DUPLICATE HXOOO 15024 a S.FUBOC HEALTH SER^ QUARANIINE LAWS AMD REGI or rtiE . pilEIJSTAfES *•* Columbia ©nibergitp intljeCitpof^etugorfe COLLEGE OF PHYSICIANS AND SURGEONS Reference Library- Given by iexwc/« — TREASURY DEPARTMENT UNITED STATES PUBLIC HEALTH SERVICE QUARANTINE LAWS AND REGULATIONS OF THE UNITED STATES ' 4; Revised Edition : June, 1920 WASHINGTON GOVERNMENT PRINTING OFFICE 1920 Treasury Department, Bureau of the Public Health Service, Washington, March 22, 1920. To Tnedical officers of the Public Health Service, collectors of customs, consular officers, and others concerned: Upon the recommendation of the Surgeon General of the Public Health Service and pursuant to the act of Congress approved Feb- ruary 15, 1893, entitled "An act granting additional quarantine powers and imposing additional duties upon the Marine Hospital Service," and other quarantine laws, the following regulations are hereby promulgated for the information and guidance of all con- cerned. All previous regulations inconsistent herewith are hereby revoked. J). F. Houston, Secretary. (3) Digitized by the Internet Arciiive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/quarantinelawsreOOunit QUAKANTIXE REGULATIONS. CHAPTER I. QUARANTINABLE DISEASES. 1. For the purpose of these regulations the quarantinable diseases are cholera, yellow fever, smallpox, typhus fever, leprosy, plague, and anthrax. GENERAL. BELLS OF HEALTH. 2. Masters of vessels clearing from or leaving any foreign port or any port in the possessions or other dependencies of the United States for a port in the United States or its possessions or other de- pendencies must obtain a bill of health, in duplicate, signed by the proper officer or officers of the United States as pro^dded for by law, except as provided for in paragraph 3. The following form is prescribed: Form 1937. United States of America. bill of health. I ( (the person authorized to issue the bill, at the port of ) do hereby state that the vessel here- inafter named clears (or leaves) from the port of ,. under the following circumstances: Name of ves- sel ............. . . Nationality Master Tonnage, gross Net Name of medical officer Number of officers Of crew, including petty officers ^ .,,... . Officers' families Passengers destined (5) for the United States First cabin second cabin , steerage \dsited within preceding four months Ports Location of vessel while in port: Wharf open bay Distance from shore If any passenger or member of crew disembarked on account of sick- ness, state. disease Time vessel was in port Character of communication with shore Sanitary- condition of vessel - Sanitar\* measures, if any. adopted while in port Saiiitar\- condition of port and vicinity Prevailing diseases at port and ^"icinity Number of cases and deaths from the following-named diseases during the past two weeks ending ; Diseases. Number of cases. Number of deaths.i Yellow fever Asiatic cholera Cbolera nostras or cholerine. Smallpox , Typhus fever Plague Leprosy Remarks. [Any conditions affecting the public health existing in the port of departure or vicinity to be here stated . 1 1 When there are no cas^ or deaths, entry to that effect must be made. Date of last case 'within preceding year): Cholera Yellow fever Human plague TA'phus Rodent plague I certify that the vessel has complied with the Quarantine Rules and Regulations made under the act of February 15, 1893, and that the vessel leaves this port bound for United States of America, via Given under my hand and seal this day of 19... (Signature of consular officer.) [seal.] Countersigned by — Medical Officer, U. S. Public Health Service. 3. In accordance with the provisions of the act of Congress approved August 18, 1894, vessels hereinafter named are exempt from the provisions of section 2 of the act granting additional quaran- tine powers and imposing additional duties upon the Marine Hospital Service, approved February 15, 1893, which requires vessels clearing from a foreign port for a port in the United States to obtain from the consular or medical officer a bill of health. Vessels so exempt are those plying between Canadian ports on the St. Croix River, the St. Lawrence River, the Niagara River, the Detroit Riier, the St. Clair River, and the St. Marys River, and adjacent ports of the United States on the same waters; also vessels plying between Canadian ports on the following-named lakes, viz, Ontario, Erie, St. Clair, Huron, Superior, Rainy Lake, Lake of the Woods, Lake Champlain, and ports of the L^nited States; also vessels plying between ports in British Columbia and ports on the Pacific coast of the United States as far south as (inclusive) San Francisco; also vessels plying between Canadian ports on the Atlantic coast and ports of the United States on the Atlantic coast as far south (inclusive) as Boston; also vessels plying between Mexican ports on the Rio Grande River and ports of the United States on the same river. Vessels sailing originally from other fgreign ports and merely calling at Canadian ports en route to the United States are not exempt from 8 the pro\T.sioiis of section 2, of the act approved February 15, 1893. During the prevalence of any of the quarantinable diseases at the foreign port of departure, vessels above referred to are hereby required to obtain from the consular officer of the United States, or from the medical officer of the United States, when such officer has been detailed by the President, a bill of health, in duplicate, in the form prescribed by the Secretary of the Treasury*. CHAPTER II. GENERAL REQUIREMENTS AT FOREIGN AND INSULAR PORTS. 4. The officer issuing the bill of health to vessels leaving foreign ports and ports in the possessions or other dependencies of the United States for ports in the United States or its possessions or other de- pendencies shall satisfy himself, by inspection if necessary, that the condition^ certified to therein are true. He is authorized, in accord- ance with law, to withhold the bill of health until he is satisfied that the vessel, the passengers, the crew, and the cargo have complied with all the quarantine laws and regulations of the United States. 5. Inspection is required of — (a) All vessels from ports at which cholera, yellow fever, or plague in men or rodents prevail, or at which smallpox or typhus fever prevails in epidemic form, and at which a medical officer is detailed. (b) All vessels carrj-ing steerage passengers; but need only in- clude the inspection of such passengers and their living apSjrtments if sailing from a healthful port. 6. Inspection of the vessel is such an examination of the vessel, cargo, passengers, crew, personal effects of same, including exami- nation of manifests and other papers, food and water supply, the ascertainment of its relations with the shore, the manner of loading and possibilities of invasion by rats and insects as will enable the inspecting officer to determine if these regulations have been com- plied with. 9 7. When an inspection is required, it should be made by daylight, as late as practicable before sailing. The vessel should be inspected before the passengers go abroad, the passengers just before embark- ation, and the crew on deck, and no communication should be had with the vessel after such inspection except by permission of the officer issuing the bill of health. 8. Vessels, prior to stowing cargo or receiving passengers, should be mechanically clean in all parts, especially in the hold, forecastle, and steerage and loose dunnage in unladened compartments shall be so arranged as to prevent harborage of rodents. 9. Any portions of the vessel liable to have been infected by any communicable disease should be disinfected before the issuance of the bill of health. 10. The ail' space, ventilation, food and water supply, hospital accommodations, and all other matters mentioned therein promotive of the health and comfort of the passengers must be in accordance with the provisions of the act of Congress approved August 2, 1882, entitled "An act to regulate the carriage of passengers by sea." 11. Bedding, upholstered furniture, soiled wearing apparel, per- sonal effects, and second-hand articles of a similar nature coming from a district known to be infected with smallpox or as to the origin of which no positive evidence can be obtained, and which the consular or medical officer has reason to believe is infected, should be disinfected prior to shipment. Articles similar to the above mentioned, if from a district infected by plague or typhus, should be inspected, and, if necessary, treated to destroy vermin. 12. Articles from an uninfected district shipped through an in- fected port may be accepted without restriction if not exposed to infection in transit. 13. Nothing in these regulations shall be construed to modify or nullify in any way existing restrictions promulgated by the Secre- tary of the Treasury at the instance of the Secretary of Agriculture for the prevention of the introduction of diseases of animals. 14. Any article shipped from or through an infected port or place which the consul or medical officer has reason to believe infected, should be disinfected. 10 15. Any article presumably infected which can not be disin- fected should not be shipped. 16. Passengers, for the purpose of these regulations, are divided into two classes, cabin and steerage.^ 17. So far as possible passengers should avoid embarking at a port where quarantinable disease prevails, and communication be- tween the vessel and the shore should be reduced to a minimum. In such a port the personnel of the vessel should remain on board during their stay. 18. No person suffering from a quarantinable disease, or scarlet fever, measles, diphtheria, poliomyelitis (infantile paralysis), influenza, chicken pox, or cerebrospinal meningitis should be allowed to ship. 19. Passengers and crews, merchandise, and baggage, prior to ship- ment at a non infected port but coming from an infected locality should be subject to the same restrictions as are imposed at an infected port. CHAPTER III. GENERAL REQUIREMENTS AT SEA.^ 20. The master of a vessel should observe the following measures on board his vessel: (a) The water-closets, forecastle, bilges, and similar portions of the vessel liable to harbor infection should be frequently cleansed and disinfected. (h) Free ventilation and rigorous cleanliness should be main- tained in all portions of the ship during the voyage and measures taken to destroy rats. mice, fleas, flies, mosquitoes, and all vermin: 1 The sanitary measures applicable to second-cabin passengers will be those desig- nated for first-cabin passengers or for steerage passengers, according as the arrange- ments of their quarters and accommodations aboard, both sanitary and for associa- tion, class them in the opinion of the inspecting oflBcer with the first cabin or steerage. 2 These requirements ^At sea are largely advisory in character, but it is nevertheless true that a careful compliance with them should tend, at the port of arrival, to largely relieve the stringency of quarantine measures. 11 (c) A patient sick of a communicable disease should be isolated and one member of the crew detailed for his care and comfort, who, if practicable, should be immune to the disease. (d) Communication between the patient or his nurse and other persons on board should be reduced to a minimum. (e) Used clothing, body linen, and bedding of the patient and nurse should be immersed at once in boiling water or in a disinfect- ing solution. (/) The compartment from which the patient was removed should be disinfected and thoroughly cleansed. Articles liable to convey infection should remain in the compartments during the disinfec- tion when gaseous disinfection is used. (g) Any person suffering from malaria or yellow fever should be kept under mosquito bars and the apartment in which he is con- fined closely screened with mosquito netting. All mosquitoes on board should be destroyed by fumigation. Mosquito larvro (wigglers or wiggle-tails) should be destroyed in water barrels, casks, and other collections of water about the vessel by the use of petroleum (kerosene); where this is not practicable, the receptacle should be covered by mosquito netting to prevent the exit of mosquitoes from such breeding places. (h) In the case of bubonic plague, special measures must be taken to destroy rats, mice, fleas, and other vermin on board, and in case of pneumonic plague, the patient should be isolated, the body discharges disinfected, especially sputum, and the attendant should wear a mask. ({) In the case of typhus, special measures should be taken to destroy yernain. (j) in the case of cholera, tj'phoid fever, or dysentery, the drink- ing water should be boiled and the food thoroughly cooked. The discharges from the patient should be immediately disinfected and thrown overboard. 21. An inspection of the vessel, including the steerage, should be made by the ship's physician once each day. 22. Should cholera, yellow fever, smallpox, typhus fever, plague, or any other conmiunicable disease appear on board a ship while at sea, those who show symptoms of these diseases should be immedi- 12 ately isolated in a proper place; the ship's physician should then immediately notify the captain, who should note same in his log, and all of the effects liable to convey infection which have been exposed to infection should be destroyed or disinfected. In the case of smallpox, the entire personnel should be vaccinated. 23. The hospital should be cleansed as soon as it becomes vacant. 24. The dead, except those dead of yellow fever, should be en- veloped in a sheet saturated with one of the strong disinfecting solutions, without previous washing of the body, and at once buried at sea or placed in a coffin hermetically sealed. 25. A complete clinical record shall be kept by the ship's surgeon of all cases of sickness on board, and the record delivered to the quarantine officer at the port of arrival. 26. The following disinfecting solutions are recommended for use at sea : Formulsefor strong disinfecting solutions. BICHLORIDE OF MERCURY (1:500). Parts. Bichloride of mercury 1 Sea water 500 Mix. CARBOLIC ACID (5 PER CENT). Alcohol 50 Carbolic acid, pure 50 Mix. Then add fresh water 900 Formulsefor weak solutions. BICHLORIDE OF MERCURY (1:1,000). ft Bichloride of mercury 1 Sea water 1, 000 CARBOLIC ACID (2| PER CENT). Carbolic acid, pure 25 Fresh water 1, 000 FORMALIN (5 PER CENT). Formalin (or formal) 50 Water.... ^ '. 950 13 It is suggested that a vessel should carry for every 100 passengers : Bichloride of mercury, 5 pounds; carbolic acid, 10 pounds; alcohol, 10 pounds; formalin, 10 pounds; 100 pounds of sulphur and 12 Dutch ovens, about 12 inches diameter, and an adequate supply of fresh vaccine ^orus. CHAPTER IV. GENERAL REQUIREMENTS AT DOMESTIC PORTS. 27. At or convenient to the principal ports, quarantine stations should be equipped with all appliances for the inspection and treat- ment of vessels, their passengers, crews, and cargoes. 28. For all ports where such provisions have not been made, and where quarantine inspection is required, inspection stations should be maintained. 29. At a fully equipped maritime quarantine station there should be adequate provision for boarding and inspection, apparatus for mechanical cleansing of vessels, apparatus for disinfection by steam, by sulphur, by formaldehyde, by disinfecting solutions, or any other methods prescribed in these regulations; also a clinical laboratory, hospitals for contagious and doubtful cases, a steam laundry, deten- tion barracks for suspects, bathing facilities, a crematory, a sufficient supply of good water, and a proper system for the disposal of sewage. 30. The personnel of quarantine stations in the yellow fever zone should be immune to yellow fever, and at all stations the personnel shall be vaccinated against smallpox. Officers when entering upon a tour of duty at a quarantine station should be vaccinated against smallpox, and the same shall apply to all subordinates and their families on the station. 