FINAL REPORT 
INTERDEPARTMENTAL QUARANTINE COMMISSION 
G. L. Dunnahoo, Chairman 
Medical Director, United States 
Public Health Service 
T. B. Magath, Member 
Captain, MC-V(S) United States Naval 
Reserve 
P. T. Knies, Member 
Lieutenant Colonel, MC Army of the 
United States 
10 June 19IX TABLE OF CONTENTS 
Part I 
INTRODUCTION , 1 
FORMATION OF THE COMMISSION 2 
PROCEDURE OF THE COMMISSION 2 
GENERAL OBSERVATIONS 3 
Need for quarantine 5 
QUARANTINE METHODS $ 
Yellow fever 7 
Cholera 8 
Typhus fever 8 
Smallpox ' 9 
Plague 9 
Leprosy 9 
Persons to be detained for observation 10 
QUARANTINE FORMS AND DEVICES 10 
International travel log and immunization record .... 10 
Physical inspection ... 11 
Surveillance 11 
Communicable diseases ....... 13 
Hospital and detention facilities 13 
Boarding 14 
Radio and signal pratique 14 
Ship sanitation 15 
Fumigation 16 
Rat guards 16 
Ship inspection 17 
Delousing 17 
Military traffic 18 
EPIDEMIOLOGICAL INTELLIGENCE . 18 
Consular Health Reports 19 
Bills of Health 20 
Suggested plan 21 
DISINSECTIZATION : 23 
Problems 23 
Importation of disease by infected vectors 29 
Transmission of yellow fever by airplanes ........ 30 
Responsibility for disinsectization 33 
Hazards to the United States 31 
Fumigants - Disinfectants 31 
Methods 33 
Before flight 34 
During flight 35 
On landing 36 
Responsibility of carrier 37 
Reactions of passengers 37 
Confine spraying to one period 37 
Stowaway animals 38 
Marine and terrestrial conveyances 39 
Military aircraft 39 
Page Page 
ADMINISTRATION OF QUARANTINE 41 
Flexibility of regulations 41 
Treaty provisions 41 
Lack of correlation 41 
Codes 43 
Transportation of animals 44 
Divided effort 44 
SUGGESTED ORGANIZATION 45 
Officers in charge of quarantine 45 
Informal liaison board 45 
Spheres of responsibility 45 
Training of personnel 47 
QUARANTINABLE AND EXOTIC DISEASES IN FORCES ABROAD 4B 
Part II 
INTRODUCTION 1 
I. QUARANTINE; INTERNATIONAL CONSIDERATIONS 1 
II. QUARANTINE: THE UNITED STATES 3 
III. QUARANTINE: INTERSTATE TRAFFIC 4 
IV. QUARANTINE: UNITED STATES . 4 
SPECIAL SUMMARY 6 
Part III 
SUGGESTIONS FOR MODIFICATIONS OF CURRENT REGULATIONS 1 
United States Public Health Service Code 2 
United States Array Regulations and directives . 51 
United States Navy Regulations and directives „ 5B 
Part IV 
Appendix 
Items 
LETTERS 1 to 10 
ITINERARIES . 11 
TRANSLATION: TRAVEL LOG AND IMMUNIZATION RECORD . . 12 
TRAVEL LOG AND IMMUNIZATION RECORD 13 
SURVEILLANCE FORM 14 
SIMPLIFIED BILL OF HEALTH 15 
QUARANTINE DECLARATION . . . 16 
EPIDEMIOLOGICAL INTELLIGENCE: CODE 17 
EMERGENCY CODE . . IB 
DECLARATION OF QUARANTINE-MILITARY VESSELS 19 
AAF REGULATION 61-3 (Revision of) 20 INTERDEPARTMENTAL QUARANTINE COM SSI ON 
Final Report - Part I 
10 June 19U INTRODUCTION 
For centuries, the practice of quarantine* has had an important effect 
on man, agriculture, and commerce. Quarantine officials have been granted 
power to direct and, if need be, to stop international traffic. At times 
such drastic action has been required, but fortunately, it has rarely been 
necessary in recent years. In countries like the United States, the need 
for it has not existed for a long time because of the protection modern 
sanitary progress and hygiene affords. 
Although the trend in quarantine practice has been toward less strin- 
gency, the increase in travel by air and the mass movements of people due 
to war and economic readjustment, require re-examination of quarantine 
practice so that maximal freedom of commerce compatible with adequate pro- 
tection may be assured. 
A published code of quarantine regulations should record the adjust- 
ment between these somewhat opposed ideals in the light of scientific 
knowledge, and as conditions influencing quarantine are not everywhere 
identical, practice in different parts of the world must differ in details. 
Past differences have been partly resolved in the several international 
conferences on aerial and marine quarantine. 
In the United States, national policy in regard to quarantine was 
stated in the basic law of 1893 and further amplified in the codes of 
quarantine regulations of 1920, 1937 and 1944 These have been adminis- 
tered by the United States Public Health Service, through the Division of 
Foreign Quarantine. Other phases of quarantine, such as those related to 
agricultural problems have been covered by other laws and regulations. 
In recent years it had become evident that some quarantine procedures 
might be -revised in view of advances ip sanitation and preventive medicine. 
Interest in -such revision was stimulated by the problems encountered in the 
tremendous volume and necessary secrecy of war traffic, and by the entry of 
airplanes in areas where quarantine facilities were not previously main- 
tained. The situation was presented to the Surgeon General of the United 
States Public Health Service in a memorandum, 26 March, 1943* (App, Item 1) 
*Dr, Robert Olesen, Chief Quarantine Officer at Rosebank, New York, 
properly raised an objection to the use of the word "quarantine” in connec- 
tion with present health and sanitary supervision of traffic and pointed 
out that the word was no longer applicable to nor descriptive of present 
practice. With this the Commission agrees. A number of terms may be 
suggested including his own, "ship health supervision" and "ship health 
supervisors". Others which might be considered are; health supervision 
of traffic, health supervisor of traffic, ship hygiene supervision, air- 
plane hygiene supervisor, health control of traffic, supervisor of health 
control of traffic, port health service, port health officer, traffic 
hygienist and traffic hygiene. The use of the word "quarantine" through- 
out the report is made therefore not as a matter of approval, but because 
no other has been generally accepted. FORMATION OF THE INTERDEPARTMENTAL QUARANTINE COMMISSION 
The Surgeon General of the United States Public Health Service ar- 
ranged for discussion of the matter with the Surgeons General of the 
United States Army and of the United States Navy. In a meeting on 12 April 
1943 the need for a broad study of the subject, and for a coordination of 
the quarantine work of the three services was outlined, with particular 
reference to air-travel and the movements of military personnel. It was 
agreed that a study should be made, and plans were developed for the 
establishment of an Interdepartmental Quarantine Commission consisting of 
a medical representative from each of the services. 
Letters of 23 April 1943 from the Administrator of the Federal 
Security Agency formally proposed to the Secretary of War and to the 
Secretary of Navy that this Commission be formed, requesting represent- 
atives be appointed if the secretaries were in agreement (App. Item 2). 
The Secretary of Navy by letter of 15 May 1943, (App. Items 3 and 4), 
appointed Captain Thomas B. Magath, MC-V(S), U.S.N.H.* as representative. 
The Secretary of War on 11 May 1943 (App. Item 5) appointed Lieutenant 
Colonel Karl R. Lundeberg, MC, U. S. Army, War Department representative, 
but in a letter of July 28, 1943, the Acting Secretary of War appointed 
Major Phillip To Knies, MC, U. S. Army, to replace Lieutenant Colonel 
Lundeberg due to the pressure of duties of the latter in the office of 
the Surgeon General (App. Items 6 and 7). The Administrator of the Federal 
Security Agency on 2 August 1943 appointed Assistant Surgeon General 
Gilbert L. Dunnahoo, U. S. Public Health Service (App. Item 8). 
A letter from the Acting Administrator of the Federal Security Agency 
was sent to the Secretary of Agriculture on 25 May 1943 (App* Itenr9), 
enclosing a copy~af the terms of reference of the Commission, and suggest- 
ing that a representative be appointed if he so desired. The Assistant 
Secretary of Agriculture on 8 June 1943 (App. Item 10), indicated that the 
study as outlined appeared confined to public health quarantine, but 
stated that specialists of the Department would cooperate with the Commis- 
sion upon request. 
