is frequently given in two dosesof Vi cc each, the interval being seven days.


27. KERATO CONJUNCTIVITIS, INFECTIOUS(Superficial Punctate Keratitis; Nummular Keratitis)

Control of Case:a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection of conjunctival secre-tions is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.

42 Kerato-Conjunctivitis


28. LEPROSY

Control of Case:a. Placarding of premises is not required.b. Isolation is required until transfer to the Fed-eral Leprosarium or until clinical or laboratory ex-amination demonstrates non-infectivity.c. Concurrent disinfection of all discharges andarticles soiled therewith is required.d. Terminal disinfection by thorough cleaning ofliving premises is required.e. Quarantine: None.f. Immunization: None.


29. LYMPHOPATHIA VENEREUM; LYMPHOGRANU-LOMA VENEREUM; LYMPHOGRANULOMA INGUINALE

Rules applicable to venereal diseases are given mSection VII, page 58.

30. MALARIA(Acquired outside U. S.; Acquired within U. S.)

Control of Case:

a. Placarding of premises is not required.

b. Isolation is not required, but the patient must beproperly protected from bites of mosquitoes andshall be treated continuously until the blood is freeof malaria parasites. No patient, who has been inoc-ulated with malaria parasites for the purpose oftreatment, shall be discharged from a hospital orfrom the care of a physician until he has been rend-ered free of parasites by adequate specific treat-ment.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


Measles 43

31. MEASLES (Morbilli; Rubeola)

Control of Case:a. Placarding of premises is not required.b. Isolation is required from the onset of catarrhalsymptoms until five days after the appearance of therash and thereafter until the catarrhal symptoms andthe abnormal secretions of the mucous membraneshave ceased.c. Concurrent disinfection of all articles soiled withsecretions from the nose and throat is required.d. Terminal disinfection other than thorough clean-ing is not required.e. Quarantine: When the disease is very prevalentand in large' communities, quarantine of exposedsusceptible children is impracticable and of no value.Exclusion of exposed susceptible school children andteachers from school until fourteen days from lastexposure may be justifiable under sparsely settledrural conditions. This applies to exposure in thehousehold. Exclusion of exposed susceptible chil-dren from all public gatherings under the same con-ditions for the same period. If the date of only ex-posure is reasonably certain, an exposed susceptiblechild of school age may be allowed to attend schoolfor the first seven days of the incubation period.Quarantining of institutions of young children andof wards or dormitories where exposure is suspectedis of value. Strict segregation of infants if a caseoccurs in an institution is important.

f. Immunization: By the use of the serum of con-valescent patients, or of any healthy adult who hashad measles, or by the use of an immune globulinpreparation given to a person within five days afterhis first exposure to a known case of measles, theattack in the exposed person may be averted in aconsiderable percentage of instances; if not averted,the disease may be modified. Such passive immunitymay persist for a few weeks, but not more thanfour. Given later, but at a time prior to the clinicalonset of the disease, convalescent serum usuallymodifies the severity of the attack and the patientprobably acquires the usual lasting immunity to thedisease.


a. See “e” above.

44 Meningitis

32. MENINGOCOCCAL MENINGITIS ANDMENINGOCOCCEMIA

Control of Case:a. Placarding of premises is required.b. Isolation is required for two weeks from date ofonset and thereafter until clinical recovery, or untila negative culture from nasopharynx is obtained.c. Concurrent disinfection of discharges from noseand throat and articles soiled therewith is required.d. Terminal disinfection other than cleaning is notrequired.e. Quarantine: None.f. Immunization: None.


a. Contacts who continue to reside on the samepremises with the case shall be quarantined for theperiod of isolation of the case.b. Household contacts may with permission of thelocal health officer be removed from the premisesto remain away for the duration of the isolation pe-riod.


33. MUMPS (Infectious Parotitis)

Control of Case;

a. Placarding of premises is not required.b. Isolation is required until the swelling of thesalivary glands has disappeared.c. Concurrent disinfection of secretions of nose andthroat is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.



34. PARATYPHOID FEVER

See Typhoid Fever,- page 53.

Plague 45

35. PLAGUE (Human)

Control of Case:a. Placarding of premises is required.b. Isolation in a screened room free from rats, bedbugs and fleas is required. Attendants must exerciseextreme care for their own protection.c. Concurrent disinfection of all secretions and ex-cretions and articles soiled therewith is required.d. Terminal disinfection, including disinfestation,is required.e. Quarantine: All contacts shall be quarantined forseven days following last exposure to case.f. Immunization: Practicable only for persons be-lieved to be exposed to unusual risks of infection.g. Cremation of corpses of fatal cases is recom-mended. Local health officers should advise em-balmers of measures for own protection.


36. PNEUMONIA(Pneumococcal; Primary Bacterial, Other thanPneumococcal; Primary Atypical or “Virus”)

Control of Case:a. Placarding of premises is not required.b. Isolation is required during the febrile and acuteclinical stage of the disease.c. Concurrent disinfection of secretions of mouthand nose is required.d. Terminal disinfection by thorough cleaning andairing is required.e. Quarantine: None.f. Immunization: For active type—specific immu-nization against pneumococcal pneumonia—Solutionof Pneumoncoccus Polysaccharides Type—specific,is administered subcutaneously in one injection. Ad-ministration in the fall will give adequate protectionthroughout the following year.


46 Poliomyelitis

37. POLIOMYELITIS (Acute Anterior)

Control of Case;

a. Placarding of premises is required.b. Isolation is required for two weeks from date ofonset.c. Concurrent disinfection of all nose, throat, andbowel discharges and articles soiled therewith is re-quired.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.

Control of Contacts:a. All household contacts under sixteen years ofage shall be quarantined for two weeks from date oflast contact with patient.b. Adult contacts who are food handlers or schoolteachers are prohibited from engaging in their usualoccupation for two weeks from date of last contactwith patient; otherwise, there are no restrictions ontheir movements or activities.


38. PSITTACOSIS AND ORNITHOSIS

Control of Case:a. Placarding of premises is required.b. Isolation is required during the febrile and acuteclinical stage of the disease. •

c. Concurrent disinfection of all secretions of mouthand nose is required.d. Terminal disinfection: Incriminated birds shouldbe killed and their bodies immersed in 2 per centcresol. Carcasses should be burned before feathersdry.

e. Quarantine: Buildings which house birds shouldbe quarantined until thoroughly cleaned and disin-fected.f. Immunization: No demonstrated method yet fullyaccepted.