31. At quarantine stations south of the southern boundary of Maryland the reservation shall be free of Aedes (stegomyia) ealopus, and general antimosquito measures shall be enforced on the reser- vation and environment. 32. At quarantine stations, all articles liable to convey infection should be handled only by the employees of said station, unless the services of the crew of the vessel in quarantine are indispensable. 14 S3. The lollo-vring regulations are the required minimum standard and do not prevent the addition of such other rules as, for special reasons, may be legally made by State or local authorities.^ INSPECTION. 34. Every vessel subject to quarantine inspection, entering a port oi the United States, its possessions or dependencies, shall be considered in quarantine until given free pratique. Such vessel shall fly a yellow flag at the foremast head and shall observe all the other requirements of vessels actually quarantined. 35. Vessels arriving at ports of the TTnited States under the follow- ing conditions shall be inspected by a quarantine oflicer prior to entr^': a J All vessels from foreign ports except those covered by para- graph 3. Vessels from a foreign port shall be inspected only at first port of call in the United States, except vessels from ports suspected of yellow fever a^^i^-ing during the active quarantine season at southern, \m northern ports. (h) Any vessel with sickness on board. (c) Vessels from domestic ports where cholera, plague, or yellow fever prevails, or where smallpox or t\-phus fever prevails in epi- demic form. 36. The inspection of vessels required by these regulations shall be made between sunrise and sunset, except in case of vessels in distress. Exception may also be made in the case of vessels cany^- ing perishable cargoes, and regular line vessels under regulations approved by the Secretan- of the Treasur^^ 37. In making the inspection of a vessel the bill of health and clinical record of aU cases treated during the voyage, crew and pa^engers' lists and manifests, and, when necessary-, the ship's log shall be examined. The crew and passengers shall be mustered and examined and compared with the lists and manifests and any discrepancies investigated. The clinical thermometer should be 1 Poialties for violation of these -regulations are provided in sec. 10, act of Mar. 2, 19W., and in see. 4, act of June 19, 1906. 15 used in the examination of the personnel of vessels under suspicion. When a freight manifest shows that articles requiring disinfection under these regulations are carried by the vessel, a certificate of disinfection, signed by a United States consul or a medical officer of the United States, shall be exhibited and compared with same. If no certificate of disinfection is produced, the collector of customs at the port of entry shall be notified of same by the quarantine officer. The collector of customs shall then hold such consignment in a designated place, separate from other freight, pending the arrival of the certificate of disinfection; and in the event of its nonarrival the articles shall be disinfected as hereinbefore prescribed, or shall be returned by the common carrier conve;>T.ng same. 38. Medical officers of the United States duly clothed with authority to act as quarantine officers at any port or place within the United States, when performing the said duties, are hereby authorized to take declarations and administer oaths in matters pertaining to the administration of the quarantine laws and regu- lations of the United States. (Act of Mar. 2, 1901, sec. 12.) 39. No person, except the quarantine officer, his employees, or pilots, shall be permitted to board any vessel subject to quarantine inspection until after the vessel has been inspected by the quar- antine officer and granted pratique, and all such persons so boarding such vessel shall, in the discretion of the quarantine officer, be sub- ject to the same restrictions as the personnel of the vessel, or other- wise, action may be taken as proiided for in section 10, act of March 2, 1901: Provided, however, That the United States customs officials may be permitted to board a vessel that has been inspected and held in quarantine for detention or treatment, they being subject to the same restrictions as the personnel of the vessel. 40. When a vessel arriving at quarantine has on board any of the communicable but nonquarantinable diseases, the quarantine officer shall promptly inform the local health authorities of the existence of such disease aboard and shall make every effort to furnish such notification in ample time, if possible, to permit of the case being seen by the local authorities before discharged from the vessel. 16 QUARANTINE DETENTION. 41. Vessels arri\ing under the following conditions shall be placed in detention: (a) With quarantinable disease on board or having had such disease on board during the voyage. (6) Any vessel which the quarantine officer considers infected with quarantinable disease. (c) A vessel arriving at a port south of the southern boundary of Virginia in the season of active quarantine, April 1 to November 1, from a port infected or suspected of infection with yellow fever. (d) Vessels arri\TjQg at ports north of this line and south of the southern boundary of Maryland between May 15 and October 1, if from a port infected or suspected of infection with yellow fever. (e) In the case of vessels arriving at a northern port without sick- ness on board from ports where yellow fever prevails, the personnel shall be detained under observation at quarantine to complete six days from the port of departure. (/) Towboats and other vessels having had communication with vessels subjected to quarantine shall themselves be quarantined if they have been exposed to infection. 42. The duration of detention of vessels or personnel herein con- templated will depend upon the quarantinable disease involved and will hereinafter be specifically provided for. CHAPTER V. GENERAL REQUIREMENTS AT QUARANTINE STATIONS. 43. Pilots will be detained in quarantine a sufficient time to cover the period of incubation of the disease for which the vessel is quar- antined, if, in the opinion of the quarantine officer, such pilots have been exposed to infection. The dunnage of pilots shall be disinfected when necessary. 17 44. No direct commiinicatioii shall be allowed between any vessel in quarantine and any person or place outside, and no com- munication whatever between quarantine or any vessel in quaran- tine and any person or place outside except under the supervision of the quarantine officer. 45. After a vessel has been rendered free from Infection, it may be furnished with a fresh crew and released from quarantine, while all or part of the personnel are detained. 46. Vessels detained at any national quarantine will be subject to such additional rules and regulations as may be promulgated from time to time by the Surgeon General. 47. The form of certificate which shall be issued to a vessel when released from quarantine shall be prescribed by the Surgeon General of the Public Health Service, and shall embody the statement that the vessel has in all respects complied with the quarantine regula- tions prescribed by the Secretary of the Treasury, and that in the opinion of the quarantine officer it will not convey quarantinable disease, and that said vessel is granted free or pro\TLsional pratique to enter her port of destination, the name of which is to be embodied in the blank. 48. The persons detained shall be inspected by the physician twice daily, and be under his constant surveillance, aud no inter- course will be allowed between different groups while in quarantine. 49. No presumably infected articles from an infected vessel shall be carried into the place of detention until disinfected. 50. Cleanliness of quarters and of person will be enjoined and daily enforced. Disinfection shall be practiced where there is any pos- sibility of infection. 51. In any group in which communicable disease appears, the sick will be immediately isolated in hospital, and the remaining persons in the group and their effects appropriately treated and then removed to other quarters, if possible, and the compartments disinfected. 52. Communication between the physician and attendants of the hospital and those detained in other parts of the quarantine station shall be reduced to a minimum. 181214—20 2 18 53. No convalescent shall be discharged from quarantine until after a sufficient time has elapsed to insure his freedom from infec- tion, and this is to be determined by bacteriological examination when necessary and possible. 54. Passengers and crew from vessels in quarantine shall be sub- sisted at the vessels' expense. Rations and service may be pro- vided at national quarantine stations at rates to be fixed by the Secretary of the Treasury. 55 . The body of a person dead from cholera or smallpox shall not be allowed to pass through quarantine until one year has elapsed since death. The body of a person dead from typhus or plague may be permitted to pass through quarantine if free from vermin ; if dead from yellow fever, no precautions are required. Bodies of persons dying at quarantine stations from quarantinable disease should pref- erably be cremated or buried at station. 56. The quarantine officer shall report to the Secretary of the Treasury, tlirough the Surgeon General of the United States Public Health Service, all violations of the quarantine laws. 57. The quarantine officer shall report to the collector of customs any vessel wliicli arrives without the bill of health hereinbefore prescribed, 58. All vessels requiring inspection under these regulations must present to the collector of customs at the port of entry the quarantine certificate above prescribed. SPECIAL REGULATIONS. CHAPTER VI. SPECIAL MEASURES AGAINST CHOLERA AT FOREIGN AND INSULAR PORTS. 59. At ports where cholera prevails special care should be taken to prevent the water and the food supply from being infected. The 19 drinking water, unless of known purity, should be boiled and the food thoroughly cooked and protected against contamination by flies, etc. 60. The latrines of vessels must be so arranged that they, including their discharge pipes, can be made and kept mechanically clean. 61. Certain food products that are ordinarily consumed in an un- cooked state coming from cholera-infected localities or through such localities, if exposed to infection therein, should not be shipped. Vegetables ordinarily eaten in an uncooked state when grown in dis- tricts where cholera prevails, shall not be shipped. Fruits grown on trees or on shrubs may be shipped. 62. The baggage of steerage passengers shall be inspected and no food shall be taken aboard in such baggage. 63. Steerage passengers and crew coming from cholera-infected districts should be subjected to bacteriological examination, or otherwise detained five days in an environment known to be free from any source of infection. 64. Steerage passengers and crew from districts not infected with cholera, shipping at a port infected with cholera, unless passed through without danger of infection, should be treated as those in the last paragraph. 65. Cabin passengers coming from cholera-infected districts should produce satisfactory e\i.dence as to their exact place of abode during the five days immediately preceding embarkation. If it appears that they haA'e been exposed to infection, they shall be detained under medical super"vision a sufficient time to cover the period of incubation since last exposure, or otherwise be subjected to bacterio- logical examination. 66. Should cholera appear in the barracks or house in which pas- sengers are undergoing detention, no passengers from said houses or barracks who have been previously exposed to this new infection should embark until they have been determined free of the infection by bacteriological examination, or otherwise isolated for a period of five days. 20 CHAPTER VII. SPECIAL MEASURES AGAINST CHOLERA AT DOMESTIC PORTS. 67. Special measures sliall be employed against vessels and per- sons from a cholera infected place, as likewise when cholera has appeared on board during the voyage. 68. All steerage passengers arri\d.ng at ports in the United States, its possessions or dependencies, from ports or places where cholera prevails, shall be subjected to bacteriological examination and shall not be admitted to entry until it has been determined by said ex- amination that they are free from cholera vibrios. 69. All persons on vessels upon which cholera has appeared during the voyage shall upon arrival at quarantine be detained until it has been determined by bacteriological examination that they are free from cholera vibrios. 70. Persons in detention who are proven by bacteriological exam- ination (performed not less than 24 hours after remo /al from expo- sure to infection in cholera case or carrier) to be free from cholera organisms may be discharged from quarantine without further detention. 71. In lieu of bacteriological examination (and then only when it is impracticable) persons exposed to infection in cholera case or carrier shall be detained in quarantine five days after being isolated from such case or carrier. 72. If a case clinically diagnosed as cholera has occurred on voyage, or if bacteriological examination should reveal the presence of infection in any person on board, such infected person or persons should be removed and isolated. All contacts should be segre- gated in small groups, and no material capable of conveying in- fection shall be removed from the ship. 73. Fruits and vegetables from an infected ship, that are ordi- narily consumed in an uncooked state, shall be destroyed or ren- dered harmless by cooking. 74. The food served to persons in quarantine, unless from a source known to be free from cholera infection, shall be cooked. 21 75. The water supply of a vessel detained in quarantine on account of cholera infection, unless determined by bacteriological examina- tion to be free from cholera organisms or b. Coll, shall be sterilized. Otherwise it shall be discharged after disinfection. 76. The dejecta of all persons in quarantine on account of cholera shall be disinfected before final dispo^tion, and special precautions shall be exercised in order to pre\^ent the contamination of food or water supply or the spread of the infection through the agency of flies or other insects. 77. Personal effects contaminated by dejecta from a cholera case or carrier shall be disinfected. 78. Any part of the ship that has been contaminated by dejecta from a cholera case or carrier shall be washed down with a solution of bichloride or carbolic acid. 79. Carriers or recovered cases shall not be released from quaran- tine detention until three bacteriological tests performed on consec- utive days shall have been proven to be negative. YELLOW FEVER. CHAPTER VIII. SPECIAL MEASURES AT FOREIGN AND INSULAR PORTS. 80. For the purpose of these regulations six days shall be consid- ered as the period of incubation of yellow fever. 81. It is advisable that at ports where yellow fever prevails, pre- cautions should be taken to prevent the introduction of mosquitoes, aedes (stegomyia) calopus on board the vessel. Water tanks, water buckets, and other collections of water about the vessel should be guarded in such a manner that they shall not become breeding places for mosquitoes. Where the vessel has lain in such proximity to the shore at such places as to render it liable, in the opinion of the inspecting officer, to the access of aedes (stegomyia) calopus, measures should be taken to destroy mosquitoes that may have come on board. 