Article IV Communicable and Noncommunicable Diseases

Every physician who treats or examines any person who is suffering from or who is suspected of having a communicable disease, or any person who is suspected of being a carrier or who is infected asymptomatically, shall make a prompt report of the disease or condition to the Board of Health. The report shall be on a standard-type report form or cases may be reported by telephone. The report shall state the name of the disease, the name of the patient or carrier, the address at which the patient or carrier may be located, the date of onset of the disease and the name of the householder in whose family the disease may have occurred.

Any physician who treats a patient with a reportable communicable disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease; the name, age, sex and race of the patient; and the address at which the patient may be located. The reports shall be mailed in sealed envelopes to the Pennsylvania Department of Health, as required by law.

Reports of laboratory examinations.

Any person who is in charge of a laboratory in which a laboratory examination of any specimen derived from the human body yields microscopical, cultural, immunological, serological or other evidence significant from a public health standpoint of the presence of any one of the diseases listed below shall report promptly such findings to the Health Officer as well as to the Pennsylvania Department of Health, as required by law, giving the name and address of the person from whom the specimen was obtained and the name and address of the physician for whom such examination or test was made. This regulation shall not apply when a reported case of tuberculosis is hospitalized for treatment for tuberculosis and specimens are examined for that disease.

	Amebiasis
	Anthrax
	Brucellosis
	Diphtheria
	Bacillary dysentery
	Malaria
	Meningococcal infection
	Rickettsial infection
	Salmonella infection (including paratyphoid fever infections)
	Trichinosis
	Tuberculosis infection
	Tularemia
	Typhoid infection

Copies of laboratory findings for venereal disease are required to be sent to the health authorities of cities of the first class and to county health departments when the patients are residents of such city or county; all other reports shall be sent to the Pennsylvania Department of Health.

School nurses shall report to school administrators and Health Officers the presence of suspected communicable disease in school children. The school administrator shall forward these reports to the Board of Health. Any unusual increase in the number of absentees among school children shall be reported to such Board.

(5)

Reporting by heads of institutions. Superintendents of hospitals or other persons in charge of any institution for treatment of disease or of any institution maintaining dormitories and living rooms or of an orphanage shall notify the Board of Health upon the occurrence in or admission to such institution of a reportable disease and shall thereafter follow the advice and instructions of the health authorities for controlling such disease, but such notification shall not relieve physicians of their duty to report in the manner set forth in Subsection A(1) and (2) cases which they may treat or examine in any such institution.

(6)

Reporting by householders and others. Any householder, proprietor of a hotel or a rooming, lodging or boarding house or any other person having knowledge or suspicion of any communicable disease shall report such knowledge or suspicion promptly to the Board.

(7)

Revision of diagnosis by attending physician. No diagnosis of disease for which isolation or quarantine is required shall be revised without the concurrence of a medical member of the Board.

(8)

Unusual outbreak or occurrence of illness. Any person having knowledge of the occurrence of any unusual disease or group expression of illness which may be of public concern, whether or not it is known to be of a communicable nature, shall report this promptly to the Board.

(9)

Report of animal bites or other trauma caused by animals. Anyone who treats a patient who has received a bite or a laceration caused by an animal[1] shall report such injury to the Board in accordance with the provisions of article III.

Editor's Note: See Ch. 52, Animals.

Noncommunicable diseases. Any person in charge of an institution for the treatment of disease shall be authorized upon request of this Board to make a report of such diseases and conditions other than communicable diseases for which this Board has approved a specific study to enable this Board to determine and employ the most efficient and practical means to protect and to promote the health of the people by the prevention and control of such diseases and conditions. The reports shall be made upon forms prescribed by this Board and shall be transmitted to this Board.

§ 93-15 Quarantine and isolation.

Establishment of isolation and quarantine. When the initiation of isolation of patients ill with any communicable disease or the quarantine of susceptible contacts is required by any of the provisions of § 93-17 of this chapter, the Health Officer shall cause the same to be done promptly following receipt of the report.

Isolation will be applied as instructed below. If the disease is one requiring isolation, the Health Officer shall ensure that instructions are given to the patient and members of the household defining the areas within which the patient is to be isolated and stating the measures to be taken to prevent the spread of the disease.

Modified isolation. If the disease is one in which only a modified isolation is required, the Health Officer shall issue appropriate instructions prescribing the isolation technique to be followed. The isolation technique will depend upon the disease.

Isolation in hospitals. Cases of communicable diseases may be treated in any hospital, provided that the patient is isolated in a private room or cubicle or in a ward where none but patients with the same disease are segregated, and further provided that the isolation technique is observed. The requirements of the rule relating to isolation for a specific disease which the patient experienced, as described in § 93-17, must be observed while the patient is hospitalized. However, the removal of the patient to his home during the convalescent period of isolation may be permitted, provided the requirements in this section are observed.

Nurses and attendants caring for communicable disease patients, where possible, shall not come in contact with obstetrical patients or maternity services until a period of time equal to the incubation period of the particular disease has elapsed since their last contact with such patients.

Quarantine. If the disease is one requiring quarantine of the contacts in addition to isolation of the case, the Health Officer shall determine the contacts who are subject to quarantine, specify the place to which they shall be quarantined and issue appropriate instructions. He shall ensure that provisions are made for the medical observation of such contacts as frequently as necessary during the quarantine period.

Placarding. Whenever in any particular instance the Health Officer is unable to enforce such isolation or quarantine as required for the protection of the public health and deems it necessary to use placards, such placards may be utilized only if the specific use is approved by the Board of Health.

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

A person under isolation or quarantine may be removed to another dwelling or hospital only with the permission of the Health Officer.

