NEBRASKA.

Communicable Diseases-Notification of Cases-Quarantine-Isolation-Placarding-Observation of Certain Persons Possibly Infected-DisinfectionCarriers-Smallpox Vaccination-Control Measures for Specific DiseasesBurial-Libraries. (Reg. Bd. of H., July 12, 1918.)

REPORTING DISEASE.

COUNTY BOARDS OF HEALTH. It shall be the duty of the county board of health, through its secretary, to report to the State department of health, on cards furnished by the Siate department of health for this purpose, which cards will be furnished upon application, all cases of chicken pox, smallpox, diphtheria, septic sore throat, scarlet fever cerebrospinal meningitis, typhoid fever, pulmonary tuberculosis, and poliomyeì tis, giving at least the name of the disease, the age, sex, and color of the individual, and the source of contagion. For rubella, measles, mumps, and whooping cough, it shall be the duty of the county board of health, through its secretary, to report to the State department of health the approximate gross number of cases. Gonorrhea and syphilis are to be reported by number.

How often to report.-Upon the outbreak of any communicable disease enumerated above, it shall be the duty of the county board of health, through its secretary, to immediately report to the State department of health, and at least once a week thereafter. In the event of no communicable disease existing in the territory under its jurisdiction, it shall be the duty of the county board of health, through its secretary, to report to the State department of health at least once a month, on "no contagious disease" card, furnished by the State department of health, upon application thereto.

In the absence of a physician.-Should anyone have a disease, presumably communicable, and not call a physician, it shall be his or her duty or the duty of the head of the house, or guardian, to report to the county board of health immediately, if within its jurisdiction. If no county board of health, report direct to the State department of health. When a physician is in attendance it shall be his duty to report the disease.

CITY OR VILLAGE BOARDS OF HEALTH. It shall be the duty of the city or village board of health, through its secretary, to report to the State department of health, on cards furnished by the State department of health for this purpose, which cards will be furnished upon application, all cases of chickenpox, smallpox, diphtheria, septic sore throat, scarlet fever, cerebrospinal meningitis, typhoid fever, pulmonary tuberculosis, and poliomyelitis, giving at least the name of the disease, the age, sex, and color of the individual, and the source of contagion.

For rubella, measles, mumps, and whooping cough, it shall be the duty of the city or village board of health, through its secretary, to report to the State department of health the approximate gross number of cases. Gonorrhea and syphilis are to be reported by number.

How often to report.-Upon the outbreak of any communicable disease enumerated above, it shall be the duty of the city or village board of health, through its secretary, to immediately report to the State department of health,

and at least once a week thereafter. In the event of no communicable disease existing in the territory under its jurisdiction it shall be the duty of the city or village board of health, through its secretary, to report to the State department of health, at least once a month, on "no contagious disease" card, furnished by the State department of health, upon application thereto.

In the absence of a physician.-Should anyone have a disease, presumably communicable, and not call a physician, it shall be his or her duty or the duty of the head of the house, or guardian, to report to the city or village board of health immediately. If no city or village board of health, report directly to the State department of health. When a physician is in attendance, It shall be his duty to report the disease.

REPORTING COMMUNICABLE DISEASES BY PHYSICIAN. It shall be the duty of every physician called to attend a case of communicable disease, to report within 24 hours on cards sent out by the State department of health for this purpose, which cards will be sent on application to the State department of health, to the county or the city or village board of health in which jurisdiction the case may be, or if no county or city or village board of health, directly to the State department of health.

Cases of chicken pox, smallpox, diphtheria, septic sore throat, scarlet fever, typhoid fever, pulmonary tuberculosis, cerebrospinal meningitis, and poliomyelitis shall be reported immediately, giving at least the name of the disease, age, sex, and color of the patient, and the source of the contagion.

For rubella, measles, mumps, and whooping cough, it will be necessary to report to the county or city or village board of health, the individual cases, which can be done by telephone, but for the purpose of enabling these boards to report to the State department of health, the approximate gross number of cases will answer.

Gonorrhea and syphilis are to be reported by number.

Cases occurring outside of the corporate limits of a city or village shall be reported to the county board of health; those occurring within the corporate limits of a city or village shall be reported to the city or village board of health.

REPORTING CASES IN WHICH NO PHYSICIAN IS IN ATTENDANCE. Whenever a case or disease, presumably communicable, exists where no physician is in attendance, it is the duty of the head of the house or institution to immediately notify the county board of health, if within its jurisdicion, or the city or village board of health, if within its jurisdiction. If no county or city or village board of health, they are to notify the State department of health directly. This notification must be sent immediately upon the discovery of the disease that is presumably communicable. Those cases occurring outside of a city or village must be reported to the county board of health, and those occurring within the corporate limits of a city or village, to the city or vil lage board of health.