22 82. Passengers and crew who. in the opinion of the inspecting oflEicer, have been definitely exposed to the infection of yellow fever (i. e., -as from a house or locality known to be infected), should not be allowed to embark for six days after said exposure. Those im- mune to yellow fever are exempt from this provision. CHAPTER IX. SPECIAL MEASURES AT PORTS OF ARRIVAL (DOMESTIC AND INSULAR). 83. A vessel aboard which a case of yellow fever has occurred at any time during the voyage shall be treated as follows: (a) Careful visual and thermometric inspection of all persons. (b) The sick are to be immediately disembarked, protected by netting against the access of stegom>T.a mosquitoes, and transferred to a place of isolation. (c) Other persons should be disembarked, if possible, and detained under observ^ation for six days, dating from the day of last possible exposure. (d) Persons under observation presenting an elevation of tem- perature above 37.6° C. shall be isolated in a screened apartment. (g) The ship shall be moored if possible at least 200 meters from the inhabited shore. (/) The ship shall be fumigated for the destraction of mosquitoes before the discharge of cargo, if possible. If a fumigation be not possible before the discharge of the cargo, the discharge of cargo shall be under the supervision of the quarantine officer, and may be permitted as follows: By (1) the employment of immune persons for discharging the cargo; or (2) if nonimmunes be employed, they shall be kept under obser\^ation during the discharging of cargo and for six days, to date from the last day of exposure on board. 84. A vessel which has lain in such proximity to the shore of a port known to be infected as to render it liable to the access of 28 stegomyia mosquitoes shall be fumigated and the personnel held in detention under observation for six days. 85. A vessel arriving at a southern port (either direct or by way of a northern port of the United States, which, although coming from an infected port or suspected port, has had neither death nor case of yellow fever on board, either before departure, during the voyage, or at the time of arrival, and which the quarantine officer is satisfied has not lain in such proximity to the shore as to render it liable to the access of stegomyia mosquitoes, or which has been fumigated under the supervision of an accredited medical officer of the United States immediately before sailing, may, upon arrival at a port of destination in the United States with good sanitary history and in good condition (including the absence of any exposed collec- tion of water in which A. calopus might breed) be subjected to the following treatment: (a) If arriving in six days or less, she may be admitted to pratique, with or without fumigation, in the discretion of the quarantine officer, and without further detention than is necessary to complete the six days. (b) If arriving after six days she shall be immediately fumigated (unless previously fumigated at a northern port) and may be admitted without detention. 86. Vessels from ports infected or suspected of infection with yellow fever, calling at southern ports for bunker coal or supplies during the active quarantine season may be allowed to take on such cargo after fumigation, provided the vessel be anchored in a place inaccessible to stegomyia and the crew or passengers be detained on board. 87. Traffic without detention may be allowed during the active quarantine season, from ports infected or suspected of infection with yellow fever, to ports in the United States south of the southern boundary of Maryland under the following conditions: (a) The vessel must lie at approved moorings in the open harbor; the crew must not be allowed ashore at the port of departure. Every M possible precaution must be taken to prevent the ingress of steg- omyia misquitoes and their access to the crew. (6) The officer who must go ashore to enter his vessel must be immune to yellow fever. Passengers, unless immune to yellow fever, must have been free from possible exposure to yellow fever for six days immediately prior to embarking. (c) All the above conditions to ])e certified to specifically by an accredited medical officer of the United States. 88. All persons who can prove their immunity to yellow fever or who have not been exposed to possible infection of yellow fever, may be permitted to land at once. 89. For the destruction of mosquitoes there shall be a complete and simultaneous fumigation of all parts of the vessel by sulphur dioxide gas, 2 per cent volume gas, two hours' exposure, or by cyanide gas in strength of ^ ounce of cyanide per 1,000 cubic feet of space, one-half hour exposui'e, PLAGUE. CHAPTER X. SPECIAL MEASURES AT FOREIGN OR INSULAR PORTS. 90. At ports or places suspected of plague infection in rodents ^ every precaution shall be taken to prevent rats, (mice) and fleas from getting aboard. 91. A^essels sailing from such ports shall be simultaneously fumi- gated in all parts, preferably when empty, for the destruction of rats. Lighters should be free of rats, and this is best accomplished by peri- odic fumigation. 92. If the vessel lies at a dock all connecting lines should be guarded by inverted cones or disks not less than 3 feet in diameter and so fixed as to be always at a right angle to the line to which it is attached. 1 Human cases shall be considered as proof of an existent rodent infection. •25 93. Articles which harbor or are liable to harbor rats or rat fleas should not be shipped until freed of such vermin, either by the use of chemicals, fumigation, or by preventing the access of rats. The nature of the merchandise and the place and method of stowing prior to shipment must be considered in determining its liability to be a rat or vermin carrier, thus: crated cargo, bags of grain, etc., so stowed as to be used as nesting places for rats would be flea, and might be rat, carriers, and cargo should preferably have been previously stored in rat-proof warehouses. Articles of cargo in open crates should be carefully inspected to determine freedom from rats and, at the discretion of the inspector, may be rejected for shipment if consid- ered as rodent infected. When the cargo of a vessel consists of grain or other rat food, extra precautions should be taken to prevent rats from going aboard. CHAPTER XI. SPECIAL MEASURES AGAINST PLAGUE AT PORT OF ARRIVAL. 94. Ships on which plague has occurred in men or rodents shall be detained in quarantine, the sick, if any, shall be removed and iso- lated, and the destruction of rats shall be effected as soon as prac- ticable. 95. A plague-infected ship shall be fumigated simultaneously in all parts for the destruction of rats, including those that may be within articles of cargo, and other precautions shall in the meantime be observed to prevent the escape of rats from the ship. 96. AH rodents destroyed on vessels at quarantine shall, when practicable, be bacteriologically examined. 97. All persons sick of plague shall be detained in quarantine until well, but no detention of healthy contacts is contemplated (except in the pneumonic type of the disease) other than is incidental to the treatment of vessels or cargo. 26 98. If pneumonic plague has occurred on board ship during the voyage, the sick shall be removed and isolated, and all crew and passengers that have been exposed to the infection shall be detained in quarantine for a period of 7 daj^s, or, at the discretion of the quar- antine officer, until their secretions shall be proven to be free from B. pestis. 99. The quarantine officer, before granting pratique to a vessel that has been detained in quarantine on account of plague infection, shall assure himself that the vessel is free from rats and vermin. 100. The personal effects in use, and the belongings of crew and passengers, which in the opinion of the quarantine officer are con- sidered as infected, shall be disinfected and rendered free from vermin. 101. Vessels from foreign ports or ports in the possessions or de- pendencies of the United States, or domestic ports that are known or suspected of being infected with plague, may, when loaded with cargo, the nature of which or manner of storage precludes effective fumigation, be permitted to enter subject to the terms of a pro- visional pratique. When lying alongside wharf or dock at United States ports such vessels shall take proper precautions to prevent the passage of rodents. The vessel shall be fended off from wharf or dock not less than 4 feet, and on all connecting lines shall be fixed rat-guards of sheet metal of an approved design, not less than 3 feet in diameter. All cargo nets and similar dcAdces extending between the vessel and shore structures shall be removed at night unless in actual use, as likemse gangways and ladders unless guarded. Any vessel so entering and neglecting to effectively apply such measures may, at the discretion of the Surgeon General, be remanded to the quarantine station for discharge of cargo, or required to discharge cargo at anchor well removed from the wharf. 102. Vessels from ports known to be infected with plague, in man or rodents, which have docked or which have not taken precautions necessary to prevent the ingress of rats, and on which effective measures have not been taken to destroy the same under the super- vision of an accredited medical officer of the United States Govern- 27 ment, shall, upon arrival at a port in the United States, be fumigated for the destruction of rats. 103. All vessels engaged in trade with foreign ports shall be fiuni- gated not less than once every 6 months for the purpose of destroying rats. This is best done when the vessel is empty. 104. A fumigation certificate signed by an accredited medical officer of the United States Goverimient will be the evidence accepted by the quarantine officer in considering the enforcement of paragraph 103. 105. In applying plague preventive measures, vessels without cargo shall be fumigated simultaneously in all parts with sulphur dioxide gas, not less than 3 pounds per 1,000 cubic feet for 6 hoiu^s' exposui'e; or by hydrocyanic acid gas in the proportion of 5 ounces of sodiimi cyanide per 1,000 cubic feet of space (or equivalent amount of potassium cyanide) for 2 hours. If the vessel be loaded, the time of exposure shall be doubled. 106. When necessary in the treatment of infected vessels, the quarantine officer may require the master to partially discharge cargo for the purpose of effective performance of fumigation. SMALLPOX. CHAPTEK XII. SPECIAL MEASURES AGAINST SMALLPOX AT FOREIGN AND INSULAR PORTS. 107. For the purpose of these regulations 14 days shall be con- sidered as the incubation period of smallpox. 108. Passengers and crew coming from districts where smallpox prevails in epidemic form, or who have been exposed to smallpox, should be vaccinated before embarkation, unless they show satis- factory evidence of having acquired immunity to smallpox by previous attack, or successful vaccination within one year, and their baggage inspected and, if necosv^ary, disinfected. 28 109. Each steerage passenger shall be furnished with an inspection card as follows. This card, stamped by the consular or medical officer, is to be issued to every member of a family as well as to the head thereof. INSPECTION CARD. [Immigrants and steerage passengers.] Port of departure Name of ship Name of immigrant Date of departure Last permanent residence Inspeeted. and passed at [Seal or stamp of consular or medical officer.] Passed at quarantine, Passed by Imnoigra- port of United States. [Date.] tion Bureau, port of [Date.] [The following to be filled in by ship's surgeon or agent prior to or after embar kation.] Ship's list or manifest No. on ship's list or manifest Berth No. OTC^M-^OOt-OOOsO'-i T-t I-! .-I p.J3 K c3 — ' 29 VACCINATED. [Signature or stamp.] [Revebse Side.] Keep this card to avoid detention at Quarantine and on Rail- roads in the United States. Diese Karte mnss aufbewahrt werden. um Aufenthalt an der Qnarantane, sowie auf den Eisenbahnen der Vereinigten Staaten zu vermeiden. Cette carte doit §tre coDservee pour eviter une detention a la Quarantaine, ainsi que sur les chemins de fer des Etats-Unis. Deze kaart moet bewaard worden, ten einde oponthoud aan de Quarantijn, alsook op de ijzeren wegen der Vereenigde Staten te vermijden. Conservate questo biglietto onde evitare detenzione alia Quarantina e sulle Ferrovie degU Stati Uniti. Tento listek musite uschovati, nechcete-li ukaranteny (zastaveni ohledn^ zjisteni zdravl) neb na draze ve spojenych stdtech zdrzeni byti. Tuto kartocku treba trimat' u sebe aby sa predeslo zderzovanu T karantene aj na zeleznici ve Spojenych Statoch. CHAPTER XIII. SPECIAL MEASURES AGAINST SMALLPOX AT PORT OF ARRIVAL. 110. Vessels arriving with smallpox on board, or having had small- pox on board during the voyage, shall be treated as follows: (a) The sick shall be removed and detained until recovered. (6) All persons who in the opinion of the quarantine officer have been exposed to the infection shall be A'accinated, imless protected by a previous attack of smallpox, and detained in quarantine until the vaccination is protective against said exposure, or, if they refuse 30 vaccination, detained in quarantine for 14 days after last exposure to the infection. (c) Those persons that have not been exposed to the infection may be released. (d) All personal effects of passengers and crew that have been exposed to infections shall be disinfected. All compartments that have been exposed to the liability of infection shall be disinfected. TYPHUS. CHAPTER XIV. SPECIAL MEASURES AGAINST TYPHUS AT FOREIGN AND INSULAR PORTS. 111. For the purpose of these regulations 12 days shall be con- sidered as the period of incubation for typhus fever. 112. Passengers and crew from ports infected with typhus shall not be allowed to embark unless demonstrably free from vermin, or other- wise treated for the destruction of vermin. The personal effects, wearing apparel, and baggage of those infested with vermin shall be disinfected. 113. Passengers from localities where typhus prevails embarking at a port not infected with typhus shall be treated as in the preceding paragraph. 114. Passengers and crew who, in the opinion of the inspecting oj95^cer, have been definitel}'^ exposed to infection (from a house, bar- racks, or other building in which has occurred a case of typhus) shall not be allowed to embark until 12 days after removal from the infected environment. CHAPTER XV. SPECIAL MEASURES AGAINST TYPHUS AT PORTS OF ARRIVAL. 115. Vessels on which typhus infection has occurred shall be de- tained in quarantine and the sick, if any, removed and isolated. 51 The clothing, personal effects, and baggage of those infected and of those not demonstrably vermin free shall be treated for the destruc- tion of vermin. 116. All persons found to be vermin (louse) infested shall be treated for destruction of lice. 117. All passengers and crew that have been exposed to the infec- tion shall be detained under observation for a period of 12 days from last exposure to infection. 118. Those of the personnel that are demonstrably free from vermin, and have not been exposed to the infection, may be released without detention or disinfection of baggage. 119. Vessels on which typhus has appeared shall be detained and fumigated for destruction of vermin. 120. Cargo compartments of typhus infected vessels need not be fumigated, unless there be exceptional conditions that may render them vermin infested. 121. Sulphur dioxide and hydrocyanic acid gas are effective agents for the destruction of lice when used in proper strength and exposure. LEPROSY. CHAPTER XVI. 122. Alien lepers should not be permitted to embark at a foreign port for a port of the United States, its possessions or dependencies, either as a passenger or as a member of the crew. 123. Vessels arriving in quarantine with leprosy on board shall not be granted pratique until the leper and his baggage has been removed from the vessel to the quarantine station. 