Removal of a patient under isolation or quarantine from or to this Borough may be made only with the permission of the Health Officer and the health authorities of the other jurisdiction concerned.

Transportation of a person under isolation or quarantine shall be made by private conveyance or as otherwise ordered by the Health Officer, due care being taken to prevent the spread of the disease.

Isolation or quarantine shall be immediately resumed upon arrival of the patient at the point of destination, for the period of time required for the specific disease.

Release from isolation and quarantine. The Health Officer may order release from isolation or quarantine when he is satisfied that compliance with the provisions of this chapter has been met.

Control of communicable disease in school children.

Period of exclusion from the school for specified diseases. The duration of the period of exclusion from school for any person who has or has had one of the diseases specified below is declared to be as follows:

Chicken pox, seven days.

German measles, until disappearance of rash.

Measles, seven days from onset of rash.

Mumps, until swelling can no longer be seen or felt.

Respiratory streptococcal infections, including scarlet fever, if no physician is in attendance on the patient, not less than seven days from onset.

Whooping cough, four weeks from onset.

Readmission to school for specified diseases. Teachers and others in charge of any public, private, parochial or other school or college shall not readmit before the expiration of the exclusion period, as stated in Subsection J(1), any person who has been absent because of an illness from chicken pox, German measles, measles, mumps, respiratory streptococcal infection and scarlet fever or whooping cough. In case of respiratory streptococcal infection, the attending physician shall certify to the Health Officer as to the patient's recovery, and the Health Officer shall grant permission for readmission to school when the requirements of these regulations for respiratory streptococcal infections have been fulfilled.

Exclusion from school of pupils showing symptoms of a communicable disease. Every teacher, nurse, principal, superintendent or other person or persons in charge of any public, private, parochial or other school or college shall immediately exclude any person showing an unusual skin eruption or soreness of the throat or having symptoms of whooping cough or diseases of the eyes and shall report the fact of such exclusion and the reasons therefor to the Health Officer, together with the name and address of the person excluded.

Readmission to school of pupils excluded because of a suspected communicable disease. No person excluded from any public, private, parochial or other school or college on account of having or being suspected to have a disease for which isolation is required shall be readmitted until he presents a certificate from a physician stating that the condition for which the person was excluded was not communicable or until he presents a certificate from the Health Officer indicating release from isolation. No person who has been absent from school by reason of having had or because of residing on premises where there has been a disease for which isolation is required shall be readmitted to school except with the permission of the Health Officer, whether or not there has been a physician in attendance or whether or not isolation has been established in the household.

(5)

School attendance by pupils with infectious condition or acute contagious conjunctivitis prohibited. No person suffering from acute contagious conjunctivitis (pink eye), impetigo contagiosa, pediculosis capitis, pediculosis corporis, scabies, tinea circinata, tonsillitis, trachoma or favus shall be permitted to attend any public, private, parochial or other school or college. The teachers of public schools and the principals, superintendents or other persons in charge of private, parochial or other schools or colleges shall exclude any such persons from said schools, such exclusions to continue until the case has recovered, provided that any person suffering from ringworm of the scalp caused by microsporon audouini shall be admitted to school if the person is under treatment.

(6)

Readmission to school of pupils recovered from infectious conditions or acute contagious conjunctivitis. No person who has been excluded or who has been absent from any school by reason of having or of being suspected to have had acute contagious conjunctivitis (pink eye), impetigo contagiosa, pediculosis capitis, pediculosis corporis, scabies, tinea circinata, tonsillitis, trachoma or favus shall be readmitted except with a certificate of recovery from a physician.

Laboratory examinations to determine release from isolation or quarantine. Whenever the provisions of this chapter provide for the submission of laboratory specimens to be examined for the presence of microorganisms in order to determine the duration of isolation or quarantine or to determine the eligibility for the release therefrom, such specimens shall be examined in a laboratory of the Pennsylvania Department of Health or in a laboratory approved by the Secretary of Health for examination of such specimens.

§ 93-16 Venereal disease examinations.

Person in custody.

Any person taken into custody and charged with any crime involving lewd conduct or a sex offense, or any person to whom the jurisdiction of a juvenile court attaches, may be examined for a venereal disease by a qualified physician appointed by the Board of Health.

Any person convicted of a crime or pending trial who is confined in or committed to any state or local penal institution, reformatory or any other house of correction or detention may be examined for venereal disease by a qualified physician appointed by the Board of Health or the Pennsylvania Department of Health.

Any such persons noted in Subsection A(1) and (2) found, upon such examination, to be infected with any venereal disease shall be given appropriate treatment by a qualified physician appointed by the Board of Health or by the attending physician of the institution, if any.

Diagnosis and treatment of venereal disease. Upon approval of the Pennsylvania Department of Health, this Board may undertake to share the expense of furnishing free diagnosis and free treatment of venereal disease or this Board may take over entirely or in part the furnishing of free diagnosis and free treatment of venereal disease with or without financial assistance from the Pennsylvania Department of Health.

Sale of drugs for venereal disease. The sale of drugs or other remedies for the treatment of venereal disease is prohibited except under prescription of physicians licensed to practice in this commonwealth.

Persons refusing to submit to treatment for venereal disease.

If the Health Officer finds that any person who is infected with a venereal disease in a communicable stage refuses to submit to treatment approved by this Board, the Health Officer may file a bill in equity in the Court of Common Pleas of Delaware County to commit such person to an appropriate institution designated by this Board for safekeeping and treatment until the disease has been rendered noncommunicable.

§ 93-17 Reportable disease regulations.

Any county jail or other appropriate institution may receive persons who are isolated or quarantined by this Board by reason of a venereal disease for the purpose of safekeeping and treatment. This Board shall reimburse any institution which accepts such persons at the rate of maintenance that prevails in such institution and shall furnish the necessary medical treatment to the persons committed to such institution.