Psittacosis 47


a. No restrictions are required.Control of Infected Birds and Premises:

a. All premises, where any bird known to be in-fected with Psittacosis or Ornithosis is or has beenlocated, shall be closed and placarded for one weekand shall not be reopened until thoroughly cleanedand disinfected.b. All incriminated birds shall be killed and thebodies immersed in 2 per cent cresol. Carcassesshall be burned before the feathers have dried.When shipment of the carcass to a laboratory forexamination is desired, prior permission must be ob-tained from the State Health Officer or his dulyauthorized representative and made in accordancewith instructions given.

Sale of Birds within State:a. There are no restrictions on the sale of birds freefrom Psittacosis within the State of Florida.

Interstate Shipment of Birds:a. Shipment of birds to points within or outside theState of Florida must comply with the U. S. Inter-state Quarantine Regulations which pertain to theshipment and transportation of birds of the Psitta-cine family. (See Appendix I, page 61.)

Procedure for Obtaining Interstate Certificate;a. Copies of “Interstate Certificate,” which are tobe filled out in quadruplicate by the shipper, areprovided upon request by the Florida State Board ofHealth, Jacksonville. An affidavit filled out by alocal veterinarian, certifying that the bird or birdsis/are free from any evidence of disease, must ac-company the certificate. Two copies of the certificateare then returned to the shipper, one copy to beretained by him and one copy to accompany theshipment. One copy is forwarded by the FloridaState Health Officer to the State Health Departmentinto which state the birds are shipped.

39. RABIES (Hydrophobia)(Human and Animal)

Control of Case:a. Placarding of premises is not required.

48 Rabies

b. Isolation is not required if the patient is underadequate medical supervision, and the immediate at-tendants are warned of possibility of inoculationby human virus.c. Concurrent disinfection of saliva of patients andarticles soiled therewith is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: Immediate antirabic vaccinationof persons bitten by or intimately exposed to thesaliva of a rabid animal, or of any animal suspectedof being rabid, especially a dog. The possible chanceof infection is to be weighed against the very smallchance of developing paralysis due to treatment.


40. RINGWORM OF THE SCALP

Control of Case:a. Placarding of premises is not required.b. Isolation is not required, but infected childrenshall be excluded from schools, theaters, and otherpublic places until all lesions have healed. However,the local health officer may grant permission to in-fected children to attend school provided such chil-dren are receiving adequate treatment and furtherprovided that a tight fitting, washable, or dis-posable skull cap, covering all the hair, is worn atall times. Such a cap shall be changed once daily andboiled in a 5 per cent cresol solution for ten minutesafter each use or if disposable shall be burned afteruse.c. Concurrent disinfection of all towels, washcloths,head coverings and all toilet articles is required.d. Terminal disinfection is not required.e. Quarantine: None, but all children under fifteenin the household or institution group should be ex-amined with suitably filtered ultraviolet light atregular intervals until the source case is completelycured.f. Immunization; None.

Control of Contacts:a. Sec “e” above.

Rocky Mountain Spotted Fever 49

41. ROCKY MOUNTAIN SPOTTED FEVER

Control of Case:a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfestation, consisting of the care-ful removal and destruction, without crushing,' of allticks on the patient, is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


42. SCARLET FEVER AND OTHER HEMOLYTICSTREPTOCOCCAL INFECTIONS OF THE

UPPER RESPIRATORY TRACT

Control of Case:

a. Placarding of premises is not required.b. Isolation is required for a minimum period offourteen days after onset and thereafter until thenose, throat, glands, and ears are normal on inspec-tion or until the physician reports complete clinicalrecovery.c. Concurrent disinfection of secretions of mouth,nose, any purulent discharges, or articles soiledtherewith, is required.d. Terminal disinfection by thorough cleaning ofcontaminated objects, scrubbing floors, and sunningblankets is required.e. Quarantine: None.f. Immunization: By active immunization a poten-tial Scarlet Fever patient can be made Dick negative.

Control of Contacts:a. All home contacts who continue to reside on thepremises shall be restricted for the duration of theisolation period of the patient, with the following ex-ception: With the written permission of the localhealth officer, the wage earner may be permitted tocontinue his work provided he is over sixteen yearsof age, has no direct contact with the patient and is

Scarlet Fever

not a food handler, a school teacher, or employeearound a school or other place where there are chil-dren. This privilege is granted solely for the purposeof permitting the wage earner to continue his oc-cupation and he shall not enter any other premisesnot in line with his employment.

b. Household contacts may, with the permission ofthe local health officer, be removed from the prem-ises to remain .away for the duration of the isolationperiod and after removal may go about their usualroutine.c. When a case occurs in school, the health officershall notify the school authorities and all children inthe room shall be placed under daily medical ornursing observation for seven days for any signs ofillness. Any child with suggestive symptoms shall beexcluded from school and the health officer notified.d. Home contacts should be advised to take theDick test and if they react positively to be immu-nized with Scarlet Fever toxoid.

Sale of Food, Milk, etc.:

See “G,” Section V, page 25.

43. SMALLPOX (Variola)

Control of Case:a. Placarding of premises is required.b. Isolation is required until all lesions have healedand the scabs have fallen off. The attendant shouldbe a person who has recently been successfullyvaccinated or shows an immune reaction.c. Concurrent disinfection of all discharges andarticles soiled therewith is required.

d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine: All contacts will be quarantineduntil vaccinated with a vaccine of full potency anddaily medical observation of these contacts until theheight of the reaction is passed, if vaccination is per-formed within twenty-four hours of the first ex-posure and the strain of smallpox was of the VariolaMinot type; otherwise for sixteen days from lastexposure.

Smallpox 51

f. Immunization; Vaccination. Only dermal vaccin-ation is recommended. The reaction at the vaccina-tion site should be carefully observed and recordedat least three and nine days after vaccination todetermine whether the maximum diameter of red-ness was under three days (immediate reaction),over seven days (vaccinia), or intermediate betweenthese two (vaccinoid).

Control of Contacts:See “e” above.

Sale of Food, Milk, etc.See “G,” Section V, page 25.

44. SYPHILIS

Rules applicable to venereal diseases are given inSection VII, page 58.