124. No alien leper shall be permitted to land, and to this end the case shall be certified as a leper and reported to the nearest commis- sioner of immigration. 125. If the leper be a citizen of the United States, the case shall promptly be reported to the Surgeon General for further action. 32 ANTHRAX.i CHAPTER XVII. 126. Slia%TLng brushes or lather brushes destined for shipment into the United States shall be made only from hair or bristles, known to be free from anthrax spores, i^ 127. Unless known to be free from anthrax spores such hair or bristles, before being made into shaAT.ng or lather brushes, shall be disinfected b'"* one of the following methods: (a) By boiling for not less than 3 .urs; (6) by exposure to steam under not less than 15 pounds gau^c for not less than 30 minutes with a preliminary vacuum of at least 10 inches; (c) by exposure to streaming steam for not less than 6 hours. 128. Consignments of sha\-ing brushes of foreign manufactiu-e shall be accompanied by a consular certificate containing a state- ment as to the prevalence or nonprevalence of anthrax in the ter- ritory'- from which the brushes emanate and also to the effect that the materials entering into the manufacture of the brushes have or have not complied with the requirements of these regulations. CHAPTER XVIII. BORDER QUARANTINE. 129. When necessaiy, travelers arri^■ing at Canadian or Mexican ports, destined for the United States, shall be inspected at the Canadian or Mexican port of arrival by the United States consular 1 These regulations contemplate that anthi-ax is primarily a disease of animals; that the infection in man is comparatively rare and. under such circumstances is not transmitted from man to man. Inasmuch as the infection tends to spread only as an epizootic disease, the responsibility for its exclusion primarily pertains to the United States Bureau of Animal Industry. The rules and regulations of that Government agency appear to be sufficient for their purpose, and the requirements contained herein are merely for the additional protection of persons against possible infection from any animal product in such widespread and everyday use as the shaving brush. 33 or medical officer, and. be subjected to the same sanitary restrictions as are called for by the rules and regulations applicable at foreign ports. 130. Where not otherwise specifically stated, the rules and regu- lations for maritime quarantine shall be applied at stations on the Canadian and Mexican frontiers; and the methods of disinfection shall be those prescribed i:^ these regulations. 131. If any person be found suffering from a quarantinable dis- ease, or be presumably infected, he shall be denied entry or shall be kept under quarantine observation so long as ^^ anger of convey- ing the infection exists. 132. Any baggage or other effects believed to be infected shall be refused entry unless disinfected in accordance with these regulations. 133. Persons coming from localities where cholera is prevailing shall not be allowed entry until they have been proven to be free of cholera vibrios, by laboratory examination, or otherwise detained five days. 134. During the active quarantine season persons not positively identified as immune to yellow fever, coming from places where yel- low fever prevails, will not be permitted to enter until they have been away from said locality six full days, or otherwise held in quar- antine to complete six days. 135. Persons coming from localities where smallpox is prevailing shall not be allowed entry without vaccination, unless they are protected by a previous attack of the disease or a recent successful vaccination. 136. Persons coming from localities where typhus fever prevails shall not be allowed entry unless demonstrably free from vermin or otherwise disinfected for the destruction of vermin. Disinfection of wearing apparel, baggage, and personal effects for the destruction of vermin shall be practiced when necessary. 137. No common carrier which is infected, or suspected of being infected, shall be allowed to enter the United States until after such measures have been taken as will render it safe. 181214—20 — 3 34 138. Articles of merchandise, personal effects, etc., which are presumably infected, shall not be allowed entry into the United States until after disinfection. 139. Persons shall not enter the United States from countries where any of the quarantinable diseases are reported excepting at ports of entry, and after inspection by a quarantine oflScer and such neces- sary treatment as indicated in the foregoing paragraphs. CHAPTER XIX. SPECIAL REGULATIONS RELATING TO NAVAL VESSELS. 140. Vessels of the United States Navy entering ports of the United States, its possessions or dependencies, are exempt from inspection if there be a medical oflicer aboard, provided such vessel has not sailed from a foreign port known to be or suspected of being infected with typhus, cholera, yellow fever, plague, or smallpox. 141. Vessels of the United States Navy are subject to quarantine inspection upon arrival at ports of the United States, its possessions or dependencies, when from a foreign port known or suspected to be infected with yellow fever, bubonic plague, typhus, cholera, and such subsequent detention for disinfection as may be required by reason of disease aboard or exposure to such disease in foreign ports. 142. The certificate of the medical officer of the United States Navy as to the sanitary history of the vessel and its personnel may be accepted for naval vessels by the quarantine officer boarding the vessel in lieu of actual inspection. 143. Vessels of the United States NaA^ ha\T.ng entered the harbors of infected ports but having held no communication which is liable to convey infection may be exempted from the disinfection and detention imposed on merchant vessels from such ports. 144. Vessels of the United States Na^^ not carrying a medical officer shall, upon arrival at ports of the United States from foreign ports, be subject to the same provisions of these regulations as apply to merchant vessels. 35 CHAPTER XX. INSPECTION OF STATE AND LOCAL QUARANTINES. 145. In the performance of the duties imposed upon him by the act of February 15, 1893, the Surgeon General of the Public Health Service shall, from time to time, personally or through a duly de- tailed officer of the Public Health Service, inspect the maritime quarantines of the United States, State and local, as well as national, for the purpose of ascertaining whether the quarantine regulations prescribed by the Secretary of the Treasury have been or are being complied with. ' The Surgeon General, or the officer detailed by him as inspector, shall, at his discretion, visit any incoming vessel or any vessel detained in quarantine, and all portions of the quaran- tine establishment, for the above-named purposes, and with a Adew to certifying, if need be, that the regulations have been or are being enforced . 146. The Surgeon General of the Public Health Ser\T.ce is author- ized, when in his discretion such action is necessaiy in the interest of the public health, to remand, by direction of the Secretary of the Treasury, any vessel to the nearest national. State, or local quaran- tine station provided with proper facilities for handling infected vessels. APPENDIX. PREAMBLE. 147 . For the proper appreciation of the logical and effective method of destroying all sources of the infection of the quarantinable diseases, consideration should be given to the various ways in which such infectious agents may, under natural conditions, survive or operate toward dissemination. 148. Bubonic plague : This disease is caused by the bacillus pestis, which is transmitted to man through the agency of rats and mice and their ecto-parasites, i. e., fleas. It is primarily and essentially a 36 disease of rodents. It is only accidentally transmitted to the human by means of the fleas which have fed on an infected rodent host and which, having become dislodged and finding no other preferred host available, perforce turn to the human as the only source of blood supply. It is alleged that the bedbug may transmit the disease. As it is not a parasite of the rat. it probably would never attack the rat under natural conditions. The only means of its transmitting the disease would be through the ingestion of blood from the human host during the infectious stage. This would be possible only in cases of septicemic plague. Under such conditions it is not im- probable that the bedbug may be infectious for any subsequent human host which it might attack. Such a combination of circum- stances are rare occurrences. In any event, the bedbug would cause only individual cases of the disease and would not be productive of an epidemic or operate to the widespread dissemination of the disease. 149. Pneumonic PLAGrE: From an epidemiological standpoint and as to the application of preventive measures, pneumonic plague and bubonic plague are to be considered as wholly separate diseases. Pneumonic plague is transmitted solely through personal contact in the same fashion as pneumonia or other respiratory diseases. Neither the flea or other insects are concerned in the direct trans- mission of pneumonic plague. 150. Yellow fever: The organism causing this disease remains unknown, but the virus is inert except it be transmitted by a species of mosquito, i.e., Aedes calopus (stegomAia;, and this only after an intrinsic cycle of development in the body of such raosquito. 151. Typhus fever: The causative organism of this disease has not as yet been definitely isolated and accepted as such. The transmitting agent of tj'phus, however, is the louse, both the body louse and the head louse, but chiefly the former. No natural means of transmission of tv'phus infection other than the louse has been accepted . 152. Cholera: This disease is caused by the cholera vibrio when introduced into the gastro-intestinal tract. Food or water indi- rectly contaminated is the chief means by which the disease is con- 37 veyed, but on board ship, direct contact or the immediate pollu- tion of alimentary substances by "carriers" or acute cases are to be considered the more common means by which the cholera infection is transmitted. The possibility of water ballast being infected or constituting a probable source of spreading the disease is so remote as to be negligible, and the same applies in a general way to cargo and ship supplies. Accurate knowledge that none of the personnel is harboring the cholera organisms in their gastro-intestinal tract is the most important feature in the treatment of cholera-infected vessels. 153. Smallpox: The causative agent of this disease has not been identified, but for all practical purposes it may be considered that more or less intimacy of. contact is essential for the spread of the disease. It should also be borne in mind that immune contacts or convalescents may transmit the virus in either their clothing, their personal effects, or possibly in the body secretions. 154. Leprosy: The causative agent of this disease is believed to be B. leprae, which is an "acid-fast" bacillus found in the tissues of persons having the disease. Nothing definite has been worked out as to to the manner in which the infection is transmitted and preventive measures are practically confined solely to the isolation and segregation of the leprous persons. 155. From the foregoing, therefore, it is evident that the treat- ment of plague-infected vessels calls for the definite destruction of all rodents and their parasites and bedbugs where there has been septicemic types of the disease. While fleas normally have their habitat on their preferred host, it must be borne in mind that these parasites may occasionally be dislodged and temporarily be found in the environment. When rodent infection has actually been demonstrated on board a vessel, consideration should be given to the destruction of rats, mice, and fleas in all parts of the vessel by some disinfecting agent which will penetrate to all parts of the vessel and will be toxic both to animal and insect life. Sulphur dioxide and hydrocyanic acid gas are best adapted for this purpose. When himian cases are found on vessels that have acquired their infection en route, indicating the dispersal of infected fleas, it may be advis- 38 able that the clothing and personal effects of the passengers and crew be treated for the destruction of any fleas that may have become lodged thereon. Disinfection for the purpose of destro;^dng bacteria for the preven- tion of bubonic plague is irrational and unnecessary, 156. The only procedure that is called for in preventing the spread of yellow fever (aside from the control of the human host) is that for the destruction of mosquitoes, and this is best accomplished by fumigation with sulphur dioxide or hydrocyanic acid gas. Bacteri- cidal measures have no place in the prevention or destruction of yellow fever infection. 157. In cholera the control of the human host and the safe disposal of the excreta therefrom, the destruction of contaminated food or water, or their sterilization (cooking, boiling, etc.), are the essential features in preventive measures. Fumigation or place disinfection is not called for in cholera preventive measures. T\'Tiere a case of cholera has resulted in soiling the bedding, as an added precaution such effects should be sterilized and the floors and walls of the com- partment washed down with bichloride solution. The cholera \ibrio has practically no resistance to diying, however, and under natural conditions it is improbable that soiled linen or an infected place will result in the spread of the disease. "U'hile bathing and personal cleanliness is to be encouraged at the quarantine station, it is not to be assumed that disinfection of wearing apparel and personal effects of the contacts, or the disinfection of the body has any mate- rial effect in preventing the spread of the infection. The control of the personnel and the assured safe disposal of body discharges and protection of food and water supply are the important features to be observed in the prevention of cholera. 158. The important feature in tjnphus preventive measures is the assured destruction of all vermin on the person, clothing, and personal effects of those actually sick with typhus and those who have been in contact with typhus infected persons. In this latter group are to be included those persons from a known tj'phus-infected area. The destruction of lice on clothing is best affected by heat, steam under 39 pressure by preference, but flowing steam without pressure will suffice, provided the articles to be disinfected are not closely packed. Dry heat is likewise effective. Body lice and head lice can very well be destroyed by mechanical cleaning — soap and hot water — but the application of a solution of equal parts of vinegar and kerosene to hairy parts will greatly assist in the removal of nits and lice. This solution should be allowed to remain 15 minutes or half an hour before bathing. The treatment of personal effects and baggage or verminous persons is necessarj^, but in the case of those individuals who are passed as free of vermin, and not requiring disinfection, their baggage likewise should be passed without treatment. Bactericidal measures are not called for in typhus prevention. The question is solely that of the destruction of lice and the detention in quarantine for a period of 12 days those persons who have been intimately exposed to typhus infection and who presumably may develop the disease, as well as those actually sick. 159. For the prevention of the spread of leprosy, the chief and practically the only measure called for is the isolation of the patient, either in a National or State leprosarium. WTien in temporary con- finement at the quarantine stations, when traveling, or under other conditions that would entail contact with the public, especial pre- cautions would include the sterilization of eating utensils used by the leper and the disinfection of bed clothes. x\s a measure of added precaution, the compartment in which the leper has lived or been confined should, after his removal, be sterilized by mechani- cal cleaning and fumigation by formaldehyde gas. DISINFECTANTS AUTHORIZED BY THE UNITED STATES QUARANTINE REGULATIONS AND THE PROPER METHODS OF GENERATING AND USING SAME. PHYSICAL DISINFECTANTS. 