The following regulations pertain to the designated reportable disease:

Actinomycosis: control of the infected individual, contacts and environment:

Report to Health Officer.

Isolation: none.

Concurrent disinfection of discharges and contaminated dressings.

Terminal disinfection: thorough cleaning.

Quarantine of contacts: none.

Anthrax: control of the infected individual, contacts and environment.

Report to Health Officer.

Isolation: until lesions are healed.

Concurrent disinfection of discharges from lesions and articles soiled therewith. Spores require steam sterilization under pressure or burning.

Terminal disinfection: thorough cleaning.

Quarantine of contacts: none.

Brucellosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of body discharges.

Terminal disinfection: none.

Quarantine of contacts: none.

Chancroid: control of the infected individual, contacts and environment.

Any physician who treats a patient with a reportable communicable disease which is classed as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease, the name, age, sex and race of the patient and the address at which the patient may be located. The report shall be made directly to the Pennsylvania Department of Health.

Isolation: at the discretion of the attending physician until adequate therapy renders patient noninfectious.

Concurrent disinfection: none, ordinary personal cleanliness.

Terminal disinfection: none.

Quarantine of contacts: none.

(5)

Chicken pox: control of the infected individual, contacts and environment.

Report to the Health Officer. In all cases occurring in persons 15 years of age or older, the diagnosis shall be confirmed by a qualified medical health officer.

Isolation: seven days.

Concurrent disinfection: none.

Terminal disinfection: none.

(6)

Cholera: control of the infected individual, contacts and environment.

Report to the Health Officer by telephone.

Isolation of patient in hospital or screened room during communicable period.

Concurrent disinfection: prompt and thorough disinfection of feces and vomitus and of articles used by patient; practice by attendants of scrupulous cleanliness and of disinfection of hands each time after handling or touching articles contaminated by feces.

Terminal disinfection: thorough cleaning.

Quarantine: surveillance of contacts for five days from last exposure and longer if feces contain cholera vibrio.

(7)

Diarrhea of the newborn, epidemic: control of the infected individual, contacts and environment.

Report. Any infant under one month of age in a hospital or institution or any infant hospitalized because of prematurity who has two or more watery stools within a twenty-four-hour period shall be considered a suspicious case of diarrhea of the newborn. Any newborn who within four days after discharge from a hospital has two or more watery stools within a twenty-four-hour period shall be considered a suspicious case and be kept under close observation. If the infant has diarrhea of the newborn, the case immediately shall be reported to the Health Officer by telephone or other equally prompt means as a case of diarrhea of the newborn.

Isolation. The infected infant shall be placed in isolation until discharged from the hospital.

Concurrent disinfection of all discharges and articles soiled therewith.

Observation quarantine of infants in nursery. Upon occurrence in the nursery of a case of diarrhea of the newborn, all infants in the nursery shall be placed under observation quarantine and no infants shall be admitted until all exposed infants have been discharged, the nursery has been thoroughly cleaned and the Health Officer has approved the removal of the observation quarantine.

Care of noncontacts. Infants born subsequent to the establishment of observation quarantine of infants in the newborn nursery shall be cared for in a separate, clean newborn nursery by a different nursing staff.

Closure of maternity section to admissions. If one case of diarrhea of the newborn occurs in the temporary clean nursery, that maternity section of the hospital shall be closed to maternity admissions until all cases and newborn contacts have been discharged, all nursery rooms and equipment have been cleaned thoroughly and the Health Officer has approved the reopening.

(8)

Diphtheria: control of the infected individual, contacts and environment.

Report to the Health Officer by telephone.

A warning placard shall be posted on the premises, stating the name of the disease, and shall not be removed until all provisions of this subsection have been met.

Isolation: until cultures from nose and throat taken on two occasions not less than 24 hours apart fail to show diphtheria bacilli. Cultures for release shall not be taken before the twelfth day of the disease nor earlier than the seventh day after the last dose of any effective antibiotic or chemotherapeutic agent. Local or general application of antibiotic or chemotherapeutic agents invalidates the usefulness of bacteriological examinations. Where termination of isolation by culture is impracticable, isolation may end with fair safety 14 days after onset. Where practicable, a virulence test should be made if throat cultures are reported positive three weeks or more after onset. Isolation may be terminated if the microorganism reported present is proved avirulent.

Concurrent disinfection of all articles in contact with patient and all articles soiled by discharges of patient.

Terminal disinfection: thorough airing and sunning of the sickroom, with cleaning.

Quarantine. All intimate contacts, especially young children, should be kept under surveillance if found to be carriers or suffering from nasal discharge or sore throat. Adult contacts whose occupation involves handling of food or close association with children should be excluded from such occupations until shown not to be carriers by bacteriological examination.

Diphtheria carriers. A "chronic diphtheria carrier" is defined as any person who has been free from the symptoms of diphtheria for four weeks or longer and who harbors virulent diphtheria bacilli. A chronic carrier of diphtheria bacilli may be placed under quarantine until cultures from the nose and throat on four successive occasions not less than 24 hours apart are negative or the cultures are found to be avirulent. When appropriate medical and surgical measures to eliminate the carrier state fail, the Health Officer may release the carrier from quarantine when such release is not detrimental to the public health.

(9)

Dysentery, amebic: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none; exclusion of patient from food preparation, processing and serving; release from supervision by the Health Officer only after submission of not less than six consecutive negative feces specimens collected at intervals of not less than one week.

Concurrent disinfection: sanitary disposal of feces; handwashing after defecation.

Terminal disinfection: cleaning.

Quarantine of contacts: none.

