FEDERAL SECURITY AGENCY 
UNITED STATES PUBLIC HEALTH SERVICE 
QUARANTINE LAWS AND REGULATIONS 
OF THE UNITED STATES 
AND 
INTERNATIONAL TREATIES 
APPLICABLE TO INTERNATIONAL 
AERIAL NAVIGATION FEDERAL SECURITY AGENCY 
UNITED STATES PUBLIC HEALTH SERVICE 
QUARANTINE LAWS AND REGULATIONS 
OF THE UNITED STATES 
AND 
INTERNATIONAL TREATIES 
APPLICABLE TO INTERNATIONAL 
AERIAL NAVIGATION 
UNITED STATES 
GOVERNMENT PRINTING OFFICE 
WASHINGTON : 1942 Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE 
Washington 
April 2S, 1943. 
To Medical Officers of the Public Health Service, Aircraft Operators, 
and others concerned: 
The following manual of aircraft quarantine procedure is issued 
for the guidance of quarantine officers, aircraft operators, and others 
concerned. 
Thomas Parran, 
Surgeon General. 
Thomas Parran, 
Surgeon General. 
IT CONTENTS 
iv 
Regulations for the application to civil air navigation of the laws and 
regulations relating to public health, January 1, 1942 (Code of Federal 
Regulations, Title 42, sections 11.501-11.516) 1 
Quarantine treatment of military aircraft, Foreign Quarantine Division 
Circular No. 71 9 
Disinsectization of commercial aircraft, Foreign Quarantine Division Cir- 
cular No. 77 10 
Quarantine and immigration medical inspection of passengers and crew 
of aircraft ; 11 
Forms used in international aerial quarantine: 
Aircraft Quarantine Declaration 16 
Certificate of Origin of Passengers 18 
International Certificate of Vaccination 20 
Notice to Passengers Arriving by Aircraft 20 
Letter requesting Surveillance of Traveler 21 
Inspection and disinsectization of aircraft 22 
Abstract of the International Sanitary Convention for Aerial Navigation, 25 
Pan American Sanitary Code 36 
Page 
XIX FOREWORD 
In the accompanying publication an effort has been made to pre- 
sent in concise and simple form, for the use of quarantine officers, air- 
ways, personnel, and others concerned, regulations and pertinent 
information relative to quarantine measures applicable to aerial 
navigation. 
The fundamental principles of aircraft quarantine are in all essen- 
tials comparable to those governing maritime quarantine, except for 
the added health hazard which air transport has introduced by 
bringing persons in before the incubation period of diseases to which 
they may have been exposed has elapsed. As the speed and volume 
of air travel increase, it is obvious that increased vigilance on the 
part of quarantine officers becomes necessary for the protection of 
infectible ports and areas in the United States. 
Chief among the quarantine problems incident to air commerce 
with foreign areas is the danger of the importation of cases of yel- 
low fever and of pernicious forms of malaria, as well as other com- 
municable diseases which may still be in the incubation stage upon 
the arrival of the traveler at a United States airport of entry. 
Coupled with this is the requirement that insect vectors which may 
be conveyed by aircraft must be excluded. 
Careful medical inspection, supplemented by sanitary surveillance 
of persons arriving by air from infected foreign areas until the 
incubation period of the suspected diseases has passed, serves to 
limit the danger of introducing quarantinable diseases into the United 
States and to forestall the local development of these diseases in 
epidemic form. 
Disinsectization of aircraft has become an exact and effective pro- 
cedure which, if faithfully applied, will, for all practical purposes, 
exclude Aedes aegypti and Anopheles gambiae mosquitoes, thus elimi- 
nating two of the most serious disease threats associated with air 
transport. 
;iv: AIRCRAFT QUARANTINE REGULATIONS 
FEDERAL SECURITY AGENCY 
PUBLIC HEALTH SERVICE 
TITLE 42—PUBLIC HEALTH 
Part 11—Foreign Quarantine 
REGULATIONS FOR THE APPLICATION TO CIVIL AIR NAVIGATION OF THE LAWS AND 
REGULATIONS RELATING TO PUBLIC HEALTH* 
The Federal Security Administrator prescribes the following 
regulations for the application to civil air navigation of the laws 
and regulations relating to public health which shall be effective on 
and after January 1, 1942. 
Part 11—Foreign Quarantine 
11.501 Regulation and supervision. 
11.502 Scope and definitions. 
11.503 Landing requirements. 
11.504 Entry and clearance. 
11.505 Entry of aircraft of scheduled airlines. 
11.506 Clearance of aircraft of scheduled airlines. 
11.507 Documents. 
11.508 Documents for entry. 
11.509 Documents for clearance. 
11.510 Omission of lists of aliens employed on board aircraft 
11.511 Residue cargo ; customs. 
11.512 General provisions; customs. 
11.513 Public health requirements. 
11.514 General provisions; entry and clearance. 
11.515 Penalties. 
11.516 Airports of entry. 
11.501 Regulation and Supervision.—The following regulations 
(11.501 to 11.516, inclusive) are prescribed by * * * the Federal 
Security Administrator under the Air Commerce Act of 1926, as 
amended, sections 7 (b), 9 (b), and 11 (b) and (c) [49 U. S. C. 177 
(b), 179 (b), 181 (b) and (c)]; Reorganization Plan No. 1 of the 
President, sections 201 (a) and 205 (b) [4 F. R. 2727, 2728]. 
‘These regulations, which relate directly to the public health aspects of air commerce, 
were abstracted from “Joint regulations of the Secretary of the Treasury, the Federal 
Security Administrator, the Secretary of Commerce, and the Attorney General with respect 
to civil air navigation.’’ The full text of the combined regulations will be found in the 
Federal Register of September 8, 1941, and in subsequent amendments. 2 
11.502 Scope and definitions.—For the purposes of the regula- 
tions contained in this part: 
(a) Every paragraph and clause relates to customs, public 
health, entry, clearance, and immigration, except where it applies 
only to certain of these matters, which is shown by headnote or 
context. 
(b) The term “United States” when used in a geographical sense 
means the territory comprising the several States, Territories, 
possessions, and the District of Columbia, including the territorial 
waters thereof and the overlying airspace, but shall not include the 
Canal Zone. 
(c) The term “area” shall mean any one of the following parts 
of the United States: 
1. The Mainland. 
2. Alaska, but to be regarded as part of the Mainland for immigration 
purposes. 
3. Hawaii. 
4. Puerto Rico. 
5. Virgin Islands, an area for the purpose of the immigration laws except as 
provided in further immigration regulations specifically mentioning those 
islands in 8 CFR Part 116, but shall be regarded as foreign territory for other 
purposes. 
6. Such area as shall hereafter be specified to include possessions of the 
United States not mentioned herein. 
The regulations in this part shall not be applicable to the Philip- 
pine Islands, the Islands of Guam, Midway, American Samoa, Wake, 
Kingman Reef, and other insular possessions not specified herein, 
nor to the Virgin Islands except as specified in subparagraph (5) of 
this paragraph until notice supplementary hereto is given. 
(d) The term “aircraft” means civil aircraft, i. e., any aircraft 
not used exclusively in the governmental service of the United 
States or a foreign country, but includes any government-owned 
aircraft engaged in carrying persons or property for commercial 
purposes. 
(e) The term “aircraft commander” means the person serving on 
the aircraft having charge or command of its operation and 
navigation, 
(f) The term “scheduled airline” means any individual, partner- 
ship, corporation, or association engaged in air transportation upon 
regular schedules to, over, or away from the United States or from 
area to area and holding a Foreign Air Carrier Permit or a Certifi- 
cate of Public Convenience and Necessity issued pursuant to the Civil 
Aeronautics Act of 1938. 
(g) The term “airport of entry” means any airport designated 
* * * by the Federal Security Administrator as a place for quar- 
antine inspection. 3 
(h) The term “airman” means any individual (including the per- 
son in command and any pilot, mechanic, or other member of the crew) 
who engages in the navigation of aircraft while under way and any 
individual who is in charge of the inspection, overhauling, or repairing 
of aircraft. 
11.503. Landing requirements.— (a) Place of landing.—Every air- 
craft coming into any area from any place outside thereof shall land 
in such area unless exempted from this requirement by the Adminis- 
trator of Civil Aeronautics, Washington, D. C. The first landing 
shall be at an airport of entry, unless permission to land elsewhere 
than at an airport of entry is first granted by the Commissioner of 
Customs, Washington, D. C., who upon granting such permission 
shall immediately notify the Surgeon General, Public Health Service, 
* * * and any other agency affected thereby. In cases where 
such permission is given, the owner, operator, or person in charge of 
the aircraft shall pay the additional expenses, if any, incurred in 
inspecting the aircraft, passengers, employees, merchandise, and bag- 
gage carried therein. When such admission is granted to a scheduled 
airline to land aircraft operating on a schedule, no inspection charge 
shall be made except for overtime service performed by customs offi- 
cers, and if the aircraft arrives substantially in accordance with sched- 
ules on file with the immigration authorities, no inspection charge 
shall be made for overtime service by immigration officers. 
(b) Advance notice of arrival.—No aircraft coming into any area 
from any place outside thereof may land in such area unless notice of 
the intended flight has been furnished to the collector or deputy col- 
lector of customs at the airport of entry at or nearest the intended 
place of first landing in such area; nor unless the same notice has 
been furnished to the quarantine and the immigration officers in 
charge at or nearest such place. Such notice shall specify the type 
of aircraft, the registration marks thereon, the name of the aircraft 
commander, the place of last departure, the airport of entry, or other 
place at which landing has been authorized, number of alien passen- 
gers, number of citizen passengers, and the estimated time of arrival; 
and shall be sent so as to be received in sufficient time to enable the offi- 
cers designated to inspect the aircraft to reach the airport of entry or 
such other place of first landing prior to the arrival of the aircraft. 