REPORTING CASES OF DISEASE, PRESUMABLY COMMUNICABLE, IN SCHOOLS. See rules and regulations, section "Schools."

REPORTING DISEASES ON RAILROAD TRAINS AND OTHER PUBLIC CONVEYANCES. Whenever a disease, presumably communicable, exists on a railroad train, it shall be the duty of the conductor to notify the county or city or village board of health in which jurisdiction the patient will be when leaving the train, and in the absence of a county or city or village board of health, to notify the State department of health direct. The patient must not be turned loose on any community. If no county or city or village board of health, the patient

shall be turned over to the sheriff, if in the county outside of a city or village, and to the chief of police or the marshal, if in a city or village.

Immediately upon the discovery of a communicable disease, other persons in the conveyance must be taken out, and no others besides the physician or nurse permitted to enter. It is further provided that the patient can only be turned over to the health authorities in the community in which he usually resides, unless it be agreeable to the local authorities to accept the patient.

If the disease existed before the individual entered the conveyance, he must be returned to the point at which he entered, and in returning, must not be brought in contact with any individual or individuals excepting the attending physician, if one be necessary, or the nurse in charge. For this purpose, it is recommended that the baggage car be used, and terminal disinfection, or terminal disinfection and fumigation, as the case may be (see rules and regulations, section “Communicable diseases"), employed when the patient leaves

car.

REPORTING CASES OF COMMUNICABLE DISEASE IN HOTELS, BOARDING AND LODGING HOUSES. Whenever a disease exists that is presumably communicable, and no physician is in attendance, it shall be the duty of the proprietor, keeper, manager, superintendent, or head of the place, to notify the county or city or village board of health within which jurisdiction it is, or, if no county or city or village board of health, to notify the State department of health direct.

REPORTING CASES OF DISEASE, PRESUMABLY COMMUNICABLE, IN CAMPS. Whenever a disease, presumably communicable, exists in a camp where no physician is in attendance, it shall be the duty of the person in charge of the camp, og in his absence, whoever has been left in charge, to notify the county or city or village board of health within which jurisdiction it exists, and if no county or city or village board of health, notify the State department of health direct. REPORTING CASES OF DISEASE, PRESUMABLY COMMUNICABLE, ON DAIRY FARMS. Whenever a disease exists that is presumably communicable on a dairy farm where no physician is in attendance, it shall be the duty of the owner, or, in his absence, the person in charge of any farm where dairy products, milk, cream, butter, cheese, or other food products likely to be consumed raw are produced, to report to the county or city or village board of health within which jurisdiction it is, and if no county or city or village board of health, to notify the State department of health direct.

REPORTING CASES OF DISEASE, PRESUMABLY COMMUNICABLE, IN PUBLIC GATHERINGS. Whenever there exists a disease, presumably communicable, in a public gathering in which no physician is in attendance, it shall be the duty of the person in charge, or one of his assistants, to immediately notify the county or city or village board of health within which jurisdiction it exists, and if no county or city or village board of health, to notify the State department of health direct. It shall be the duty of the one in charge, or in his absence, whoever has been left in charge, to see that the case is turned over to the proper authorities.

DUTY OF EVERY PERSON TO REPORT DISEASES PRESUMABLY COMMUNICABLE. Whenever a disease exists that is presumably communicable, where no physician is in attendance, that has not been reported, or there is reason to believe it has not been reported, it shall be the duty of any and every person having knowledge of same, to report to the county or city or village board of health within which jurisdiction it is, or, if no county or city or village board of health, to notify the State department of health direct.

QUARANTINE.

The word "premises " used herein shall include all dwellings, hotels, rooming and lodging houses, and all other places where quarantine is established.

WHAT TO QUARANTINE. Whenever a communicable disease that is quarantinable exists in a premises, the entire building is to be placed under quarantine except that when a communicable disease that is quarantinable exists in an apartment house where each apartment has a separate exit, quarantine applies to the single apartment: Provided, That if those in other apartments in the building are not obeying the quarantine, the entire building shall then be placed under quarantine.

FOR WHAT DISEASES. meningitis, poliomyelitis.

Smallpox, diphtheria, scarlet fever, cerebrospinal

WHEN TO ESTABLISH. Immediately upon notice, by telephone or otherwise, that a communicable disease exists that should be quarantined.

WHO TO QUARANTINE. Those suffering with a quarantinable disease, or those who have been in contact.