Convalescents from amebic dysentery shall be subject to the restrictions placed upon chronic carriers of Endamoeba histolytica until there have been received from the laboratory at least six successive negative reports on specimens of feces taken at intervals of not less than seven days nor earlier than 14 days after the last dose of any antibiotic or chemotherapeutic drug effective against the etiologic organism.

Convalescent carriers. Any person found to be excreting or harboring the organism three months (90 days) after the date of onset, or, in the case of asymptomatic infection, three months (90 days) after the date of first isolation of the etiologic organism, shall be registered as a convalescent carrier and shall be studied until one year after the date of onset of the illness, or, in the case of asymptomatic infections, until one year after the date of the first isolation of the etiological agent, during which time specimens of feces, as required by the Health Officer and the Secretary of Health, shall be submitted to the Pennsylvania Department of Health Laboratory or a laboratory approved by the Secretary of Health for examination to determine whether or not the carrier state is permanent. If at the end of the period of observation -- one year after the date of onset of the illness, or, in the case of asymptomatic infection, one year after the initial isolation of the etiologic agent -- it has not been demonstrated to the satisfaction of the Health Officer and the Secretary of Health that the person is no longer a carrier, the person shall be registered as a chronic carrier.

Restrictions governing the sale or handling of food, milk or drink for public consumption. The sale, handling for sale or any other distributing of milk for public consumption, or the sale handling, distributing or manufacture of any milk product or any other article of food or any beverage or candy or tobacco intended for public consumption, on the premises in which exists a case of amebic dysentery or amebiasis, a convalescent from amebic dysentery or a convalescent or chronic carrier of amebic dysentery, is prohibited unless special permission for such sale, handling, manufacture or distribution shall have been given by the Health Officer and measures approved by the Secretary of Health for the protection of consumers are carried out faithfully.

Restrictions imposed on persons with Endamoeba histolytica, cases and carriers. No person suffering from amebic dysentery or amebiasis or who is a convalescent from amebic dysentery or who is a convalescent or chronic carrier shall change his address without notice to the Health Officer, nor shall such person serve, cook, produce or otherwise handle foods or beverages, including milk and its derivatives, candy, tobacco or cigars intended for consumption by any except his immediate household.

(10)

Dysentery, bacillary: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: during acute illness; rigid personal precautions by attendants.

Concurrent disinfection of feces and of articles soiled therewith.

Terminal disinfection: cleaning.

Quarantine. Contacts should not be employed as foodhandlers during period of contact nor before repeated negative feces cultures are obtained.

Convalescents from bacillary dysentery. Convalescents shall be subject to the restrictions placed upon chronic bacillary dysentery carriers until there have been received from the laboratory at least three successive negative reports on specimens of feces taken not less than five days apart nor earlier than 14 days after the last dose of any antibiotic or chemotherapeutic drug effective against the etiologic organism.

Convalescent carriers. Any person found to be excreting or harboring the organism three months (90 days) after the date of onset, or, in the case of asymptomatic infection, three months (90 days) after the date of the first isolation of the etiologic organism, shall be registered as a convalescent carrier and shall be studied until one year after the date of onset of the illness, or, in the case of asymptomatic infections, until one year after the date of the first isolation of the organism, during which time specimens of blood and feces, as required by the Health Officer and the Secretary of Health, shall be submitted to the Pennsylvania Department of Health Laboratory or a laboratory approved by the Secretary of Health for examination to determine whether or not the carrier state is permanent. If at the end of the period of observation -- one year after the date of onset of the illness, or, in the case of asymptomatic infection, one year after the initial isolation of the organism -- it has not been demonstrated to the satisfaction of the Health Officer and the Secretary of Health that the person is no longer a carrier, the person shall be registered as a chronic carrier.

Restrictions governing the sale or handling of food, milk or drink for public consumption. The sale, handling for sale or other distributing of milk for public consumption, or the sale, handling, distributing or manufacture of any milk product or any other article of food or any beverage or candy or tobacco intended for public consumption, on the premises in which exists a case of bacillary dysentery or a convalescent from bacillary dysentery, is prohibited unless special permission for such sale, handling, manufacture or distribution shall have been given by the Board of Health and measures approved by the Secretary of Health for the protection of consumers are carried out faithfully.

Restrictions imposed on persons infected with bacillary dysentery organisms, cases and carriers. No person suffering from bacillary dysentery or who is a convalescent from bacillary dysentery or who is a convalescent or chronic carrier shall change his address without notice to the health authorities, nor shall such person serve, cook, produce or otherwise handle foods or beverages, including milk and its derivatives, candy, tobacco or cigars intended for consumption by any except his immediate household.

(11)

Encephalitis, arthropod-borne viral: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none. Virus is not usually found in blood, secretions or discharges during clinical manifestations.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(12)

Food poisoning.

Staphylococcus intoxication: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

Botulinus intoxication (botulism): control of the affected (poisoned) individual, contacts and environments.

Report to the Health Officer by telephone.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(13)

German measles (rubella): control of infected individual, contacts and environment.

Report to the Health Officer.

Isolation: until rash has disappeared.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(14)

Gonococcal infections.

Gonococcal urethritis (gonorrhea): control of the infected individual, contacts and environment.

Any physician who treats a patient with a reportable communicable disease which is classed as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease, the name, age, sex and race of the patient and the address at which the patient may be located. These reports shall be made directly to the Pennsylvania Department of Health.

Isolation: at discretion of attending physician until adequate therapy renders patient noninfectious.

Concurrent disinfection: care in disposal of discharges from lesions and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

Gonococcal vulvovaginitis in children: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation. Isolation may be terminated after 24 hours of adequate and effective therapy under medical supervision.

Concurrent disinfection: care in disposal of conjunctival discharges and articles soiled therewith.

Terminal disinfection: none.