Such advance notice will not be required in the case of aircraft of a 
scheduled airline arriving in accordance with the regular schedule 
filed with the collector of customs for the district in which the place 
of first landing in the area is situated and also with the immigration 
officer in charge for such place. 
(c) Permission to discharge or depart.—No aircraft arriving in the 
United States from any place outside thereof, or in an area from 4 
another area carrying residue foreign cargo (cargo destined to a port 
in the United States other than the first port of entry) shall, without 
receiving permission from the quarantine and the customs officers in 
charge, depart from the place of landing, or discharge any merchan- 
dise, passengers, or baggage ; and no aircraft arriving in the United 
States from any place outside thereof or in an area from another area 
except directly from the Mainland shall discharge any passenger or 
employee without permission from the immigration officer in charge. 
(d) Emergency or forced landing.—Should any aircraft coming 
into the United States from any place outside thereof, or into any area 
from any other area, make a forced landing in the United States, the 
aircraft commander or operator shall not allow any merchandise or 
baggage to be removed from the landing place without permission 
from a customs officer, nor allow any passenger or person employed 
thereon to depart from such landing place without permission of the 
quarantine and immigration officers, unless such removal or departure 
is necessary for purposes of safety or the preservation of life or prop- 
erty, As soon as practicable, the aircraft commander, or a member of 
the crew in charge, or the owner of the aircraft, shall communicate 
with the customs officer at the intended place of first landing or at the 
nearest airport of entry or other customs port of entry in that area 
and also with the nearest quarantine officer and immigration officer and 
make a full report of the circumstances of the flight and of the emer- 
gency or forced landing. * * * 
11.504 Entry and clearance.—tThese are functions of the United 
States Customs and have no bearing on quarantine.] 
11.505 Entry of aircraft of scheduled airlines.—[Regulated by 
the United States Customs and has no bearing on quarantine.] 
11.506 Clearance of aircraft of scheduled airlines.—[Regulated 
by the United States Customs and has no bearing on quarantine.] 
11.507 Documents.—[The forms described in 11.508 (a) (1) and 
11.513 (c) and (e) shall be the primary documents required by the 
quarantine officer for the entry of aircraft.] 
11.508 Documents for entry.— (a) At the time any aircraft arriv- 
ing from outside the United States lands in any area in which making 
of entry is required * * *, the aircraft commander shall deliver 
(1) The aircraft’s journey log book to the quarantine officer for 
inspection as to entries required by 11.513, * * * 
(2) [Has no bearing on quarantine.] 
[(2) to (9), inclusive, and (c), (1) to (3), inclusive, have no bear- 
ing on quarantine.] 
11.509 Documents for clearance.—[Regulated by the Department 
of Commerce, the United States Customs, and the United States Im- 
migration Service and have no bearing on quarantine.] 11.510 Omission of lists of aliens employed on hoard aircraft.— 
[Regulated by the Commissioner of Immigration and Naturalization 
and has no bearing on quarantine.] 
11.511 Residue cargo; Customs.— [Regulated by the United States 
States Customs and has no bearing on quarantine.] 
11.512 General provisions; Customs.—[Regulated by the United 
States Customs and has no bearing on quarantine.] 
11.513 Public health requirements.— (a) Release by Public 
Health Service.—No passengers or persons employed on board any 
aircraft arriving from any place outside the United States or landing 
in an area from another area shall be permitted to leave the aircraft 
at the place of first landing or the airport of entry in the United 
States except by authority of the quarantine officer assigned thereto. 
Such aircraft and any mail, baggage, cargo, or other contents on 
board shall be held at such place or airport until released by such 
officer. * * * 
(b) Special sanitary treatment.—Any aircraft arriving from any 
foreign port or place which the quarantine officer declares to be of 
such menace that it cannot be adequately or safely handled at the air- 
port of first or intended landing shall be required to proceed with all 
passengers and persons employed on board and all mail, baggage, cargo, 
or other contents on board, as may be designated by such officer, to 
an airport indicated by such officer to have adequate facilities for 
such treatment as shall be prescribed by him, 
(c) Entries in journey log book of arriving aircraft.—Any air- 
craft departing for the United States from any place outside thereof 
shall have entered in the journey log book 1 statements as to the 
occurrence of plague, cholera, yellow fever, typhus fever, and small- 
pox in the country from which the aircraft departed and in countries 
in which landings are made en route. There also shall be entered in 
the journey log book statements as to any sanitary measures under- 
gone before departure or at such landings. These statements shall 
be verified and signed by the officers in charge of the airports from 
which the aircraft departed and at which it landed en route. In 
addition the aircraft commander shall enter a statement as to the 
occurrence of any sicknesss among the passengers and persons em- 
ployed on board and as to any sanitary treatment performed en route. 
(d) Spraying of arriving aircraft.—Any aircraft bound for the 
1 For this purpose, a journey log book is any document or book containing the following 
information: (1) nationality and identification marks of aircraft; (2) name and address 
of owner of aircraft: (3) name and address of commander of aircraft; (4) point of 
origin; (5) point of ultimate destination: (6) place and time of departure on trip; 
(7) intermediate stops and time of arrival at each stop; and (8) remarks; signed by 
the aircraft commander. 6 
United States, from any place in South America or tropical Africa, 
or from any other region where yellow fever may appear, shall be 
sprayed during flight with an insecticide approved by the Surgeon 
General of the Public Health Service. The spraying shall be per- 
formed as soon as possible after departure from the last foreign port, 
in accordance with such method as may be prescribed by the Surgeon 
General of the Public Health Service. The same provision applies 
to aircraft bound for the mainland of the United States from any 
United States insular port. 
(e) Statement of whereabouts of passengers and crew.—The com- 
mander of any aircraft arriving in the United States from any place 
in the Western Hemisphere located within the region bounded by 30 
degrees south latitude and 13 degrees north latitude, or from any 
place in the African Continent located within the region bounded 
by 12 degrees south latitude and 16 degrees north latitude, or from 
any other place where yellow fever may appear, shall furnish the 
quarantine officer with a written statement showing the whereabouts 
of all passengers and members of the crew for a period of 6 days 
prior to embarkation for the United States. 
(f) Importations of living disease organisms and vectors, shaving 
brushes, and parrots.—Importations of living disease organisms and 
vectors,2 of shaving or lather brushes,8 and of birds of the parrot 
family 4 are subject to the special regulations prescribed therefor, 
(g) Entries in journey log book of departing aircraft.—Any air- 
craft clearing from any area for any place outside the United States 
may obtain from the quarantine officer for entry in the journey log 
book information regarding the occurrence of plague, cholera, yellow 
fever, typhus fever, and smallpox in the area. 
(h) General provisions.—Except as otherwise provided in the reg- 
ulations in this part (11.501 to 11.516, inclusive), aircraft and the 
passengers and merchandise and baggage carried thereon, arriving 
from any place outside the United States, shall be subject to the 
United States quarantine laws and regulations applicable to vessels 
so arriving, insofar as such laws and regulations are applicable to 
aircraft. 
11.514 General provisions/ Entry and clearance.—All naviga- 
tion laws and regulations pertaining to the entry and clearance of 
vessels shall apply to civil aircraft to such extent and upon such 
conditions as are specified in the regulations in this part. 
2 Living disease organisms and vectors; Amendment No. 17 to Quarantine Regulations 
of the United States, March 4, 1938 ; Federal Register, March 10, 1938, p. 555. 
3 Brushes : Amendment No. 18 to Quarantine Regulations of the United States ; Federal 
Register, March 22, 1939, p. 1287. 
4 Parrots : Executive Order 5264, Jan. 24, 1930 ; Foreign Quarantine Division Circular 
No. 67 and amendments ; Federal Register, May 3, 1939, p. 1766. 7 
11.515 Penalties.— (a) [Relates to violations of customs regula- 
tions and has no bearing on quarantine.] 
(b) Any person violating any public health regulation relating 
to aircraft- or any provision of the public health laws or regulations 
made applicable to aircraft by § 11.513 shall be subject to a civil 
penalty of $500, and any aircraft used in connection with such viola- 
tion shall be subject to seizure and forfeiture, as provided for in the 
public health laws and section 11 (b) and (c) of the Air Commerce 
Act of 1926 (49 II. S. C. 181 (b), (c)). Such penalty and forfeiture 
may be remitted or mitigated by the Federal Security Administrator. 
(c) [Relates to violations of regulations of the Department of 
Commerce and has no bearing on quarantine.] 
(d) [Relates to violations of immigration regulations and has no 
bearing on quarantine.] 
(e) Liability to penalties with respect to any one of the sets of 
laws, i. e., the customs laws, the public health laws, the entry and 
clearance laws, and the immigration laws, under which the regula- 
tions in this part are prescribed, shall be separate from such liability 
with respect to any other set of such laws, 
11.516 Airports of entry.— (a) Airports of entry will be desig- 
nated after due investigation to establish the fact that a sufficient 
need exists in any particular district or area to justify such designa- 
tion and to determine the airport best suited for such purpose. 
(b) A specific airport will be designated in each case rather than 
a general area or district which may include several airports. 
(c) The designation as an airport of entry may be withdrawn if 
it is found that the volume of business clearing through the port does 
not justify maintenance or inspection equipment and personnel, if 
proper facilities are not provided and maintained by the airport, if 
the rules and regulations of the Federal Government are not com- 
plied with, or if it be found that some other location would be more 
advantageous. 
