(e) Shall permit wage earners to continue their vocations, provided they do not come into personal contact with patients.

(f) Shall use such other measures, consistent with these rules and regulations and the instructions of the State department of health, as may be deemed advisable because of widespread infection or threatened epidemics.

C. D. REG. 23. Methods of isolation of certain diseases.-The local health officer upon receiving a report of a case of any of the diseases designated in this regulation shall promptly institute and maintain control during the period of communicability by the method hereinafter designated:

(a) When the disease is anthrax, cholera (Asiatic), glanders, plague, typhus fever, yellow fever, smallpox, the premises where such disease exists shall be placarded and all occupants and frequenters of the same shall be quarantined. (b) When the disease is diphtheria, scarlet fever, poliomyelitis, cerebrospinal meningitis, smallpox, the apartment or premises where such disease exists shall be placarded and the affected person and attendants shall be isolated.

(c) When the disease is ophthalmia neonatorum, German measles, mumps, measles, pneumonia (lobar and broncho), trachoma, whooping cough, chicken pox, the person affected shall be subjected to restriction of movement, without placard of the room or premises.

When a health officer finds it impossible to maintain proper control of any individual case of communicable disease by the methods designated, he may quarantine and employ guards if necessary, placard or resort to such other measures as are proper for the protection of public health.

C. D. REG. 24. Method of isolation of contacts.-It shall be the duty of the health officer to institute measures for the control of contacts of cerebrospinal meningitis, chicken pox, diphtheria, measles, mumps, poliomyelitis, scarlet fever, smallpox and whooping cough, in the manner prescribed for the disease to which the " contact has been exposed, for a period of time equivalent to the maximum period of incubation of said disease, except where laboratory methods determine the absence of the infectious agent at an earlier date. The health officer may modify the restrictions placed upon contacts when such contacts are known to be immune, or adults who do not come in contact with children or handle food.

C. D. REG. 25. Methods of isolation of "carriers."-" Carriers of the infectious agent of cholera (Asiatic), dysentery, paratyphoid fever, or typhoid fever shall be controlled by isolation or restriction of movement until repeated examination of excretia shows the absence of the infectious agent.

"Carriers" of the infectious agent of diphtheria shall be restricted in their movements until cultures from nose and throat have been taken and show the absence of virulent Klebs-Loeffler bacillus.

"Carriers" of the infectious agent of cerebrospinal meningitis shall be restricted until the specific organism is no longer present in the nasal and mouth discharges.

C. D. REG. 26. Concurrent disinfection.-It shall be the duty of the physician in attendance on any case or suspected case of cerebrospinal meningitis, diphtheria, measles, peumonia (lobar and broncho), scarlet fever, poliomyelitis, septic sore throat, smallpox, whooping cough, typhoid fever, and paratyphoid fever to give detailed information to the nurse or other person in attendance in regard to the disinfection and disposal of the discharges from the nose, mouth, bowels, bladder, and discharges from any lesion which may occur as well as other measures which may be essential to prevent the spread of the

infection. Such instructions should be given on the first visit. The nurse or person in charge shall carry out the disinfection in detail until isolation is terminated by the local health officer.

C. D. REG. 27. Terminal disinfection.-It shall be the duty of the health officer when a case of communicable disease ceases to be infectious or after the death or removal of such case, to institute and have properly executed such terminal disinfection and cleansing as may be necessary as an added precaution, but terminal disinfection should in no case be employed as a substitute for concurrent disinfection.

The use of soap and hot water, sterilization with boiling water or steam, and the use of antiseptic solutions should be employed where practical. Renovation may be required in certain cases. Direct sunlight and fresh air are very valuable.

Fumigation alone should not be depended upon.

C. D. REG. 28. Measures for control in schools.-It shall be the duty of the health officer in the event of an outbreak of communicable disease in any public, private, or parochial school, to make a prompt and thorough investigation and where possible to control such outbreak by individual examination of pupils and teachers and to employ such assistance as may be necessary.

Every child absent from school for five consecutive days, or longer, must on returning to school present to the teacher a signed certificate of a health officer or a practicing physician that such child has not been affected with any infectious or contagious disease.