PROCEDURE FOLLOWED BY THE COMMISSION 
In its investigations, the Commission first examined the current laws 
and regulations of the United States, and consulted officials whose work 
had familiarized them with the subject. Certain governmental agencies were 
requested to appoint consultants to the Commission, and several shipping 
companies and airways operating foreign services, were asked for comments 
and recommendations. Various military personnel were consulted with par- 
ticular reference to current regulations and projected travel routes, and 
the Commission visited quarantine stations and aerodromes in the United 
States to observe methods in use, and for discussions with experienced 
quarantine officers. 
The Commission then traveled together for about one month in the 
Caribbean area making preliminary observations, and formulating a method 
of investigation to be continued by the members separately in other parts 
of the world. It had become apparent that unless the members of the 
Commission traveled independently, the necessary studies could not be made. The members, separately and together, observed quarantine problems 
and procedures at both civilian and military ports and aerodromes, examined 
local laws and regulations, consulted quarantine officials and Ministers of 
Health, visited laboratories and hospitals of tropical and exotic disease, 
and consulted with well known epidemiologists„ The itineraries of the 
members of the Commission will be found in the Appendix (Item 11)« 
During the course of these studies a critical situation developed 
relative to air traffic between West Africa and Brazil* Fear developed 
over the possibility of transplantation* of Anopheles garabiae by the 
frequent flights between these two areas» The Commission made a thorough 
investigation of the problem and in its second interim report outlined the 
hazards and recommended certain preventive procedures to be put into effect 
in order to satisfy the various requirements. These measures have produced 
the desired results and while they are not specifically reviewed in this 
report, they are embraced in the general discussion of administration of 
quarantine and disinsectization of aircraft* 
It is gratifying to note that although the Commission did not have 
knowledge of the conclusions reached by the quarantine committee of the 
United Nations Relief and Rehabilitation Administration, or of the similar 
committee of the National Directors of Health of the Fifth Pan-American 
Conference, until after it had completed the draft of its final report, the 
general conclusions of the three groups are practically identical. Most of 
the details of administration and procedures suggested are entirely compat- 
ible with each other* 
GENERAL OBSERVATIONS 
No investigation of this subject» particularly during war, would find 
matters static, for details of practice must necessarily be changed often* 
Some procedures noted by the Commission have already been modified or 
replaced, and no action therefore should be taken on the basis of this 
report with respect to any specific item unless its status is reexamined. 
In almost all areas visited there were revisions of practice either under 
way or contemplated in order to catch up with modern conceptions of 
quarantine. 
Cuba was modernizing a marine quarantine code which, along with that 
of the Dominican Republic, had been fundamentally unchanged since 1902. 
Costa Rica was recodifying quarantine regulations, and Colombia was sur- 
veying its problem with the help of an officer of the UoS* Public Health 
Service. Argentina, Chile, and Venezuela were considering revision, and 
Brazil had recently strengthened quarantine by Decree Law No* 5181 in 
January, 1943« The British West Indies, after preliminary conferences at 
Barbadoes in 1942, proposed a modernized quarantine code in November, 1943, 
*As used in this report, Transportation refers to the carrying of 
insects and pests in a conveyance without reference as to whether they 
arrive at a destination in a viable condition or dead and without reference 
to whether they establish a new generation there* Transplantation, refers 
to the arrival, in viable condition, of insects or pests, at a destination, 
but without the production of a new generation. Implantation refers to the 
fact that a new species has been transported, transplanted and has produced 
a new generation at a destination* and in Egypt, Anglo-Egyptian Sudan and India reviews of the problems of 
aerial quarantine were found in progress. During this time, studies of 
the European aspects of the problem were also undertaken by the United 
Nations Relief and Rehabilitation Administration. 
The Commission encountered encouragement and enthusiastic assistance 
in its studies throughout its travel, and noted with satisfaction the 
unanimous opinion of Ministers of Health that international conferences, 
particularly after the war, would be necessary and welcome to establish 
uniformity and effectiveness of international sanitation, particular!}' in 
regard to air travel. It is not premature for the United States to fteview 
the subject of quarantine. 
Many existing provisions of quarantine are not discussed in this 
report in as much as they appear competent to accomplish their purpose. 
Details of quarantine practice were found to vary widely in different 
countries, and even in ports of the same country. In the United States 
quarantine emphasis was found to be placed on yellow fever in aerial 
traffic and on plague in marine; in Brazil, the chief interest was to 
prevent reintroduction of Anopheles garabiae; the Philipine Islands had 
been principally concerned with cholera before invasion; Australia with 
smallpox; and Egypt, Aden and India with yellow fever. Such variations, 
of course, reflected to a considerable degree the dangers pertinent to 
the several areas. 
Travelers from British Honduras ?;ere vaccinated at the Mexican border, 
although in Mexico City and Merida no attention was paid to immunizations. 
On the Gold Coast at Takoradi, the quarantine officer devoted at least ten 
minutes to a careful physical examination of each incoming passenger, while 
at Accra, passengers were seen by a physician only if obviously ill. On a 
Puerto Rican Army airfield, the oral temperature was taken of all passengers 
from the South; at the commercial airfield, only of passengers not immunized 
against yellow fever; and at the Naval Air Station, of no passengers at all. 
Particularly divergent was emphasis on immunization. In the United 
States, a traveler is ordinarily excused from further quarantine if accep- 
tably immunized, while in Australia immunization procedures were not con- 
sidered to eliminate the need for surveillance or even observation under 
detention. 
The United States has placed great emphasis on rat-proof vessels, and 
upon professional inspection to determine the need for fumigation; Australia 
and several other countries were not convinced of the reliability of either 
procedure. Steam and formaldehyde were used for fumigation in New Zealand, 
and sulphur in Australia, Lebanon, and India, while the United States con- 
sidered hydrogen cyanide unsurpassed. 
Many variations in practice might be equally effective, but some 
quarantine procedures observed could not have been expected to exclude or 
detect disease. At the Air Transport Command station at Belem, the temper- 
ature of a passenger was taken only if he reported himself ill, and at the 
hydroplane station though everyone's temperature was taken, it was by 
axillary technic. On a certain island, all vessels of the United Nations 
and airplanes of the Pan American Airways were exempted from quarantine; 
other carriers were carefully examined. In one country, a guard was kept 
on the road from the seaport to the capitol on weekdays during an epidemic 
of smallpox, but was absent on Sundays and holidays. These random examples 
could be multiplied almost indefinitely. Need for quarantine. 
It is the rarity with which cases of quarantinable disease have 
apparently been carried past imperfect quarantine barriers in recent years 
that suggests the re-evaluation of actual quarantine requirements, parti- 
cularly in well-sanitated countries. On the other hand, the historical 
facts of transmission of quarantinable diseases along trade routes 
cannot be discredited. The spread of plague and of typhus along the 
caravan and shipping routes of Asia and Europe are matters of record; 
filariasis in South Carolina was introduced by slaves from Africa, and 
the tapeworm, Diphyllobothriura latum, owes its presence in the north- 
central states to immigration from Finland. 
Malaria has been carried into previously non-malarious areas of this 
country, of the British Isles, and of Australia, by troops returning from 
other wars. Repetition of these misfortunes in the present conflict has 
been anticipated by many speakers and writers, and their apprehension has 
been expressed in terms which at times have been sensational and fanciful. 
Alarm has been voiced, too, over the possible implantation of insect 
vectors of disease, or of agricultural pests into new areas. That such 
implantations have rjceurred in the past by surface carriers are historical 
facts, including the introduction of mosquitoes and plant parasites into 
Hawaii, the cotton boll-weevil and Mediterranean fruit fly into the 
southern, and the corn-borer into the northern states. It seemed reason- 
able to expect additional implantations by air-traffic, and it is, there- 
fore, the more notable that in no known instance to date has an insect 
species succeeded in establishing itself in a new country by this method. 