Quarantine: none.

Opthalmia neonatorum: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation. Isolation may be terminated after 24 hours of adequate and effective therapy under medical supervision.

Concurrent disinfection: care in disposal of conjunctival discharges and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

[6]

It shall be the duty of physicians and midwives attending women in confinement to instill in each eye of the newborn child as soon as practicable after birth a one-percent silver nitrate solution for the purpose of preventing the disease known as "ophthalmia neonatorum."

[7]

The Pennsylvania Department of Health will distribute without charge to the physicians and midwives of the commonwealth necessary quantities of silver nitrate solution placed to ampuls suitable for its preservation; provided, however, that these regulations shall not prohibit the use of silver nitrate solution other than that furnished by the Pennsylvania Department of Health.

Gonococcal conjunctivitis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation. Isolation may be terminated after 24 hours of adequate and effective therapy under medical supervision.

Concurrent disinfection: care in disposal of conjunctival discharges and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(15)

Granuloma inguinale: control of the infected individual, contacts and environment.

Any physician who treats a patient with a reportable communicable disease which is classed as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease, the name, age, sex and race of the patient and the address at which the patient may be located. These reports shall be made directly to the Pennsylvania Department of Health.

Isolation: at discretion of attending physician until adequate therapy renders patient noninfectious.

Concurrent disinfection: care in disposal of discharges from lesions and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(16)

Hepatitis.

Infectious: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: during first week of illness; exclusion of patient from all food and drink preparation, processing and serving for the public consumption for a period of four weeks after the onset of illness.

Concurrent disinfection of feces and nose and throat secretions.

Terminal disinfection: none.

Quarantine of contacts: none.

Serum: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none. Such disease is not known to be communicable except by injection.

Concurrent disinfection of equipment contaminated with blood.

Terminal disinfection: none.

Quarantine of contacts: none.

(17)

Histoplasmosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: discharge from skin lesions and necrotic lymph nodes, sputum and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(18)

Influenza: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: during the acute illness as directed by attending physician.

Concurrent disinfection: discharges from the nose and throat of the patient.

Terminal disinfection: none.

Quarantine of contacts: none.

(19)

Leprosy: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: isolated and treated until bacteriologically negative for at least six months.

Concurrent disinfection: discharges from lesions and articles soiled therewith.

Terminal disinfection: thorough cleaning of living premises of patient.

Quarantine: none.

(20)

Leptospirosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

(21)

Lymphocytic choriomeningitis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of discharges from the nose and throat, of urine and feces and of articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(22)

Lymphogranuloma venereum: control of the infected individual, contacts and environment.

Any physician who treats a patient with a reportable communicable disease which is classed as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease, the name, age, sex and race of the patient and the address at which the patient may be located. These reports shall be made directly to the Pennsylvania Department of Health.

Isolation: at discretion of attending physician until adequate therapy renders patient noninfectious.

Concurrent disinfection: none; care in disposal of discharges from lesions and of articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(23)

Malaria: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none. Patients shall be protected at night by screens or bed nets in areas where vector anophelines are present.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(24)

Measles: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: restriction to own premises for 7 days after the appearance of the rash.

Concurrent disinfection: all articles soiled with secretions of nose and throat.

Terminal disinfection: thorough cleaning.

Quarantine of contacts: none.

(25)

Meningitis, meningococcal: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: until recovery from acute illness.

Concurrent disinfection of discharges from the nose and throat and of articles soiled therewith.

Terminal disinfection: cleaning.

Quarantine: no quarantine; surveillance at the discretion of the Health Officer.

(26)

Mononucleosis, infectious: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of articles soiled with nose and throat discharges.

Terminal disinfection: none.

Quarantine of contacts: none.

(27)

Mumps: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: until swelling can no longer be seen or felt.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(28)

Plague: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: hospitalization of all patients if practical; reasonable aseptic precautions for patients with bubonic plague, and isolation for primary pneumonic plague or patients developing plague pneumonia.

Concurrent disinfection of sputum and purulent discharges and articles soiled therewith and of urine and feces of patients.

Terminal disinfection: thorough cleaning. Bodies of persons dying of plague should be handled with strict aseptic precautions.

Quarantine. For contacts of bubonic plague, disinfect with insecticide powder, such as five- to ten-percent DDT in talc or pyrophyllite, and maintain surveillance for six days. For contacts of pneumonic plague, quarantine for six days, with close surveillance for developing illness, and dust with insecticide powder.

(29)

Pneumonia.

Pneumonococcal: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: thorough cleaning and airing.

Terminal disinfection: thorough cleaning and airing.

Quarantine of contacts: none.

Bacterial, other than pneumonococcal: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of discharges from mouth and nose, and of articles soiled therewith.

Terminal disinfection: thorough cleaning and airing.

Quarantine of contacts: none.

Primary atypical (virus): control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of discharges from nose and throat.

Terminal disinfection: thorough cleaning and airing.

Quarantine of contacts: none.

(30)

Poisoning by drugs or toxic agents: control of the affected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Disinfection: none.

Quarantine of contacts: none.

(31)

Poliomyelitis: control of the infected individual, contacts and environment:

Report to the Health Officer.

Isolation for one week from date of onset or for duration of fever.

Concurrent disinfection of throat discharges and feces and of articles soiled therewith.

Terminal disinfection: none.

Quarantine: at the discretion of the Health Officer.

(32)

Psittacosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: important during acute febrile stages. Nurses caring for patients with a cough should wear adequate gauze masks.

Concurrent disinfection of all discharges.

Terminal disinfection: Thorough wet cleaning and exposure to sunlight.

Quarantine of household contacts: none. Environment and buildings having housed birds should not be used by human beings until thoroughly cleaned and disinfected.

