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Ord 238 12/28/1916 AN ORDIILIECE REQUIRING PHYSICIANS AND OTHER r'' RSONS TO ?DEPORT THE EXIST10CE OF CE?2TAIN COiiii NICABLE DISaISES PROVIDING FOR QUAR�U TINE, ISOLA- TION, ISINF �CTIO5 REGULATING THEE CON- DUCT OF PERSONS SUFFERING FROM SUCH DISEASES AND OF CONTACTS. FIX- ING PENALTIES. „.,.# SECTION I. NOTIFICATION OF CASES. A. ALL CONTAGIOUS AND IIIFECTIOUS DISEASES TO BE RETORTED TO THE HEALTH OFFICER. 1. Every physician who attends any person_ in the Cit r of Wichita Falls affected with scarlet fever, smallpox, diptheria, measles, typhoid fever, pulmonary tuberculosis , anterior poliomyelitis, epidemic cerebrospinal meningitis, chicken pox, whooping cough, or mumps, shall report the same, within 24 hours from the time of such attendance, to the health officer, in writing, on card` kfurni shed by the health department, giving the name of the disease, the name, age, sex, and color of patient, and the number and name of the street, or shall otherwise designate the location of the house or dwelling place where such patient may be Mound. A report by telephone shall be re- quired in addition in the case of persons affected with scarlet fever, diptheria, or smallpox. 2. In the absence or disability of any physician in attend- ance on such case, or in default of such physician, the head of the family or some other member of the family to which the patient be- longs shall make a report as specified in paragraph 1. 3. Hotel and boarding house keepers, managers of public or private institutions , and teachers in public and private schools, and finally, any person who is awate of the existence of any of the diseases enumerated, where there is no physician in attendance, or where the case has not been reported, shall make a report of the same to the health officer, as specified in paragraph 1 of t1is Section. B. SEP�IRAT-w, Ra?ORTS RI{2UIR_EJD FOR EACH CASE. 1. Every physician or other person,as specified in Sec- tion 1, shall make separate reports for each and every case occurring in the same family or in the same dwelling place. C. SUSPECTED CASES TO BE RaORTED. l. . Any physician who attends any person whom he suspects of being ill of any of the deseases enumerated in Section 1, but on whom he is not able to make a positive diagnosis at the time of the first visit, shall report the same to the health officer as a sus- picious case, on the card furnished by the health department. Such a case will not be placarded unless a warranting diagnosis is later established. When the diagnosis is established, the physician shall immediately notify the health officer. In suspected cases the physi- cian in attendance shall inform the family,and others living in the same dwelling place as the patient, of the probable nature of the disease, and shall instruct them in the maintenance of tke SgMo tppe.�; cautions which are prescribed when the diagnosis is positive. D. DEATH OR RECOV3:T?Y FR02i CONT"AGICUS DISEASE TO BE R 2ORTED TO THE HEI^LTH OFFIC ER. 1. When any person ill of any contagious disease recovers or dies, the attending physician shall at once notify the health officer. In the case of the death of the patient, the report shall be made in writing on blanks provided for the purpose. But no per- son shall certify knowingly or negligently that any person has re- covered from any disease aforesaid until such patient is in such condition as to be free from danger of communicating the disease to other persons. SECTION II. QUARANTINE AND ISOLATION. A. QUARANTIidE TO BIS ESTABLISHED IN CERTAIN CASES. 1. Immediately upon receiving notice of the existence of any of the diseases enumerated in Section 1 the health officer shall investigate the same and shall take such measures as hereinafter provided to prevent the spreading of such disease. 2. The health officer shall remove or ca-ase to be -removed any patient affected with scarlet fever, diptheria, smallpox, or epidemic cerebro-spinal meningitis to the city quarantine hospital, or shall establish, or cause to be established, proper quarantine at the dwelling place of the person so affected, provided that house quarantine can be carried out without danger to the general public. 3. The expenses of hospital quarantine shall be borne by the patient when the patient is able to pay them, otherwise the ex- penses shall be borne by the city, 2 4. In cases of house quarantine a warning curd shall be displayed on the front and rear entrances, that anyone coming to either door will be warned of the presence of the disease within. 5. No person who has been in contact with a person having any of the above named diseases, excepting the attending physician or a health officer, shall leave the premises of come in contact with any one other than the patient unless properly disinfected, and per- mitted to do so by the health officer. 6. The members of the family who work out must either (a) board and room at another house, or (b) stop work and stay in the house. 7. The health officer may after personal investigation of the premises wherein a contagious case or cases exist, issue a writ- ten permit to wage earners to enter and leave the premises during the period. of quarantine, providing he finds that s2zch a modification of quarantine will not endanger the public health. Neither this nor any other modification of quarantine will be permitted excepting with the written consent of the health officer, and no modification of quarantine will be allowed in the case of any wage earner who is en- gaged in the prodmetion, sale or manufacture of wearing apparel, bed- ding, foodstu 'fs cillt rs ci ra ® t� or candy. If he is so employed he shall be reclLirod to take a disinfecting bath and put on disinfect- ed elotninr Lnd leave the premises. d. Milkmen must empty milk delivered to infected premises into covered containers placed outside the door of such premises. They must not enter such premises nor remove milk bottles therefrom until the house has been fumigated and the bottles have been steril- ized. If bottles are delivered they must not be taken from the house until the case is terminated and. the bottles have been sterilized. 