(d) Airports of entry shall be municipal airports, unless particu- 
lar conditions which prevail warrant a departure from such require- 
ment and shall be possessed of a currently effective designation as a 
“Designated Landing Area” issued by the Administrator of Civil 
Aeronautics. Additional requirements may be imposed as the needs 
of the district or area to be served by the airport may demand. 
(e) Airports of entry shall provide without cost to the Federal 
Government suitable office and other space for the exclusive use of 
Federal officials connected with the port. A suitable surfaced load- 
ing area shall, in each case, be provided by the airport at a convenient 
location with respect to such office space. Such loading area shall 8 
be reserved for the use of aircraft entering or clearing through the 
airport. 
(f) Airports of entry shall be open to all aircraft for entry and 
clearance purposes and no charge shall be made for the use of said 
airports for such purposes. However, in cases where airports of 
entry authorize any such aircraft to use such airports for the taking 
on or discharging of passengers or cargo, or as a base for other com- 
mercial operations or for private operations, this paragraph shall 
not be interpreted to mean that charges may not be made for such 
commercial or private use of such airports. 
(g) All aircraft entering or clearing through airports of entry 
shall receive the required servicing by airport personnel promptly 
and in the order of arrival or preparation for departure without dis- 
crimination. The charges made for such servicing shall in no case 
exceed the schedule of charges prevailing at the airport in question. 
A copy of said schedule of charges shall be posted in a conspicuous 
place at the office space provided for the use of Federal officials con- 
nected with the port. 
(h) Airports of entry shall adopt and enforce observance of such 
requirements for the operation of airports, including airport rules, 
as may be prescribed or recommended by the Civil Aeronautics 
Authority. (R. S. 161, 251; sec. 644, 46 Stat. 761; sec. 7, 44 Stat. 572; 
sec. 5, 27 Stat. 451; sec. 23, 39 Stat. 894; sec. 24, 43 Stat. 166; 5 U. S. C. 
22; 19 U. S. C. 66,1644; 49 U. S. C. 177; 42 II. S. C. 94; 8 U. S. C. 102, 
222. Secs. 201 (a), 205 (b), President’s Reorganization Plan No. I, 
sec. 1, President’s Reorganization Plan No. Y; 4 F. R. 2728, 2729, 5 
F. R. 2132, 2223. E. O. 9083, Feb. 28,1942; 7 F. R. 1609.) 
The Airport of Entry Regulations approved on October 6, 1931, by 
the Secretary of the Treasury, the Secretary of Commerce, and the 
Secretary of Labor, published in T. D. 45174 (19 CFR 4.11), are 
hereby superseded. 
[seal] 
Paul V. McNutt, 
Federal Security* Administrator. 
(The above regulations, designated as “Air Commerce Regula- 
tions,” were signed also by the administrative heads of the Treasury 
Department,-the Department of Commerce, and the Department of 
Justice.) 
Noth.—Additional authority for the application of sanitary measures to aircraft is to 
be found in the International Sanitary Convention for Aerial Navigation (pp. 28 to 41) ; 
and in Article 61 of the Pan American Sanitary Code (pp. 42 and 43). QUARANTINE TREATMENT OF MILITARY AIRCRAFT 
Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE 
Washington 
Revised December 20, 19J/1. 
Foreign Quarantine Division Circular No. 71. 
To: Medical Officers in Charge, U. S. Quarantine Stations, and Others Concerned. 
Subject: Quarantine Inspection and Treatment of Aircraft of the Military 
Forces of the United States. 
The following measures will be observed in connection with quarantine in- 
spection and treatment of aircraft of the military forces of the United States: 
Class I. In the absence of quarantinahle diseases or epidemic conditions at 
any port of departure or call, flights of military aircraft of the United States 
may be made nonstop to and from the following areas without quarantine re- 
strictions : 
United States Canada 
Puerto Rico Cuba and Bahama Islands 
Canal Zone (All other islands of the Caribbean 
Virgin Islands area where U. S. air bases may be 
Alaska established are included.) 
Class II. Flights having contact tcith all other areas.—The officer in charge 
of the flight should communicate with the quarantine authority in the area 
where landing is contemplated in ample time to permit this official to be on 
the field and carry out such procedures as may be indicated. 
All personnel on the flight must be confined to the landing field, or to such 
area as may be designated by the quarantine officer, until released by the 
quarantine officer. 
Disinsectization of aircraft.—Disinsectization procedure may be carried out 
on the ground immediately prior to the take-off from the last field en route to 
the United States or immediately after landing on United States soil. Planes 
coming from areas where yellow fever is endemic or epidemic should be sprayed 
both on departure from such areas and on arrival in the United States. 
(a) Using compressed air spraying mechanism.—All enclosed spaces of the 
planes must be sprayed with insecticide of a strength not less than standard 
pyrethrum extract (2 grams pyrethrins per 100 cubic centimeters) using not 
less than 5 cubic centimeters of the mixture per 1,000 cubic feet of enclosed 
space. Compartments occupied by passengers and aircraft personnel should be 
kept tightly closed for at least 2 minutes after the insecticide is introduced. 
(I)) Using hand-type spraying mechanism.—When a hand-pump type of spray 
apparatus is used, the quantity of insecticide should be increased to not less 
than 8 cubic centimeters of the standard pyrethrum extract per 1,000 cubic feet, 
with the plane closed for not less than 2 minutes. 
Special temporary provisions.—For the period of the existing national emer- 
gency, the Surgeon General may in his discretion, when requested by the com- 
petent military authorities, designate the senior medical officer of an Army or a 
Navy air base to serve as quarantine officer for the inspection and treatment 
of military aircraft, carrying only military personnel, which may he proceed- 
ing on confidential missions. This delegation of quarantine authority will con- 
vey to the military service concerned full responsibility for preventing the 
introduction into the United States of dangerous communicable diseases and of 
insect vectors of disease. 
Thomas Parran, 
Surgeon General. DISINSECTIZATION OF COMMERCIAL AIRCRAFT 
Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE 
Washington 
June 15, 1942. 
Foreign Quarantine Division Circular No. 77. 
To: Medical Officers in Charge, U. S. Quarantine Stations, and Others Concerned. 
Subject: Disinsectization of Commercial Aircraft. 
1. Incident to the increase of aircraft traffic with foreign areas the danger 
of the introduction into the United States of exotic insect vectors of disease 
is greatly increased. In this connection, the Service is especially interested in 
preventing the introduction of Aedes aegypti mosquitoes from areas in which 
yellow fever is endemic or epidemic and in excluding the Anopheles gambiae, a 
highly efficient carrier of malaria, which as yet has not appeared in the United 
States. 
2. Under existing circumstances, sole dependence cannot be placed on inspec- 
tion to determine whether an aircraft has on board living insects capable of 
transmitting disease and in consequence is in need of disinsectization. 
3. (a) Aircraft arriving at United States airports located south of 40 degrees 
north latitude from points on the South American mainland lying north of 30 
degrees south latitude or from any point on the African continent will he dis- 
insectized, without preliminary inspection, immediately after the disembarkation 
of passengers and crew and before baggage, merchandise, and mail are discharged. 
(h) When the quarantine officer is informed or has good reason to believe that 
yellow fever is epidemic in an area from which an aircraft arrives, he is directed 
to disinsectize all compartments of the aircraft before the discharge of passen- 
gers, crew, baggage, merchandise, and mail. No person other than the quaran- 
tine officer or the inspector who does the spraying will be allowed on hoard until 
disinsectization is completed, and the plane will be kept tightly closed throughout 
the procedure. 
(c) The same treatment shall be applied to aircraft coming nonstop from 
Africa or any other foreign area which may be designated by the Surgeon Gen- 
eral as dangerous on account of the presence of exotic insect vectors of disease. 
4. Tlie specifications for disinsectization set forth in Foreign Quarantine Divi- 
sion Circular No. 71 will be applied whenever aircraft are sprayed for the 
destruction of mosquitoes and other insects. 
5. It is not intended that the practice of spraying aircraft in flight be discon- 
tinued. Rather its importance is to be emphasized, and operators of commercial 
aircraft should be encouraged to spray thoroughly as a means of safeguarding 
passengers and flight personnel on board. 
Thomas Parran, 
Surgeon General. QUARANTINE AND IMMIGRATION MEDICAL INSPECTION OF 
PASSENGERS AND CREW OF AIRCRAFT 
The accelerated tempo of travel by air is reflected in the desire of 
the aircraft passenger that his entry on arrival be expedited in every 
way possible. It is the manifest duty of the quarantine officer to co- 
operate in the accomplishment of this desire to the fullest extent 
compatible with the effective application of quarantine safeguards. 
1. Quarantine inspection.—The arrival of an airplane of a sched- 
uled airline from a foreign area is followed by an orderly succession 
of events in which the United States quarantine, immigration, and 
customs officials perform the inspections provided for in the regula- 
tions which govern their respective functions. Logically, quarantine 
inspection is completed first and is conducted so as to expedite the 
reference of passengers to the other Federal inspection services con- 
cerned with their entry. 
The “Aircraft Quarantine Declaration/’ previously signed by the 
aircraft commander, together with “Certificates of Origin of Pass- 
engers,” when these are applicable, are delivered to the quarantine 
officer before passengers are presented for inspection. The declara- 
tion lists ports of origin and call, giving dates of the aircraft’s de- 
parture in every instance; gives numbers and citizenship status of 
passengers and crewT; lists persons by name who were ill during the 
voyage; lists living animals and bacterial cultures or viruses carried 
as merchandise or mail; and certifies as to the disinsectization of the 
aircraft. As the aircraft commander’s declaration contains all or 
substantially all data prescribed for entries in a journey log book (see 
11.513 (c) and footnote (1) thereto) the quarantine officer may accept 
the declaration in lieu thereof. 