(33)

Q fever: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of sputum and blood and of articles freshly soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(34)

Rabies: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: through duration of illness. Immediate attendants should be warned of the hazard of inoculation through saliva of patients.

Concurrent disinfection of saliva and articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(35)

Rickettsialpox: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(36)

Rocky Mountain spotted fever: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection. All ticks on patients should be destroyed, using appropriate technique to prevent further dissemination of the disease.

Terminal disinfection: none.

Quarantine of contacts: none.

(37)

Salmonellosis, Salmonella infections caused by any of the Salmonella species (includes paratyphoid fever A, Salmonella paratyphi A; paratyphoid fever B, Salmonella paratyphi B; paratyphoid fever C, Salmonella hirschfeldii): control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: in screened room until recovery or death of the patient.

Concurrent disinfection of feces and urine and of articles soiled therewith. In areas with modern and adequate sewage disposal systems, feces and urine can be disposed of directly into sewer without preliminary disinfection.

Terminal disinfection: cleaning.

Quarantine. A household contact who is a food handler shall be excluded until two successive feces and urine specimens taken no less than 24 hours apart, either after termination of isolation of the case or after he ceases to live in the same premises as the case, are examined by a laboratory approved by the Pennsylvania Department of Health and found free of Salmonella paratyphi A or B.

Convalescents from salmonellosis shall be subject to the restrictions placed upon chronic salmonellosis carriers until there have been received from the laboratory at least three successive negative reports on specimens of feces and urine taken not less than five days apart nor earlier than 14 days after the last dose of any antibiotic or chemotherapeutic drug effective against the etiologic organism. Additional feces specimens and urine specimens at the end of four months and six months from the date of onset shall be taken for culture.

Convalescent carriers. Any person found to be excreting or harboring the organism three months (90 days) after the date of onset, or, in the case of asymptomatic infection, three months (90 days) after the date of the first isolation of the etiologic organism, shall be registered as a convalescent carrier and shall be studied until one year after the date of onset of the illness, or, in the case of asymptomatic infections, until one year after the date of the first isolation of the organism, during which time specimens of blood, feces and urine, as required by the Health Officer and the Secretary of Health, shall be submitted to the Pennsylvania Department of Health Laboratory or a laboratory approved by the Secretary of Health for examination to determine whether or not the carrier state is permanent. If at the end of the period of observation -- one year after the date of the onset of the illness, or, in the case of asymptomatic infection, one year after the initial isolation of the organism -- it has not been demonstrated to the satisfaction of the Health Officer and the Secretary of Health that the person is no longer a carrier, the person shall be registered as a chronic carrier.

Restrictions governing the sale or handling of food, milk or drink for public consumption. The sale, handling for sale or any other distributing of milk for public consumption, or the sale, handling, distributing or manufacture of any milk product or any other article of food or any beverage or candy or tobacco intended for public consumption, on the premises in which exists a case of salmonellosis, a convalescent from Salmonella or a convalescent or chronic carrier of Salmonella organisms, is prohibited unless special permission for such sale, handling, manufacture or distribution shall have been given by the Health Officer and measures approved by the Secretary of Health for the protection of consumers are carried out faithfully.

Restrictions imposed on persons affected with Salmonella organisms, cases and carriers. No person suffering from salmonellosis or who is a convalescent from salmonellosis or who is a convalescent or chronic carrier shall change his address without notice to the Health Officer, nor shall such person serve, cook, produce or otherwise handle foods or beverages, including milk and its derivatives, candy, tobacco or cigars intended for consumption by any except his immediate household.

(j)

Cure of chronic carrier or determination that chronic salmonellosis carrier state no longer exists. Any person declared to be a chronic carrier may be released from further supervision and the restrictions imposed because of the carrier state removed when the following requirements have been fulfilled:

The attending physician of the carrier shall notify the Health Officer of the intent to carry out studies to determine whether or not the carrier state continues to exist.

Two specimens of blood, one taken at the beginning and the second not less than six months later, shall be examined for the existence of antibodies against the virulence, flagellar and somatic antigens.

Twelve authenticated consecutive specimens of feces and 12 authenticated consecutive specimens of urine taken at intervals of not less than two weeks nor less than 14 days after the last dose of antibiotic or chemotherapeutic agent effective against the etiologic organism are found upon laboratory examination to be negative for the etiologic organism.

Two authenticated consecutive bile specimens obtained by duodenal drainage at intervals of not less than one month nor less than 14 days after the last dose of antibiotic or chemotherapeutic agent effective against the etiologic organism are found upon bacteriological examination to be negative for the etiologic organisms.

All laboratory examinations of specimens from a chronic carrier who desires to be released from supervision shall be performed in the Pennsylvania Department of Health Laboratory or in a laboratory approved by the Secretary of Health for the examination of such specimens.

[6]

If the results of the studies outlined in the above Subsection A(37)(j)[1] to A(37)(i)[5], after competent review, indicate that the person is no longer a carrier, the person may be released by the Secretary of Health from further supervision and the restrictions imposed because of the carrier state removed.

(38)

Smallpox: control of the infected individual, contacts and environment.

Report by telephone to the Health Officer.

Placard: a warning placard shall be posted on the premises stating the name of the disease and shall not be removed until the provisions of this section have been met.

Isolation: in screened wards or rooms until complete cicatrization of all lesions.

Concurrent disinfection: oral and nasal discharges to be deposited in a paper bag or other suitable container and burned. All articles associated with the patient shall be sterilized by high pressure steam or by boiling.

Terminal disinfection: thorough cleaning of sick room and furniture; sterilization of mattress, pillow and bedding.