No case of quarantinable disease has been known to have been carried over 
international boundaries by airplane .*=■ 
Nevertheless, regardless of~the failure of such disasters to materi- 
alize in recent years in spite of new methods of travel and imperfect 
quarantine practice, the conclusion seems inescapable that quarantine 
measures will, continue to be required, even in countries with exce3.1ent 
sanitation, hygiene, and medical care in order to afford that degree of 
assurance reasonably demanded by an alert public. It is equally impor- 
tant, properly to evaluate the problem, and to follow a reasonable 
practice based on maximal efficiency. In this connection, the prophy- 
lactic value of the mere existence of a quarantine service is readily 
admitted« 
QUARANTINE METHODS 
In the past, it was not uncommon for a passenger to arrive from 
abroad suffering from a quarantinable disease, or within the incubation 
period of the disease after exposure en route. Under these conditions 
it was necessary to maintain at each port, facilities for the examination, 
detention and care of such persons„ So fearful were both officials and 
*Since this report was prepared, the Commission has learned of a case 
of smallpox being intercepted at Miami, Florida on arrival of an airplane 
from South America0 The patient admitted he had not been previously vac- 
cinated, although he possessed a certificate to that effects This then 
becomes the first time an international traveler by air has been found 
to be suffering from a quarantinable disease, the public, and so incomplete was the knowledge of the day that these 
quarantine stations were usually located on segregated areas of land, 
preferably on islands. 
As knowledge has increased, and sanitation and medical care has 
improved, the need for such places of detention has decreased, so that 
the Interdepartmental Quarantine Commission found in its studies only a 
few facilities which had been used within recent years, while in some 
countries special hospital and detention spaces have never been used for 
quarantine purposes. In the United States, the formerly extensive de- 
tention facilities are either in use for other purposes, or are lying 
idle as many have done for years, since only thirteen persons have been 
intercepted for quarantina-ble disease in the past ten years. Nine of 
these were for smallpox, a disease by no means absent in the United 
States; two for typhus; and one each for bubonic plague and leprosy. 
It is true that international traffic was greatly depressed during this 
period by economic circumstances, restrictive laws, and by war, but in 
the preceding ten years only one hundred fifteen cases of all quaran- 
tine ble diseases had been intercepted, one half of which were smallpox. 
Thus in both decades the number of interceptions have been inconsiderable 
and during the past three years, only a case of leprosy has been inter- 
cepted. (See table 1). 
Nevertheless, some countries have recently built, and others are 
planning, new quarantine facilities, while there is generally an effort 
to maintain installations already existent. The economy of these moves 
may be questioned. 
There are, of course, outstanding exceptions to the decreased impor- 
tance of quarantine and the disuse of facilities, as in the religious 
pilgrimages of the Near and Middle East, and probably the anticipated 
movements of populations displaced by the war. In these instances there 
has been little evidence to justify lessened precaution., but these pro- 
blems are peculiar to local traffic and of temporary duration-. 
As knowledge grew of the roles of vectors and animal reservoirs in 
the transmission of disease, attempts were made to exclude them from new 
areas. Extensive efforts were made to control rats, yet the several 
species have distributed themselves widely, and Sylvatic plague has 
extended from the West coast to include at least eleven states, and tifcks, 
infected with Rocky Mountain Spotted Fever have been spread throughout 
the United States from the Bitter Root Valley. The control of insect 
vectors has called for delousing procedures, ship sanitation, and fumi- 
gation of conveyances. Although disease might be carried in special 
instances by infected vectors in modern transportation, as plague in rats, 
experience indicates the greater importance of the infected person. Even 
this risk has not seemed large in some countries. 
Experience over a long period of time, and more particularly during 
the present war, has shown that great reliance may be placed on immuniza- 
tion against smallpox, yellow fever, cholera and typhus. The Commission 
believes sufficient evidence has been procured so that a premium in the 
form of freedom from quarantine restrictions may now be given international 
travelers who have valid immunization certificates against these diseases. 
With the exception of restrictions due to the rare possible exposure to 
pneumonic plague, travelers need no longer be quarantined if they are wise. 
In countries like the United States with high sanitary and medical Table 1 
QUARANTINABLE DISEASES INTERCEPTED AT MARITIME PORTS BY THE 
UNITED STATES PUBLIC HEALTH SERVICE 
Year 
Smallpox 
Typhus 
Plague 
.era 
Leprosy 
c 
T 
c 
T 
q 
T 
c 
T 
q 
r-T- 
1924 
7 
14 
1 
8 
1925 
6 
5 
i 
2 
2 
1926 
17 
2 
2 
1927 
10 
2 
2 
2 
1928 
5 
1 
2 
7 
1 
1929 
3 
1930 
4 
1 
1931 
5 
1 
1 
1932 
1933 
1 
\ 
1934 
1 
2 
1 
1935 
1 
1936 
1 
2 
1937 
1938 
1 
1 
1939 
1940 
1 
1 
1941 
1942 
1943 
1 
Total 
62 
25 
6 
0 
4 
0 
0 
7 
5 
14 
C“-continental T~territories and possessions standards as a defense in depth, it must be conceded that one person or 
even several, suffering from querantinable disease might gain entry with- 
out the development of secondary cases, or with the quick limitation of 
any spread which might occur. One may practically disregard, for purposes 
of this discussion, the danger of anthrax or psittacosis since regulations 
are not concerned with persons, but with bristles and with psittacine 
birds respectively. Of course, as with persons suffering from other in- 
fectious diseases, such a patient, if diagnosed should be allowed to enter 
the country only after proper precautions have been taken. 
It is frequently proposed that the five internationally quarantin- 
able and the several additional internationally notifiable diseases should 
be supplemented, or perhaps reduced in numberu The Commission has dis- 
cussed this point at length, and contrary to earlier opinions is convinced 
that no change is necessary now0 
Certain remarks on the several quarantinable diseases follow 
Yellow fever 
It has been nearly forty years since the last known person with 
yellow fever arrived in the United States. The present distribution of 
epidemic yellow fever renders it improbable that a person in the incuba- 
tion period would arrive in this country by ship or plane, and if such 
did occur in this or in other countries with well-organized Public Health 
Departments and reasonably low indices of Aedes aegypti, few if any 
secondary cases would likely occur. In less fortunately situated or in 
unsanitated countries, however, the introduction and spread of the dis- 
ease remains a threat and quarantine must be effective. 
This is not meant to imply that Aedes control is practiced or is 
effective in all cities of the United States. In Key West, Florida, an 
elaborate attempt to control breeding of Aedes aegypti has not met with 
the success it has in Brazil. Nevertheless the past epidemics of yellow 
fever have been brought under control by reduction of Aedes aegypti, and 
by the expedient of placing persons with yellow fever under screens. 
With the understanding of the mode of transmission of yellow fever and 
the facilities available in the United States for its control, it is not 
reasonable to expect a serious calamity in the form of a widespread 
epidemic of yellow fever. In a recent report published by the Rockefeller 
Foundation (19-43) it was stated: "The reduction of aegypti breeding to a 
point where yellow fever disappears from the towns and cities worked is 
relatively easy, as the dramatic results of early campaigns testify." 
No traveler should be permitted to pass from an endemic or epidemic 
yellow fever zone, into a "clean" country unless protected by immuniza- 
tion, or until the lapse of the incubation period of six days after last 
possible exposure or unless the traveler is followed by surveillance or 
is detained. Immunization should be evidenced by dependable certificate 
attesting prior infection with the disease, or vaccination at least ten 
days and not more than four years before entry into the "clean" area, or 
serological evidence within one year of post-vaccinal immunity* Owing 
to the nature of the vaccine, at this time the certificates should be 
given by organizations or persons approved internationally, or by the 
Public Health Service of the country to which entrance is sought. In 
the United States persons presumptively exposed in an endemic area, but 
not immune, should be released under surveillance, and if from an epidemic 
area, should be detained for the necessary period. The local quarantine 
7 officer should be allowed some discretion in applying these regulations« 
. From time to time, the boundaries of those areas considered dan- 
gerous from the standpoint of yellow fever should be reconsidered on the 
basis of current knowledge, by international health agents and represen- 
tatives of the country concerned. It is considered that any arbitrary 
period after infection before an area may be considered "dean" is 
impracticable and should be replaced by regular and frequent review of 
the status of all questionable areas. Much of the past and current 
difficulty in reaching rational policy in immunization of travelers 
transient through arbitrarily designated yellow fever areas would be 
automatically eliminated in this manner. 