The reverse side of the aircraft quarantine declaration form is used 
by the quarantine officer to record the particulars of the plane’s ar- 
rival and clearance; the number of immigration medical examina- 
tions performed, and action taken; the names and addresses of per- 
sons placed under sanitary surveillance; and the number and kind of 
insects found alive or dead on the aircraft. Particulars of quaran- 
tine treatment, including disinsectization, are noted whenever such 
measures are applied. 
As rapidly as possible after being discharged from an arriving 
aircraft, passengers are assembled and presented to the quarantine 
officer for inspection. The names and citizenship status of passengers 12 
are obtained from a master list furnished by the immigration officer 
at the airport. American citizens are inspected first, but the tempera- 
ture is taken simultaneously of all passengers arriving from areas in 
which yellow fever is endemic or epidemic. Persons showing an eleva- 
tion of temperature or other evidence of illness are detained by the 
quarantine officer until a diagnosis is made. 
When a quarantinable disease is recognized or suspected, all passen- 
gers are detained until disposed of by the quarantine officer in accord- 
ance with the requirements of the United States Quarantine Laws 
and Regulations applying in the particular instance. 
A “Certificate of Origin of Passengers,” issued to the passenger by 
the agency furnishing the aircraft transportation, is required of each 
passenger embarking at a place in the Western Hemisphere lying in 
the region bounded by 30 degrees south latitude and 13 degrees north 
latitude but an approved certificate of vaccination against yellow fever 
will be accepted in lieu of this certificate. The certificate of origin 
accounts for the passenger’s whereabouts during the six-day period 
immediately preceding his embarkation by air on the flight which 
brought him to the United States. Passengers presenting such certifi- 
cates of origin are questioned to verify the statements contained 
therein. 
Persons who present satisfactory evidence (International Certificate 
of Vaccination or other certificate issued by a representative of the 
national health department of a foreign country signatory to the Pan 
American Sanitary Code or the International Sanitary Convention 
for Aerial Navigation) of having been immunized against yellow 
fever, cholera, typhus fever or smallpox will not be detained on suspi- 
cion of one of these diseases nor be subjected to sanitary surveillance 
because of presumed exposure to such diseases. 
If a nonimmune passenger has been, within the six days covered by 
the certificate of origin, in an area known or suspected of being infected 
with yellow fever (endemic or epidemic), a record is made of his name 
and of his United States destination and of any intermediate stops he 
proposes to make. If an apparently well passenger who presumably 
may have been exposed to yellow fever or to another quarantinable 
disease while in a foreign area, gives satisfactory assurance of coop- 
eration, he is permitted to continue his travel after being handed a 
typed request (in English, Spanish, Portuguese and French) to report 
his arrival to the health officer of each community in which he plans 
to stop, including his final destination, during the period of time he 
is to remain under sanitary surveillance. The traveler is given to 
understand that the surveillance contemplated will not interfere with 
his movements so long as he remains in good health and that in any 
event surveillance will not extend over a maximum of fourteen days 13 
to cover the incubation period of any or all of the quarantinable 
diseases. The length of time for which surveillance is to be maintained 
will, in each instance, be dictated by the incubation period of the disease 
or diseases to which the passenger presumably has been exposed. 
To supplement the notice given the passenger, the quarantine officer 
notifies health officers having jurisdiction in the communities to be 
visited, giving the traveler’s name and address and the probable date 
of arrival. Copies of such notices will be sent to the State health 
officers concerned. The quarantine officer is authorized to use either 
air mail or the telegraph in notifying local health officers but, in any 
event, is required to select a method of communication which will 
insure the delivery of the notice before the traveler arrives within 
the jurisdiction of the health officer being notified. 
As a general proposition, health officers in the area south of a line 
running from Philadelphia to San Francisco (roughly 40 degrees 
north latitude) are requested to maintain surveillance of air travelers 
for yellow fever during the period May 1 to October 30, inclusive. 
During the remainder of the year requests for such surveillance are 
sent only to health officers in Texas, Louisiana, Mississippi, Alabama, 
and Florida. 
Cases of quarantinable disease will be handled in accordance with 
the provisions of the United States Quarantine Laws and Regulations 
and the International Sanitary Convention for Aerial Navigation. 
Cases of nonquarantinable communicable diseases will be reported 
to the local health officer having jurisdiction in the community in 
which the airport of arrival is located. Such cases will be held pend- 
ing disposition by the local health officer. 
As soon as the quarantine inspection is completed, American citi- 
zens are dismissed so that other official formalities connected with 
their entry may be expedited. 
2. Immigration medical inspection.—Passengers and aircraft 
whose voyages originate at points in Puerto Rico, Cuba, the Virgin 
Islands, and the Bahamas ordinarily have no quarantine significance 
and. in the absence of quarantinable diseases or epidemics of danger- 
ous communicable diseases in those areas, are exempt from quaran- 
tine inspection. However, all passengers arriving by air from the 
islands named above are questioned as to whether they have been 
within the 6 days just prior to their arrival in the United States, 
in South America or another area in which yellow fever may be 
endemic or epidemic. American citizens who answer in the negative 
are dismissed; both citizens and aliens who have been in an area 
known or suspected of being infected with yellow fever within the 
preceding 6 days are handled in accordance with the appropriate 
provisions contained in Section 1, “Quarantine Inspection.” 14 
The inspection of aliens is conducted in the manner prescribed by 
the Immigration Laws and as provided for in the Public Health 
Service Regulations governing the medical examination of aliens. 
3. Special examination*.— (a) Living disease organisms and vec- 
tors: The importation of living disease organisms and vectors, in- 
cluding bacteria, viruses, and any insect, animal, or plant, capable 
of transmitting any contagious or infectious disease, is regulated by 
Amendment No. 17 to the Quarantine Regulations of the United 
States. No article or thing coming within the provisions of para- 
graph 128-A or paragraph 128-B of this Amendment shall be ad- 
mitted into the United States without a specific permit issued by 
the Surgeon General of the Public Health Service, and in the absence 
of such a permit shall be held in customs custody and excluded. 
The quarantine officer is authorized to exercise discretion in ad- 
mitting suitably packed and protected specimens of human tissues 
obviously intended for diagnostic examination, when the shipment 
is consigned from a physician to a pathological or bacteriological 
laboratory. When the quarantine officer is in doubt regarding the 
application of Amendment No, 17 to such a shipment, it should be 
held pending the receipt of instructions from the Surgeon General 
of the Public Health Service. 
(b) Psittacine birds: The provisions of Amendment No. 17 do not 
apply to birds of the parrot family. Executive order No. 5264, Jan- 
uary 24. 1930, and Foreign Quarantine Division Circular No. 67 and 
amendments thereto govern the admission of such birds. 15 
FORMS USED IN INTERNATIONAL AERIAL QUARANTINE 
The forms used in international aerial quarantine are presented on 
pages 16-21, inclusive. Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE 
AIRCRAFT QUARANTINE DECLARATION 
Airport of entry 
Date 
1. License number Nationality 
2. List below port of origin and all ports of call, giving date of departure from 
each: 
Port of origin and ports of call Date of departure 
(1) 
(2) 
(3) 
(4) 
(5) 
(6) 
(7) * 
(8) 
(9) 
(10) 
(11) ' 
(12) 
3. Total aboard: Crew (U. S. citizens) Crew (aliens) 
Passengers (II. S. citizens) Passengers 
(aliens) 
4. Names of persons ill during trip (passengers and crew) : 
5. List of living animals, birds, insects, bacterial cultures and viruses mani- 
fested or known to be on board 
6. Disinsectization : Method 
Date and hour: Performed by: 
I certify that the foregoing statements are true and that, to the best of my 
knowledge and belief, the aircraft, passengers, officers, crew, and cargo conform 
in all respects to the requirements imposed by the Quarantine Laws and 
Regulations of the United States. 
(Signature of Aircraft Commander) 
Note.—This declaration, signed by the Commander of the aircraft, is to be delivered to 
the U. S. Quarantine Officer immediately upon arrival. 
[Face] 17 
(This is the reverse side of the Aircraft Quarantine Declaration form and Is for the use 
of the Quarantine Officer) 
7. Insect inspection: 
Species Number Viability Where m Plane Recovered 
8. Entered quarantine Released 
9. Pratique granted 
Exceptions and requirements 
10. Persons placed under surveillance; 
Name Place of departure Address at destination 
11. Immigration examinations; 
Inspected and passed Examined intensively Certified 
A B 
Passengers: 
Crow; 
Total: 
VI. Certificates: 
Name Nationality Class Defect 
U. S. Public Health Service 
Quarantine Officer 18 
CERTIFICATE OF ORIGIN 
Pan American Sanitary Bureau 
Standard Form 
Issuing Agency 
Agenda emisora 
Agencia emissora 
Modelo Oficial, Oficina Sanitaria Pan- 
americana 
Place 
Sitio 
Logar 
Modelo Official, Repartigao Sanitaria 
Panamericana 
Date issued 
Fecha 
Data 
CERTIFICATE OF ORIGIN OF PASSENGERS* 
CERTIFICADO DE ORIGEN DE LOS PASAJEROS* 
CERTIDAO DE ORIGEM DOS PASSAGEIROS* 
(7 o be filled in by agency issuing airplane passage) 
(Para ser llenado par la agenda emisora del pasaje par avion) 
(Para ser enchida pela agenda emissora da passagem par avido) 
Note: This certificate is a personal one and should be retained by the passenger along with vaccination 
and health certificates. 
Nota: Este certiflcado es propiedad personal y debe retenerlo el pasajero junto con los certiflcados de 
vacunacion y de salud. 
Nota: Esta certidao £ propriedade pessoal e o passageiro deye retel-a junta com as certidoes de vaccina e 
satlde. 