Quarantine: all persons living or working on the same premises as the person who develops smallpox or otherwise having intensive exposure, shall be considered contacts, and promptly vaccinated or revaccinated, or quarantined for 16 days from last exposure. If such contacts are considered immune by reason of prior attack or successful revaccination within the previous three years, they shall be kept under surveillance until the height of the reaction to the recent vaccination has passed. If the contact is not considered immune, he shall be kept under surveillance until 16 days have passed since the last contact. Any rise of temperature during surveillance calls for prompt isolation until smallpox can be excluded.

(39)

Streptococcal infections.

Streptococcal sore throat with rash (scarlet fever, scarlet rash or scarlatina): control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: in order of preference, in a single room, cubicle or small ward in uncomplicated cases until clinical recovery or not less than seven days from onset. Isolation may be terminated after 24 hours of adequate and effective therapy maintained under medical supervision.

Concurrent disinfection of purulent discharges and of all articles soiled therewith.

Terminal disinfection: thorough cleaning; sunning or other treatment of blankets.

Quarantine of household contacts: none, except that those persons of the household who are food and milk handlers or milk producers shall not be permitted to work for seven days, provided that they may continue to work if adequate and effective prophylactic therapy is maintained under medical supervision. Children under 18 years of age shall be excluded from school for seven days unless adequate and effective prophylactic therapy is maintained under medical supervision.

Streptococcal sore throat without rash (streptococcal nasopharyngitis or streptococcal tonsillitis).

Report to the Health Officer.

Concurrent disinfection of purulent discharges and of all articles soiled therewith.

Terminal disinfection: thorough cleaning; sunning or other treatment of blankets.

Streptococcal puerperal fever (puerperal septicemia): control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: strict isolation while infectious discharges persist. In patients with Group A streptococcal infection, isolation may be terminated after 24 hours of adequate and effective therapy maintained under medical supervision.

Concurrent disinfection of dressings and discharges.

Terminal disinfection: thorough cleaning; sunning or other treatment of blankets.

Quarantine of contacts: none.

Erysipelas: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: during the period of communicability (patients are a potential danger to young infants and to surgical and obstetrical patients). Isolation may be terminated after 24 hours of adequate and effective therapy maintained under medical supervision.

Concurrent disinfection of dressings and discharges from lesions.

Terminal disinfection: thorough cleaning; sunning or other treatment of blankets.

Quarantine of contacts: none.

(40)

Syphilis: control of the infected individual, contacts and environment.

Any physician who treats a patient with a reportable communicable disease which is classed as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stage of the disease, the name, age, sex and race of the patient and the address at which the patient may be located. These reports shall be made directly to the Pennsylvania Department of Health, by mail, in a sealed envelope. Also, contacts of patients, if known, shall be reported to the Health Officer.

Isolation: at discretion of attending physician until adequate therapy renders patient noninfectious.

Concurrent disinfection: none, in adequately treated cases; care in disposal of discharges from open lesions and articles soiled therewith.

Terminal disinfection: none.

Quarantine may be established at direction of the Health Officer.

(41)

Tetanus: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(42)

Toxoplasmosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(43)

Trachoma: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation. Children shall be excluded from school if active lesions exist and adequate preventive measures are not practicable.

Concurrent disinfection of eye discharges and of articles soiled therewith.

Terminal disinfection: none.

Quarantine of contacts: none.

(44)

Trichinosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection: none.

Terminal disinfection: none.

Quarantine of contacts: none.

(45)

Tuberculosis: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation.

Any person having tuberculosis in its communicable stage shall be isolated.

Isolation for tuberculosis shall be established at the usual residence of the patient suffering from tuberculosis whenever facilities for adequate isolation of such infectious patient are available in the home and where the patient will accept such isolation.

If isolation for tuberculosis cannot be accomplished or maintained at the usual residence of the patient and whenever in the opinion of the Health Officer such person is a menace to others by reason of his habits or his neglect of treatment or of the measures designed to protect others from infection, such isolation shall be enforced by removing the patient to an institution in this commonwealth determined by the Secretary of Health to be suitable for the care and treatment of such cases.

Concurrent disinfection of sputum and articles soiled therewith, including handkerchiefs, cloths or paper napkins, and of eating utensils used by patient.

Terminal disinfection: cleaning; wet cleaning of walls and floors and subsequent exposure to sunlight and fresh air.

Quarantine. All household contacts and other intimate contacts shall be required under this chapter to have a chest X ray at periodic intervals. If lesions suspicious of tuberculosis are found on X ray of contacts, such laboratory studies shall be done as are necessary to determine whether or not such patients represent public health problems.

(46)

Tularemia: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: none.

Concurrent disinfection of discharges from ulcer, lymph nodes or conjunctival sac.

Terminal disinfection: none.

Quarantine of contacts: none.

(47)

Typhoid fever: control of the infected individual, contacts and environment.

Report to the Health Officer.

Isolation: in screened room until recovery or death of the patient, provided that the physician shall not certify to recovery until the patient's temperature has been normal for at least seven consecutive days.

Concurrent disinfection of feces and urine and of articles soiled therewith. In communities with modern and adequate sewage disposal systems, feces and urine can be disposed of directly into sewer without preliminary disinfection.

Terminal disinfection: cleaning.

Quarantine. A household contact who is a food handler shall be excluded from work until two successive feces and urine specimens taken no less than 24 hours apart, either after termination or isolation of the case or after he ceases to live in the same premises as the case, are examined by a laboratory approved by the Pennsylvania Department of Health.

Convalescents from typhoid fever. Convalescents from typhoid fever shall be subject to the restrictions placed upon chronic typhoid carriers until there have been received from the laboratory at least three successive negative reports on specimens of feces and urine taken not less than five days apart nor earlier than 14 days after the last dose of any antibiotic or chemotherapeutic drug effective against the etiologic organism. Additional feces specimens and urine specimens at the end of four months and six months from the date of onset shall be taken for culture.