Unofficially, due regard has properly been given by the U.S. Public 
Health Service to the exception from endemic status of those coastal 
areas of South America free from clinical yellow-fever, the vector, or 
both, such as Natal, Belem, Rio de Janiero and Recife. Many other places 
important in international travel could be excepted similarly by evalua- 
tion of their status * It is obvious that any effort to take advantage 
of anti-araaryl conditions must depend not only upon the current incidence 
of vector and disease, but also upon current knowledge of health conditions 
and continuous inspection. Where these are not available, zonal desig- 
nation cannot be abandoned. 
Cholera 
Since cholera is spread primarily by contaminated water and poor 
general sanitation, there is little reason to expect epidemics in countries 
like the United States, even if carriers or persons with the disease were 
to enter. Under poor sanitary standards the threat always remains, but 
in the light of experience with vaccine in pilgrimage traffic and among 
military forces in China and India, valid vaccination certificates should 
relieve the traveler of all quarantine procedure„ Immunisation should be 
accomplished within six months before entering a "clean" country from one 
reporting epidemic cholera, The vaccination of individuals in areas of 
endemic cholera, not of epidemic proportion, is a matter of individual 
preventive medicine rather than of quarantine importance., 
Typnus fever 
The typhus group of diseases is endemic over such a wide area of the 
earth that in many countries quarantine against them appears futi3.e. In 
the United States where murine typhus* tick-fever (typhus) and Rocky 
Mountain Spotted Fever of both eastern and western types are endemic, 
rickettsioses have certainly been spread more extensively by domestic 
commerce than by importation, and hence the value of restraint of inter- 
national travel would appear limited, the more so since in the absence 
of generalized lousiness, exanthematous (European, epidemic, louse-borne) 
typhus could not be expected to achieve important incidence here. 
Persons demonstrably lousy upon arriving in this country should, of course, 
be deloused as at present. 
As a general quarantine policy, a valid vaccination certificate should 
relieve a passenger from all quarantine procedure except for delousing, 
but as with cholera, should not be insisted upon unless the traveler ar- 
rives within the incubation period from areas in which the disease is 
present in epidemic degree. Vaccination In non-epidemic areas is again 
individual prophylactic medicine. Smallpox 
One requisite of all international travel should be a valid certifi- 
cate of immunity against smallpox. This is considered reasonable, and 
is already required by some countries as the only practicable measure 
in view of the wide distribution of the disease. If generally required, 
no further consideration of smallpox from a quarantine viewpoint would 
be necessary. In the absence of exposure to epidemic smallpox, the as- 
surance of immunity at three-year intervals is considered adequate, if 
over the signature of a registered physician; yearly assurance should 
be given by an accredited public health official in case of epidemic or 
malignant smallpox. 
Any person without a certificate should be refused international 
travel and failure of a carrier to observe this requirement should call 
for a penalty. Persons arriving without certificates should be vaccinated 
and placed under observation or surveillance until immunity is assured, 
or should be detained for the remainder of fourteen days not expired after 
last contact. Objectors should be required to obtain the prior consent 
of the countries concerned before beginning travel without immunization 
certificates. 
Plague 
Plague in wild rodents has existed in the western United States for 
years with no more than occasional human infections Of course, were 
domestic rodents to become infected widely, thereby increasing opportunity 
for human exposure, plague might become a much more serious problem« 
Pneumonic plague is a menace of note fortunately rare, and its occur- 
rence aboard an international conveyance or in an international port, 
should require that the patient be isolated and that contacts be detained 
under observation» 
Were a conveyance to arrive with bubonic plague aboard, it would be 
sufficient to isolate the patient in any approved infectious disease 
hospital. Even if persons were to enter the United States without such 
segregation, secondary cases would be very unlikely. Undoubtedly endemic 
disease has been cared for in this as in many other countries without un- 
fortunate consequence. The value of antiplague vaccination is not at 
this time sufficiently established to warrant its acceptance in lieu of 
all other quarantine procedure. The chief concern is of the introduction 
of plague infected and flea-infested rats among the rodent population of 
ports of arrival. This phase of the subject will be discussed in the 
section on Ship sanitation. 
Leprosy 
No special quarantine procedures need be instituted against leprosy 
although infected aliens should not be granted international passage 
except under close immigration control. If arriving otherwise in a 
foreign port, a patient should be detained and returned to his native 
country. 
Despite recognition by quarantine officers of advanced stages of 
this disease, the probability of detection and identification of persons 
in early stages at quarantine stations must be considered slight. Tradi- 
tional abhorrence of the disease should not prevent judicious rather than 
hysterical assessment of the problem. Persons to be detained for observation 
In the United States and other countries of like sanitation and 
health standards, detention in quarantine should be limited to the fol- 
lowing exceptional conditions of arrival: 
(1) Persons whose exposure to pneumonic plague has been less than 
seven days before arrival. 
(2) Persons, unvaccinated or non-immune to yellow fever, from an 
area of epidemic yellow fever less than six days before arrivals 
(3) Persons, refusing vaccination on arrival and not vaccinated 
within the preceding three years, who have been exposed to smallpox less 
than fourteen days before arrival. 
Detention of these persons need not be in a hospital but persons 
in the second category should be required to remain behind screens. 
Personnel employed in and about all ports of entry should ordinarily 
be required to be immunized against smallpox, yellow fever, and typhus. 
QUARANTINE FORMS AND DEVICES 
International travel log and immunization record 
The examination of all persons just prior to international travel 
by a qualified quarantine official would be most desirable, but it is 
evident that no such procedure is likely to be effected in view of obvious 
impracticability except perhaps in the military services or in post-war 
immigration processing. In the absence of such examination, the passenger 
should be required to give a written statement of his whereabouts for the 
past fourteen days in order to permit evaluation of his possible contact 
with quarantinable disease. He should also offer valid certificates of 
vaccination against smallpox, against yellow fever if he has been within 
areas considered endemic or epidemic, and against the other quarantinable 
diseases in accordance with the policy previously discussed* Certificates 
should be signed either by Public Health Service officers, or by selected 
physicians approved by the Public Health Service or by the consuls of the 
countries to be visited. 
Data can be given~±n a Travel Log and Immunization Record which 
should be internationally approved, and should be possessed by every 
individual in international travel. Any form for this purpose should be 
kept as simple as possible, and the use of a consolidated form, parti- 
cularly for immunizations, should be insisted upon rather than separate 
forms for each. A suggested example of this document is presented in 
the Appendix (Item 13), which can be inserted in a typewriter or filled 
out by hand. 
Forms should be available from the agent of the carrier in order 
to facilitate travel procedure, and the passenger should be required to 
fill in data as to areas visited both before and in the course of his 
travels. A responsible representative of the carrier should be empowered 
to copy valid vaccination certificates onto the form, thus attesting to 
the existence of the original copy. This copying is only for the purpose 
of obtaining a consolidated form, and in no way should be considered to 
eliminate the requirements for the original certificates, nor to infer 
the endorsement by the carrier of the physician giving the immunization. 
It is suggested that the difficulties of language be overcome by 
having the form printed in the language of the country of origin of the traveler; translation can be assured by a transparent sheet superiraposable 
upon the traveler’s record, so as to cover the unintelligible language 
thereon with the proper equivalent in the language of the quarantine 
officer* An example of such a transparency is also included in the 
Appendix (Item 12), Another method of solving the problem of language 
difficulties, would be to number the several items in the document and to 
have available translations of the numbered items. 
In the absence of this form, which should greatly simplify quarantine 
procedure upon arrival, the traveler should be required at each interested 
station en route and at his destination to present the data as to his 
whereabouts, and to show the original certificates of immunizations which 
may be required. 
As noted, any form should be kept simple; data, such as age, sex, 
occupation, etc., which are available from the passport, or on observation, 
or inquiry should be omitted. It is to be noted that the form suggested 
is not the usual "health certificate" which indicates only the absence 
of illness at the moment of a medical examination, without reference to 
immunizations* It is further believed that quarantine and immigration 
medical procedures should be kept distinct, even though performed by the 
same personnel. 