45. TETANUS

Control of Case;

a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.e. Quarantine; None.f. Immunization; Active immunization with tetanustoxoid is desirable for those likely to be exposed toinfection with tetanus. In the absence of adequateprevious immunization with tetanus toxoid rein-forced by another injection of toxoid at the time ofinjury, a person who has been wounded in such away that there is danger from tetanus should re-ceive a subcutaneous injection of tetanus antitoxin,1,500 U.S.A. units (3,000 International units), givenon the day of the wound. A second injection withinten days may be desirable in certain instances.



52 Trachoma

46. TRACHOMA

Control of Case:a. Placarding of premises is not required.b. Isolation is required during the period of persist-ence of lesions of the conjunctiva or the dischargestherefrom unless the patient is under adequatetreatment and is observing precautions against thespread of the secretions of the eye to others; how-ever, exclusion from school until there is no longerany discharge from the eye is required.c. Concurrent disinfection of conjunctival secre-tions and articles soiled therewith is required.d. Terminal disinfection is not requii'ed.e. Quarantine: None.f. Immunization: None.


47. TUBERCULOSIS, PULMONARY

Control of Case:a. All cases or suspected cases of Tuberculosis shallsubmit for laboratory examination such specimensof sputum, gastric contents, or any other body dis-charges, as may be requested from time to time bythe local health officer. The following rules shallapply only to those cases or suspected cases of tuber-culosis who have not demonstrated the absence oftubercle bacilli in at least three successive authen-ticated concentrated specimens of their sputum,taken at intervals of not less than one a week, andexamined in a laboratory of the Florida State Boardof Health or one approved by it for such examina-tions.

1. Cases shall be hospitalized at public expensewhenever facilities for tuberculosis patients areavailable.2. Cases who refuse hospitalization, or who leavea hospital against medical advice, shall be isolated,the premises shall be placarded and concurrent

and terminal disinfection shall be required.3. Whenever hospital facilities for tuberculosispatients are not available at public expense, the

Tuberculosis 53

patient shall be isolated but the premises need notbe placarded provided proper isolation and con-current disinfection are in effect.


a. Quarantine of contacts is not required, but in-timate contacts shall not handle food or engage inoccupations which bring them into close associationwith children.b. All household contacts and other intimate con-tacts should have a chest x-ray at least once everyyear.


48. TULAREMIA

Control of Case:

a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection of purulent dischargesis required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.



49. TYPHOID AND PARATYPHOID FEVER

Control of Case:

a. Placarding of premises is not required.b. Isolation in a fly-proof room is required untilfour successive specimens of feces and urine,negative for typhoid or paratyphoid bacilli, are ob-tained in the following manner:

1. The first release specimen shall not be takenuntil at least seven days after the temperature isnormal and the second specimen not earlier thanseventy-two hours following the first. The thirdspecimen shall be taken one month after the sec-ond and the fourth taken one month after the

54 Typhoid Fever

third. (The first two specimens are advised to benon-cathartic.) The third and fourth specimensshall be after a saline cathartic has been given.No negative reports will be considered if the spe-cimen has been in transit more than twenty-fourhours. If either of the last two specimens are posi-tive, then four additional successive negative spe-cimens are required to be taken one month apart.2. Convalescent cases of typhoid or paratyphoidfever, who continue to harbor typhoid or para-typhoid bacilli in their feces or urine for threemonths after onset of their illness shall be classedas temporary typhoid or paratyphoid carriers.If they continue to harbor the typhoid or para-typhoid bacilli for twelve months after onset oftheir illness, their classification, then, automatic-ally becomes that of a chronic carrier.

c. Concurrent disinfection of all bowel and urinarydischarges and articles soiled therewith is required.d. Terminal disinfection by thorough cleaning isrequired.e. Quarantine: Family contacts should not be em-ployed as food handlers during period of contactnor before repeated negative stool and urine cul-tures are obtained.f. Immunization: Of susceptibles in the family orhousehold of the patient who have been or may beexposed during the course of the disease.


a. All attendants and all persons residing upon thepremises shall be immunized against typhoid orparatyphoid fever, if not so protected within theprevious two years.b. All contacts except food handlers, shall sub-mit two post-cathartic specimens of feces and urineone week apart and need not be quarantined duringthat time if cooperative, and if they do not come incontact with the patient.c. Contacts in the home who are engaged in theproduction or handling of milk, cream, milk pro-ducts and other foods, including all beverages, andwho have submitted four successive negative post-cathartic specimens of feces and urine taken notless than four days apart, may, with permission ofthe local health officer, be permitted to live at someother address so that they may resume their usual

Typhoid Fever 55

occupations, provided they do not again enter thepatient’s premises.


Control of Carriers:a. See “L,” Section V, page 29.b. If a typhoid carrier becomes ill with any otherdisease and requires hospital care, the hospital shallbe advised of his carrier status before admission asa patient so that proper precautions may be taken.A nurse, upon taking charge of the case at homeshall also be informed for her protection.c. When a chronic carrier desires to submit spe-cimens of feces and urine for release, he shall, underthe supervision of the local health officer, take acathartic, and a specimen if practicable shall betaken from the second or third bowel movement andshall be sent to the laboratory of the Florida StateBoard of Health or to a laboratory approved by it.A chronic carrier shall not be released from obser-vation and the rules of modified quarantine until hehas submitted eight successive, negative, specimensof feces and urine taken not less than one monthapart and two authentic negative bile specimensobtained by direct tube drainage, one week apart.The first bile specimen shall be taken approximatelyone month following the eighth feces and urinespecimen. SPECIMENS DELAYED IN TRANSITWILL NOT BE ACCEPTED IF MORE THANTWENTY-FOUR HOURS HAVE ELAPSED BE-TWEEN THE COLLECTION OF THE SPECIMENAND ITS EXAMINATION.d. Check-up on Carriers. The local health officershall visit, or cause to be visited, chronic carriersas often as is necessary to insure compliance with thecarrier agreement and all carriers must be visitedat least every six months or at more frequent inter-vals if directed by the State Health Officer.

50, TYPHUS FEVER (Brill’s Fever; Murine Typhus Fever)

Control of Case:

a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection is not required.d. Terminal disinfection is not required.