Convalescent carriers. Any person found to be excreting or harboring the organism three months (90 days) after the date of onset, or, in the case of asymptomatic infection, three months (90 days) after the date of the first isolation of the etiologic organism, shall be registered as a convalescent carrier and shall be studied until one year after the date of onset of the illness, or, in the case of asymptomatic infections, until one year after the date of the first isolation of the organism, during which time specimens of blood, feces and urine, as required by the Health Officer and the Secretary of Health, shall be submitted to the Pennsylvania Department of Health Laboratory or a laboratory approved by the Secretary of Health for examination to determine whether or not the carrier state is permanent. If at the end of the period of observation -- one year after the date of onset of the illness, or, in the case of asymptomatic infection, one year after the initial isolation of the organism -- it has not been demonstrated to the satisfaction of the Health Officer and the Secretary of Health that the person is no longer a carrier, the person shall be registered as a chronic carrier.

Restrictions governing the sale or handling of food, milk or drink for public consumption. The sale, handling for sale or any other distributing of milk for public consumption, or the sale, handling, distributing or manufacture of any milk product or any other article of food or any beverage or candy or tobacco intended for public consumption, on the premises in which exists a case of typhoid fever, a convalescent from typhoid fever or a convalescent or chronic carrier of typhoid fever, is prohibited unless special permission for such sale, handling, manufacture or distribution shall have been given by the Health Officer and measures approved by the Secretary of Health for the protection of consumers are carried out faithfully.

Restrictions imposed on persons infected with Salmonella typhi, cases and carriers. No person suffering from typhoid fever, or who is a convalescent from typhoid fever or who is a convalescent or chronic carrier shall change his address without notice to the Health Officer, nor shall such person serve, cook, produce or otherwise handle foods or beverages, including milk and its derivatives, candy, tobacco or cigars intended for consumption by any except his immediate household.

(j)

Cure of chronic carrier or determination that chronic typhoid carrier state no longer exists. Same as Subsection A(37)(j) of this section.

(48)

Typhus fever.

Epidemic or classical typhus (louse-borne): control of the infected individual, contacts and environment.

Report to the Health Officer by telephone.

Isolation: not required after proper delousing of patient, clothing, living quarters and household contacts.

Concurrent disinfection: appropriate insecticide powder applied to clothing and bedding of patient and contacts; treatment of hair for louse eggs (nits) with tested chemical agents.

Terminal disinfection: if death occurs before delousing, thorough application of insecticides to body and clothing.

§ 93-18 Psittacosis and birds of psittacine family.

Quarantine. Exposed lousy susceptibles should be quarantined for 15 days but may be released after application of insecticide with residual effect.

All dealers who shall purchase, sell, exchange or give away any bird of the psittacine family shall keep a record for a period of two years of each such transaction. This record shall include the number of birds purchased, sold, exchanged or given away, the date of the transaction and the name and address of the person from whom purchased or to whom sold or given away or with whom exchanged. All records herein prescribed shall be available for official inspection at all times.

Each such dealer shall report to the Health Officer any illness or deaths among birds in his possession or consigned to him or in any way passing through his hands.

The Health Officer shall verify compliance with these regulations at least every six months.

No person who sells, exchanges, gives away or otherwise disposes of psittacine birds shall procure such birds from any source where psittacosis is known to exist.

The occurrence of a case of psittacosis in the human or avian family shall be due cause for the Health Officer to make an epidemiologic investigation to determine the source of infection. Psittacine birds or other birds found on the same premises with a case of human or avian psittacosis shall be quarantined and/or destroyed as prescribed by the Health Officer. Aviaries, pet shops or other sources from which such birds were procured shall be quarantined until it can be determined that psittacosis does not exist in such sources. If such quarantine cannot be maintained, the Health Officer may seize and destroy the bird or birds for which quarantine was ordered. Bodies of birds so destroyed shall be immersed in a disinfectant solution and the carcasses burned before the feathers dry.

All persons who breed, raise, sell or exchange psittacine birds shall register annually with the Board of Health on forms prescribed by this Board for such purpose.

§ 93-19 Permit required for importation of wild rabbits, hares or rodents.

No person shall bring, cause to be brought or transport any live wild rabbit, hare or rodent into this Borough unless such animal or animals are accompanied with a permit issued by the Pennsylvania Department of Health or other agency authorized to issue the same by the Department. If such animal or animals are not accompanied with a permit or if the source of such animal or animals is not the same as that set forth in the permit, such animal or animals shall be immediately seized and destroyed and the means of conveyance disinfected at the owner's expense.

§ 93-20 Miscellaneous provisions.

Infectious sick: transportation and disposition of property.

Transportation of persons ill with certain communicable diseases. A person suffering from a disease for which isolation is required or from chicken pox, German measles, measles, mumps or whooping cough may be permitted to enter and be transported by a private or public conveyance or common carrier, provided that:

The entire vehicle, car or separate compartment in a car is used for the purpose of transporting only such person and the physician or trained nurse or other responsible person in charge of such patient.

The patient or the person in charge of such patient has secured and presented to the person in charge of such vehicle, car or common carrier a permit in writing from the Health Officer if the transportation is to be entirely within this Borough, and, if beyond the limits of the jurisdiction of the Board of Health, also approval of the Secretary of Health and the health authorities of the municipality into which the patient is to be moved.

The person in charge of the patient disinfects effectively all infectious discharges from the patient while enroute.

The Board of Health, when it is deemed advisable, may cause a placard to be posted on the car or conveyance, bearing the name of the disease from which the person transported is suffering and any additional information required by this Board.