160. Burning. — Of unquestioned efficiency, but seldom required. Boiling. — Very efficient and of wide r^nge of applicability. The articles must be wholly immersed for not less than 10 minutes in, water actually boUing (100° C). The addition of 1 per cent of . 40 carbonate of soda renders the process applicable to polished steel, cutting instruments, or tools. Steam. — (a) Flowing steam {not under pressure): Flowing steam when applied under suitable conditions is an efficient disinfecting agent. The exposure must be continued 30 minutes after the tem- peratiue has reached 100° C. (&) Steam under pressure ivithout vacuum: Steam under pressure will sterilize, provided that the process is continued 20 minutes after the pressure reaches 15 pounds per square inch. The air must be expelled from the apparatus at the beginning of the process. If impracticable to obtain the designated pressure, a longer exposure will accomplish the same result. (c) Steam under pressure with vacuum: Steam in a special ap- paratus with vacuum attachment is the best method of applying steam under pressure, the object of the vacuum apparatus being to expel the air and to promote the penetration of the steam. The process is to be continued for 20 minutes after the pressure reaches 10 pounds to the square inch. CHEMICAL SOLUTIONS. 161. Bichloride of mercury. — Bichloride of mercury is a dis- infectant of undoubted potency and wide range of applicability. It can not be depended upon to penetrate substances in the presence of albuminous matter. It should be used in solutions of 1 to 1,000. The solubility of bichloride of mercury may be increased by using sea water for the solution, or by adding 2 parts per 1,000 of sodium or aminonium chloride to the water employed. 162. Carbolic acid. — Carbolic acid in the strength of 5 per cent (see paragraph 27) may be substituted for the bichloride of mercury, and should be employed in the disinfection of the cabins and living apartments of ships to obviate injurious action on polished metals, bright work, etc. 363. Formalin. — Formalin containing 40 per cent of formalde- hyde may be used in a 5 per cent solution as a substitute for bi- chloride of mercury or carbolic acid, and is useful for the disinfec- 41 tion of surfaces, dejecta, fabrics, and a great variety of objects, owing to its noninjurious character. GASEOUS AGENTS. 164. Sulphur dioxide. — Sulphur dioxide is efficient, but requires the presence of moisture. It is only a surface disinfectant, and is lacking in penetrating properties. An atmosphere containing 4.5 per cent can be obtained by burning 5 pounds of sulphur per 1,000 cubic feet of space. This amount would require the evaporation or volatilization of about 1 pint of water. In the above proportion it may be used as a disinfectant for some quarantinable diseases, as smallpox, cholera. Its principal use in maritime quarantine is in the destruction of disease-carrying vermin, rats, fleas, lice, mos- quitoes, etc. For this it is a very efficient agent, ranking next to hydrocyanic acid gas. 165. The sulphur may be burned in shallow iron ovens (Dutch ovens) containing not more than 30 pounds of sulphur for each pot- and the pots should stand in vessels of water. Quicker and better results can be obtained from burning the same total amount of sulphur in a number of small shallow ovens (Dutch ovens), 5 to 10 pounds in each, than in a few large ovens. The sulphur ovens should be elevated from the bottom of the compartment to be dis- infected in order to obtain the maximum possible percentage of combustion of sulphur. The sulphur should be in a state of fine division, and ignition is best accomplished by alcohol; special care to be taken with this method to prevent damage to cargo of vessel by fire; or the sulphur may be burned in a special furnace, the sulphur dioxide being distributed by a power fan. This method is peculiarly applicable to cargo vessels. 166. Liquified sulphur dioxide may be used for disinfection in place of sulphur dioxide generated as above, it being borne in mind that this process will require 2 pounds of the liquified gas for each pound of sulphur, as indicated in the above paragraphs. 167. Sulphur dioxide is especially applicable to the holds of vessels, or to freight cars and apartments that may be tightly closed and which do not contain objects injured by the gas. Sulphur 42 dioxide bleaches fabrics or materials dyed with vegetable or aniline dyes. It destroys linen or cotton goods by rotting the fiber through the agency of the acids formed. It injures most metals. FORMALDEHYDE GAS. 168. Formaldehyde gas. — Formaldehyde gas is effective if applied by one of the methods given below. Formaldehyde gas has the advantage as a disinfectant that it does not injure fabrics or most colors. It is not poisonous to the higher forms of animal life. It fails to kill vermin, such as rats, mice, roaches, bedbugs, etc. The method is not applicable to the holds of large vessels. Formal- dehyde is applicable to the disinfection of rooms, clothing, and fabrics, but should not be depended upon for bedding, upholstered furniture, and the like, when deep penetration is required. 169. Many formaldehyde solutions do not contain 40 per cent of formaldehyde, and all are apt to deteriorate with time. It is there- fore necessary to use a quantity in excess of the amount prescribed in these regulations unless the solution has been recently analyzed. 170. The following methods of evolving the gas may be used: (a) Autoclave under pressure, 3 to 12 hours' exposure. (6) Lamp generator, 6 to 18 hours' exposure. (c) Spraying, 12 to 24 hours' exposure. (d) Formaldehyde and dry heat in partial vacuum, 1 hour's ex- posure. (e) Chemical, as formalin-permanganate method of Russel (see pat. 166); formalin-aluminum sulphate-lime of Walker (see par. 166). 171. The minimum number of hours' exposure as. given above applies to empty rooms of tight construction containing smooth, hard surfaces; the maximum number of hours' exposure applying in all cases to textile and other articles of a similar kind requiring more or less penetration. 172. Autoclave under pressure. — This method has considerable penetrating power when applied as detailed below. Rooms or apartments need no special preparation beyond the ordinary closing of doors and windows. Pasting, calking, or chinking of ordinary 43 cracks and crevices is not necessary. The doors of lockers and closets and the drawers of bureaus should be opened. In this apparatus use formalin (40 per cent), with the addition of a neutral salt, such as calcium chloride (20 per cent). The gas must be evolved under a pressure not less than 45 pounds. After the gas is separated from its watery solution the pressure may be allowed to fall and steam projected into the compartment to supply the necessary moisture. Use not less than 10 ounces of formalin per 1,000 cubic feet, and keep the room closed for 3 to 12 hours after the completion of the process. For large rooms the gas must be intro- duced at several points as far apart as possible. It is applicable to the disinfection of clothing and fabrics suspended loosely in such a manner that every article is freely accessible to the gas from all directions. 173. Lamp generator. — This method requires an apparatus pro- ducing formaldehyde by a partial oxidation of wood alcohol, and in using it the room or apartment should be rendered tight as prac- ticable. Oxidize 24 ounces of wood alcohol per 1,000 cubic feet and keep the room closed for 6 to 18 hours, in accordance with the pro- visions of paragraph 160. This method leaves little or no odor. When applied to clothing and textiles, the articles should be sus- pended in a tight room and so disposed as to permit free access of the gas. (See also par. 171.) The wood alcohol should be of 95 per cent strength, and should not contain more than 5 per cent of acetone. 174. Spraying. — The formalin (40 per cent) should be sprayed on sheets suspended in the room in such a manner that the solution remains in small drops on the sheet. Spray not less than 10 ounces of formalin f40 per cent) for each 1,000 cubic feet. Used in this way a sheet will hold about 5 ounces without dripping or the drops run- ning together. The room must be very tightly sealed in disinfecting with this process, and kept closed not less than 12 hours. The method is limited to rooms or apartments not exceeding 2,000 cubic feet. The formalin may also be sprayed upon the walls, floors, and objects in the room. This method is markedly interfered with by, and is not to be relied on, at low temperatures, say below 72° F. 44 At 43.5^ F. very little formaldehyde is liberated, the formaldehyde being pol>Tnerized on the sheets. 175. Formaldehyde ivith dry heat in partial vacuum. — This method has superior penetrating powers and is especially applicable to clothing and baggage. The requirements of this method are (1) dry heat of 60° C. sustained for one hour; (2) a vacuum of 15 inches; (3) formaldehyde evolved from a mixture of formalin with a neutral salt, in an autoclave under pressiu-e, using not less than 30 ounces of formalin (40 per cent) for 1,000 cubic feet; and (4) a total exposure, under these combined conditions, of one hour. ^ 176. Chemical, as — (1) Formalin permanganate method. — When formalin is pom'ed over crystals of permanganate of potash a vigorous reaction takes place and a large quantity of formaldehyde gas is liberated. Reac- tion is over in a short time, five minutes, and if a proper proportion of substance is used, the residue is almost dry. The proportion is 2 pints of formalin to 1 pound of permanganate of potash. One pint of formalin for 1,000 cubic feet of space should be used if the tem- perature is 60° F. or less; a less amount may be used for higher tempera tm*es, but not less than 10 ounces per 1,000 cubic feet. This method is extremely efficient on account of the rapidity with which the gas is liberated, but the danger of fire should be guarded against, as the formaldehyde gas, being in a comparatively dry state, is inflammable in the presence of a light, such as lighted matches, lamps, etc. (2) Formalin-aluminum sulphate-lime method. — Add 1 part sul- phate of aluminum to 2 parts of hot water. One part of this solution is added to 2 parts of formalin (both by volume). One part of this second solution is poured on 2 parts of unslaked lime (quicklime), broken into small particles. The process of liberation of formalde- hyde gas is completed in about 20 minutes. This method is not as efficient as the previous one, as less than half the amount of formal- dehyde gas is yielded from the same amount of formalin. Two pints of formalin per 1,000 cubic feet of space should be used if the tem- perature is 60° F. or less. 1 It should be noted that formaldehyde disinfection is more efficient in warm, moist, or still weather than in cold, drj^, or windy weather. 45 AGENTS FOR THE DESTRUCTION OF VERMIN, I. E., RATS, FLEAS, LICE, MOSQUITOES, ETC. (FUNNEL GASES.) 177. The oxides of carbon are efficient to destroy rats, but do not kill fleas or other insects. They are obtained by burning carbon, coke, or charcoal, in special apparatus, and the gas as produced consists of about 5 per cent carbon monoxide, 18 per cent carbon dioxide, and 77 per cent nitrogen. Twenty kilos of carbon, coke, or charcoal are used for every 1,000 meters of space. The gas is allowed to remain in the ship for two hours, and from seven to eight hours are allowed for it to leave. This is about equivalent to IJ pounds of carbon (coke) to 1,000 cubic feet of air space. As this gas is very fatal to man and gives no warning of its presence, being odorless, a small amount of sulphur dioxide should be added to give warning of its presence. As it does not kill fleas, it can not be depended on for complete work, where there is evidence of plague among rats on the vessel, as the infected fleas would infect the rats coming aboard after the deratization. PYRETHRUM. 178. The fumes of burning pyrethrum may be used to destroy mosquitoes when other fumigants are not available or where they can not be used. Four pounds per 1,000 cubic feet of space for two hours' exposure with thia amount, all or practically all of the mosquitoes will be killed, but precautions should be taken to sweep up and destroy any that may have escaped. Pyrethrum stains walls and paper, and is the least reliable of the culecides. HYDROCYANIC-ACID GAS. 179. Hydrocyanic -acid gas is the most penetrating and the most toxic of all fumigants. It is easily and quickly generated, requires very little apparatus, is not destructive to inanimate ob- jects, and in the hands of experienced operators and safeguarded by certain precautionary measures its use is not attended by unusual dangers. 46 This gas is generated by the mixture of water, sulphuric acid and a cyanide salt, either potassium^ or sodium in the following pro- portions : To each ounce of potassium cyanide 1 fluid ounce of commercial sulphuric acid 66B and 2 J fluid ounces of water shall be used. To each ounce of sodium cj^anide 1^ ounces of commercial sul- phuric acid 66B and 2 fluid ounces of water shall be used. All ingredients shall be weighed and mixed immediately prior to each fumigation. All parts of the vessel shall be placed under fumigation simul- taneously except such compartments as may not require fumiga- tion in the opinion of a representative of the United States Public Health Service. The paraphernalia required includes a tight wooden barrel (pref- erably of oak) for use in holds ; earthenware crocks or jars for smaller compartments, and earthenware jugs or carboys as acid containers. In the fumigation of superstructures, the acid and water are mixed after all openings have been sealed except the exit for the operator. Finally the operator drops the cyanide into the acid water by hand and hastily leaves the apartment, the door of exit being quickly sealed. On account of the great danger to human life from hydrocyanic acid gas, specific arrangements should be made for the disposition of the crew during the fumigation process, especially if one or two compartments of a vessel are to be treated. A written statement must be obtained from the captain or first ofl&cer of the vessel that the latter is ready for fumigation, and that every member of the crew has been accounted for, as not being in the vessel or else not • exposed to the fumes of the gas. Persons in one compartment have been killed by fumes escaping from another compartment under- going fumigation. Compartments above deck should have danger labels pasted on doorways after fumigation has commenced. 