Physical inspection 
The quarantine processing of travelers entering a port or airfield 
has traditionally included "physical inspection", a term chosen in acknow- 
ledgement that "physical examination" at such a time would be an imprac- 
ticable routine« This inspection ordinarily consists of a visual examina- 
tion of the exposed parts of the body, with an appraisal of the general 
appearance of the traveler* In some placed temperatures are taken* 
It is recognized that the symptoms of the quarantinable diseases will 
ordinarily be evident, though In some cases the existence or nature of 
illness may be missed in rapid routine processing* While the quarantine 
officer in this country has authority to detain a suspect for extensive 
examination to establish freedom from quarantinable disease, the value of 
this provision depends on the efficacy of the screening inspection which 
some consider competent and others regard as a gesture* Regardless of 
that point> some consider that physical inspection has the disciplinary 
value of discouraging disregard or flouting of regulations * 
It is believed that evaluation of a traveler’s itinerary and 
immunizations in the light of current knowledge of disease conditions 
recently encountered by the traveler would afford a more effective, 
dependable, and defensible quarantine control than is obtained by visual 
inspection without other aids, avoiding ridicule at times heaped upon 
the present procedure* This system would be equally applicable to air, 
marine, or•rail travel * 
Surveillance 
It is at times desired to follow certain persons, entering a 
country, by surveillance for quarantinable disease. This may become 
more common as air travel increases in view of the possibility that 
persons may arrive by air within the incubation time of exotic diseases. 
In small, well-organized countries, with district health officers in 
sufficient numbers, persons under surveillance can be followed with ease, 
11 but in large countries the practice becomes difficult and frequently 
fails. 
The technic of surveillance has varied. In the Eastern pilgrimages, 
its completion is assured by the deposit of a bond by the traveler; the 
same procedure is employed in the Gold Coast, and was recently adopted 
for the British West Indies, since it was considered that a monetary 
incentive or penalty was necessary. 
Present practice of the U.S. Public Health Service places the 
responsibility jointly on the passenger without bond, and on the local 
health officer, with no consistent method of follow-up. The efficiency 
of this method is not known, for while it is anticipated that quarantin- 
able disease would be reported to the U.S. Public Health Service, there 
is no data available as to the number of persons for whom the system of 
surveillance may have failed. 
It is recommended that persons placed under surveillance in the 
United States should deposit #100.00 with the Customs official, and be 
given in return a serially numbered receipt in the form of a return post 
card (App. Item 14-). The receipt should contain instructions to the 
passenger and the physician to be consulted. The passenger should 
present the card to the physician of his choice and upon completion of 
the surveillance, the card, properly filled out, should be returned to 
the Customs official who will return the deposit fee and forward the 
card to the Chief of the Division of Foreign Quarantine, U. S. Public 
Health Service. The passenger should be required to report every second 
day by telephone or in person, to either an authorized Public Health 
Medical officer or to a licensed physician, and in person on the terminal 
date of surveillance. 
The details of handling the money and the receipts should be worked 
out by the Treasury Department. This procedure has been discussed with 
the consultant to the Commission from the Bureau of Customs and in his 
opinion is feasible. 
Surveillance should be limited to those persons who, because of 
probable exposure, actually warrant this procedure, as in the following 
circumstances: 
a. Persons from an endemic yellow-fever area less than 
six days, and unvaccinated or non-immune. 
b. Persons from an area of epidemic cholera, not 
immunized and arriving in less than five days 
after exposure. 
c. Persons, vaccinated upon arrival, who have been 
vaccinated within the preceding three years, and 
who have been exposed to smallpox less than 
fourteen days-before arrival. 
This practice would minimize the number of persons placed under 
surveillance, and at the same time assure effective procedure when consi- 
dered necessary, whether the traveler became ill or remained well. It 
is necessary that addresses given by travelers for surveillance be 
dependable, and the names of transient hotels should not be accepted 
as a rule. Permanent, semi-permanent, or business addresses should be 
required; the local office of the carrier may at times suffice. 
On some occasions it will be necessary to permit important persons 
to travel internationally without having been properly immunized. From the public health standpoint this will involve yellow fever and smallpox 
only. In order to facilitate his travel and at the same time insure 
that such requests are not excessive, it is proposed that all requests 
for U. S. citizens and military personnel be forwarded through proper 
channels to either the Secretary of War, Navy or State. Others should 
forward requests to comparable authorities„ The proper authority should 
then furnish the applicant, if he deems it proper, with a statement 
attesting to the urgency of the trip and requesting all countries to 
honor the request. Such an individual should be immunized at the first 
opportunity and report for a physical inspection at least every other day 
until the immunizations become effective. If passing through a yellow 
fever zone during the same period he should remain behind screens from 
sundown to sunrise, and should sleep under a bed net. 
Communicable diseases 
The terras of reference of the Commission directed it to inquire into 
the general problem of exotic and communicable diseases, and therefore 
in several paragraphs will be found reference to certain non-quarantinable 
diseases. 
Some communicable diseases not on the quarantine list should be 
notifiable to the local health authorities, and infected persons should 
be isolated by the U.S Public Health Service on account of these diseases 
whenever the local health authorities cannot, for adequate reason, handle 
the situation, costs in such instances being assessed to the local agency. 
These diseases should include typhoid fever, chicken-pox, measles, 
raeningococcic meningitis, whooping cough, scarlet fever, diphtheria, 
poliomyelitis, and infectious encephalitis; others might be added as 
required locally. Notification without detention should be made in known 
cases of malaria, filariasis, leishmaniasis, leprosy in a citizen of the 
United States, relapsing fever, trypanosomiasis and richettsioses other 
than louse-borne typhus fever. As noted elsewhere, the Commission is 
of the opinion that none of these need be added to the quarantinable 
diseases as understood in international procedure. 
Quarantine hospitals and detention facilities 
Rarely should it be necessary for the U.S. Public Health Service 
to own and operate detention space for quarantine purposes. Marine 
hospitals, or other federal, state, county, municipal, or private 
institutions should be utilized providing adequate isolation facilities 
are available. It is considered that any quarantinable disease can 
properly be cared for in the isolation section of a licensed hospital 
in this country without undue exposure of attendants or of other patients. 
Certainly endemic cases of the quarantinable diseases have thus been 
successfully handled. On the rare occasions when a group of persons may 
require detention for a short period, local hotels or other buildings 
may be utilized. Funds formerly devoted to the upkeep of special deten- 
tion spaces, and to transportation to inaccessible stations may be better 
used in some other public health activity. Boarding of vessels, planes, and trains 
For years it has been increasingly apparent that the use of well- 
trained physicians to meet ships, and to inspect planes and passengers 
was a questionable use of critical manpower. This has in practice been 
reflected in dissatisfaction with such assignments on the parts of 
ambitious officers. Some countries with sanitary standards comparable 
to those of the United States have already substituted trained but non- 
medical personnel for this purpose, and if the system outlined in this 
report for disease notification, and for individual travel-logs and 
immunization records were adopted, physicians-would be needed only in 
consultative capacity. 
In the routine handling of passengers arriving by air, a nurse, 
preferably with public health training, should be able to carry out all 
necessary functions. There should be available for consultation when 
necessary either a medical officer of the U.S. Public Health Service, 
or an approved local civilian physician familiar with the quarantine 
viewpoint. This practice is now in effect in certain Army posts in 
foreigh areas where quarantine duties are being well handled by Air 
Corps nurseso 
The question has been correctly raised as to whether -or not a nurse 
would be able to perform these duties. There is no question concerning 
her ability from a professional standpoint. The fact that nowhere in 
the world to date has a single case of quarantinable disease been en- 
countered in international air traffic, suggests that one not even so 
well trained as a nurse would be able to perform the duties, they being 
essentially clerical in nature. The question concerns the psychological 
effect on the passengers and crew which might result in a belief that 
the function lacked importance and therefore could be side-stepped. The 
general esteem in which nurses are held, the general use of women as 
hostesses in and about air fields and the fact a physician would be 
always available for consultation would appear to assure success to the 
use of nurses in this duty. In certain ports, physicians of the Civil 
Aeronautics Administration would be available as health consultants. 
In marine traffic, the essential information could be. obtained 
a Sanitary Inspector or by other personnel below the status of physician 
including the Customs officer, immigration Officer, or the pilot. It is 
understood, of course, that when such personnel encounter a situation 
beyond definitely prescribed limits, a physician should be available for 
consultation. These suggestions, while opposed to the tradition that all 
quarantine must be accomplished by a medical officer, are already in 
effect with success in some Dutch, Canadian, and British ports. It is 
to be emphasized that the non-professional personnel will not be called 
upon to determine medical judgements, for.which they are obviously un- 
qualified, but rather to determine compliance with quarantine require- 
ments in the matter of travel, elapsed time, and immunizations, essentially 
clerical functions. Severe penalty for non-cooperation should discourage 
carriers from attempting any advantage of the situation. 