When any school child has been affected with, or is a "carrier of, a communicable disease, or has been excluded from school because of having been in contact with a communicable disease, it shall be the duty of the parent or guardian of such child to obtain a permit to reenter school from a health officer or practicing physician. This certificate shall be issued only when the incubation period of the disease, or period of communicability of the disease, has passed, or when the organism producing the disease can no longer be demonstrated by laboratory examination.

Children living in the same house, who are not sick, may return to school before the infected child recovers, provided the attending physician or health officer gives a certificate that, to his knowledge, they have had the disease. This applies to chicken pox, measles, mumps, whooping cough, and German measles, but not to scarlet fever or diphtheria.

When scarlet fever or diphtheria is present the other children must remain at home until the sick one is well, except when such children have been removed by permission of the attending physician and the health officer to another house. In such instances, negative cultures of nose and throat of those contacts may be obtained in case of diphtheria, and in scarlet fever an interval of eight days without rise of temperature must be allowed.

Children having pediculosis (lice), scabies (itch), ringworm, or impetigo contagiosa (contagious sores) upon any part of the body shall be excluded from school. On applying for readmission a certificate from the health officer or physician shall be presented to the teacher stating that the disease has been cured and the clothing worn by the child disinfected.

No

Vaccination of school children.-(See 59, art. 43, annotated code). teacher in any of the public schools of this State shall receive into such school as a pupil any person who has not been successfully vaccinated.

C. D. REC. 29. Deviation from the foregoing regulations will be permissible only with the consent of the State department of health.

Communicable Diseases-Cleansing and Disinfection-Destruction of Articles Exposed to Infection-Reports of Deaths from Communicable Diseases. (Ch. 496, Act Apr. 9, 1920.)

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SECTION 1. That section 41 of article 43 of the Annotated Code of Maryland, title Health," subtitle "Infectious diseases," be, and the same is hereby, repealed and reenacted so as to read as follows:

SEC. 41. When any local health officer is of opinion that the cleansing and disinfecting of any house or part thereof and of articles therein would tend to prevent or check infectious diseases, it shall be the duty of such health officer to cause such house or parts thereof and articles to be cleansed and disinfected, and the city, town, or county in which such house is situated shall defray the expenses thereof.

Any local health officer may direct the disinfection or destruction of any bedding, clothing, or other articles which have been exposed to infection from any dangerous infectious disease: Provided, That when any person sustains any damage by reason of the exercise of any of the powers of this section, in relation to any matter as to which he is not himself in default, reasonable compensation shall be made by the municipal or county authorities to such person.

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SEC. 2. That section 42 of article 43 of the Annotated Code of Maryland, title Health." subtitle "Infectious diseases," be, and the same is hereby, repealed, and that a new section, to be known as section 42, be, and the same is hereby, enacted in lieu thereof, the same to read as follows:

SEC. 42. Whenever any physician shall know or have cause to believe that any person whom he has attended during the last illness of such person has died of any infectious disease dangerous to public health, the said physician shall immediately give notice thereof, over his own signature to the health officer of the place where such death occurred, giving the name, age, sex, and race of the person so dying, the place of death and the name of the disease if known; and if no physician was in attendance, then it shall be the duty of the undertakers who have charge of such remains to give notice to the local health office; and any physician or undertaker who shall fail, refuse, or neglect to give such notice shall be fined not less than $10 nor more than $100. Communicable Diseases-Removal to Other Jurisdictions of Infected Persons or Carriers. (Reg. Bd. of H., Apr. 15, 1920.)

C. D. No. 7. No person infected with any dangerous infectious disease as set out in section 64 of article 43 of the Annotated Code of Public General Laws of Maryland or who is a known carrier of such disease shall go to or be removed from one city, town, district, or county, to any other city, town, district, or county without permission of the health officer at the place of removal and at the place of destination, and any such person violating the provisions of this section, or any person or persons assisting in the violation of this section, shall be guilty of a misdemeanor, and upon conviction shall be fined not exceeding $50.

Communicable Diseases-Restriction or Suppression of, by State and Local Health Officers. (Ch. 314, Act Apr. 9, 1920.)