56 Typhus Fever

e. Quarantine: None.f. Immunization: It may be possible to preparekilled vaccine against murine typhus somewhat afterthe technique employed with the epidemic virus,but as yet there is no definite evidence as to its effi-cacy.


51. UNDULANT FEVER (Brucellosis)

Control of Case;a. Placarding of premises is not required.b. Isolation is not required.c. Concurrent disinfection other than ordinary san-itary precautions is not required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


52. VINCENT’S INFECTIONS (Including Vincent’s Anginaand Ulcerative Stomatitis)

Control of Case:a. Placarding of premises is not required.b. Isolation is not required but patient shall beexcluded from school until clinically recovered.c. Concurrent disinfection of secretions of mouthand nose is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: None.


Whooping Cough 57

53. WHOOPING COUGH (Pertussis)

Control of Case:a. Placarding of premises is not required.b. Isolation is required until three weeks after theappearance of the first paroxysmal cough, but pa-tient may be granted the liberty of his own homeand yard provided he does not come in contact withother children.c. Concurrent disinfection of secretions of mouthand nose is required.d. Terminal disinfection other than thorough clean-ing is not required.e. Quarantine: Non-immune children will be ex-cluded from school and public gatherings for four-teen days after their last exposure to a recognizedcase. This applies to exposure in the household orunder other similar conditions.f. Immunization: A brief passive immunity may beconveyed to young children by the administrationof appropriate amounts of convalescent serum orsimilar agent. Artificial active immunization isrecommended for children in the early months oflife, preferably before the sixth month.


54. YELLOW FEVER

Control of Case:a. Placarding of premises is required.b. Isolation in a screened room is required for thefirst four days of the fever.c. Concurrent disinfestation (destruction of mos-quitoes) is required.d. Terminal disinfection is not required.e. Quarantine: None.f. Immunization: Immunity is quickly conferred bya single inoculation with an attenuated strainof living virus with an apparent effective durationof four years and probably longer.

Control of Contacts:a. No restrictions are required, but immunizationis desirable.

58 Venereal Diseases

Section VIIProcedure applicable to the control of venereal diseases.

(See Appendix II for Opinion of the Attorney General.A. The words “health officer” when used in these rulesand regulations relating to venereal diseases shall meanany local health officer, the State Health Officer, vene-real disease control officer of the State Board of Health,or any duly authorized deputy or duly accredited repre-sentative of a local health officer or the State HealthOfficer.B. Syphilis, Gonorrhea, Chancroid, Granuloma Inguinale,and Lymphopathia Venereum are hereby designated asvenereal diseases and are declared to be contagious, infec-tious, communicable and dangerous to the public health.C. All cases of venereal diseases shall be reported in ac-cordance with the provisions of law to the local healthofficer if such is available, or to the State Health Officer,on a morbidity report card form prescribed for that pur-pose and enclosed and sealed in a franked envelope pro-vided by the State Board of Health.D. Whenever a health officer shall have reasonablegrounds to believe that any person within his jurisdictionis infected with any venereal disease he may cause medi-cal examination to be made for the purpose of ascertain-ing whether such person is in fact infected with such adisease in a stage which is or may become communicable,as defined in this Sanitary Code of the State of Florida.Any person, personally advised by a health officer thatsaid health officer has the opinion that he or she may havea venereal disease, shall submit to such examination, andpermit such specimens of blood or bodily discharges to betaken for such laboratory examinations as may be neces-sary to establish the presence or absence of such diseasesor infections, or shall submit to quarantine in a place andmanner determined by the health officer. Such laboratoryexaminations shall be performed in a laboratory of theFlorida State Board of Health, or in one approved by itfor such examinations.E. The health officer may require any person within hisjurisdiction who is found to be infected with a venerealdisease in a stage which is or may become communicableas defined by the health officer, to submit to such treat-ment or quarantine, or both, as described for the termina-tion of infectiousness. The health officer shall definethe place and limit the area within which such personsshall be quarantined and the conditions under whichsuch treatment or quarantine or both shall be terminated.

Venereal Diseases 59

F. The infectiousness of a person with communicablesyphilis shall be considered terminated by: (1) the ad-ministration of 60 units of anti-syphilitic drugs, one injec-tion of a trivalent arsenical of the arsphenamine or phe-narsine group being equivalent to two units, and one in-jection of a bismuth or mercury same being equivalent toone unit; or (2) the administration of 1,200 mg. of a phe-narsine compound within a period of two months or less,followed by one year of observation without clinical orserological evidence of release; (3) the administration ofat least 3,000,000 units of penicillin in a period of 10 daysor less, followed by one year of observation without clini-cal or serological evidence of relapse; (4) such combina-tions of artificial hyperpyrexia and chemotherapy as areequivalent to the above followed by one year observation.G. The infectiousness of Gonorrhea in a communicablestage shall be considered terminated by the administrationof (1) 20 gm. of sulfathiazole or sulfadiazine in 5 to 10days, or (2) penicillin in a dosage of 300,000 units paren-terally, provided that the gonococcus is not identified inat least one post-treatment specimen examined by culture,or three specimens for microscopic examination taken ondifferent days following therapy. Such laboratory speci-mens shall be performed in a laboratory of the StateBoard of Health or in one approved by it for such exam-inations.H. The infectiousness of Chancroid in a communicablestage shall be considered terminated by the administra-tion of 2 to 4 gm. of sulfathiazole or sulfadiazine per dayin divided doses for 7 to 12 days, provided that all ulcersand discharging buboes are fully .healed.I. The infectiousness of Granuloma Inguinale in a com-municable stage shall be considered terminated when allskin lesions are fully healed.J. The infectiousness of Lymphopathia Venereum in acommunicable stage shall be considered terminated whenall acute inflammatory lesions have healed.K. 1. Alternative Quarantine: Any person ordered by a

health officer to submit to examination under “D” ofthis Section, may elect to submit to quarantine as analternative to such examination, when the health officermay order him or her to remain within such limits andto conduct himself or herself in such a manner that noperson shall be exposed to the venereal disease sus-pected to be in a stage which is or may become com-municable. Such an order of quarantine may specifythe suspected person’s home or living quarters, or may

60 Venereal Diseases

direct him or her to proceed to and remain in an in-stitution, other than a penal institution, until the personmay be reasonably considered no longer infectious.2. Temporary Quarantine: Any person ordered by ahealth officer to submit to examination pursuant to ; ‘D”of this Section, may be required by an order of quar-antine to remain in an institution or within other limitsdetermined by the health officer until the results ofexamination are known.3. Conditional Quarantine: Any person ordered by ahealth officer to submit to treatment for venereal dis-ease shall be required to remain within limits specifiedby the health officer, and to submit to such examina-tions are are necessary to determine the effectivenessof therapy.