WHO ARE CONTACTS. Those who have been in association with a quarantinable disease, or those who violate quarantine by entering premises under quarantine, or those who, in violation of quarantine, get within 30 feet of the persons or premises under quarantine: Provided, That when a communicable disease exists in a schoolroom, public hall, railway coach, or other public conveyance, or on the streets, those who unavoidably come in association are not to be considered as contacts: Provided further, That the disease is not smallpox. For the above conditions as relating to smallpox, see section "Communicable diseases," under heading "Smallpox."

HOW TO QUARANTINE. 1. The attending physician is to notify the family that there exists within their premises a quarantinable disease, and that the premises are in quarantine, and that no person be permitted to enter excepting the attending physician and nurse, and that no one be permitted to leave except the atteding physician; that the family must keep upon the premises, and send no articles away.

2. If the county or the city or village board of health care to or deem it necessary, a notice such as the following is recommended:

To--

QUARANTINE NOTICE.

and members of family and employees:

It having come to the knowledge of the board of health of Nebr., that individuals residing in your premises have been in contact or suffering (specify w ich) with each of you must keep upon the premis under quarantine, and permit no person except the attending physician or nurse to come within 30 feet of your premises or persons, and must send no articles away. This is by order of the board of health of

-------、 Nebr.
(Member of board of health.)

However, it is not necessary to serve this notice for the premises and the people therein to be quarantined.

3. Place upon the most conspicuous place on the premises a cloth or card not less than 12 inches square, having thereon in large letters the word “Quntantine"; under this, the name of the disease or diseases, and under this, "No one shall be permitted to enter or leave these premises."

WHO QUARANTINES. The board of health, under whose jurisdiction It is, is primarily responsible for establishing, maintaining, and enforcing the quarantine. However, if agreeable to the county or city or village board of health,

the attending physician may quarantine. If the disease is smallpox the physician and nurse must have been vaccinated in the past six years or have had the disease.

The one discovering the disease must inform the people residing within the premises that same will be reported to the board of health, and that formal quarantine will be established as soon as possible. Those residing within the premises are in quarantine as soon as informed.

WHO PAYS FOR QUARANTINE. The county or city or village within the jurisdiction of which the disease may be is responsible for this expense, but not to the extent of compensating those under quarantine for time lost or for support: Provided, That when the authorities compel a person to go to a pesthouse or other place for the purpose of segregation and treatment the person can not be subjected to the expense of care and treatment.

(This does not mean that a physician discovering a case of communicable disease on a regular trip is to receive extra pay for establishing quarantine.) HOW TO GET PROVISIONS AND OTHER NECESSITIES TO THOSE UNDER QUARANTINE. These articles can be left in a basket, box, or similar container: Provided, That the party leaving the articles does not get within 30 feet of the person or premises under quarantine. The party leaving the articles must not delay his departure.

HOW LONG SHOULD QUARANTINE EXIST. See section " Communicable diseases," under specific disease in question.

HOW CAN PEOPLE BE QUARANTINED OUT. When the head of the family or breadwinner desires to be quarantined out and he or she will render to the general public as much protection as possible, the county or city or village board of health is to be notified, and they can either visit the case or deputize the attending physician, and if there is no attending physician, it shall be the duty of the board of health or the health officer representing them to visit the case. The person desiring out is to be given an antiseptic bath, put on clothing that has been properly disinfected, and turned out: Provided, That if the disease is smallpox no one can be quarantined out unless they can prove they have had smallpox or have been vaccinated in the past six years. When anyone has been quarantined out they must stay out, and should they return they are not only to be quarantined in, but charges must be preferred for violating the quarantine: Provided, That the board of health within which jurisdiction the disease exists has the right to permit those quarantined out to enter the house upon the presentation to the board of sufficient reason therefor, but when once in they must stay in.

HOW SHOULD QUARANTINE BE RELEASED. The attending physician, or if no physician, the head of the house shall notify the board of health in which jurisdiction the quarantine exists, that the premises are now ready to be released. This can be done by telephone or in writing. The board of health is primarily responsible for the releasing in good condition and should be entirely convinced that the premises are ready to be released. The county or city or village board of health may use its discretion to leave this to the attending physician to decide. In no case is it permissible to release any premises from quarantine when such release will minimize the rules and regulations of the State department of health regarding length of time quarantine is to be established.

How CAN PREMISES BE RELEASED FROM QUARANTINE. If the patient and those in contact can be transferred to other premises without exposing anyone by being so transferred, the premises can be disinfected and quarantine raised: Provided, That no quarantinable disease is to be transferred from the premises in which it exists to other premises without written permission