Name of passenger 
N ombre del pasajero 
Nome do passageiro 
Where does voyage begin? 
iDdnde comienza el viaje? 
Onde comega a viagem? 
Date 
Fecha 
Data . 
Where does voyage end? ] 
iD6nde termina el viaje? 
Onde termina a viagem? J 
Date 
Fecha 
Data 
Will voyage be direct, or will there be stopovers? 
iSerd el viaje directo, o habra escalas? 
Serd a viagem directa, ou tera escalas? 
The Certificate of Origin of Passengers is printed in English, Spanish, and 
country signatory to the Pan American Sanitary Code this certificate may be 
during the period covered by the certificate. 19 
OF PASSENGERS 
Places of Stopover 
Escalas 
Date of arrival 
Fecha de llegada 
Date of departure 
Fecha de salida 
Data da partida 
Where does passenger reside when at home 
Domicilio fijo del pasajero 
Domicilio do passageiro 
On what date did passenger arrive in city where will embark? 
Fecha de la llegada del pasajero a la ciudad de donde embarcard 
Data da chegada do passageiro a cidade onde embarcara 
Give localities visited or resided in for 6 days prior to embarkation: 
Andtense las localidades visitadas o en que residiera durante los 6 dias anteriores 
al embarque: 
Anotem-se as localidades visitadas ou em que residio durante os 6 dias anteriores 
ao embarque: 
1st day 
ler dia ” 
1° dia 
4th day 
4° dia 
4° dia 
2nd day 
2° dia 
2° dia 
5 th day 
5° di'a 
5° ' dia 
3rd dayl 
3er dia | 
3° dia J 
6th day 
6° di'a 
6° dia 
* Remarks: ■ t 
Persons who can present satisfactory evidence that they have had yellow fever, or who can present 
certificates of vaccination against yellow fever, will not need Certificates of Origin. 
This form will not be required of international passengers originating south of 30° South Latitude 
unless they make stopovers in the area north of this parallel in excess of one day while en route to their 
destination. . 
•Observaciones: 
No necesitan Certiflcados de Origen las personas que presenten pruebas satisfactorias de que han 
padecido de flebre amarilla, o certificado de vacunacion contra la flebre amarilla. 
Tampoco se exigiri este Certificado a los pasajeros interriacionales procedentes de una localidad al sur 
de 30° Latitud Sur, a menos que hagan escala al norte de dicho paralelo por mas de un dia mientras se hallen 
en ruta a su punto de destine. 
•Observacoes: 
Nao necessitam Certidoes de Origem as pessoas que possam apresentar provas satisfactorias de que 
tiveram febre amarella ou que possuam a certidao de vaccina contra febre amarella. 
NSo se exigira esta Certidao aos passageiros internacionaes procedentes de uma localidade ao sul do 
30° Latitude Sul, a menos que faijam escala por uma zona ao norte deste parallelo por mais de um dia em 
rota aos seus pontos de destino. 
Portuguese. When completed by the agency issuing airplane passage in any 
accepted by the quarantine officer as evidence of the whereabouts of the bearer 20 
Form No. 6—Pan American Sanitary Bureau, Washington 
INTERNATIONAL CERTIFICATE OF VACCINATION 
Place.. 
Date— 
This Is to certify that 
Sex Age Color Nativity 
was on the dates indicated vaccinated against: 
(Cross out portions not applicable) 
Cholera— Doses: 
1st 2"'1 3rd 
Smallpox—Type of reaction : 
Immune Vaccinoid Vaccinia 
Typhus 
Yellow fever 
Other diseases (specify). 
Medical Officer 
(Signature of person vaccinated) 
(Title) 
(Seal) 
The International Vaccination Certificate form is printed in English, Spanish, 
Portuguese, and French, the four languages of the American republics. This 
form is approved by the Public Health Service and may be used by quarantine 
officers in certifying to the vaccination status of persons departing the United 
States and, when completed and signed by the proper official of the health 
department of any country signatory to the Pan American Sanitary Code, may 
be accepted by quarantine officers at United States Ports of entry. 
NOTICE TO PASSENGERS ARRIVING BY AIRCRAFT 
You are being permitted to proceed to your destination in the United States, 
but inasmuch as your recent travel was in an area which is under international 
quarantine observation, you are requested to promptly notify the local Health 
Officer of your arrival in his community. As advance information concerning 
your destination and the approximate time of arrival will have gone forward, 
the local Health officer will be expecting a call from you. 
Medical Officer, 
U. S. Public Health Service. 
AVISO A LOS PASAJEROS QUE LLEGAN FOR AVION 
Por la presente permitesele a Ud. seguir hasta su destino en Estados Unidos, 
pero como su reciente viaje tuvo lugar en una zona que se halla en observacidn 
de la cuarentena internacional, se le solicita que avise al Medico Municipal de 
Sanidad tan pronto como llegue a su localidad. Como ya se habran enviado de 
antemano informes acerca de su destino y fecha aproximada de su llegada, el 
Medico Municipal de Sanidad esperara que Ud. se comunique con el. 
Funcionario Medico, 
Servicio de Sanidad Puhlica 
de Estados Unidos. 21 
V. S. tern permissao de prosseguir viagem ate o ponto de destine nos Estados 
Unidos da America; dado porem o fato de sua viagem ter-se realizado em zona 
sob observagao da quarentena internacional, solicita-se-lhe avisar ao medico 
municipal da saude publica logo que chegar a localidade deste funcionario, que 
previamente informado de seu destino e data aproximada de sua chegada, 
esperara que V. S. o avise quando chegar. 
AVISO AOS VIAJANTES QUE CHEGAM FOR AVIAO 
Funciondrio Mddico, 
Service de Saudc Ptiblique 
das Estados Unidos. 
AVIS AUX VOYAGEURS ARRIVANT PAR AVION 
Par la prdsente on vous autorize il proceder a votre destination aqx Etats-Unis. 
Maintenaut comme vous venez de voyager dans une zone qui se trouve sous surveil- 
lance par la quarantaine Internationale, on prie de notifier promptement votre 
arrivee an Directeur de Sante Municipal de la localite ou vous allez. Comme 
ce fonctionnaire a £te prevent! concernant votre destination et date approximative 
de votre arrivee, vous devez vous communiquer avec lui. 
Medecin de la Saute, 
Service d’Hygiene Publique 
des Etais-Unis. 
LETTER REQUESTING SURVEILLANCE OF TRAVELER 
U. S. Quarantine Station 
(Place) 
(Date) 
Name and address 
of Local Health Officer 
Sib: This is to inform you that arrived by 
(name of passenger) 
air at on from an area 
(place of entry) (date of arrival) 
in South America where yellow fever may be present. 
This passenger expects to proceed to — and has promised to report 
(street or other local address and name of town and state) 
to you on arrival 
(date of expected arrival) 
You are requested to maintain surveillance by telephone or personal observa- 
tion, until 
(date) 
Should a suspicious fever develop, please notify this office by telegram, 
(Government rate collect) 
Respectfully, 
(CC to State Health Officer concerned.) 
Quarantine Officer. 
Note.—Suggested form of letter to be used in requesting a local health officer to maintain 
surveillance over an air traveler coming from a foreign area in which yellow fever is 
endemic or epidemic. As an original letter is to be sent in each instance, the form of the 
letter may be changed to cover any of the five designated diseases; plague, cholera, yellow 
fever, typhus, or smallpox. INSPECTION AND DISINSECTIZATION OF AIRCRAFT 
1. Inspection of aircraft for insects.—Inspection of aircraft arriv- 
ing from foreign areas to detect the presence of live mosquitoes or 
other insects which may transmit disease, or to recover dead insects 
as an index of the efficacy of disinsectization done at foreign ports, 
is an essential element of aircraft quarantine procedure. 
Success in inspecting aircraft for insects requires that the work be 
done systematically and with meticulous attention to detail. The 
ingenuity of mosquitoes, especially Aedes aegypti, in hiding or in 
resting on dark-colored materials which etfectively camouflage their 
presence, challenges the best efforts of the inspector. If potentially 
dangerous insects are not to be missed, the inspector must know where 
and how to search and must conduct his inspection so methodically 
that no possible hiding place is overlooked. Mosquitoes and other 
insects in flight are easier to detect than those which are resting. 
For this reason, hangings and other movable material should be 
shaken or otherwise disturbed so as to force the movement of flying 
insects. 
Inspector's equipment.—1. A powerful flashlight capable of being 
focused to produce a small bright spot within the larger zone of light. 
2. Hand type spraying apparatus and a supply of standardized 
pyrethrum extract. 
3. A spring-drive interval timer. 
4. If an accurate count and identification of live insects is to be 
made, the inspector should be equipped with a chloroform or cyanide 
catching tube, and pill boxes in which a few naphthalene flakes are 
covered by a layer of cotton padding. 
Method of inspection—hydroplanes.—Immediately after the last 
passenger leaves the plane, the inspector places the timer near the 
hatch, set to ring in six minutes. Closing the hatch after entering, 
lie begins in the tail section of the plane and works forward fairly 
rapidly, searching only for living insects. In each compartment 
draperies are shaken and cushions slapped, in an effort to stir into 
flight any living insect that may be present. After examining the 
anchor locker forward, the return search is devoted to an effort to 
locate dead insects. Every square foot of flat surface in the plane is 
to be examined systematically. By directing the flashlight beam 
parallel to flat surfaces, insects are more readily detected. The ring- 
ing of the timer is a signal to the porters to open the plane and begin 23 
unloading mail and baggage. At this time the crew’s compartment is 
the only space in which the inspector can work undisturbed. After 
the baggage has been unloaded, the empty compartment is re-examined 
and the search continued until the inspector is satisfied that all insects 
on the plane have been found. 
