SANITARY LEGISLATION.

STATE LAWS AND REGULATIONS PERTAINING TO PUBLIC HEALTH.

ARKANSAS.

Local Health Officers-Powers and Duties of. (Reg. Bd. of H., May 16, 1913.1)

1. The responsibility of placing quarantine or isolation rests solely with the health officer, who must satisfy himself of the existence of the disease in question before enforcing regulations governing the particular disease.

2. Health officers shall keep a record of all transactions with which they are officially concerned. They shall keep a complete record of all cases of communicable diseases reported within their jurisdiction; said record shall include the name of the disease, name of the patient, age, sex, color, address, and location, probable source of infection, measures taken for the prevention and spread, attending physician and nurse, together with the date quarantine or isolation was ordered, date released, date disinfected, name of person who disinfected the premises, termination of the case whether by death or recovery, and such other information as may seem necessary under a heading of "Remarks."

3. Health officers shall conform to the following rules:

(a) Make an annual sanitary survey and maintain a continuous sanitary supervision over the territory within their jurisdiction.

(b) Make a sanitary inspection at least once annually of all school buildings, places of public assemblage, and report thereon to those responsible for the maintenance of such school buildings and places of public assemblage.

(c) Take such steps as may be necessary to secure prompt and full reports by physicians of communicable diseases, and prompt and full registration of births and deaths.

(d) Enforce within their jurisdiction the provisions of the rules and regulations of the State board of health.

(e) Attend the annual conference of sanitary officers called by the State board of health.

4. Records. They shall keep a complete record regarding the sanitary conditions of:

(a) Slaughterhouses, dairies, butcher shops, bakeshops, restaurants, boarding houses, hotels, rooming houses, bottling works, market places, factories, soda fountains, and all other places where food and drinks are sold.

(b) Schools, jails, almshouses. hospitals, and other public buildings and places of amusement.

(c) Stables, lumber camps, and sawmills.

These regulations were promulgated by the Arkansas State Board of Health under authority of the act of Feb. 25, 1913. (Public Health Reports, May 30, 1913, p. 1107.)

(d) An inspection of all such places shall be made at least once annually and as often as may be deemed necessary.

5. Written notice shall be served on all persons responsible for the conditions found to be unfavorable to the public health and the public comfort, as provided for by regulations governing such places.

6. A reinspection shall be made after three days to see that the changes ordered have been or are being carried out.

7. A summary report giving the number of places of each class inspected and notices served for the correction of public nuisances shall be forwarded to the State health officer on the 5th day of the month for the month preceding. 8. The city health officer, in addition to the duties prescribed for county health officers, shall furnish the State health officer at the end of each month a copy of all new regulations and ordinances which have been adopted for their cities relative to any sanitary measures.

9. City health officers in cities of the first class shall cause an inspection to be made of all public buildings, institutions, and other places mentioned as requiring inspection, to be inspected at least once every two months from November 1 to May 1 and once each month from May 1 to November 1.

10. Health officers should study the causes of excessive morbidity and mor tality from any disease within their jurisdiction and endeavor to enlist the cooperation of all organizations and physicians for the improvement of the public health therein, and promote the information of the general public in all matters pertaining to the public health.

Communicable Diseases-Control of. (Reg. Bd. of H., May 16, 1913.)

11. Notifiable diseases.--For the purposes of these regulations the followingnamed diseases are declared to be contagious, infectious, and communicable and dangerous to the public health, and are made notifiable: Asiatic cholera, acute anterior poliomyelitis, epidemic cerebrospinal meningitis, chicken pox, diphtheria, hookworm disease, leprosy, malaria, measles, ophthalmia neonatorum, pellagra, plague, scarlet fever, smallpox, trachoma, tuberculosis (laryngeal and pulmonary), typhoid fever, typhus fever, whooping cough, yellow fever. Other communicable diseases not named in this list may at any time be declared noti fiable as the necessity and public health demand, and regulations for their control shall apply when so ordered by the State board of health.

12. It shall be the duty of every physician in the State of Arkansas to report, as soon as possible, every case of communicable disease declared notifiable which occurs in his practice, or which he may be called upon to attend, to the local city or county health officer having jurisdiction. When there is no physician in attendance upon any case of communicable disease mentioned it shall be the duty of any person having knowledge of the same, by reason of attendance or upon whose premises a case of such disease is suspected to exist, to make a report as specified.

13. Such report shall be made in writing within 12 hours from the time a case is recognized and discovered, and shall contain the following particulars: Name of the disease; name of patient; age; sex; color; residence or location of patient; source of infection (if ascertainable); probable date of onset; what steps have been taken to prevent spread.

14. If the case be one of yellow fever, Asiatic cholera, bubonic plague, or smallpox, notification shall be made without delay to the local city or county health officer in whose jurisdiction such case occurs, and the health officer so notified shall, except for smallpox, notify by telephone or telegraph the State health officer, and for smallpox by first mail.

15. A weekly report of communicable diseases, giving number of cases, color and sex of each, and deaths, for the period ending Saturday of each week, shall be made by local, city, and county health officers to the State health officer, and where no such diseases have been reported the report shall so state.