61

APPENDIX IUNITED STATES PUBLIC HEALTH SERVICE REGULA-

TIONS RELATIVE TO PSITTACINE BIRDS

New Interstate Quarantine Regulations, May 16, 1947“12.22 Psittacine birds. (2) The term psittacine birds shallinclude all birds commonly known as parrots, amazons,Mexican double heads, parakeets, African grays, cockatoos,macaws, love birds, lories, lorikeets, and all other birds of thepsittacine family.

(b) A person shall not offer for transportation, ortransport, in interstate traffic any psittacine bird unless:

(1) The shipment is destined to a zoological park orresearch institute, and the shipment is accompanied by apermit from the State Health Department of the State ofdestination (when required), or

(2) The shipment does not exceed two birds, the 'birdsare accompanied by the owner, have been in his possessionfor the preceding two years, have not had contact with otherpsittacine birds during that period, will be transported im-mediately to the owner’s private residence and retained thereas household pets, and are accompanied by a permit from theState Health Department of the State of destination (whererequired).”

62

APPENDIX IIFlorida State Attorney General’s Opinion Relative to

Venereal Disease Control

The following is for the purpose of prescribing a programfor the enforcement of health laws and criminal laws in con-trolling and regulating the cure and spread of venereal dis-eases and persons infected therewith. It will be divided intofour divisions in its arrangement, headed as follows:

1. Protection of Public Health under Health Regula-tions.

2. Protection of Public Health under CriminalStatutes.

3. Case examples with Suggestions for their Hand-ling.

4. Coordination of Enforcement Program in Centraland Uniform Source of Administration and Enforcement.

IPROTECTION OF PUBLIC HEALTH UNDER

HEALTH REGULATIONS(a) The State Board of Health and its authorized repre-

sentatives are authorized to require persons infected or sus-pected of being infected with a venereal disease, to submit tophysical examination and inspection, and are authorized torequire persons infected with venereal disease to report fortreatment, either to a private practitioner, or to submit totreatment provided at public expense. (Sections 384.03 and394.07, Florida Statutes 1941.)

(b) Syphilis, gonorrhea and chancroid are designated asvenereal diseases and are declared by statute to be conta-gious, infectious, communicable, and dangerous to the Pub-lic Health. (Section 384.01, Florida Statutes 1941.)

(c) In case it is known that a person or persons have be-come infected with a venereal disease by contacting a womanin a hotel, or other public place, or in a house of prostitu-tion, proper investigation should be made to determine theidentity of such woman, and she should then be prosecuted,isolated and treated. Of course, if such hotel, or other place,is in fact, and to all practical intent and purpose, a house ofprostitution, then the operator should be proceeded against.

(d) Upon the refusal of a person infected with a venerealdisease, or one suspected upon probable cause of being so in-fected, to submit to examination, a warrant may be issued bya justice of the peace or other proper officer, upon the sworn

attorney General's Opinion 63

testimony of a person or persons in possession of the facts.Such refusal is made a misdemeanor and is punishable assuch. After arrest such person should be examined and in-spected by a duly authorized representative of the StateBoard of Health, and if found to be infected with a venerealdisease, such person may be taken into custody by the StateBoard of Health, or its representative, and isolated and re-quired to submit to proper treatment until cured of suchdisease. (Section 384.04, Florida Statutes 1941).

(e) The State Board of Health is authorized to makenecessary rules for regulation and control of persons infectedwith venereal diseases, and the regulations and control of thedisease itself, including isolation and quarantine. (Sections384.09, 381.19, 381.15 and 381.49, Florida Statutes 1941.)

(f) The law fixes a penalty and punishment for viola-tions of State Board of Health quarantine regulations, or ob-structing officers of the Board in the performance of theirduties in carrying out quarantine regulations of the Board.(Sections 381.20 and 381.21, Florida Statutes 1941.)

(g) Sections 384.08, Florida Statutes, 1941, authorizesthe health authorities or their deputies to examine all per-sons who may be confined or imprisoned in any state, countyor city prison, and to treat such persons if found to be in-fected with venereal disease. The health authorities areauthorized to take over such portion of the prison as may benecessary for the confinement and treatment of persons whoare suffering from venereal diseases at the time of the ex-piration of their terms of imprisonment.

(h) It would seem to be advisable for the health au-thorities in each county to work in close harmony with thelocal enforcement officers (particularly police and sheriffs’offices), so that they may be constantly advised of the arrestand confinement of persons who may be infected with vene-real diseases, in order that proper inspection may be made ofsuch persons, and if infected, may be isolated in the isolationcamps to be established.

(i) The rules and regulations of the State Board ofHealth are designated by statute as the Sanitary Code of theState of Florida. (Section 381.49, Florida Statutes 1941). Andit is provided that this Sanitary Code may contain regulationsnecessary for the control of communicable disease or theprotection of the public health. (Section 381.50).

(j) All venereal diseases come within the classificationof both communicable, contagious, and infectious diseases.(Section 384.01, Florida Statutes 1941).

(k) The remedies of isolation, examination, treatment,

64 Attorney General's Opinion

and quarantine, are those which fall into the classification of“Protection of Public Health under Health Regulations.” Thejurisdiction and enforcement under these remedies are freedfrom some of the due process requirements of strict criminalprocedure: That is to say, more latitude in administration isprovided under the law in the enforcement of these publichealth remedies, and the rules and regulations of the StateBoard of Health to safeguard the public against persons com-ing within their purview, when the proceeding is foundedupon and instituted for the purpose of protecting puolichealth rather than to punish crime.