Land-type planes.—When the baggage compartments beneath the 
fuselage of the plane are opened, the inspector should immediately 
make a quick examination of these compartments and their contents. 
The inspector then undertakes the methodical examination of the pas- 
senger and crew compartments as prescribed for hydroplanes, finally 
re-examining the baggage compartment after it has been unloaded. 
E-fficacy of inspection.—On the basis of experimental work, it must 
be concluded that not more than 10 percent of mosquitoes which gain 
access to an airplane are subsequently detected or recovered by the 
inspector. Mosquitoes which have been killed during previous dis- 
insectization may fall into obscure places or, if they are killed in pas- 
senger compartments, may be crushed too badly by the movement of 
the passengers to make recognition or identification possible. 
Comment.—The presence of living insects in aircraft arriving from 
foreign areas must be accepted as evidence of potential danger, whether 
or not the insects are identified as carriers of disease. When living 
insects are found, it indicates inadequate disinsectization and the in- 
spector should keep the plane sealed and refumigate when such meas- 
ures are warranted. 
2. Disinsectization of aircraft.—The use of spray material contain- 
ing pyrethins for the disinsectization of aircraft has been developed to 
the point where an effective kill of all mosquitoes is assured, if spray- 
ing is thoroughly done and if the prescribed concentration of pyrethins 
and the designated exposure time are rigorously adhered to. 
The efficacy of the spray method of disinsectization depends on dis- 
persion of the finely atomized pyrethrum concentrate to all parts of the 
enclosed space. The spray apparatus described in Public Health Serv- 
ice Reprint No. 2169 operates best on air pressure of approximately 46 
pounds. 
Insecticide.—The standard pyrethrum concentrate contains not less 
than 2 grams of pyrethrins per 100 cubic centimeters of vehicle. Vari- 
ous products, approved on the basis of laboratory and field tests, are 
available under the following designations: 
“Pyrethrum Concentrate—20 to 1 strength.” 
“Pryethrum Extract Standardized.” 
“Pyrethrum Extract No. 20.” 
“Pyrethrum Concentrate No. 20.” 
“No. 20 Extract Standardized.” 24 
(In case difficulty is experienced in securing the standard insecticide, 
the names and addresses of dealers able to supply it will be furnished 
on request to the Surgeon General.) 
Using compressed air spraying mechanism.—All enclosed spaces of 
an aircraft should be sprayed, using not less than 5 cubic centimeters 
of the standardized pyrethrum extract per 1,000 cubic feet of air 
space. Compartments used by passengers and plane personnel should 
be kept tightly closed for at least 2 minutes after the insecticide is 
introduced. 
Using hand-type spraying mechanism.—Otherwise following the 
same procedure as when power driven spraying apparatus is used, 
compartments should be treated with 8 cubic centimeters of the stand- 
ardized pyrethrum extract per 1,000 cubic feet of air space. 
When to disinsectize aircraft.—Ordinarily the spraying proce- 
dure may be carried out on the ground immediately prior to the take- 
off from the last field en route to the United States or immediately 
after landing on United States soil. 
Aircraft coming from areas where yellow fever is endemic or epi- 
demic and from areas where the Anopheles gambiae mosquito is in- 
digenous, should be sprayed both on departure from such areas and 
again on arriving in the United States. ABSTRACT OF THE INTERNATIONAL SANITARY CONVENTION FOR 
AERIAL NAVIGATION 
INTRODUCTION 
The International Sanitary Convention for Aerial Navigation was 
concluded at The Hague, April 12. 1933, and signed by the representa- 
tives of twenty-three governments, including the United States of 
America. 
Subsequently, seventeen governments ratified the convention and 
seven have adhered to it, giving it the effect of law in their respective 
jurisdictions, namely, Australia, Egypt, Great Britain and Northern 
Ireland including British Colonies and Protectorates, Morocco, Mon- 
aco, the Netherlands, Rumania, Syria and Lebanon, Tunis, Germany. 
Poland, the United States of America, Italy and colonial possessions, 
Belgium, Greece, Union of South Africa, Sweden, Chile, Bolivia, 
Brazil, Iraq, Sudan, Turkey, and Liberia. 
The effective date of the convention in the United States is July 
25, 1935, on which date our ratification was deposited with the Gov- 
ernment of the Netherlands. 
In formulating the articles of the convention due consideration was 
given to insuring the maximum of protection against the importation 
of plague, cholera, yellow fever, exanthematous typhus and small- 
pox while imposing the minimum of interference with the movement 
of aircraft engaging in international commerce. 
Provision is made for immediate notification of first nonimported 
cases of plague, cholera, and yellow fever, and for notification of the 
appearance in epidemic form of exanthematous typhus and smallpox. 
Such terms as “observation,” “surveillance,” “authorized aero- 
dromes,” “sanitary aerodromes,” and “anti-amaryl aerodromes” are 
defined, and maximum standards are set up for staffing, equipping 
and operating such aerodromes. 
Detailed instructions are given for the handling of aircraft—in- 
cluding passengers, crew, personal effects, and merchandise and mail— 
arriving from infected local areas; with and without cases of the 
designated diseases on board. 
The complete text of the International Sanitary Convention for 
Aerial Navigation appears as Supplement 120 to the Public Health 
Reports, a copy of which may be secured from the Surgeon General, 
Public Health Service, Washington, D. C. 
In the following text an effort has been made to clarify the conven- 
tion and to simplify its application in quarantine practice by reas- 
sembling pertinent articles under the following headings: 26 
Page 
I. Aerodromes 26 
Authorized 26 
Sanitary 26 
Anti-amaryl 27 
II. Aircraft 27 
General provisions ; 27 
Duties (sanitary) of aircraft commander 28 
Inspection of aircraft and passengers 28 
III. Documents 28 
Bills of health not required 28 
Journey log book 28 
Certificates of sanitary measures 29 
IV. Merchandise and Mail 29 
V. Obligatory Notifications 29 
VI. Diseases 30 
Named 30 
Incubation period 30 
Application of sanitary control measures 31 
Measures applicable in case of plague, cholera, typhus, and 
smallpox 31 
Special measures applicable at sanitary aerodromes 32 
Measures applicable in case of yellow fever 33 
VII. Observation and Surveillance 35 
I. Aerodromes 
Whatever in the convention relates to aerdromes, applies, with the 
necessary changes, to places for the landing on water of hydroplanes 
and similar craft. 
(a) An authorized aerodrome is one which has been designated by 
competent authority as the place where aircraft may make their first 
landing on entering a territory or from which they may depart. An 
authorized aerodrome shall be provided with a sanitary organization 
adapted to current needs for prophylaxis. The minimum arrange- 
ment will insure the attendance of a doctor at such times as may be 
necessary for the medical examinations required by the convention. 
In order that an authorized aerodrome, which is not a sanitary aero- 
drome, may be designated a local area for the purposes of notification 
of infectious diseases and for other purposes as provided by the con- 
vention, it is necessary, in addition, that it shall be so situated topo- 
graphically as to be beyond all probable risk of infection from 
without. 
(b) A sanitary aerodrome is an authorized aerodrome organized 
and equipped as follows: 
1. Minimum medical organization of one medical officer and one or two sanitary 
inspectors—not necessarily in permanent attendance; the medical officer shall 
he an official of or approved by competent sanitary authority. 
2. A place for medical inspection. 
3. Facilities for examining or having examined suspected material. 27 
4. Facilities for the Isolation, transport and care of the sick; for the isolation 
of contacts; and for carrying out other prophylactic measures, either within the 
aerodrome or in proximity to it. 
5. Apparatus for carrying out disinfection, disinsectization, and deratization; 
as well as other authorized measures. 
6. The aerodrome shall be provided with safe drinking water, and with a proper 
system for the disposal of excreta and refuse and for the removal of waste 
water. It shall, as far as possible, be protected from rats. 
In order that a sanitary aerodrome may be designated as a local 
area for the purposes of notification of infectious diseases and for other 
purposes as provided by the convention, it must be so organized that: 
1. The entry or exit of any person is under the supervision and control of the 
competent authority. 
2. In ease of one of the five designated diseases occurring in the surrounding 
territory, access to the aerodrome by any route other than air is forbidden to 
persons suspected of being infected, and measures are applied, to the satisfaction 
of the competent authority, with a view to preventing persons who are resident 
in or passing through the aerodrome from being exposed to the risk of infection, 
either by contact with persons from outside or by any other means. 
(c) An anti-amaryl aerodrome is a sanitary aerodrome located in a 
a region where yellow fever exists in a form clinically or biologically 
recognizable. In addition to fulfilling the requirements for a sani- 
tary aerodrome, the anti-amaryl aerodrome shall be: 
3. At an adequate distance from the nearest inhabited center. 
2. Provided with a water supply protected against mosquitoes, and kept free 
from mosquitoes by suppression of breeding places and destruction of insects. 
3. Provided with mosquito-proofed dwellings for staff of aerodrome and for 
crews of aircraft. 
4. Provided with mosquito-proofed dwellings in which passengers can be housed 
or hospitalized. 
Notification of the creation of an anti-amaryl aerodrome shall be 
made in accordance with the provisions of article 7 of the convention. 
Consequent on this notification, the declaration of the presence of 
yellow fever in an adjacent town, village or local area shall not apply 
to the aerodrome, nor shall the aerodrome be declared infected unless 
yellow fever occurs among persons residing therein. 
If an anti-amaryl aerodrome becomes infected, aerial navigation 
from that aerodrome to any other territory shall be discontinued until 
all measures have been taken to free it from infection and all risk of 
the spread of yellow fever has ceased. 