Radio and signal pratique 
In recent years, under close control, certain reliable and well- known vessels, on regular run, were given permission by radio to dock 
with quarantine inspection alongside rather than in quarantine anchorage, 
and in these instances, the inspection when made was more "sanitary” than 
"quarantine". This procedure saved much time and expense to the carrier, 
and was a jealously guarded privilege. It has been suspended during the 
war for security reasons, but it would appear possible to continue the 
same practice even now, employing signal flags or other media of communi- 
cations that would permit the saving of time even more valuable now than 
in peacetime. 
In the case of approved ships with valid certificates of derati- 
zation or deratization exemption, such radio or signal pratique should 
be granted to those: 
a. From "clean" ports with or without a doctor aboard 
provided no one is ill. 
b. From "clean" ports when a doctor is aboard, and 
those ill do not have quarantinable disease. 
c. From an infected port when no communication has been 
had with the port. 
d. From an infected port if a doctor is aboard, and no 
persons are ill with quarantinable disease, and the 
port was not a plague port. 
e. From an infected port, if the incubation period for 
the quarantinable disease in question has elapsed en 
route, and no doctor is aboard but no one is ill, or a 
doctor is aboard and no one is ill of quarantinable 
disease, all providing that the port was not a plague 
port* 
In other words, radio or signal pratique should not be granted if: 
a. The ship has had communication with a plague port. 
ba There are ill persons aboard and no physician„ 
Co There were cases of quarantinable diseases aboard 
at any time during the passage. 
d. The time after leaving an infected port has not 
been greater than the incubation period of the 
disease in question, and a doctor is not aboard. 
e. The ship does not have a valid deratization 
certificate, or if there has been evidence of 
plague among rats on board. 
It is evident that the above information is the same as that called 
for in Quarantine Declaration, so that pratique is granted simply upon 
the provisions of the Declaration and approval of the carrier with 
reference to reliability. 
Ship sanitation 
In times past, it was common to have ships arrive in port with crew 
and passengers living in conditions of filth. After the rat was identi- 
fied with the spread of plague, effort was directed against the large 
rat populations that would develop on board vessels, and which were proved to be a factor in the spread of plague from one area to another 
due to the movements of the ship* In the United States there has been 
a continuous decline during the past ten years, in the number of rats 
per vessel recovered following fumigation, and a marked decline in the 
number of vessels fumigated. This decline may be attributed to a 
number of factors. ' The standards of ship sanitation have been greatly 
improved. Rat life has been kept down by persistent trapping and 
poisoning, and by measures of general cleanliness. 
The most significant factor has been the large numbers of new 
vessels of ratproof construction placed in service. During the past 
six years only one vessel of this type has had to be fumigated for the 
destruction of rat life. An increasing number of vessels already in 
service have installed ratproofing measures, and this should also be 
stressed as supplementary to ratproof construction of new ships. The 
objective of all quarantine officials and ship operators should be the 
elimination of the necessity for fumigation by improved overall ship 
sanitation. 
Fumigation 
Sulphur dioxide, generated by one of several methods, has long been 
accepted as a standard method of fumigation but is objectionable because 
of its corrosive action on metals and other ship fittings and in the 
unwieldy technic of generating the gas. 
Hydrocyanic acid gas may be used in concentrations from one half 
ounce to eight ounces per thousand cubic feet of space, and with an 
exposure time from one-half to eight hours, depending upon the circum- 
stances and purpose of the fumigation. The minimal dose and exposure 
time are directed towards the destruction of mosquitoes, while the maximal 
rate may be necessary for the destruction of all vermin. An acceptable 
dose for rodents is two ounces per thousand cubic feet, with an exposure 
time of from two to four hours. The principal disadvantage of hydro- 
cyanic acid gas is its high toxicity requiring that it be handled by 
carefully trained personnel. The most convenient method of fumigation 
is the use of fiber discs impregnated with the hydrocyanic acid.. This 
method affords a very accurate dosage for the various sized compartments. 
Rat guards 
Rat guards on lines from ships to the shore have been a traditional 
device to prevent rats from boarding ships. 
Guards of proper construction and properly applied would effectively 
serve the purpose. In some ports, an attempt is made to make rat guards 
effective by patrol by sanitary officers, but observations generally 
indicate less than 50 percent efficiency in actual application. It is 
exceptional that a vessel will have all lines protected with guards 
properly applied. Considering the risk of loading infected rodents in 
cargo or of their boarding by gangway, through ports*or other means, it 
is the opinion of the Commission that the general use of rat guards on 
hawsers may be abandoned. The results accomplished in overall control 
of rat life on shipboard will not justify the necessary materials and 
man hours for their application. The same effort applied to other measures of rat control would be more effective. If a port is infected 
with rodent plague, or plague is present on board a vessel, or under 
other exceptional circumstances, the application of rat guards or other 
special precautions will probably be justified. 
New vessels of ratproof construction when properly maintained will 
not permit a rat colony of serious disease significance to develop. 
Ordinarily these ships can be maintained completely free from rats. 
Ship Inspection 
The examination of ships for rats or other vermin should be carried 
out by sanitary inspectors trained for the purpose. These individuals 
attain, with experience, a high degree of skill and accuracy, and the 
use of their talents should be utilized, thereby minimizing the necessity 
for routine periodic fumigation of vessels. 
Delousing of personnel and their effects 
Much emphasis has in the past been placed upon assuring freedom from 
vermin of immigrants, troops, prisoners of war, evacuees and the lower 
grades of steamship passengers, upon entry into the United States. This 
has perhaps been in part in deference to ideals of personal cleanliness, 
but primarily was aimed at the exclusion of louse-borne typhus fever. As 
a result, many quarantine stations have had elaborate steam and cyanide 
delousing chambers and facilities for delousing of personnel. 
However necessary in the United States these installations were in 
the past, their frequent state of disrepair or conversion at present indi- 
cates the rarity of their use in recent years. Due to scientific advances 
and the disadvantages of steam in the damage of woolens, leather, and 
other effects, substitute measures have been sought, and employed in the 
present war. Specially designed chambers for hot air or gaseous fumigants 
including methyl bromide and hydrocyanic acid gas have been designed, and 
when carefully built and operated are considered equal to the steam units, 
at least as far as vermin are concerned. The fact that sterilization in 
a bacteriological sense is probably not attained has not restrained 
general adoption of the method. Methyl bromide in particular has been 
well thought of and provided for use in chambers as well as in impervious 
bags. 
Bathing, and dusts or sprays of pyrethrins for the person have 
recently been replaced by a louse-powder containing DDT (para-dichloro-di- 
phenyl-trl-chloro-ethane). Change has also been proposed from fumigants, 
steam, or hot air to the use of DDT for treatment of clothing and effects. 
That DDT is an efficient insecticide is certain and its use in this 
manner for routine delousing of personnel and their effects at ports of 
debarkation and quarantine stations must be seriously considered as a 
practical substitute for all other methods. Its adoption would eliminate 
the need for erection and maintenance of expensive and complicated fumi- 
gating facilities, and for trained personnel to run them. 
DDT, carefully used, would assure the killing of adult lice at the 
time of application, thus eliminating the danger of transmission of 
typhus fever since nits are not thought to inherit rickettsial infections 
Quarantine requirements would thus be satisfied, notwithstanding the possible hatching of additional lice later. Despatch at ports of entry 
would be achieved by simple DDT application, and later hatchings of nits 
could be prevented or the lice killed by retreatment at reception centers 
where esthetic rather than quarantine principles could govern. The 
scientific basis for the procedure, and the demand of necessity for con- 
servation of time, personnel, and equipment are considered by the 
Commission to justify the adoption of this procedure. 
The difficulty of treating barracks-bags and bundled clothing with 
DDT, if not amenable to thorough dusting of the contents with DDT, might 
be overcome by twenty days storage, including the time of travel, a 
procedure accepted to assure the death of both adult and larval vermin. 