2 (Commercial cyanide of potash not infrequently has a fused chloride blended with it. Such preparations should not be used as the chloride affects the generation of the gas. 47 When a vessel is fumigated with cyanide gas, no one shall be per- mitted to enter the various compartments of the ship until entry to such space is declared safe by the medical officer in charge of the fumigation. Subsequent to opening hatches, companionways and ports, not less than 15 minutes shall elapse before any one shall enter the superstructure, such as staterooms, cabins, saloon, or forecastle, and not less than one hour before entering the holds. This is the minimum and the time will be prolonged according to the discretion of the officer in charge. If artificial means for ventilation, such as blower or fan, are not available, windsails shipped into place should be utilized for aera- tion of hold. All hatch covering shall be removed. Before declaring it safe to enter holds, a captive animal (guinea- pig, rat, cat, etc.) shall be lowered and exposed to the aerial con- tent of such compartments, and the effects produced, if any, shall be a guide in estimating the amount of gas present in dangerous quantity. " After measures have been taken to free compartments of cyanide fumes, and the application of test by captive animal indicates suffici- ent dissipation of the gas to make entering the compartments a safe procedure, they should be entered in all parts by one of the fumi- gators or by the officer himself. This shall be done as a final step before the officer declares the vessel safe to be entered by the per- sonnel connected with the vessel. Decision as to safety of entering compartments shall be made by the officer in charge of the fumigation and on board the vessel con- cerned; but during the interval between the sealing of compart- ments undergoing fumigation and the time appointed for determin- ing the safety of entering, the officer may designate a trustworthy employee, or employees, to attend to the op' ning up of compart- ments, the supervising of installation of bl-jwer or windsail, and the prevention of any persons entering compartments before per- mission of the officer in charge. 48 FUMIGATION STANDARDS. 180. The strength of cyanide gas and the duration of exposure varies with the object sought. The servdce standards in this respect are as follows: (a) For destruction of mosquitoes: One-half ounce of sodium cy- anide per thousand cubic feet of space, exposure one-half hour. (6) For destruction of fleas: Two and one-half ounces of sodium cyanide per thousand cubic feet of space, exposure one-half hour. This is of academic interest only, as in practice ships are not fumi- gated for flea destruction only, but always with the idea of rat destruction as well as flea destruction. (c) For destruction of rodents (rats and mice): Five ounces of sodium cyanide per thousand cubic feet of space, exposure for two hours. (d) For destruction of lice: Ten ounces of sodium cyanide per thousand cubic feet of space, exposure for two hours. (e) For destruction of bedbugs: Five ounces of sodium cyanide per thousand cubic feet of space, exposure for one hour. The above standards apply to empty holds and superstructures, except storerooms that have a large quantit}'' of stores. In cargo- laden holds or in well-packed storerooms the length of exposure shall be doubled. 181. The standard for sulphur dioxide as to strength and exposure is as follows: (a) For mosquito destruction: Two pounds of sulphur per thousand cubic feet of space, exposure for one hour. (b) For destruction of lice: Four pounds of sulphur per thousand cubic feet of space, exposure for six hours. (c) For destruction of rats (fleas): Three pounds of sulphur per thousand cubic feet of space, exposm^e for six hours. The above standard is for superstructure, partially filled store- rooms, and empty holds. For cargo-laden holds and well-filled storerooms, or in compartments that are packed with materials, the time of exposure should be doubled. 49 GENERAL DETAILS IN THE FUMIGATION OF VESSELS. 182. For computing the air space of a vessel a registered ton should be estimated as containing 100 cubic feet. A vessel of 1,000 net ton- nage would, therefore, contain 100,000 cubic feet of air space in the holds alone, since net tonnage indicates the cargo carrying capacity in contradistinction to the gross tonnage which indicates the ship's total cubic capacity. 183. The cubic capacity of crews' quarters, cabins, engine room, poop deck, or other above-deck compartments have to be computed for each individual compartment. 184. The various details in connection with the fumigation of ves- sels are of almost equal importance as the nature of the fumigant used, and the observation of these details to a large extent determines the effectiveness or the inefficiency of the fumigation. All possible care should be observed by the quarantine officer to see that dead space in the vessel is opened up and all practical measures should be taken to aid in the diffusion of the fumigating gas, and this is especially important when sulphur dioxide is used. All dunnage and loose material from the holds of a vessel that is not cargo laden should be arranged in compact order and placed on elevated plat- forms to avoid rat harborage. If sulphur dioxide is generated in a furnace and lead into the vessel, it should be introduced at the lowest point and the hatches left open for a short while so as to permit of the escape of air and hasten diffusion of the sulphur fumes. Pipe casing should be opened up and from one end of the vessel to the other there should be a certain number of limber boards removed so as to permit of penetration of the gas into the bilges. Any planked over space between the outer and the inner sheathing of a vessel should also be freely opened, and wherever there is dead space it should be opened up so that there will be free circulation of the gas. Careful attention should be given to lifeboats, which are often in- •fested by rats which resort to these places for water. Preferably, lifeboats should be cleaned and flooded by water prior to fumigation. Very close attention should be given to the poop deck, which is a space frequently containing a heterogeneous collection of litter and 181214—20 — 4 50 is generally badly rat infested. In general, the engine room and fireroom do not harbor rats, but in the treatment of a plague-infested vessel they should be fumigated. QUARANTINE LAWS OF THE UNITED STATES. An Act Granting additional quarantine powers and imposing additional duties upon the Marine-Hospital Service. [Approved, February 15, 1S93.] Be it enacted hy the Senate and House of Representatives of the United States of America in Congress assembled, That it shall be unlawful for any merchant ship or other vessel from any foreign port or place of [to] enter any port of the United States except in accordance with the provisions of this act and with such rules and regulations of State and municipal health authorities as may be made in pursuance of, or consistent with, this act; and any such vessel wliich shall enter, or attempt to enter, a port of the United States in violation thereof shall forfeit to the United States a sum, to be awarded in the discre- tion of the court, not exceeding five thousand dollars, which shall be a lien upon said vessel, to be recovered by proceedings in the proper district court of the United States. In all such proceedings the United States district attorney for such district shall appear on behalf of the United States; and all such proceedings shall be conducted in accordance with the rules and laws governing cases of seizure of vessels for violation of the revenue laws of the United States. Sec. 2. That any vessel at any foreign port clearing for any port or place in the United States shall be required to obtain from the consul, vice-consul, or other consular officer of the United States at the port of departure, or from the medical officer where such officer has been detailed by the President for that purpose, a bill of health, in dupli- cate, in the form prescribed by the Secretary of the Treasury, setting forth the sanitary history and condition of said vessel, and that it has in all respects complied with the rules and regulations in such cases prescribed for securing the best sanitary condition of the said 51 vessel, its cargo, passengers, and crew; and said consular or medical officer is required, before granting such duplicate bill of health, to be satisfied that the matters and things therein stated are true; and for his services in that behalf he shall be entitled to demand and receive such fees as shall by lawful regulation be allowed, to be accounted for as is required in other cases. The President, in his discretion, is authorized to detail any medical officer of the Government to serve in the office of the consul at any foreign port for the purpose of furnishing information and making the inspection and giving the bills of health hereinbefore mentioned . Any vessel clearing and sailing from any such port without such bill of health, and entering any port of the United States, shall for- feit to the United States not more than five thousand dollars, the amount to be determined by the court, which shall be a lien on the same, to be recovered by proceedings in the proper district court of the United States. In all such procee'dings the United States dis- trict attorney for such district shall appear on behalf of the United States; and all such proceedings shall be conducted in accordance with the rules and laws governing cases of seizure of vessels for violation of the revenue laws of the United States. Sec. 3. That the Super^asing Surgeon-General of the Marine- Hospital Service shall, immediately after this act takes effect, examine the quarantine regulations of all State and municipal boards of health, and shall, under the direction of the Secretary of the Treasury, cooperate with and aid State and municipal boards of health in the execution and enforcement of the rules and regulations of such boards and in the execution and enforcement of the rules and regulations made by the Secretary of the Treasury, to prevent the introduction of contagious or infectious diseases into the United States from foreign countries, and into one State or Territory or the District of Columbia from another State or Territory or the District of Columbia; and all rules and regulations made by the Secretary of the Treasury shall operate uniformly and in no manner discriminate against any port or place; and at such ports and places within the United States as have no quarantine regulations under State or munici- pal authority, where such regulations are, in the opinion of the Secre- 52 tary of the Treasury, necessary to prevent the introduction of conta- gious or infectious diseases into the United States from foreign coun- tries, or into one State or Territory or the District of Cohimbia from another State or Territory or the District of Columbia, and at such ports and places witliin the United States where quarantine regulations exist under the authority of the State or municipality which, in the opinion of the Secretary of the Treasiu-y , are not sufficient to prevent the intro- duction of such diseases into the United States, or into one State or Territory or the District of Columbia from another State or Territory or the District of Columbia, the Secretary of the Treasury shall, if in his judgment it is necessary and proper, make such additional rules and regulations as are necessary to prevent the introduction of such diseases into the United States from foreign countries, or into one State or Territory or the District of Columbia from another State or Territory or the District of Columbia, and when said rules and regulations have been madfe they shall be promulgated by the Secretary of the Treasury and enforced by the sanitary authorities of the States and municipalities, where the State or municipal health authorities will undertake to execute and enforce them; but if the State or municipal authorities shall fail or refuse to enforce said rules and regulations the President shall execute and enforce the same and adopt such measures as in his judgment shall be necessary to prevent the introduction or spread of such diseases, and may detail or appoint officers for that purpose. The Secretary of the Treasury shall make such rules and regulations as are necessary to be observed by vessels at the port of departure and on the voyage, where such vessels sail from any foreign port or place to any port or place in the United States, to secure the best sanitary condition of such vessel, her cargo, passengers, and crew; which shall be published and communicated to and enforced by the consular officers of the United States. None of the penalties herein imposed shall attach to any vessel or owner or officer thereof until a copy of this act, with the rules and regulations made in pursuance thereof, has been posted up in the office of the consul or other consular officer of the United States for ten days, in the port from which said vessel sailed; and the certificate of such 53 C3nsiil or consular officer over his official signature shall be compe- tent evidence of such posting in any court of the United States. Sec. 4. That it shall be the duty of the Supervising Surgeon- General of the Marine-Hospital Service, under the direction of the Secretary of the Treasury, to perform all the duties in respect to quarantine and quarantine regulations which are provided for by this act, and to obtain information of the sanitary condition of foreign ports and places from which contagious and infectious dis- eases are or may be imported into the United States, and to this end the consular officer of the United States at such ports and places as shall be designated by the Secretary of the Treasury shall make to the Secretary of the Treasury weekly reports of the sanitary condi- tion of the ports and places at which they are respectively stationed, according to such forms as the Secretary of the Treasury shall pre- scribe; and the Secretary of the Treasury shall also obtain, through all sources accessible, including State and municipal sanitary au- thorities throughout the United States, weekly reports of the sani- tary condition of ports and places within the United States, and shall prepare, publish, and transmit to collectors of customs and to State and municipal health officers and other sanitarians weekly abstracts of the consular sanitary reports and other pertinent infor- mation received by him, and shall also, as far as he may be able, by means of the voluntary cooperation of State and municipal authorities, of public associations, and private persons, procure information relating to the climatic and other conditions affecting the public health, and shall make an annual report of his operations to Congress, with such recommendations as he may deem important to the public interests. Sec. 5, That the Secretary of the Treasury shall from time to time issue to the consular officers of the United States and to the medical officers serving at any foreign port, and otherwise make publicly known, the rules and regulations made by him, to be used and complied with by vessels in foreign ports, for securing the best sanitary condition of such vessels, their cargoes, passengers, and crew, before their departure for any part in the United States, and 54 in the course of the voyage; and all such other rules and regulations as shall be observed in the inspection of the same on the arrival thereof at any quarantine station at the port of destination, and for the disinfection and isolation of the same, and the treatment of cargo and persons on board, so as to prevent the introduction of cholera, yellow fever, or other contagious or infectious diseases; and it shall not be lawful for any vessel to enter said port to discharge its cargo, or land its passengers, except upon a certificate of the health officer at such quarantine station certifying that said rules and regu- lations have in all respects been observed and complied with, as well on his part as on the part of the said vessel and its master, in respect to the same and to its cargo, passengers, and crew; and the master of every such vessel shall produce and deliver to the collector of customs at said port of entry, together with the other papers of the vessel, the said bills of health required to be obtained at the port of departure and the certificate herein required to be obtained from the health officer at the port of entry; and that the bills of health herein prescribed