II. Aircraft 
General provisions.—The word “aircraft” includes any machine 
which can derive support in the atmosphere from reactions in the air 
and is intended for aerial navigation. 28 
Except as expressly provided for in the convention, aircraft are 
exempt from sanitary formalities at aerodromes, both of call and of 
final desination, and may not be detained for longer than is strictly 
necessary to apply prescribed prophylactic measures even when they 
have been occupied b}r persons suffering from plague, cholera, yellow 
fever, typhus, or smallpox. 
Aircraft in flight are forbidden to throw or to let fall matter 
capable of producing the outbreak of infectious disease. 
Duties (sanitary) of aircraft commander.—The commander of the 
aircraft is required, on landing, to place himself at the disposal of 
the sanitary authority, to answer all requests for information affect- 
ing public health which are made to him by the competent service, and 
to produce the aircraft’s papers for examination. 
Should an aircraft, on entering a territory, land elsewhere than 
on a sanitary or authorized aerodrome, the commander of the aircraft 
shall, if the aircraft comes from an infected local area or is itself 
infected, notify the nearest local authority to this effect. 
If the commander of an aircraft wishes to disembark a sick person 
he shall, so far as he is able, notify the aerodrome of arrival in good 
time before landing. 
Iinspection of aircraft and persons.—In the case of sanitary or au- 
thorized aerodromes, the medical officer attached to the aerodrome 
has the right, either before the departure or after the landing of air- 
craft, to inspect the sanitary condition of passengers and crew, when- 
ever circumstances justify this measure. This visit should, however, 
be so arranged as to avoid any delay or interference with the con- 
tinuation of the voyage. 
No fee shall be charged for inspection. (Exception noted in case 
of Egypt.) 
III. Documents 
(a) Bills of health.—Aircraft shall not be required to carry bills 
of health. 
(b) Journey log book.—The following entries shall be made in the 
journey log book, under the heading “Observations”: 
1. Any facts relevant to public health which have arisen on the aircraft in 
the course of the voyage; 
2. Any sanitary measures undergone by the aircraft before departure or at 
places of call in application of the present convention; 
3. Information concerning the appearance in the country from which the air- 
craft is departing of any of the five diseases specified in this convention. The 
competent authorities of authorized aerodromes shall enter information regard- 
ing outbreaks of such disease and their nature in the journey log book of any 
aircraft leaving the aerodrome during a period of 15 days from the date on which 
the information was first received. 29 
The entries made in the journey log book shall be verified and certi- 
fied free of charge by the competent authority of the aerodrome. 
(c) Certificates of sanitary measures.—The aerodrome authority 
applying sanitary measures shall, whenever requested, furnish free 
of charge to the commander of the aircraft a certificate specifying the 
nature of the measures, methods employed, parts of the aircraft 
treated, and reasons why the measures have been applied. 
The authority shall also issue, on demand and without charge, to' 
passengers arriving by aircraft in which a case of one of the five 
designated diseases has occurred, a certificate showing the date of 
their arrival and the measures to which they and their luggage have 
been subjected. 
IV. Merchandise and Mail 
Merchandise.—No cargo shall be unloaded from an aircraft com- 
ing from an infected local area without the permission of the com- 
petent sanitary authority. 
If the sanitary authority considers that merchandise coming from 
an area infected with plague may harbor rats or fleas, such mer- 
chandise shall not be discharged except with the necessary precau- 
tions. 
The unloading from aircraft of the following fresh foods may be 
prohibited: Fish, shellfish, fruit, and vegetables coming from a local 
area infected with cholera. 
Cargo of an aircraft coming from a region where yellow fever 
exists, or where conditions permit the development of the disease, 
may be inspected and, if necessary, disinsectized. 
When aircraft fly between two regions infected with yellow fever, 
cargo may not be disembarked or embarked except at anti-amaryl 
aerodromes. 
The contracting governments may designate particular sanitary 
aerodromes as those at which aircraft from territories where yellow 
fever exists shall land for the purpose of disembarking cargo. 
Mail.—Letters and correspondence, printed matter, books, news- 
papers, business documents, postal packages, and anything sent by 
post shall not be subject to any sanitary measure, unless they contain 
designated articles of fresh foods coming from a local area infected 
with cholera. 
V. Obligatory Notifications 
Each contracting government shall transmit through channels to 
other contracting governments a list of its sanitary aerodromes. 
The communication shall include, in the case of each aerodrome, 30 
details as to its situation, its sanitary equipment, and its sanitary 
staff. 
Each contracting government shall make similar notification of 
aerodromes which have been constituted local areas. 
The government of any noninfected country in which one of the 
five designated diseases makes its appearance shall transmit the 
necessary information to the competent authorities of each of its 
authorized aerodromes. 
The chief health authorities shall transmit to the sanitary and 
authorized aerodromes of their respective countries all information 
contained in the epidemiological notifications and communications 
received from the International Office of Public Health. 
The discovery in a territory of yellow fever in endemic form shall 
be immediately reported to other contracting governments. 
Special sanitary agreements reached by any two or more contract- 
ing governments shall be notified to the International Office of Public 
Health or the International Commission for Air Navigation. 
VI. Diseases 
The diseases which are the subject of the special measures pre- 
scribed by Article 18 of the convention are: Plague, cholera, yellow 
fever, exanthematous typhus, and smallpox. 
The period of incubation of these diseases is reckoned as 6 days for plague; 
5 days for cholera; 6 days for yellow fever; 12 days for exanthematous typhus; 
and 14 days for smallpox. 
For the purposes of the convention, a local area is considered to be 
infected when the following conditions exist; 
For plague and yellow fever, when the first case recognized as nonimported 
is reported; 
For cholera, when the occurrence of new cases outside the immediate sur- 
roundings of the first cases proves that the disease is spreading; 
For exanthematous typhus and smallpox, when they appear in epidemic 
form. 
Infectious diseases other than the five designated diseases.—If there 
is on board an aircraft a case of an infectious disease, duly verified 
by the medical officer attached to the aerodrome as being other than 
one of the five designated diseases, the sick person may be landed and, 
if the competent sanitary authority considers it desirable, isolated in 
a suitable place. The other passengers and crew may, after medical 
inspection and the application of necessary sanitary measures, be 
permitted to continue the voyage. 
Embarkation of infected persons prohibited.—The competent 
authority of any aerodrome may, on advice of the medical officer 31 
attached to the aerodrome, prohibit the embarkation of persons with 
symptoms of infectious disease, except in the case of the transport 
of sick persons by aircraft especially allocated for that purpose. 
Application of sanitary control measures.—The special measures 
prescribed by the convention constitute a maximum within the limits 
of which the contracting governments may regulate the sanitary 
procedure which may be applied to aircraft. 
It is for each contracting government to determine whether 
measures should be applied, within the limits of the convention, to 
arrivals from a foreign local area or aerodrome. 
In applying sanitary measures to an aircraft coming from an in- 
fected local area, the sanitary authority of each aerodrome shall, to 
the greatest possible extent, take into account all measures which 
have already been applied to the aircraft, in another sanitary aero- 
drome abroad or in the same country, and which are duly noted in 
the journey log book. Aircraft should not be subjected to a second 
application of a sanitary measure unless a subsequent incident has 
occurred which calls for the same measure, and provided the aircraft 
has not called at an infected aerodrome except to take in fuel. 
A. MEASURES APPLICABLE IN CASE OF PLAGUE, CHOLERA, TYPHUS. AND 
SMALLPOX 
ON DEPARTURE OF AIRCRAFT 
The measures to be applied on the departure of aircraft from a 
local area infected by one of the diseases named above are the 
following: 
3. Thorough cleansing of aircraft, especially parts liable to be contaminated; 
2. Medical inspection of passengers and crew; 
3. Exclusion of persons with symptoms, and of close contacts with the sick; 
4. Inspection of personal effects, which shall be excluded unless reasonably 
clean; 
5. In case of plague, deratization, if rats are suspected to be on board; 
6. In case of typhus, disinsectization, limited to persons who, after medical 
inspection, are considered as likely to convey infection, and to their effects; 
7. Details of inspection and treatment shall be entered in the aircraft’s 
journey log book. 
ON ARRIVAL OF AIRCRAFT 
1. Aircraft coming from particular local areas may be required to land at 
prescribed sanitary or authorized aerodromes, an effort being made not to 
hamper aerial navigation. 
2. At authorized aerodromes which are not sanitary aerodromes the only 
measures which, if necessary, may be taken are the medical inspection of crew 
and passengers and the landing and isolation of the sick. Passengers and crew 
may not move beyond the limits prescribed by the aerodrome authority except 
with permission of the visiting medical officer. This restriction may be imposed 32 
at each port of call until the aircraft reaches a sanitary aerodrome, where it 
will be subject to appropriate measures. 
B. SPECIAL MEASURES APPLICABLE AT SANITARY AERODROMES 
PLAGUE 
No case of plague on hoard.—Medical inspection; deratization and 
disinsectization, if required; surveillance of passengers and crew for 
6 days from date of departure from an infected area. 
With recognized or suspected case of plague on hoard.—Medical 
inspection; remove and isolate sick; deratization and disinsectization, 
if required; disinsectization and disinfection of suspected personal 
effects; contacts and suspected persons to be kept under surveillance 
for 6 days. 
CHOLERA 
No case of cholera on hoard.—Medical inspection; surveillance of 
passengers and crew for 5 days from departure from infected area. 
With clinical rase of cholera on hoard.—Medical inspection; re- 
move and isolate sick; disinfect suspected personal effects and parts 
of aircraft considered infected; disinfect and empty out suspected 
drinking water and replace, after disinfection of the container, with 
wholesome water; passengers and crew to be kept under surveillance 
for 5 days. 