At principle ports of debarkation it might be desirable to maintain 
sterilizing facilities, using steam or hot air, against possible emergen- 
cies and because of public demand, but in all average operations DDT 
alone should suffice. 
Military traffic 
Quarantine procedures, necessary in the case of military personnel, 
need not vary particularly from the above; the procedures should in most 
instances be carried out by military personnel in accordance with the 
recommendations of this report in the section on "Administration of 
quarantine" and App. Item 20. 
It should be clearly understood that the interests of the United 
States military organizations are far broader with reference to quarantine 
than are those of the United States Public Health Service. The geographic 
area is much larger and the number of persons traveling is greater. The 
military occupation of islands and areas which are not part of the United 
States , its territories and possessions, places on the Army and Navy 
responsibilities not shared by the United States Public Health Service, 
and hence a definite administrative organization for quarantine within 
the Armed Services will be necessary. 
EPIDEMIOLOGICAL INTELLIGENCE 
The sine qua non of quarantine practice is the knowledge of sanitation 
and prevalence of disease in places from which passengers, cargo, and 
conveyances originate« This information must be accurate and current, 
covering a period before and at the time of departure and available at 
places and time of arrival. This includes, obviously, vital statistics 
of the areas of origin and contact. 
Few countries, including the United States, are above criticism in 
the matter of reporting of disease; outstanding contributing factors in 
this regard include the following; (a) Lack of regulations and mechanism 
for the domestic notification of disease, (b) lack of trained and critical 
public health personnel, (c) failure of physicians to report disease, a 
common fault even in the United States, (d) inaccessibility of rural and 
mountainous areas and (e) deliberate distortion of statistics with a view 
to avoiding adverse effects upon commerce, travel, or political prestige. 
In view of these circumstances, an international structure is recom- 
mended which would provide critique and assistance by trained international observers in the preparation of vital statistics, It is believed that 
a group of such experts traveling and interchanging routes through the 
several participating countries would go far toward establishing uniformity 
and dependability in vital statistics. These observers and consultants 
should report to the central agency, any dereliction in the international 
responsibilities of the countries under their surveillance. It is axio- 
matic that so far as practicable such men should be recruited from all 
of the several areas and countries participating in this plan. For 
already existent means of creating such a corps of observers ’Hr the 
Americas, reference is made to the 19th, 55th, and 59th Articles of the 
Pan American Sanitary Code. 
Consular reports 
The United States requires consular officers in certain foreign 
areas to submit weekly reports on sanitary and epidemiological conditions 
when requested by the Federal Security Agency. Information is not always 
available on a weekly basis in all these places, and is sometimes not 
available at all, nor does uniform practice exist for securing data. 
Many consuls doubt the value of these reports and question the need for 
continuing them. Many reports are still forwarded to the Secretary of 
the Treasury instead of the Federal Security Agency, and this in itself 
may indicate an indifference to the necessity of compiling the information 
Most consuls have unofficial sources of information in addition to 
the regular reports which they receive, such as private physicians, friends 
within the departments of health, and knowledge of drug shipments and 
supplies. It is possible that more emphasis is placed on such sources 
than is justified, but the channels should be cultivated as a check on 
official sources. 
The promptness with which information concerning health is received, 
largely determines its usefulness in quarantine. As presently handled, 
such reports are from two weeks to several months old when received by 
the United States Public Health Service; the average is received in the 
third week after the end of the period to which it pertains > This delay 
is caused by three factors. The most variable of the three is the delay 
after the close of the period reported upon until the information is 
forwarded by the consul. This time may be as short as one day where the 
consul sends for the report, or as long as two to three months where 
the data comes to a local consul through the national capitol. 
The second delay is in transit from the consul to the State Depart- 
ment, which varies with the distance to be covered and the means of 
communication employed. Cabled or radiographic reports, of course, are 
received in a few hours, and airograms in a few days; standard pouch 
mail may require a few weeks. 
The third delay is in transit from the State Department to the 
United States Public Health Service, usually two to four days. However, 
those cabled and telegraphic reports which are considered of a critical 
nature are telephoned upon receipt. 
It is further to be noted that after these data are received by the 
United States Public Health Service, the process of assembling, editing, 
publishing and distributing them to the several quarantine officers at 
ports and airfields requires an additional two to three weeks in routine RESTRICTED 
reports, although special ones may be sent promptly by wire or air mail. 
It is therefore obvious that after routine information has been 
received by quarantine officers, it has exceeded the period in which it 
may be immediately applicable, although it supplements the periodic sta- 
tistical summaries received from some countries and provides an accumu- 
lated fund of fact upon which quarantine procedure of the United States 
has been based„ 
For quarantine needs in marine traffic, disease intelligence should 
reach the quarantine officer before or as soon as the conveyance, a 
purpose which would be achieved by weekly reports in most instances. Air 
travel, however, might demand almost daily reports in occasional instances 
It is apparent that the present system of consular reporting on 
health conditions of foreign areas ig not rapid enough always to satisfy 
the purposes for which it was instituted, and radiographic or cabled 
notifications will have to be considered necessary. 
Bills of health 
Bills of Health have been a traditional feature of quarantine of 
vessels since the fifteenth century, but although on first examination 
they would appear to be an ideal solution to the needs of epidemiological 
intelligence for quarantine purposes they must have serious deficiencies 
because the International Sanitary Convention in 1926 recommended "doing 
away gradually with consular visas and Bills of Health." British ports 
have done away with this document to a large extent, but many countries 
still cling to it. That the Bill of Health cannot be considered of 
crucial importance by the United States Public Health Service, is evi- 
dent from the fact that since the beginning of the foreign quarantine 
service, none was required of vessels departing ports in which no 
American consul was located. 
The Bill of Health was originally devised because of the absence 
of any other means of communication, to inform a port of arrival of the 
existence of disease in a place from which a vessel had departed; or on 
the other hand that previous infection had been controlled, and the place 
might now be considered "clean." If the data on the certificate could 
be made current as of the day of departure, it would be satisfactory, 
but as in the case of consular health reports, they are almost invariably 
too old to refer to the visit for which the bill was given. 
In instances in which data is not available the vessel might as well 
have no document at all, and the issuance of the form is only to satisfy 
the statutory requirement. 
Reliance upon Bills of Health under these circumstances is unsound 
and may lead to either excessive or defective quarantine restriction, or 
to an unwarranted, assurance of safety. 
If there were any situation in which it would be necessary to have 
Bills of Health so that epidemiological data might arrive as quickly as 
does the conveyance, it would surely be in air-traffic, since otherwise1, 
planes universally-arrive long before information is available on which 
reliably to conduct quarantine procedures. Yet the International Sanitary 
Convention for Aerial Navigation in 1933, after considering the compli- 
cations in the use of Bills of Health for worldwide air-traffic, concluded 
they should be eliminated, in favor of an entry in the flight-log of the airplane describing sanitation at the ports of departure and of call en 
route. These entries were to be inserted by the local public health 
officer. 
Unfortunately, such entries were impractical and have generally been 
discontinued, so that little has actually been accomplished in current 
notification of airports of conditions at ports of departure. 
The point is occasionally made that a Bill of Health is desirable 
to afford ”control" of a carrier by withholding it at the port of origin0 
At times, this control seems to have been made a matter of discipline and 
authority rather than of quarantine. Any control needed in quarantine is 
better obtained through critical handling of pratique on the basis of 
current epidemiological information than through insistence upon a formal- 
ity. 
It is certain that the Bill of Health has at times been utilized 
for still other purposes entirely unconnected with health; the continuance 
of a form which might otherwise be discarded is not justified on this 
basis alone, particularly in view of the availability of the manifest for 
these purposes. 
In a subsequent section, "Suggested plan," a feasible method is 
presented for quickly placing before a quarantine officer the essential 
data upon which quarantine may be based. If this is effected, no formal 
bill of health will be necessary, and procedure can be adjusted in accord- 
ance with the log of the carrier, and with the individual Travel Log and 
Immunization Record of the travelers. As long as Bills of Health are 
legally required in the United States, and when for other reasons they 
may constitute the only means of furnishing information concerning diseases 
in foreign countries, simplified Bills of Health may be used in marine 
traffic (App. Item 15)* They should be signed by a United States consul 
or any official physician of the United States on duty at the port of 
departure, 
An alternative measure, which in some respects is preferable, would 
be a Quarantine Declaration made out aboard the conveyance by a physician 
or by the commanding officer, to be acted upon according to the judgment 
of the quarantine officer, A revised form for a United States Quarantine 
Declaration for aircraft is included in the Appendix (Item 16), A suitable 
form for marine traffic is already in use. 