shall be considered as part of the ship's papers, and when duly certified to by the proper consular officer or other officer of the United States, over his official signature and seal, shall be accepted as evidence of the statements therein contained in any court of the United States. Sec. 6. That on the arrival of an infected vessel at any port not provided with proper facilities for treatment of the same, the Sec- rectary of the Treasury may remand said vessel, at its own expense, to the nearest national or other quarantine station, where accommo- dations and appliances are provided for the necessary disinfection and treatment of the vessel, passengers, and cargo; and after treat- ment of any infected vessel at a national quarantine station^ and after certificate shall have been given by the United States quaran- tine officer at said station that the vessel, cargo, and passengers are each and all free from infectious disease, or danger of conveying the same, said vessel shall be admitted to entry to any port of the United States named within the certificate. But at any ports where suffi- cient quarantine provisions has been made by State or local authori- 55 ties the Secretary of the Treasury may direct vessels bound for said ports to undergo quarantine at said State or local station. Sec, 7. That whenever it shall be shown to the satisfaction of the President that by reason of the existence of cholera or other infec- tious or contagious diseases in a foreign country there is serious dan- ger of the introduction of the same into the United States, and that notwithstanding the quarantine defense this danger is so increased by the introduction of persons or property from such country that a suspension of the right to introduce the same is demanded in the interest of the public health, the President shall have power to pro- hibit, in whole or in part, the introduction of persons and property from such countries or places as he shall designate and for such period of time as he may deem necessary. Sec. 8. That whenever the proper authorities of a State shall sur- render to the United States the use of the buildings and disinfecting apparatus at a State quarantine station the Secretary of the Treasury shall be authorized to receive them and to pay a reasonable com- pensation to the State for their use, if, in his opinion, they are neces- sary to the United States. Sec, 9. That the act entitled "An act to prevent the introduction of infectious or contagious diseases into the United States, and to establish a national board of health," approved March 3, 1879, be, and the same is hereby, repealed . And the Secretary of the Treas- ury is directed to obtain possession of any property, furniture, books, paper, or records belonging to the United States which are not in the possession of an officer of the United States under the Treasury De- partment which were formerly in the use of the National Board of Health or any officer or employee thereof. [Act of Congress approved August 18, 1891.1 An Act To amend section two of the act approved February fifteenth, eighteen hun- dred and ninetj'-three, entitled ''An act granting additional quarantine powers and imposing additional duties upon the Marine-Hospital Service." Be it enacted hy the Senate and House of Representatives of the United States of America in Congress assembled, That section two of the act approved February fifteenth, eighteen hundred and ninety-three, 56 entitled "An act granting additional quarantine powers and impos- ing additional duties upon the Marine-Hospital Service," is hereby amended by adding to the end of said section the following: "The provisions of this section shall not apply to vessels plying between foreign ports on or near the frontiers of the United States and ports of the United States adjacent thereto; but the Secretary of the Treasury is hereby authorized, when, in his discretion, it is expe- dient for the preservation of the public health, to establish regula- tions governing such vessels." REVISED STATUTES. Sec. 4794. There shall be purchased or erected, under the orders of the President, suitable warehouses, with wharves and inclosures, where merchandise may be unladen and deposited, from any vessel which shall be subject to a quarantine or other restraint, pursuant to the health laws of any State, at such convenient places therein as the safety of the public revenue and the observance of such health laws may require. Sec. 4795. Whenever the cargo of a vessel is unladen at some other place than the port of entry or delivery under the foregoing provisions, all the articles of such cargo shall be deposited, at the risk of the parties concerned therein, in such public or other ware- houses or inclosures as the collector shall designate, there to remain under the joint custody of such collector and of the owner, or master or other person having charge of such vessel, until the same are entirely unladen or discharged, and until the articles so deposited may be safely removed without contravening such health laws. And when such removal is allowed, the collector having charge of such articles may grant permits to the respective owners or consignees, their factors or agents, to receive all merchandise which has been entered, and the duties accruing upon which have been paid, upon the payment by them of a reasonable rate of storage; which shall be fixed by the Secretary of the Treasury for all public warehouses and inclosures. Sec. 4796! The Secretary of the Treasury is authorized, whenever a conformity to such quarantines and health laws requires it, and in 57 respect to vessels subject thereto, to prolong the terms limited for the entry of the same and the report or entry of their cargoes, and to vary or dispense with any other regulations applicable to such reports or entries. No part of the cargo of any vessel shall, however, in any case, be taken out or unladen therefrom otherwise than is allowed by law, or according to the regulations hereinafter established. Sec. 4797. Whenever, by the prevalence of any contagious or epidemic disease in or near the place by law established as the port of entry for any collection district, it becomes dangerous or incon- venient for the officers of the revenue employed therein to con- tinue the discharge of their respective offices at such port, the Secre- tary of the Treasury, or, in his absence, the First Comptroller, may direct the removal of the officers of the revenue from such port to any other more convenient place within or as near as may be to such collection district. And at such place such officers may exercise the same powers and shall be liable to the same duties, according to existing circumstances, as in the port or district established by law. Public notice of any such removal shall be given as soon as may be [See § 1776.] Sec. 4798. In case of the prevalence of a contagious or epidemic disease at the seat of Government, the President may permit and direct the removal of any or all the public offices to such other place or places as he shall deem most safe and convenient for conducting the public business. [See § 1776.] Sec. 4799. Whenever, in the opinion of the Chief Justice, or, in case of his death or inability, of the senior associate justice, of the Supreme Court, a contagious or epidemic sickness shall render it hazardous to hold the next stated session of the court at the seat of Government, the chief or such associate justice may issue his order to the marshal of the Supreme Court directing him to adjourn the next session of the court to such other place as such justice deems convenient. The marshal shall thereupon adjourn the court by making publication thereof in one or more public papers printed at the seat of Government from the time he shall receive such order until the time by law prescribed for commencing the session. The 58 several circuits and district judges shall, respectively, under the same circumstances, have the same power, by the same means, to direct adjournments of the several circuit and district courts to some convenient place within their districts, respectively. [See § 1176.] Sec. 4800. The judge of any district court within whose district any contagious or epidemic disease shall at any time prevail, so as, in his opinion, to endanger the lives of persons confined in the prison of such district, in pursuance of any law of the United States, may direct the marshal to cause the persons so confined to be removed to the next adjacent prison where such disease does not prevail, there to be confined until they may safely be removed back to the place of their first confinement. Such removals shall be at the expense of the United States. Sec. 4263. The master of any vessel employed in transporting pas- sengers between the United States and Eiu'ope is authorized to maintain good discipline and such habits of cleanliness among the passengers as will tend to the preservation and promotion of health, and to that end he shall cause such regulations as he may adopt for this purpose to be posted up, before sailing, on board such vessel, in a place accessible to such passengers, and shall keep the same so posted up during the voyage. Such master shall cause the apart- ments occupied by such passengers to be kept at all times in a clean, healthy state; and the owners of every such vessel so employed are required to construct the decks and all parts of the apartments so that they can be thoroughly cleansed, and also to pro\dde a safe, con- venient privy or water-closet for the exclusive use of every one hun- dred such passengers. The master shall also, when the weather is such that the passengers can not be mustered on deck with their bedding, and at such other times as he may deem necessary, cause the deck occupied by such passengers to be cleansed with chloride of lime or some other equally efficient disinfecting agent. And for each neglect or violation of any of the pro^dsions of this section the master and owner of any such vessel shall be severally liable to the United States in a penalty of fifty dollars, to be recovered in any 59 circuit or district court within the jurisdiction of which such vessel may arrive or from which she is about to depart, or at any place where the owner or master may be found. [Extract from act August 1, 1888.] Whenever any person shall trespass upon the grounds belonging to any quarantine reservation, * * * such person, trespassing, * * * shall, upon conviction thereof, pay a fine of not more than three hundred dollars, or be sentenced to imprisonment for a period of not more than thirty days, or shall be punished by both fine and imprisonment, at the discretion of the court. And it shall be the duty of the United States attorney in the district where the misde- meanor shall have been committed to take immediate cognizance of the offense, upon report made to him by any medical officer of the Marine-Hospital Service, or by any officer of the customs service, or by any State dfficer acting under authority of section five of said act. [Act March 27, 1890.] An Act To prevent the introduction of contagious diseases Irom one State to another and for the punishment of certain offenses. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That whenever it shall be made to appear to the satisfaction of the President that cholera, yel- low fever, smallpox, or plague exists in any State or Territory, or in the District of Columbia, and that there is danger of the spread of such disease into other States, Territories, or the District of Columbia, he is hereby authorized to cause the Secretary of the Treasury to promulgate such rules and regulations as in his judgment may be necessary to prevent the spread of such disease from one State or Ter- ritory into another, or from any State or Territory into the District of . Columbia, or from the District of Columbia into any State or Terri- tory, and to employ such inspectors and other persons as may be nec- essary to execute such regulations to prevent the spread of such dis- ease. The said rules and regulations shall be prepared by the Super- vising Surgeon-General of the Marine-Hospital Service under the direction of the Secretary of the Treasury. And any person who shall 60 willfully violate any rule or regulation so made and promulgated shall be deemed guilty of a misdemeanor, and upon conviction shall be punished by a fine of not more than five hundred dollars, or imprison- ment for not more than two years, or both, in the discretion of the court. Sec. 2. That any officer, or person acting as an officer, or agent of the United States at any quarantine station, or other person employed to aid in preventing the spread of such disease, who shall willfully violate any of the quarantine laws of the United States, or any of the rules and regulations made and promulgated by the Secretary of the Treasury as provided for in Section 1 of this act, or any lawful order of his superior officer or officers, shall be deemed guilty of a misde- meanor, and upon conviction shall be punished by a fine of not more than three hundred dollars or imprisonment for not more than one year, or both, in the discretion of the court. Sec. 3. That when any common carrier or officer, agent, or employe of any common carrier shall willfully violate any of the quarantine laws of the United States, or the rules and regulations made and pro- mulgated as provided for in Section 1 of this act, such common car- rier, officer, agent, or employe shall be deemed guilty of a misde- meanor, and shall, on conviction, be punished by a fine of not more than five hundred dollars, or imprisonment for not more than two years, or both, in the discretion of the court. [Act March 2, 1901.] An Act To amend "An Act granting additional quarantine powers and imposing additional duties upon the Marine-Hospital Service," approved February fifteenth, eighteen himdred and ninety-three. