Borough of Bridgeport, PA Communicable and Noncommunicable Diseases

Every physician who treats or examines any person who is suffering from or 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 this Board. 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 the 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 which is classified as a venereal disease shall report the case in the manner prescribed. The report shall state the name and stages 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 mailed in sealed envelopes to the Pennsylvania Department of Health, as required by law.

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 in § 302-9A shall report promptly such findings to the Health Officer, as well as the Pennsylvania Department of Health, as required by law. The report shall state 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.

School nurses shall report to school administrators the presence of a suspected communicable disease in schoolchildren. Any unusual increase in the number of absentees among the schoolchildren shall be reported to the Board.

Reporting by heads of institutions. Superintendents of hospitals or other persons in charge of any institution for the treatment of disease or of any institution maintaining dormitories and living rooms or of an orphanage shall notify the Board 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 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.

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

(7)

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

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.

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 shall report such injury to the Board, in accordance with the provisions of Article X of this chapter.

Noncommunicable diseases. Any person in charge of an institution for the treatment of disease shall be authorized, upon request of the Board, to make a report of such disease and conditions other than communicable diseases for which the 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 report shall be made upon forms prescribed by this Board and shall be transmitted to this Board.

§ 302-11 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 as provided by Subsection B, the Health Officer shall cause the same to be done promptly following receipt of the report.

The isolation of patients or the quarantine of susceptible contacts is required for the following diseases:

Anthrax.

Isolation until lesions are healed.

No quarantine of contacts.

Chancroid.

Isolation at the discretion of the attending physician.

No quarantine of contacts.

Chicken pox.

Isolation for seven days.

No quarantine of contacts.

Cholera.

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

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

Diarrhea of the newborn, epidemic.

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

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

Diphtheria.

Isolation until cultures from nose and throat taken on two occasions not less than 24 hours apart fail to show diphtheria bacilli. Local or general application of antibiotic or chemotherapeutic agents invalidates the usefulness of bacteriological examinations. Where termination of isolation by culture is impractical, isolation may end with fair safety 14 days after onset. Where practical, 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.

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

(7)

Dysentery, amoebic.

No isolation. Exclusion of patient from food preparation, processing, handling and serving. Release from supervision is to be 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.

No quarantine of contacts.

(8)

Dysentery, bacillary.

Isolation in flyproof 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. Rigid personal precautions by attendants.

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

(9)

German measles (rubella).

Isolation until rash has disappeared.

No quarantine of contacts.

(10)

Gonococcal urethritis (gonorrhea).

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

No quarantine of contacts.

(11)

Gonococcal vulvovaginitis in children.

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

No quarantine of contacts.

(12)

Opthalmia neonatorum.

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

No quarantine of contacts.

(13)

Gonococcal conjuctivitis.

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

No quarantine of contacts.

(14)

Granuloma inguinale.

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

No quarantine of contacts.

(15)

Hepatitis, infectious.

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

No quarantine of contacts.

(16)

Measles.

Isolation: Restriction to own premises for six days after the appearance of rash.

No quarantine of contacts.

(17)

Meningococcal infections.

Isolation until recovery from acute illness.

Quarantine: Surveillance at the discretion of the Health Officer.

(18)

Mumps.

Isolation until swelling can no longer be seen or felt.

No quarantine of contacts.

(19)

Plague.

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

Quarantine:

Contacts of bubonic plague, disinfection with insecticide powder, such as 5% to 10% DDT in talc or pyrophyllite, and surveillance for six days.

Contacts of pneumonic plague, quarantine for six days with close surveillance for developing illness; dust with insecticide powder.

(20)

Poliomyelitis.

Isolation for one week from day of onset or for the duration of the fever, if longer.

Quarantine at the discretion of the Health Officer.

(21)

Psittacosis.

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

Quarantine:

No quarantine for household contacts.

Environment quarantine: Buildings having housed birds should not be used by human beings until thoroughly cleansed and disinfected.

(22)

Rabies.

Isolation through duration of illness; immediate attendants should be warned of the hazard of inoculation through saliva of the patient.

No quarantine of contacts.

(23)

Relapsing fever, louse-borne.

Isolation not required after proper chemical delousing of patient, clothing and bedroom, and of patient's household contacts.

Quarantine: Exposed lousy susceptibles are quarantined for 15 days or may be released after application of insecticide with residual effect; for example, DDT.

(24)

Salmonellosis (cases, carriers or asymptomatic). includes paratyphoid fever A.S. paratyphi A, paratyphoid fever B.S. paratyphi B, paratyphoid fever C.S. hirschfeldii.

Isolation in flyproof room until recovery or death of patient.

Quarantine: A household contact who is a food handler shall be excluded from work until at least 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. All household contacts shall be under surveillance until 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 a chemotherapeutic drug effective against the etiologic organism.

(25)

Smallpox (variola).

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

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 shall be promptly vaccinated or revaccinated or quarantined for 16 days from last exposure. If such contacts are considered immune by reasons of prior attack or a 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, they shall be kept under surveillance until 16 days have passed since last contact. Any rise of temperature during surveillance calls for prompt isolation until smallpox can be excluded.

(26)

Streptococcal infections, hemolytic (sore throat with or without rash).

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.

No quarantine for household contacts, 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, however, 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.

(27)

Streptococcal puerperal fever (puerperal septicemia).

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

No quarantine of contacts.

(28)

Erysipelas.

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.

No quarantine of contacts.