QUARANTINE. The remedy of QUARANTINE under thehealth rules and regulations should be resorted to in everycase only after due precaution, and only under the directionof the State Board of Health officials or agents, after care-ful consideration by them of the promise and necessity there-for, and of the adequacy of the criminal laws in furnishingthe protection and remedies for the particular case, and of theadequacy of the law, including State Board of Health rulesand regulations, controlling and governing treatment andisolation without quarantine. Also when quarantine isdeemed to be necessary, it should not be made to embrace anygreater quarters than those in which the infected person orpersons actually reside. For instance, a quarantine noticeplaced upon a building in which infected persons are found,whether it be a hotel, rooming house, private home, or houseof prostitution, should not specify that the entire house issubject to the quarantine, unless the persons infected residingtherein are so numerous as to require its total quarantine.

(1) The officers and agents of the State Board of Healthmay resort to criminal prosecution under the criminal laws,and that which follows under the heading, “Protection ofPublic Health under Criminal Statutes,” contains the cita-tions of the law in this jurisdiction. When in the enforcementof State Board of Health regulations applicable to treatment,inspection, isolation, and quarantine of venereal diseases,persons affected refuse to submit themselves thereto or toconform to requirements imposed, the health officer oragent should then resort to criminal proceedings by one ormore of the statutory remedies prescribed, in order to obtainthe right for further proceeding. This is applicable againstinfected persons or persons believed to be infected. Whereresistance or opposition occurs with respect to premises, thehealth officer should proceed in one or more of the 1 egalmethods prescribed for abatement of nuisances, or by quar-antine.

(m) It is my information that plans are being workedout between the United States Government and the Florida

Attorney General s Opinion 65

State Board of Health, whereby the government proposes toturn over to the State Board of Health a number of strategic-ally located camps which were formerly used by the CivilianConservation Corps, and that the State Board of Health pro-poses to convert these camps into isolation camps or hos-pitals for persons infected with venereal diseases. In theevent these camps are taken over by the State Board ofHealth and converted into suitable places for the isolationand treatment of persons infected with venereal disease, theState Board of Health is authorized to place such infectedpersons in those camps, and treat them until cured, withoutreference, of course, to whether or not they have been ar-rested under any criminal statute, when they do not resist.

IIPROTECTION OF PUBLIC HEALTH UNDER

CRIMINAL STATUTES(n) Syphilis, gonorrhea and chancroid are designated as

venereal diseases and are declared by statute to be conta-gious, infectious, communicable, and are dangerous to thepublic health. (Section 384.01, Florida Statutes 1941).

(o) It is a misdemeanor under the laws of Florida foranyone infected with either of these diseases to expose an-other to infection. (Section 384.03, Florida Statutes 1941).

(p) It is also unlawful for any person afflicted witheither of these diseases, knowing of such condition, to havesexual intercourse with one of opposite sex. (Section 384.02,Florida Statutes 1941). A violation of this statute is made amisdemeanor. (Section 384.03, Florida Statutes 1941).

(q) Any person having a venereal disease who, knowingof such condition, has sexual intercourse with another or ex-poses in any manner any person to infection, may be prose-cuted upon the affidavit of such other person or of any per-son having knowledge of the facts. Such affidavit may bemade before a justice of the peace or county judge, uponwhich a warrant of arrest will issue; except in those juris-dictions having criminal courts of record, in which case pros-ecution should be had upon information filed by the appro-priate prosecuting official. (Sections 384.02 and 384.03, Flor-ida Statutes 1941).

(r) In case of known houses of prostitution, proper in-vestigation should be made to determine the identity of thekeeper of such house, and he or she should be prosecutedunder the provisions of Section 796.01, Florida Statutes 1941,and the inmates prosecuted under the provisions of Section865.02, Florida Statutes 1941, as vagrants. These inmatesmay be examined, and if found to be infected with any vene-

66 Attorney General’s Opinion

real disease, the health authorities should take custody ofsuch persons and isolate and treat them until cured.

(s) In each case where the infected person is undercriminal prosecution, the course of the prosecution shouldnot interfere with or affect in any manner the authority ofthe State Board of Health and its authorized representatives,to maintain supervision over such person to the extent of re-quiring proper isolation and treatment.

(t) The practice of prostitution in itself,* unconnectedwith commercialization, is not a crime under any FloridaStatute. However, fornication is (Section 798.03), and keep-ing houses of prostitution is likewise made a crime. (Section796.01, Florida Statutes 1941).

(u) Common law crimes are of full force and effect inthis State, where there are no existing provisions by statuteon the subject. (Sections 775.01 and 775.02, Florida Statutes1941).

(v) Nuisances are punishable and indictable, and maybe removed and suppressed. (Section 823.01, Florida Statutes1941). And those matters tending greatly to corrupt themanners and morals of the people are classified as beingsuch. This remedy is in addition to the civil remedy of in-junction.

(w) Vagrants, vagabonds, street walkers, lewd persons,and the like, are subject to criminal arrest and prosecution.(Section 856.02). They may be arrested with and withoutwarrant. (Section 856.03.)

(x) Places frequented by classes of persons described inthe preceding paragraph may be declared nuisances. (Sec-tion 823.05).

(y) Any place where any law of the State of Florida isviolated is deemed a nuisance. (Section 823.05). Nuisancesabated or enjoined. (Sections 64.11 and 64.15).

IllCASE EXAMPLES WITH SUGGESTIONS FOR THEIR

HANDLINGWhere Rooming Houses or Hotels are Being Used for

Prostitution

This may occur in individual cases where knowledge ofthe management cannot be presumed to exist of what is going

*NB—The 1943 Legislature passed additional laws regarding prostitu-tion and control of venereal diseases. See Florida Statutes lorcontent of these laws.

Attorney General's Opinion 67

on. It may be carried on in such a promiscuous or multipliedscale as to impute knowledge to the management.

In both these instances, the woman or women involvedwould be subject to arrest and apprehension under one ormore of the criminal statutes above cited. Both the man andthe woman are fornicators and subject to prosecution underthe fornication statute above cited, and would be liable forinspection and examination by Board of Health authoritiesto ascertain whether or not either was diseased. If there isreason to suspect the woman so engaged to be infected withvenereal disease, one or more of the statutes heretofore citedwould be violated, and arrest, apprehension, and treat-ment thereunder could be had.

If the factual surroundings will sustain such, that is to say,if the practice or practices are being carried on in such amanner as to impute knowledge in the management of therooming house or hotel, such management should be prose-cuted for keeping a house that is being resorted to for pros-titution.