Persons vaccinated against cholera.—Persons producing an accept- 
able written certificate that they have been vaccinated against cholera 
within less than 6 months and more than 6 days may be subjected to 
surveillance only. 
EXANTHEMATOUS TYPHUS 
No case of typhus on hoard.—Medical inspection; passengers and 
crew to be kept under surveillance for 12 days from departure from 
infected area. 
With case of exanthematous typhus on hoard.—Medical inspection; 
disembark, isolate and delouse the sick; personal effects suspected by 
the sanitary authority shall be disinsectized; parts of aircraft con- 
sidered to be infested shall be disinsectized; persons suspected of 
harboring lice or having been exposed to infection shall be deloused 
and may be kept under surveillance for 12 days from delousing. 
SMALLPOX 
No case of smallpox on hoard.—No sanitary measures may be car- 
ried out save in case of persons who have within 14 days left a local 
area where smallpox is epidemic and who, in the opinion of the 33 
sanitary authority, are not immune. Such persons may be subjected 
to vaccination, or to surveillance, or to vaccination followed by sur- 
veillance, for a period not to exceed 14 days after arrival. 
With case of smallpox on hoard.—Medical inspection; disembark 
and isolate the sick; nonimmnne contacts may be vaccinated or kept 
under surveillance for 14 days; suspected personal effects and such 
parts of the aircraft as may be considered infected shall be dis- 
infected. 
Persons shall he considered immune to smallpox.— (a) If they can 
produce proof of a previous attack of smallpox or of vaccination 
done within less than 3 years and more than 12 days; or 
(b) They show local signs of early reaction attesting to adequate 
immunity. 
Proof of immunity may also be afforded by an acceptable written 
certificate. 
C. MEASURES APPLICABLE IN CASE OF YELLOW FEVER 
GENERAL PROVISIONS 
Determination of existence of endemic yellow fever.—Where the 
endemicity of yellow fever is suspected, the contracting governments 
shall take the necessary steps to ascertain whether yellow fever exists 
in their territory in a form which, though not clinically recognizable, 
might be revealed by biological examination. 
Notification of other governments.—Each contracting government 
undertakes to notify immediately the other contracting governments 
and the International Office of Public Health the discovery in its 
territory of the actual existence of yellow fever in the above- 
mentioned form. 
PROVISIONS CONCERNING REGIONS IN WHIC H YELLOW FEVER IS ENDEMIC 
Every aerodrome situated in a region in which yellow fever exists 
in a form clinically or biologically recognizable, shall become an anti- 
amaryl aerodrome. 
Aerial navigation shall be suspended in any region in which yellow 
fever is endemic until an anti-amaryl aerodrome has been established. 
MEASURES TO BE TAKEN ON DEPARTURE OF AIRCRAFT PROM ANTI-AMARYL 
AERODROME 
The following measures shall be taken as late as possible before 
departure: 
1. Inspection of aircraft and cargo for mosquitoes and, if necessary, disin- 
sectization. A record of the inspection and of action taken shall be entered 
in the journey log book. 
2. Medical inspection of passengers and crew; suspected cases and those 
known to have been exposed to infection shall be kept under observation, under 34 
conditions approved by the sanitary authority, until 6 days have elapsed since 
last exposure; 
3. Names of passengers and crew shall be entered in the journey log book, 
together with relevant information regarding exposure and period of observa- 
tion. 
MEASURES TO BE TAKEN ON ARRIVAL AT AN ANTI-AM ARYL AERODROME 
1. Inspection of aircraft and cargo for mosquitoes and, if necessary, disin- 
sectization ; 
2. Medical examination of passengers and crew; 
3. Persons suspected to be suffering from yellow fever and those who do not 
satisfy the sanitary authority that 6 days has elapsed since last exposure, may 
be subjected to observation for a period not exceeding 6 days from the last, dav 
on which the person could have been infected. 
MEASURES APPLICABLE TO REGIONS WHERE YELLOW FEVER DOES NOT EXIST 
BUT IN WHICH CONDITIONS PERMIT OF ITS DEVELOPMENT 
1. Inspection of aircraft and cargo for mosquitoes and, if necessary, dis- 
insectization ; 
2. Medical examination of passengers and crew for symptoms of yellow fever; 
3. Observation of suspected cases and of persons who have not completed the 
incubation period for the disease. 
Any aircraft which does not wish to submit to these measures is 
at liberty to continue its voyage but it may not land in another 
aerodrome of the same country, except to take on supplies. 
If isolated, an aircraft may take in fuel, replacements, food and 
water, and may discharge cargo provided the goods are subjected, if 
necessary, to all sanitary measures and restrictions applicable to 
merchandise, as set forth in the convention. 
Passengers may be discharged at their request, on the condition 
that such passengers submit to the measures prescribed by the sani- 
tary authority. 
Save in exceptional circumstances, which will require to be justified, 
aircraft coming from regions where yellow fever exists will not be 
prohibited from landing in a disease-free area in which conditions 
may permit of the development of yellow fever. In this connection, 
full consideration is to be given to measures which were taken at the 
aerodrome of departure. 
Contracting governments may, however, designate particular sani- 
tary aerodromes as those at which aircraft from territories where 
yellow fever exists shall land for the purpose of disembarking pas- 
sengers, crew, and cargo. 35 
MEASURES APPLICABLE TO REGIONS WHERE CONDITIONS DO NOT PERMIT OF 
THE DEVELOPMENT OF YELLOW FEVER 
Aircraft coming from regions where yellow fever exists may land 
on any sanitary or authorized aerodrome. 
Measures which may be applied on arrival are: 
1. Medical inspection of passengers and crew ; 
2. Inspection of aircraft and cargo for mosquitoes and, if necessary, disin- 
sectization. 
VII. Observation and Surveillance 
Observation means the isolation of persons in a suitable place. 
Surveillance means that persons are not isolated, that they may 
move about freely, but that they may be subjected to a medical 
examination to determine their state of health and that the sanitary 
authorities of the place or places they propose to visit will be notified 
of their coming. 
As a means of expediting travel without sacrificing sanitary con- 
trol, surveillance is the measure of choice and may not be replaced 
by observation except: 
(a) In circumstances in which it would not be practicable to carry out 
surveillance with sufficient thoroughness; or 
(b) If the risk of the introduction of infection into the country is considered 
to be exceptionally serious; or 
(c) If the person who would be subject to surveillance cannot furnish adequate 
sanitary guarantees. 
Persons under observation or surveillance shall submit themselves 
to any examination which the competent sanitary authority may con- 
sider necessary. 
Mechanism of surveillance.—Persons liable to surveillance may nev- 
ertheless continue the voyage on condition that the fact is notified 
to the authorities of subsequent landing places and of the place of 
arrival, either by means of an entry in the journey log book, or by 
some other method sufficient to secure that they can be subjected to 
medical inspection in any subsequent aerodromes on the route. 
Conditions under ivhich observation may be modified.—Persons 
who are being observed for diseases other than yellow fever may, 
with the approval of the sanitary authorities of their place of desti- 
nation, be permitted to continue their voyage before the end of the 
incubation period of the disease for which they are being observed. PAN AMERICAN SANITARY CODE 
The Pan American Sanitary Code is an international treaty con- 
cluded at Habana, Cuba, on November 14, 1924 and ratified by all 
the twenty-one American Republics including the United States (44 
Stat. 2041). 
This Convention governs all matters, dealing with international 
quarantine as it applies to maritime and air commerce in the western 
hemisphere. 
Article 61 of the Pan American Sanitary Code provides as follows: 
“The provisions of this convention shall apply to aircraft, and the 
signatory Governments agree to designate landing places for aircraft 
which shall have the same status as quarantine anchorages.” 
In the development of international air navigation in the western 
hemisphere it has been the established policy of health authorities 
not to cause unnecessary delay in the dispatch of aircraft. 
In recognition of the above principle, the Ninth Pan American 
Sanitary Conference which met in Buenos Aires in November 1934 
“interpreted” the provision of the Pan American Sanitary Code which 
requires all vessels to carry bills of health, as follows: 
“In view of special conditions attendant upon international aerial 
navigation the master or other person in command or in charge of 
any aircraft shall be considered as having complied with Article XVI 
of the Pan American Sanitary Code when he has entered in his 
journey log book the essential sanitary information outlined in the 
model form of Bill of Health contained in the appendix of the Pan 
American Sanitary Code.” 
By virtue of this interpretation it is not necessary for aircraft to 
carry a formal bill of health, but only appropriate entries in the 
log book. 
During the early development of international air navigation in 
the western hemisphere its potential danger as a means for the spread 
of yellow fever was fully recognized. This danger was further em- 
phasized by the discovery of jungle yellow fever in Brazil and in other 
countries in South America including Paraguay, Bolivia, Peru, Ecua- 
dor, Colombia, and Venezuela. 
However, instead of resorting to stringent quarantine measures, 
under the auspices of the Pan American Sanitary Bureau an arrange- 
ment was concluded with Pan American Airways under date of July 37 
12, 1937 (Public Health Reports, July 30, 1937, page 1028) whereby 
the following minimum requirements were established; 
(1) Vaccination of all flight personnel against yellow fever; 
(2) Issuance of a form designated as “certificate of origin of passengers” 
(see pages 18-19) to northbound air passengers departing from any place in the 
western hemisphere lying within 30 degrees south latitude and 13 degrees north 
latitude; 
(3) Fumigation of airplanes while lying at airports at night. 
This program was concurred in by the health authorities of the 
other American Republics and since its establishment in 1937 has 
been continuously applied. 
Flight and ground personnel of the Pan American Airways have 
been periodically vaccinated against yellow fever and some of the 
Governments within the stipulated area of endemicity have vacci- 
nated flight and ground personnel of their national airways.