16. The State health officer may require special daily reports of new cases and deaths of notifiable diseases occurring each day in any locality. Such report shall be furnished and transmitted by health officers, by mail, telephone, or telegraph, as directed.

17. For uniformity of reports, the manner and form in which permanent records of all reported cases shall be kept by city or county health officers shall conform to the forms required and demanded by the State health officer.

18. Local city or county health officers shall notify the State health officer of any unusual prevalence or epidemic of a disease not mentioned in the list of diseases made notifiable.

19. No person shall interfere with any health authorities having jurisdiction, carry or remove from one building to another, or from one locality to another, within or without the State, any patient affected with a communicable disease dangerous to the public health.

20. Health officers shall satisfy themselves that all preventive measures prescribed in these regulations for control and prevention of spread of infection are being carried out in each and all cases of communicable diseases reported to them.

21. Whenever a health officer shall know or suspect or be informed of the existence of any communicable disease declared notifiable, and no licensed physician is in attendance, or should a physician in attendance fail or refuse to report such case to the health officer, it shall be the duty of said health officer to investigate such case or cases of alleged communicable diseases and act as required, even when doubt exists, under the rules governing such cases of communicable diseases.

22. Where doubt exists as to the diagnosis, the health officer should enforce quarantine measures for the suspected disease as if it were a communicable disease, and refer the matter to the State officer, who will have an investigation made for final decision.

23. Whenever a case of obscure illness shall be reported to the health officer, which upon investigation presents symptoms of a disease subject to quarantine or isolation, but in which, in the judgment of the health officer, sufficient time has not elapsed to render a positive diagnosis of the disease possible, a temporary quarantine or isolation shall be imposed, which quarantine or isolation shall be in all respects governed by the same rules and regulations as a permanent quarantine or isolation. If the disease proves not to be one of a contagious or infectious nature, the health officer shall then declare the temporary quarantine or isolation terminated.

24. Any person reported suffering with a communicable disease residing in a boarding house, lodging house, hotel, or hospital shall be effectively isolated together with all his attendants, and where these regulations are obeyed the public need not fear transmission of the disease to them. The door of the sick room shall be placarded.

25. No quarantine regulations of commerce or travel shall be instituted or operated by any place, city, town, or county against another place or county in this or in any other State except by authority of the State health officer.

26. The State health officer shall impose such quarantine restrictions and regulations upon commerce and travel by railway, common carrier, or any other

means, and upon all individuals as in his judgment may be necessary to prevent the introduction of communicable diseases into the State or from one place to another within the State.

27. Quarantine, isolation, and observation.-The following degrees of control are to be carried out in all cases of communicable diseases declared notifiable: Quarantine, isolation, and observation.

28. Quarantine.-Quarantine is defined to mean and include

(a) Strict isolation of the person sick and of those attendant upon him, in a room screened against flies and mosquitoes.

(b) Absolute prohibition of entrance to or exit from a building of any persons except the attending physician, health authorities, or any person or persons especially authorized by the health authorities.

(c) The following-named diseases shall be placed under quarantine: Plague, cholera, and typhus and yellow fever.

29. Isolation.-Isolation is defined to mean and include

(a) Complete separation of the person sick with the communicable disease and of those attendant upon him, from all other persons on the premises, in a room screened against flies and mosquitoes.

(b) Prohibition of entrance to and exit from a building except against certain members of the family authorized by the health authorities under certain definite restrictions. Persons permitted ingress and egress under this regulation, who do not come in contact with the sick, may go about their occupations, provided they do not bring them in contact with assemblages of children. They must also refrain from visiting places of amusement, worship, or education.

30. Placarding of premises.-On all premises where a case of a communicable disease exists subject to quarantine or isolation, there shall be posted in conspicuous places, both at the back and front of the house or apartment, white placards bearing the name of the disease in large black letters with the following warning: "All persons are by this means notified of the presence of the above-named disease and are warned of the danger of coming in contact with it. It is unlawful to deface, mutilate, cover up, or remove this placard without the authority of the health officer. Penalty: Fine of not less than $10 nor more than $100, or by imprisonment not exceeding one month, or both." The placard shall be not less than 6 inches in width and 10 inches in length. In the case of scarlet fever the color of the placard shall be red; of diphtheria, blue; and of smallpox, yellow. For all other diseases the color shall be white. 31. The following-named diseases shall be placed under isolation: Acute anterior poliomyelitis, chicken pox, epidemic cerebrospinal meningitis, measles, smallpox, diphtheria, scarlet fever, and leprosy. Other restrictions governing this class of diseases shall be carried out according to the regulations laid down for each individual disease.

32. Observation.-Observation is defined to mean and include

(a) Inspection from time to time by the local health officer of a person suffering from a communicable disease not subject to the regulations for isolation or quarantine.

(b) The supplying of information, printed or otherwise, to such persons relative to the measures for the care and prevention of the spread of infection. The health officer shall have such surveillance over such persons deemed necessary to prevent their becoming dangerous to the public health.

33. The following-named diseases shall be placed under observation: Tubercu losis, whooping cough, ophthalmia neonatorum, typhoid and paratyphoid fever, trachoma, malaria, pellagra, and hookworm disease.