Quarantine may be used to stop assignation practice, ir-respective of the kind of lodging house or hotel involved, butmy opinion is that the quarantine should be placed upon theroom or rooms being so used, rather than upon the entirepremises in this kind of case, except where the practices areso general as to include all persons domiciled upon theoffending premises.

Street walkers, pimps, vagrants, and lewd persons aresubject to arrest under one or more of the above mentionedstatutes.

Under the rules and regulations of the State Board ofHealth, persons making a business of fornication can be pre-sumed to be infected with a venereal disease and subjectedto examination therefor by the State Board of Health au-thorities. And if they refuse to be examined, they may beproceeded against under the statutes above cited applicablein such instances.

Persons using automobiles to pick up men or women forlicentious purposes, are engaged in prostitution for commer-cial ends, and may be so prosecuted. Special attention iscalled to Sections 384.02 and 384.03, Florida Statutes 1941,where in those named cases prosecutions must be originatedwith county solicitors.

The officers and agents of the State Board of Health areexpected to use the courts of the State for obtaining warrantsof arrest in all cases where the facts in the particular case,and the remedies required for either the protection of the

68 Attorney General’s Opinion

public health or the punishment of the offenders, make pros-ecution necessary and justifiable.

The nuisance statute above cited, providing for abate-ment through proceedings in the justice of the peace court,provides a remedy which would be effective under extremecircumstances. It should not be overlooked that the ordin-nances of the various municipalities of the State and thepolice force and municipal courts thereof, would find appli-cation and could be of much assistance in the more effectivehandling of our venereal disease problems.

IV

COORDINATION OF ENFORCEMENT PROGRAM INCENTRAL AND UNIFORM SOURCE OF ADMIN-

ISTRATION AND ENFORCEMENT

I believe that the State Attorneys of the State, togetherwith all prosecuting officers such as County Solicitors andCounty Prosecutors, should be called into a conference atTallahassee, together with a representative of the State Boardof Health, a representative of the F. B. I., the Director ofPublic Health for the State Defense Council Division, and arepresentative of the Governor, to coordinate source of ad-ministration and enforcement in the field to which thismemorandum relates.

A program submitted to this group, and agreed upon byall participating as one acceptable for general and uniformenforcement throughout the State, should be accepted andmade effective, and a state-wide program adopted there-uder this conference grou'p; and aljl law enforcementofficers, including State Board of Health agents, police offi-cers, sheriffs and federal government agents, should be in-formed of its contents and plan, and directed to work inconformity therewith.

J. TOM WATSON,Attorney General.

Index 69

INDEX PageActinomycosis, control of __

_ 30Acute catarrhal jaundice—see hepatitis infectious 40Adult, definition 15Agreement releasing chronic carrier 29Amebiasis, control of 30An Act in Relation to Public Health 7Animal bites 35Ankylostomiasis (hookworm disease), control of * 40Anthrax, control of 31

funeral 27Appendix I (Interstate regulations relative to psittacine birds) 61Appendix II (Attorney General’s opinion relative to venereal

disease control) 62Attorney General’s opinion relative to venereal disease control

(See Appendix II) 62Authentic release specimens, definition 15Bites, animal 35Books, use of during quarantine (disinfection of after quarantine) 25Botulism—see food poisoning 38Brill’s fever (typhus fever) 55Brucellosis—see undulant fever I 56Carriers:

amebiasis 30diphtheria 34definition 15

chronic carrier 15contact carrier 15convalescent carrier 15incubationary carrier 15

dysentery, bacillary 36release of 29typhoid and paratyphoid 53

Case:definition 15

missed 16typical 15

removal 22Cerebrospinal fever, control of—see meningococcal meningitis 44Chancroid—see venereal diseases 58Chapter 381, Florida Statutes 7Chemical disinfection, definition 17Chickenpox, control of 31Child, definition 16Cholera, control of 32

funeral 27Cleaning, definition 16Closing of schools—see specific diseases 30 to 60Communicable diseases, definition 16Communicable period, definition 16Concurrent disinfection, definition 17, 23Conjunctivitis, acute infectious (over one month of age), control of 33Conjunctivitis of the newborn, acute infectious (ophthalmia neona-

torum), control of 32Contact, definition 16Contagious disease, definition 16Control of milk and milk products or other food stuffs on premises

quarantined for certain communicable diseases 25Control of specific communicable diseases 30 to 60Dairy farm under quarantine, control of milk, milk products and

other foods likely to be consumed raw 25Dead, transportation of 27Definition of terms 15 to 20Delousing, definition 16Dengue .control of 33Diarrhea of the newborn, epidemic, control of 34Diphtheria, control of cases and carriers 34Disinfection, definition 16

chemical 17concurrent - 17, 53

Disinfestation, definition 16

70 Index

Disinterment of bodies 27also see specific diseases 30 to CO

Disinterred bodies, shipping of .... 27Dog and other animal bites 35Dysentery:

amebic 30bacillary (shigellosis) 36

carrier agreement . 29restriction on sale of diary products and other foods likely

to be consumed raw ,. 25

Embalming, when death occurs from a communicable disease ...... 27Encephalitis, acute infectious, control of 361 ncephalomyelitis, equine, control of—see encephalitis 36Enforcement of communicable disease rules and regulations 7, 8, 9Epidemic, closing of schools during—see specific diseases 30 to 60Epidemic meningitis—see meningococcal meningitis 44Equine encephalitis—see encephalitis 36Erysipelas, control of , 37Exclusion of children from school .... 2,6

also see specific diseases 30 to 60Florida Statutes 7Fomites, definition 17Food handler, definition 17Food infection (salmonellosis), control of 37Food poisoning (staphylococcus intoxications), control of 38Food stuffs, milk and milk products, control of 29Food, suspected 38Fumigation, definition isFunerals, of persons dead from a communicable disease 27General hospitals, restrictions that apply to communicable diseasecases

.. ... 26General procedure for the control of communicable diseases 21German measles (rubella), control of 38Glanders, control of 39

funeral__ 27Gonorrhea, control of—see venereal diseases 58

Granuloma inquinale, control of—see venereal diseases 58Hemolytic streptococcal infections of the upper respiratory tract 49Hemorrhagic jaundice (spirochetosis: Weil’s disease), control of .. 39Hepatitis, infectious (acute catarrhal jaundice), control of 40Hookworm—see ankylostomiasis 40Hospitals, general, restrictions that apply to communicable diseasecases 26Hydrophobia, control of—see rabies 47Ictero-spirochetosis (hemorrhagic jaundice) 39Immune globulin—see measles 43Immunization—see specific diseases 30 to 60Impetigo, contagiosa (institutions), control of 40Inapparent infection, definition 20Incubation period, definition