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That an Act granting addi- tional quarantine powers and imposing additional duties upon the Marine-Hospital ServT.ce, approved February fifteenth, eighteen hun- dred and ninety-three, be amended by addition of the following sections: "Sec. 10. That the Supervising Surgeon-General, with the ap- proval of the Secretary of the Treasury, is authorized to designate 61 and mark the boundaries of the quarantine grounds and quarantine anchorages for vessels which are reserv^ed for use at each United States quarantine station; and any vessel or officer of any vessel or other ■ person, other than State or municipal health or quarantine officers, trespassing or otherwise entering upon such grounds or anchorages in disregard of the quarantine rules and regulations, or without per- mission of the officer in charge of such station, shall be deemed guilty of a misdemeanor and subject to arrest, and upon con\-iction thereof be punished by a fine of not more than three hundred dollars or im- prisonment for not more than one year, or both, in the discretion of the court. Any master or owner of any vessel, or any person iso- lating any provision of this Act or any rule or regulation made in accordance with this Act, relating to inspection of vessels or relating to the prevention of the introduction of contagious or infectious dis- eases, or any master, owner, or agent of any vessel making a false statement relative to the sanitary condition of said vessel or its con- tents or as to the health of any passenger or person thereon, shall be deemed guilty of a misdemeanor and subject to arrest, and upon conviction thereof be punished by a fine of not more than five hun- dred dollars or imprisonment for not more than one year, or both, in the discretion of the coiut. "Sec. 11. That any vessel sailing from any foreign port without the bill of health required by section two of this Act, and arriving within the limits of any collection district of the United States, and not entering or attempting to enter any port of the United States, shall be subject to such quarantine measures as shall be prescribed by regulations of the Secretary of the Treasury, and the cost of such measures shall be a lien on said vessel, to be recovered by proceedings in the proper district court of the United States and in the manner set forth above as regards vessels from foreign ports without bills of health and entering any port of the United States. "Sec. 12. That the medical officers of the United States, duly clothed with authority to act as quarantine officers at any port or place within the United States, and when performing the said duties, are hereby authorized to take declarations and administer oaths in 62 matters pertaining to the administration of the quarantine laws and regulations of the United States." [PubUc— No. 243.1 An Act To tother protect the public health and make more effective the national quarantine. [Approved, June 19, 1906.] Be it enacted by the Senate and House of Representatives of the United States of Amenca in Congress assembled, That the Secretary of the Treasiuy shall have the control, direction, and management of all quarantine stations, grounds, and anchorages established by author- ity of the United States, and as soon as practicable after the approval of this Act shall select and designate such suitable places for them and establish the same at such points on or near the coast line of the United States or the border of the United States and a foreign country as in his judgment are best suited for the same and necessary to pre- vent the introduction of yellow fever into the United States, and, in his discretion, he may also establish at the group of islands known as the Dry Tortugas, at the western end of the Florida reef, and at such other point or points on or near the coast line of the United States (not to exceed four in the aggregate) as he deems necessary, quai'an- tine grounds, stations, and anchorages, whereat or whereto infected vessels bound for an}' port in the United States may be detained or sent for the purpose of being disinfected, having their cargoes disin- fected and discharged, if necessaiy, and their sick treated in hospitals until all danger of infection or contagion from such vessels, their cargoes, passengers, or crews has been removed. Sec. 2. That in cases in which the title to the land and water so selected and designated is in the United States it shall be the duty of the department, bureau, or official of the United States having cus- tody or possession of such land and water, or any part thereof, not used by the Government for other pui'poses designated by law, or posses- sion of said Dry Tortugas Islands, on demand of the Secretary of the Treasim% to deliver the same into his custody and possession for the use of the Public Health and Marine Hospital Service, evidencing 63 such, delivery by a suitable instrument in writing to be delivered to the Secretary of the Treasury. That in cases in which the title to such land and water, or any part thereof, is in any other owner than the United States it shall be the duty of the Secretary of the Treasury to secure the title and possession of the same to the United States for the use of the Public Health and Marine-Hospital Service of the United States, by purchase at a reasonable price, if possible, but if, in his judgment, the price demanded for such property be excessive, he is hereby authorized to apply to the Attorney General of the United States to cause to be instituted, in the proper tribunal, con- demnation proceedings in the name of the United States for the pur- pose of acquiring for the United States the title and possession of such land and water, and said Attorney General shall, as soon as possible after such application by the Secretary of the Treasury^ cause such proceedings to be instituted and conducted to a conclusion, and the custody and possession of such land and water, when duly acquired in accordance with the award made in such condemnation proceedings, shall be delivered to the Secretary of the Treasury for the use of the Public Health and Marine Hospital Service. Sec. 3. That on acquiring possession of any land and water in accordance with the proA'isions of this Act for the purpose of establish- ing thereat a quarantine station and anchorage, the Secretary of the Treasury shall cause to be published in such newspapers as he may think proper, once a week for four successvie weeks, a notice of the selection and designation of such places for quarantine stations and anchorages, with a description of the boundaries of such quarantine stations and anchorages, and such rules and regulations as he shall adopt and promulgate, requiring vessels with yellow fever among their passengers or crews to go to specified quarantine stations and anchorages, to be dealt with there before "visiting any port of the United States. He shall establish at such quarantine stations and anchorages all necessary instrumentahties for disinfecting vessels and their cargoes, and where the same shall be required shall erect the necessary hospital buildings and install the necessary furniture and fittings for recei\dng and treating the sick among the passengers and (>4 crews of vessels going to such quarantine stations and anchorages, and pro^'ide for the separation of those among their passengers and crews who are suffering from yellow fever from those who are in good health, and shall further provide for doing all things necessary to eradicate such disease from such vessels, their cargoes, passengers, and crews. Sec. 4. That any vessel, or any officer of any vessel, or other per- son other than State health or quarantine officers, entering within the limits of any quarantine grounds and anchorages, or any quarantine station and anchorage, or departing therefrom, in disregard of the quarantine rules and regulations or without the permission of the offi- cer in charge of such quarantine ground and anchorage, or of such quarantine station and anchorage, shall be deemed guilty of a misde- meanor, and upon conviction thereof shall be punished by a fine of not more than three hundred dollars or by imprisonment for not more than one year, or both, in the discretion of the court. That any master or owner of any vessel Aiolating any provision of this Act, or any pro- \T.sion of an Act entitled ■"An Act granting additional powers and im- posing additional duties on the Marine-Hospital Service, " approved February fifteenth, eighteen hundred and ninety-three, or \-iolating any rule or regulation made in accordance with this Act or said Act of Februarv^ fifteenth, eighteen hundred and ninety-three, relating to the inspection of vessels, or to the prevention of the introduction of contagious or infectious diseases into the United States, or any master, owner, or agent of any vessel maldng a false statement relative to the sanitary condition of such vessel or its contents, or as to the health of any passenger or person thereon shall be deemed guilty of a misde- meanor, and on con^iction thereof shall be punished by a fine of not more than five hundred dollars or imprisonment for not more than one year, or both, in the discretion of the court. Sec. 5. That in any place where a quarantine station and plant is already established by State or local authorities it shall be the duty of the Secretary of the Treasury, before selecting and designating a quar- antine station and grounds and anchorage for vessels, to examine such established stations and plants, with a view of obtaining a transfer of 65 the site and plants to the United States, and vrhenever the proper authorities shall be ready to transfer the same or surrender the use thereof to the United States, the Secretary of the Treasury is author- ized to obtain title thereto or possession and use thereof, and to pay a reasonable compensation therefor, if, in his opinion, such purchase or use will be necessary to the United States for quarantine piu-poses and the quarantine stations established by authority of this Act shall, when so established, be used to preA'ent the introduction of all quar- antinable diseases. Sec. 6. That whenever any established station, or any land or water, or any part thereof, shall be acquired by the United States under the provisions of this Act, jurisdiction over the same shall be ceded to the United States by any State in which the same is situated before any compensation therefor shall be paid. Sec. 7. That the sum of five hundred thousand dollars, or so much thereof as may be necessary, is hereby appropriated, out of any money in the Treasury not otherwise appropriated, for the purpose of carry- ing into effect the pro^risions of this Act, as well as for the purpose generally of preventing the importation of yellow fever and other quarantinable diseases into the United States, and for the fui'ther purposes, in cooperation with State or municipal health authorities, of eradicating them should they be imported, of preventing their spread from one State into arioth(^r State, and of destroying their causes. 181214—20 5 INDEX. Paragrapli . Anthrax 1, 126 Bacteriological examination: Cholera 63, 65, 66, 68, 72, 79 Rodents 96 Baggage, treatment of 19, 62, 110(d), 112, 115, 132, 136, 158 Ballast 132 Bedding, treatment of 11 Bichloride of mercury. 26, 161 Bills of health: General requirements 2, 4, 37 Exemptions relative to 3 May be withheld 4 Bodies of deceased persons: Disposal at sea 24 Disposal at quarantine 55 Prohibition as to transportation of 55 Boiling, for disinfection 160 Border quarantine 129-139 Exemption at borders 3 Brushes, shaving 126, 127, 128 Bubonic plague. {See Plague.) Burning, to destroy infection 160 Canadian border. {See Border quarantine.) Carbolic acid solution 26, 162 Cards, inspection 109 Cargo: Inspection of 4, 6, 93 Treatment of 95 To be partially removed 106 (67) 68 Certificate: Paragraph. Discharge from quarantine 34, 47, 58 Of fumigation 37, 104 Of disinfection 37 Cholera: Requirements at foreign ports 59 Requirements at sea 20(j), 2-2 Requirements at domestic ports 67-79 Clothing, treatment of {also see Wearing apparel) 20(e) Common carriers on the border 137 Communicable diseases ^ 40 Comm.unication ■with vessels in quarantine prohibited 39, 44 Cremation of bodies 55 Cre^^s, substitute crevr 45 Customs inspectors, permitted aboard vessels in quarantine .. 39 Cyanide fumigation. {See Hydrocyanic acid gas.) Daylight inspection 36 Dead, bodies of the 24, 55 Dejecta, treatment of 20 (j), 76, 78 Department of Agiicultm'e, regulations of 13 Detention of vessels 41, 42 Deratizatoin of vessels {also see Fumigation) 20(h), 91, 95, 102, 105, 155, 184 Discharge fi'om quarantine 47, 58 Dphtheria 13 Disinfection : For cholera. {See Cholera.) For leprosy. {See Leprosy.) For plague. {See Plague.) For smallpox. {See Smallpox.) For typhus. {See Typhus.) For yellow fever. {See Yellow fever.) Exemption: Bills of health 3 Border travel. 129-139 As to customs officers 39 69 Exemption — Continued. Paragrapti. Inspection 5(b), 142 Naval vessels 140-144 As to pilots 39 Equipment of quarantine stations 27, 29 Eood stuffs 59, 61, 62, 73, 152 Eormalin 163 Formaldehyde gas 168 Frontiers. {See Border quarantine.) Fruits and vegetables 73 Fruit vessels 36 Fumigation: Cyanide gas 179, 180, 184 Carbon dioxide gas 177 Pyrethrum. 178 Sulphur dioxide • 164, 167, 181, 184 For destruction of fleas 164, 179, 180(c), 181(c) For destruction of lice 179, 180(d), 181(b) For destruction of mosquitoes 164, 181(a), 179, 180(a) For destruction of rats 164, 181(c), 179, 180(c) Harbors for rats, prevention of 8 Hydrocyanic acid gas 89, 105, 179, 180 Inspection: Baggage 4 Cards 109 Cargo 4 Crew 4 Definition of 6 Exemption from 5(b) Time of 7, 36 Vessels 34, 35, 36, 37, 39 Incubation, period of: Cholera 71 Plague 1 98 Smallpox : 107 181214—20 b TO Incubation, period of— Continued, raragraph. Typhus Ill Yellow fever 80 Isolation: Of sick : 21(c), 22, 51 Of suspects 51 Leprosy 122-125 Lighters, fumigation of 91 Local health authorities, to be notified of communicable diseases 40 Log, ship's log — ^Xoting of disease by master 22 Malaria T T ' 20(g) Manifests, freight, to be examined 37 Measles 18 Merchandise, articles of 93 Mexican frontier. {See Border quarantine.) Mosquitoes: Prevention of 20(gj, 31, 81, 87(a) Destruction of 81, 83(b), 84, 85, 89, 156, 164, 178, 179 Oaths, quarantine officers authorized to administer 38 Oxides of carbon 177 Passengers: Cabin 16, 65 Steerage 16, 63, 68 Personal effects 11, 43, 77, 100, 110(d), 112, 115, 136 Penalties 4, 33 Pilots 39, 43 Plague: Requirements at foreign ports 90-93 Requii'ements at sea 20(h), 22 Requii-ements at domestic ports 94—106, 148, 155 Pratique. (See Certificate of discharge from quarantine.) P^Tethriun for destruction of mosquitoes 178 Quai'antine, certificate of dischai'ge from . - 34, 47, 58 Quarantine seasdn, active Quai'antine station, equipment of 27, 29 71 Rats: Destruction of 164, 179, 180(c), 181(c> Prevention of harborage & Guarding ship against 90 Rat-guards to mooring lines 92, 101 Records, ship's surgeon to keep clinical 25 Reports, quarantine officer to report violations of laws 56, 57 Scarlet fever 18 Smallpox: Requii'ements at foreign ports 107-109 Requirements at sea 21(c), 22 Requirements at domestic ports 110, 153 Solutions for disinfection 161, 162, 163 Steerage passengers. {8ee Passengers.) Steam as disinfectant 127, 160 State and local quarantine, inspection of 145, 14& Subsistence to persons in detention, expense of 54 Sulphur dioxide 164-167, 181 Typhus: Requirements at foreign ports 111-114 Requirements at sea 21(i), 22 Requirements at domestic ports 115-121, 136, 151, 158, 180(d), 181(b) Vaccination of personnel at quarantine stations (also see Smallpox) 3a Vaccine vhus 26 Vessels: At sea 20-26 Certificate of discharge from quarantine 34, 47, 58 Clearing for United States ports 2 Detention of. [See Detention.) Plying on frontiers 3 May be released after disinfection 45 To be mechanically clean 8, 20(a) Ventilation 10 Water supply ." 10, 21(j), 2^ 72 Water, contaminated, treatment of 59, 75, 157 Wearing apparel.^ 11, 77, 100, 110(d), 112, 115, 136, 158 Yellow fever: Requirements at foreign ports 80-83 Requii'ements at sea 21(g), 22 Requirements at domestic ports 83-89, 135, 150, 156, 164, 179, 180(a), 181(a) UNITED STATES QUARANTINE LAWS. Act of March 27, 1890. Act of August 1, 1888 Act of February 15, 1893 Act of August 18, 1894 Act of March 3, 1901 Act of June 19, 1906 Anchorage, Secretary of Treasury to fix boundaries. . . Bills of health: Consular officers to issue Exemption as to Failure to produce Masters to secure at foreign ports Masters to deliver at domestic ports Violations as to securing .- Certificate of discharge from quarantine, master to produce Cholera ■Consular officers Exemptions as to bills of health False statements, penalties for master making Sec. Page. 1 10 59 59 50 55 00 62 63 50 55 50 50 53 51 53 53 50 55 60 73 UNITED STATES QUARANTINE LAWS— Continued. Fees for bills of health Foreign ports, consular reports as to sanitary condi- tions Infected vessels, treatment of, at United States ports. Medical officers may be detailed for duty in American consulate office Penalties for \T.olation of law : As to bills of health As to violations of regulations As to trespass on quarantine stations As to false statements Ports of entry, requirements at, as to quarantine Posting of quarantine regulations in consular office . . . Quarantine anchorage to be fixed by Secretary of Treasury Quarantine officers, powers of Regulations: Issuance of To be posted in consular office Sanitary reports to be made by consular officers Secretary of Treasury, powers and duties of Surgeon General of Public Health Service, powers and duties of Trespass on quarantine reservations . . , Vessels plying between frontier ports Sec. 1 10 10 5 2 3 12 2 2 4 3 O COLUMBIA UNIVERSITY LIBR^^^^^ 0052124037