9. Grocerymen and other persons delivering merchandise are forbidden to enter such premises or remove packages therefrom. 10. Laundrymen are forbidden to enter such premises or to remove any clothing therefrom until such articles have first been boiled or otherwise sterilized. 11. No one shall remove anything from such premises ex- cept by permission of the health officer. No person shall enter any infected portion of such premises, except physicinas and health inspectors, except by per- mission of the health officer. 12. No cat, dog, or other household domestic animal shall be allowed to rnn in and out of the house during the quarantine period . These animals must be either kept inside or tied up outside, or kept away from the premises altogether . If such animals are kept in the house during the quarantine period they must be disinfected before they are allowed to run loose. 13. Representatives of the health department shall visit the premises from time to time as they see fit to observe the efficien- cy of quarantine, and for such purposes shall haire the right of entry at any time. 14. Cases which cannot or do not comply with the above requirements will be taken to the hospital. 15. It shall be the duty of the attending physician to instruct those dwelling in the same house as the pateiAt of the pro- visions of the ordinance and of the meaning of quarantine. 16. The health department shall issue to each family in quarantine a circular setting forth in simple language the rules of quarantine and the rules to be observed in the care of these cases. 17. The period of quarantine will be reckoned from the date on which the case is reported to the health officer, or from the day on which the first symptoms appeared.. Provided, that the attending physician certifies to this fact in writing to the health o fficer. 18. The minimum period of quarantine in cases of scarlet fever shall be 21 days with such additional time as may be necessary for the complete recovery of the case. No case under any circum- stances shall be released until desquamation has absolutely and en- tirely ceased and until all nose and ear discharges have healed. 19. The minimum period of quarantine for cases of diptheria shall be 21 days excepting where two successive negative cultures are made on two successive dAys, when the minimum period shall be 7 days, provided that antitoxin has been used.. 20. The minimum period of quarantine in cases of smallpox shall be 21 days with such additional time as is necessary for the complete recovery of the case. No patient shall be discharged until desquamation has entirely ceased. 21. The minimum period of quarantine for cases of epidemic cerebro-spinal meningitis shall be 14 days with such additional time as is necessary for the complete recovery of the case. B. ISOLA_TI._)N R.1PQUl1-1 D IN CERTAIN CUDTAGIOUS DISE«SES. 1. Patients affected with measles, mumps, whooping cough, chicken pox, or anterior poliomyelitis will be isolated at home, and those living in thie same premises Mvho are not affected with the disease will be permitted to leave the premises to attend to their regular duties, except when such individuals are associated with children away from the quarantined house. Provided further. , that the health officer shall give notice to the public by placing a placard in a conspicuous place on the building as in quarantine. If these regulations are not complied with to the satisfaction of the health officer, the patient and other occupants of the house shall be placed under strict quarantine, as described in Section 11 A of these regulations. 2. The minimum period of isolation in cases of measles shall be 14 days, with such additional time as is necessary for the complete recovery of the case. 3. Cases of whooping cough shall be isolated until parozys- mal cough has entirely ceased. 4. Cases os mumps shall be isolated at least 14 days or until all swelling has subsided. B. Cases of chicken pox sliall be isolated at least 7 days or until the skin is clean grid :.tree from infection. �. Cases of anterior poliomyelitis shall be isolated at least 21 days , or until recovery is complete. SECTION III. DISILTFECTIJN aND FLMIGATIO.JJ. A. H7+4"lYLTH OF','ICER TO TLi I;kATE LUARANTINA AND TSOI,ATION. ,~ 1. Upon receipt of notice from the attending p p g physician of the complete recovery of any peroon af:�eeted with any of t.ie aforesaid diseases, the health o-ficer shall termin&te the quarantine ' w or isolation, provided that the minimum period of quarantine or ._. isolation as set forth in Section II.has elapsed. He shall remove the placard and shall cause the premises to be fumigated End the n patient and attendants to be disinfected in such manner as provided by the board of health. 2. The fumigation of premises shall be done under the supervision of the health department. The expense of fumigation shall be borne by the patient when the patient is able to pay, other- wise the expense shall be borne by the city. The maximum expense of fumigating shall be $5.00 except in the case of public buildings,when the expense shall be determined by the capacity to be fumigated. SECTION-14-, EXCLUSION OF CHILDR EN FROIA SCHOOL. A. Hi+;AI,TH 0FFIC PR TO H�'OR CASE'S OF CONTAGICUS DISj11aSi `:v � ED,, .w SUP ,RIJT.;�IJD„TJT OF SCHOOLS. 