(29)

Syphilis.

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

Quarantine may be established at discretion of the Health Officer.

(30)

Trachoma.

Isolation: Children shall be excluded from school if active lesions exist and adequate preventive measures are practical.

(31)

Tuberculosis.

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.

[3]

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 designated 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.

Quarantine or commitment may be established at the discretion of Health Officer in accordance with provisions of Article IV of this chapter.

Contacts in themselves shall not be considered as public health problems unless proven by examination to be active infectious cases of tuberculosis.

All household contacts and other intimate contacts shall be required under these regulations to have a tuberculin test or chest X-ray, or both, 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.

(32)

Typhoid fever.

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

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 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. All household contacts shall be under surveillance until at least three consecutive negative reports on specimens of feces and urine are 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.

(33)

Typhus fever.

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

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

(34)

Whooping cough.

Isolation: Restriction of the patient to his own premises and separation of the patient from susceptible children for a period of four weeks after onset.

No quarantine.

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 disease may be treated in any hospital, provided that the patient is isolated in a proper private room, 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 related to isolation for a specific disease which the patient experienced, as described in Subsection B, 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 that the requirements in Subsection G of this section are observed.

Nurses and attendants caring for patients with communicable diseases, 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 quarantine.

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

Conditions under which patients subject to isolation or quarantine may be removed or transported are as follows:

A person under isolation or quarantine may be removed to another dwelling or a 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 under 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 a release from isolation or quarantine when he is satisfied that compliance with the provisions of Article IV of this chapter has been mot.

Control of communicable disease in schoolchildren:

The duration of the period of exclusion from 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.

(c)

Measles, six days from onset of rash.

(d)

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

(e)

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

(f)

Whooping cough, four weeks from onset.

Readmission to school after specified diseases: Teachers and others in charge of public, private, parochial or other schools or colleges shall not readmit, before the expiration of the exclusion period as stated in Subsection I(1), any person who has been absent because of an illness from chicken pox, German measles, measles, mumps, respiratory streptococcal infection and scarlet fever and whooping cough. In the 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 the regulations for respiratory streptococcal infection have been fulfilled.

Exclusion from school of pupils showing symptoms of a communicable disease: Every teacher, 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 having soreness of the throat, 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 been suspected of having 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 at 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.

School attendance by pupils with infectious conditions or acute contagious conjunctivitis prohibited: No person suffering from acute contagious conjunctivitis, 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 exclusion to continue until the case has recovered, provided that any person suffering from ringworm of the scalp caused by microsporon audouini shall be readmitted to school if such person is under treatment.

Readmission to school of pupils recovered from infectious conditions or acute contagious conjunctivitis: No person who has been excluded or has been absent from any school by reason of having or being suspected of having had acute contagious conjunctivitis, 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 of 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.

§ 302-12 Examinations for venereal disease.

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 this Board.

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.

Persons refusing to submit to treatment for venereal diseases, tuberculosis or other communicable disease:

If the Health Officer finds that any person who is infected with venereal disease, tuberculosis or other communicable disease in a communicable state refuses to submit to treatment approved by the Board, the Health Officer may cause the person to be isolated in an appropriate institution designated by the Board for safekeeping and treatment until the disease has been rendered noncommunicable.

The Health Officer may file a petition in the Court of Common Pleas of Montgomery County to commit such person to an appropriate institution designated by this Board for safekeeping and treatment until such time as the disease has been rendered noncommunicable.

§ 302-13 Additional public health provisions.

Psittacosis and importation of live wild rabbits, hares or rodents:

All dealers who 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 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 where the case of human or avian psittacosis is found 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. When such quarantine is not able to 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 the Board for such purpose.

(7)

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. A permit will be issued upon request, provided the source of such animal or animals is submitted and such source is known to be free of infection. The permit shall accompany such animal or animals whenever brought into the Commonwealth of Pennsylvania. 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 on the permit, such animal or animals shall be immediately seized and destroyed and the means of conveyance disinfected at the owner's expense.

Gift, sale or other disposition of bedding and other articles exposed to infection: No person shall give, lend, sell, transmit, expose or otherwise dispose of, without previous disinfection and a certificate from the Health Officer attesting to such disinfection, any bedding, clothing, rags or other articles which have been exposed to infection from tuberculosis, bubonic plague, scarlet fever, hemolytic streptococcal sore throat, smallpox (variola, varioloid) or anthrax, but these restrictions will not apply to the transmission of such articles with proper precaution and permission of the Health Officer for the purpose of having them disinfected.

Lease of premises previously occupied by tuberculous person: No person shall let any room, house or part of a house in which there has been a person suffering from tuberculosis without having such room, house or part of house and all articles therein previously disinfected to the satisfaction of the Health Officer. The keeping of a hotel, boardinghouse or apartment house shall be deemed as letting part of a house to any person who shall be admitted as a guest in such hotel, boardinghouse or apartment house.

Burial.

Preparation for burial of bodies dead from certain diseases: In the preparation for burial of the body of any person who has died of anthrax, plague, cholera, diphtheria, poliomyelitis, scarlet fever, hemolytic streptococcal sore throat, smallpox, paratyphoid fever or other Salmonella infections, typhoid fever or bacillary or amoebic dysentery, it shall be the duty of the undertaker or person acting as such to disinfect thoroughly by arterial and cavity injection with an approved disinfectant fluid, to wash the surface of the body with an efficient germicidal solution and to plug effectively the body orifices.