SECTION 1. That section 40 of article 43 of the Annotated Code of Public General Laws of Maryland, title " Health," subtitle "Local boards of health," be and the same is hereby repealed, and reenacted so as to read as follows:

effect, be approved by the attorney general.

*

SEC. 38. If the town votes to have its selectmen the selectmen may appoint an inspector of health, who in the performance of their duties as such board.

Bakeries and Bakery Products-Sanitation and Re May 6, 1920.)

SECTION 1. The word "bakery" is defined, for the building or part of a building wherein is carried on th packing, storing, display, or sale of bread, cakes, pies, including any separate room or rooms used for the co tion of the workers: Provided, That sections 3, 4, 6, 7 retail stores where bakery products are sold but not p

SEC. 2. The standards and requirements hereinafter to such rules and regulations as may be adopted by health, and the provisions of this act and of said rule enforced by said department and by the boards of h and towns, acting under the supervision of said dep the provisions of this act relating to industrial health department of labor and industries in accordance wi tions as it may prescribe.

SEC. 3. Every bakery shall be constructed, drained maintained in a clean and sanitary condition, and w screened against flies, shall have plumbing and dra with suitable washbasins, wash sinks, and toilets or be kept in a clean and sanitary condition. The sai shall be in rooms having no direct connection with a products or ingredients are prepared, stored, handled,

member of the State Board of Health of Maryland. The said member, who shall be not less than 30 years of age, shall be an experienced, certified pharmacist, and shall have been for four years next preceding his appointment, a resident of the State of Maryland. He shall hold office for four years or until his successor has been appointed and qualified: Provided, That the term of office of the first appointee under this act shall expire on the last day of January, 1924.

Town or City Boards of Health-Organization, Powers, and Duties. Town or City Health Officers-Appointment, Powers, and Duties. (Ch. 495, Act Apr. 16, 1920.)

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SECTION 1. That section 35 of article 43 of the Annotated Code of Maryland, title, Health," subtitle, Miscellaneous," be, and the same is hereby, repealed, and that a new section to be known as section 35, in lieu thereof providing for the organization of city boards of health, and the appointment of city health officers in certain cases, and providing for the powers and duties of such boards and officers be, and the same is hereby, enacted so as to read as follows:

SEC. 35. In any incorporated town or city of this State, having a population of 10,000 or more, where no board of health has been created or established by the charter of said town or city, the mayor and city council or other duly authorized legislative body of said town or city may in the discretion of said mayor and city council or other duly authorized body of such incorporated town or city, organize a town or city board of health; such city board of health shall be composed of the mayor of said town or city and two other members, one of whom shall be a physician, and both of whom shall be appointed by the mayor by and with the advice and consent of the council or other legislative body as aforesaid. The qualifications of said two members, other than herein specified, shall be determined by the mayor and council of said town or city; said members shall serve for a term of two years or until their successors are duly appointed and qualified, the terms of the first appointees beginning on the first Monday of May, 1920. A city board of health, organized under the provisions of this law, shall meet at least once in each month; shall adopt, publish, and enforce by appropriate penalties all needful rules and regulations, not inconsistent with law or the regulations of the State board of health, necessary for the protection of public health, to prevent the introduction or spread of disease; to abate insanitary nuisances and shall have supervision and control of all matters relating to public health. The city board of health shall appoint a city health officer whose duty shall be the execution and enforcement of all laws and regulations relating to public health; the collection of reports of deaths, births, and sickness; the abatement of insanitary conditions; and shall perform such other duties as are now or may be hereafter provided by law or the city board of health. Such health officer shall hold for the term of two years from the date of his appointment, unless by reason of his conduct, he is required to vacate his office. The health officer shall be authorized to appoint, with the consent of the city board of health, such assistants as may be necessary for the proper performance of his duties. He shall aid and assist the health authorities in all matters of prevention and suppression of disease, quarantine, inspection, and sanitation within his jurisdiction. The mayor and council or the properly constituted authorities of any city in which a board of health is organized under the provisions of this act is hereby authorized and empowered to levy and collect, as other moneys for said city governmental purposes are collected,