1. The health officer shall make reports to the super- intendent of schools, giving the names and. addresses of all contagious cases reported to him in the previous 24 hours. 2. When any child is taken from any school building ill wi-th a contagious disease, the room from which the child was taken shall be fumigated within 12 hours. B. CHILDREN READMITTED TO SCHOOL ►ME111. 1. Children affected ;with any of the following; diseases will be given certificates by the health officer recommending ad- mission to school as follows: Scarlet fever at least 21 days. Dipthbria at least 21 days. Smallpox at least 21 days. Epidemic cerebro-spinal meningitis, when recovery is complete. Ileasles at least 14 days. Chicken pox at least 14 days. Whooping cough upon recovery, Mumps upon recovery. Anterior poliomyelitis at least 21 days. C. 001,11 V�,CTS I �SIDIi1C III T.11L 31U.ZE DIVELs Iid, PLACEI?A:'II+ 11 TO BE EX.CLUDIM FROM SCHOOL. 1. I10 child or other person residing in the sw,le pre?nix es as the patient shall be permitted to attend any public, private, Sunday, or sectarian school, and. teachers of public, and private schools are hereby required to exclude any and all such children from said schools until the expiration of the qaarantine period or the isolation period for the last person in the premises so affected; provided, the person or persons so affected have been properly isolat- ed during the quarantine period. Otherwise the exclusion for con- tacts shall continue for the following periods: Scarlet fever, 7 days. Diptheria, 7 days . Smallpox, 14 days (unless vaccinated) Epidemic cerebrospinal Meningitis, 14 days. Meacles, 7 dvys. Chicken pox, 7 days. Whooping cough, 7 days. Mumps, 7 da;;fs . Anterior poliomyelitis, 14 days. D. CONTACTS RESIDII .;" Ill A DIVELLIIZO PLACE OT ?i+R ".."A T THAT OF 71ME+' PATIET " TO BE it.X({:ZUD�.D FROs.� 33CHOOL. 1. Iny child residing in the same premises where an out- break of any of the contagious diseases enumerat<.d occurs, at the time of the outbreak may be allowed after taking a disinfecting bath and putting on disinfected clothing to remove therefrom and take up his or her residence in other premises occupied exclusively by adults, and , providing the disease has not been contracted r:_t the end of the periods here specified., vtill be given a certificate by the health officer recommending; re-admission to school. Scarlet fever, and diptheria, oach 14 dai-s. Epidemic cerebro-spinal meningitis, 14 day;. Smallpox, 7 days, Measles, 7 da.Js. Chicken pox, 7 days. Whooping cough, 7 days. plumps, 7 da�,7s. Poliomyelitis, 14 days. 6ECTIOIT V. TRAITSP012TATI-11 OF CASES. 1. Infected persons shall not move about or be moved about in the city or expose themselves in such manner as to en- danger the general public. Cares shall be transported only by the conveyance of the health department except by special permi:;sion of the health o '_ficer. Patients transported to the city quarantine hospital in the city carriage may be ficcorlpanied by a nurse or other attendant if there be need of such an attend&-nt, but such attendant shall, before leaving the city quarantine hospital, take a disinfecting bath and put on disinfected clothing and comply with such other rules as are directed by the board of health. SECTION VI. PR1eCAUJION3 "0 BE' TA1'E i BY THOSI. ATTENDING PATIEUTM AFFECTED WITH 001,1iAGIOUS DISEASES. 1. Every person in attendance upon a case of contagious disease shall exercise due precaution to prevent the transmission of the disease. SECTION VII. HI AL1`II BOAI1D TO HAVE POWI�]? :0 ACT. 1. The health officer and the board of health shall h-ave the power to make such ppecial regulations for the prevention and. cen: rol of contagious diseases as they from time to time find necessary. SECTION VIII. PREVIOUS REGULATIONS RRV01M. I. . All ordinances and parts of ordinances ;In conflict herewith are hereby repealed. S7,10 1'ION ,mac PIVALTI ES. 1. Any physician who shall knowingly conceal the ex- i,,tence of any d.ise€ase named in the foregoing ordinance, or o shall fail to report to the City health Olficer any case of any such disease of wjiich he may have knowledge, or who shall in any other manner fail or .refuse to do any of the acts or things re- quired, or who shall do or perform any of the things prohibited , shall., upon conviction, be fined :in any sum not less then $26.00 nor more than $200100. 2. .Any person whomsoever who shall violate any clause, provision, or requirement , duty or regulationz of this chapter or of any rules or regulations of the said health officer, physician or person in charge of any quarantine, or who shall fail or neglect to comply with any such rules, provisions, requirements, duty or orders, or who shall interfere with or in any manner resist any o `fieer or agent of the city in the discharge of his duty as herein contemplated or who shall commit any breach of the peace, or be guilty of any act, or thing calculated to defeat or interrupt the carrying into effwat any part of this ordinance or any regulation of the board of health, shall, upon conviction, be fired in any sum not less than •P5.00 nor more than $200.00. 3. Any parent or guard 4a.n of any minor affected with any disease named. ir, the foregoing ordinance who shall, r,ithout authority from the health officer, knowingly permit or allow an such minor to attend any public school or go into any public pla�a or gather- ing, shall, upon conviction, be fined in any sum not less t1lan $25.00 nor more than $200.00. d` Y ia;"or.