..... 18Infantile paralysis, control of—see poliomyelitis 46Infected person, definition 18Influenza, control of 41Infection, definition jgInfectious agent, definition isInfectious disease, definition isInfectious parotitis (mumps) 44Infestation, definition jgInterstate quarantine regulations relative to psittacosis 61Isolation, definition 18

establishment, duration, termination, hospitals . 21, 22, 25, 26also see specific diseases 30 to €0

Jaundice, acute catarrhal—see hepatitis infectious 40Kerato-conjunctivitis, infectious (superficial punctate keratitis;nummular keratitis), control of 41Laboratory examination of:

release specimens 26suspect food 38also see specific diseases 30 to 60

Leprosy, control of 42Lethargic encephalitis, control of—see encephalitis 36

71Lymphopathia venereum (lymphogranuloma venereum; lympho-

granuloma inguinale), control of, see venereal diseases E8Malaria, control of 42Measles, control of 43

immune globulin 43Meningococcal meningitis, meningococcemia, control of 44

funeral 27Meningococcemia—see meningococcal meningitis 44Microorganism, definition 19Milk and milk products on premises quarantined for certain

communicable diseases, control of 25Morbilli (measles), control of , 43Mumps (infectious parotitis), control of 44Murine typhus fever, control of . 55Notifiable diseases, list of 10, 11Nummular keratitis—see kerato-conjunctivitis 41Official notice;

rules and regulations for the control of communicablediseases 3

Ophthalmia neonatorum—see conjunctivitis of the newborn 32Ornithosis, control of 46Parotitis, infectious (mumps), control of 44Paratyphoid fever, control of cases and carriers—see typhoid fever 53Pasteurization of all milk, cream and milk products from farms,

dairy farms, or homes of distributors where there are certaincommunicable diseases .

25Patient, definition 1 19Penalty for violation of these rules 9Pertussis (whooping cough), control of 57Placarding 19

carriers 23definition i 19diseases requiring—see specific diseases 30 to (50of hospitals 22,-23premises 22, 23who shall post and remove 22

Plague, control of 45funeral 27

Pneumonia, control of 45Poliomyelitis, acute anterior, control of 36Premises, definition 19Private funerals 27Promulgation of rules 3, 7Psittacosis and ornithosis, control of 46

Interstate quarantine—see Appendix I 61Public funerals 27Punishment for violation of sanitary code 9Punishment for obstructing State Board 9Quarantine;

animals when rabies is prevalent in a community 35dairy farms or home of a distributor of milk 25definition 19establishment, duration and termination 21, 22. 25, 26pertaining to venereal diseases 59, 60placarding of premises 22, 23removal from 21, 22, 25. 26store or place of business 22who may establish or terminate 21also see specific diseases 30 to 60

Rabies (hydrophobia), control of 47control of dogs 35laboratory examination of heads of animals suspected of

having rabies 35Release of chronic carriers 29Release specimens:

submission of, approved laboratory 26requirements, see specific diseases 30 to 60

Removal of case or suspected case to other premises or healthjurisdiction 22

Report of disease or suspected disease 10 to 13information required in report of communicable disease 12method of reporting 12, 13Responsibility for reporting cases and suspected cases 12, 13special report for venereal diseases—see venereal disease

section 58Reportable diseases, list of 10, 11

72Responsibility of local health officer 14Responsibility of practicing physician and others 12. 13Ringworm of the scalp, control of 48Rocky mountain spotted fever, control of

~

49Rubella—see German measles. _ 38Rubeola—see measles

~ _Z 43Rules and regulations. State Board of Health LZllZl 7, 8, 9Salmonellosis—see food infection 37Sanitary code 7Scarlet fever and other hemolytic streptococcal infections of theupper respiratory tract, control of 49Schools;

exclusion from 26school books from quarantine premises, disinfection

of 23, 24, 25. 26closing of for a communicable disease—see specific

diseases 30 to 60Segregation, definition 19Shigellosis—see bacillary dysentery 36Sick person, definition 19Sleeping sickness, control of, encephalitis 36, 37Smallpox, control of 50Source of infection, definition 20Special reports required for venereal diseases 58Specimens for laboratory examination—see specific diseases 30 to 60Spirochetosis—see hemorrhagic jaundice 39Staphylococcus—see food poisoning 38Stale Board of Health, powers and duties 7Streptococcal infections of the upper respiratory tract—see scarlet

fever 49Sub-clinical infection, definilion . 20Superficial punctate keratitis—see kerato-conjunctivitis 41Susceptible, definition 20Suspect, definition 20Suspected cases:

placarding 22, 23reporting of 38

Syphilis, control of—see venereal diseases 58Table of contents 5Terminal disinfection, definition 17

when required—see specific diseases 30 to 60Tetanus, control of 51Trachoma, control of 52Transportation of the dead ; 27, 28Tuberculosis, control of 52Tularemia, control of 53Typhoid and paratyphoid fever, control of cases and carriers 53

carrier ..... 54carrier agreement 29carrier check-up 55hospitalization of carrier 55immunization 54restrictions on sale of dairy products or other foods likely

to be consumed raw 25submission of specimens 55

Typhus fever, control of 55Ulcerative Stomatitis (Vincent’s angina) 56Undulant fever (brucellosis), control of ..... 56Uncinariasis 40USPHS regulations relative to psittacine birds 61Vaccination:

see smallpox 50of dogs, against rabies 47, 48

Varicella (chickenpox) 31Variola (smallpox) 50Vector, definition 20Venereal diseases, control of 58 to 60

alternative quarantine 59temporary quarantine 60conditional quarantine 60

Vincent’s infection (Vincent’s angina), control of 56Violation of rules, penalty for 9Weil’s disease—see hemorrhagic jaundice 39Whooping cough (pertussis) 57Yellow fever, control of 57

AND CONTROL OF COMMUNICABLE DISEASES › ext › dw › 29210930R › ... · 8 Florida Statutes ment, segregation, isolation, and disinfection of all animals or birds, having or suspectedof

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