It is not anticipated that the partial adoption of newer methods of 
international exchange of epidemiological data must necessarily await the 
end of the war, especially in this hemisphere which represents the most 
critical areas in the quarantine interest of the United States at present, 
except those which are primarily of military concern. 
Sugges plan for international epidemiological intelligence 
It is recommended that a world-wide system of international exchange 
of epidemiological data be set up on the pattern employed, before the war, 
in the Far Eastern Office of the League of Nations at Singapore, utilizing 
telegraphic, cable, and particularly wireless communication« In this 
arrangement, outlying health stations in each political or national area 
would report weekly, at a fixed time, to the capitols or designated centers, 
and these in turn would forward summaries to designated international 
regional offices, favorably situated from the standpoint of geography and communication, and maintained by appropriate international health 
agencies. That these agencies might differ in various areas of the world 
would be immaterial to the functioning of the system. Reporting to 
national and international centers in this manner should utilize any 
immediate means available, whether telephone, telegraph, cable, or wire- 
less. 
The international centers, which would receive their data also at 
designated hours weekly, in perhaps the half-day following the receipt 
of the individual reports by the national centers, would edit, summarize, 
and exchange the summaries with the other international centers within 
the third half-day, and issue a general radio broadcast of the consoli- 
dated reports to their constituent areas. These reports being in 
prearranged abbreviated International Code would be accessible and 
intelligible to all areas, and might be received at the local outlying 
stations directly, or by the national centers, with distribution to the 
outlying stations by telephone, telegram, cable, or teletype. The last 
means would be particularly applicable to airports to which weather and 
other data are normally distributed in the same manner. 
With careful supervision and adjustment the critical quarantine 
data of the world could in this manner be made available at all Interested 
quarantine stations within forty-eight hours after the period to which it 
pertained, thus making the data useful not only for marine, but also for 
long-distance aerial traffic. Confirmatory reports might also be sent out 
but in most instances would probably be superfluous, and replaceable by 
periodic statistical summaries from the international offices. Tentative 
suggestions for such international centers include Singapore, Moscow, 
Alexandria, Geneva, and Balboa. The Balboa station should be able to 
cover both North and South America. 
The Appendix (Item 17) contains a suggested code for such a system, 
and a typical message illustrating the condensation and economy which 
might be effected over word-codes. 
A supplementary mechanism might at times be desirable in addition 
to that just described, permitting even more rapid adjustment of quaran- 
tine procedures should the necessity arise in air-travel. This would 
provide for similar code reports (App. Item 18) via the communications 
system of the air-carrier, which might be sent alone, or which might be 
incorporated in flight-plans or interstation weather reports. Occasions 
for use of this mechanism would be extremely rare, notifying aerial ports 
of call and termination of the local occurrence of an epidemiological 
situation which demanded immediate change in the quarantine handling of 
contacts with the area. The communications, office of the carrier should 
be obligated to notify appropriate local health officers. In view of the 
rare need for this mechanism, the cost and inconvenience occasioned by 
it would be insignificant, and it might well be made an obligation of the 
carrier involved. Routine confirmation and readjustment of the quarantine 
practice would be accomplished by the regular weekly reports. 
In making recommendations for a more elaborate system of notification 
of conditions of health throughout the world, the Commission realizes it 
is submitting itself to criticism that such current information is not 
necessary in order to exercise a reliable quarantine system. The Commis- 
sion is of the opinion that with more rapid traffic both by air and sea, 
it is desirable to have accurate and current information at hand, so that traffic may be expedited with confidence and surety, and so that by this 
knowledge quarantine officers will be able to exercise as much control 
as needed and at the same time not interfere with the flow of traffic. 
Periodic health reports by international agencies are already 
provided by the InternationaI“t)ffice of Public Hygiene, by the Inter- 
national Health Office of the League of Nations, and by the Pan American 
Sanitary Bureau. These, are of great value in many respects, but are not 
currently significant in quarantine practice because of the age of the 
data. When received, these reports are from several weeks to several 
months later than the periods of time which they cover, being from this 
standpoint even less valuable than the consular reports. As already 
noted, it is conceived that the international communications centers 
discussed above for quarantine purposes would be functions of these same 
international organizations in their respective areas, and the present 
reports of those bodies would b& issued as statistical summaries and 
confirmations. 
Direct notification of epidemiological emergencies between countries 
which are contiguous either geographically or on trade routes must remain 
for use in unusual circumstances, especially of restricted interest, but 
the general adoption of such action could result only in confusion. On 
the other hand, nothing in the method of notification described above 
should be taken to preclude the cabled reports by consuls of urgent epi- 
demiological information, which should alter quarantine procedure at 
places of entry, nor the periodic health reports of consuls, if any need 
for them existed after establishment of the system described. 
Under circumstances of war, in which the quarantine problems are 
predominantly concerned with military carriers and personnel, the basic 
concepts and provisions discussed in this section need be altered only 
in so far as demanded by military interest. This could largely be effected 
as suggested in the sections on "Administration'1, and "Prevention of 
quarantinable and exotic diseases in military forces." 
DISINSECTIZATION * 
Problem of implantation of insects by aerial transportation 
That insects and other animals may be carried by aircraft to areas 
in which they do not occur-naturally has been appreciated for many years« 
The potential danger of the implantation of such insects has been consi- 
dered at length in writing and lecture which have frequently been sensa- 
tional and alarmist. Careful determinations were needed of the 
qualitative and quantitative risks to which receptive areas might be 
subjected in this regard, and numerous studies have been made in several 
parts of the world; the United States Public Health Service pioneered 
in this work. 
*The words "disinsectization", "disinsectize", "delouse", "derat", 
"deratization", etc., have many objections both from a phonetic and 
etymological standpoint. In an attempt to find more acceptable words, 
Prof,iKemp Malone,tauthority on English words, was consulted. He sug- 
gested the word "bane" in combination with the various stems as "rat- 
bane", "louse-bane", "insect-bane", "rat-bane", etc. It is a curious fact that although surface ships have been respon- 
sible for the transplantation of insects, both harmful and dangerous, 
and numerous instances have been known of the occurrence, infinitely 
more concern has been manifested and greater effort has been expended in 
attempts to prevent ipsect transportation by aircraft. 
A few authors, including Pemberton, have studied the agricultural 
aspects of the problem, but most investigations have consisted in identi- 
fications of insects recovered from planes after foreign flight, and 
discussion of their potential importance in human disease. This has 
focused principal attention on mosquitoes, flies, and occasionally fleas, 
lice, and other rarer forms, while mites, ticks, midges, and beetles, 
along with many other species have often not been enumerated„ 
The particular emphasis upon Aedes aegypti and Anopheles gambiae 
has suggested that they alone were the entomological problem in air 
traffic. Complete recovery and identification, however, show the fallacy 
of this conclusion» and point to the fact that of insects and pests 
borne by planes those of importance in human disease comprise a minor 
percentage of the total. The significant feature of the remainder is 
their potential agricultural importance, a viewpoint which apparently 
encouraged the development of insecticides and methods for their use by 
agricultural agencies. Principal agricultural interest has been less 
in stowaway adult forms than in eggs and larvae, and hence in the ex- 
clusion of certain articles, including flowers, fruits, and vegetables 
which act as hosts. 
The general restriction of interest in disinsectization to mosqui- 
toes has resulted in control measures assayed largely upon them. Pyre- 
thrins have proved satisfactory in this regard, and in solutions have 
been dispersed by a variety of mechanical means includirg power atomizers, 
steam actuated vaporizers, hand-guns, and fans. More recently, the 
freon actuated aerosol spray has been widely adopted. Despite the high 
efficiency of these measures in the control of insects concerned with 
human disease as encountered on planes, the resistance of many agricul- 
tural pests is great, with the result that measures now in use are largely 
inapplicable to insects more difficult to control and of more disastrous 
ultimate consequence. Recently, the control of stowaway insects in 
airplanes by synthetic insecticides has been studied and though promising, 
pyrethrins remain the chief weapon. 
Since insects have survived conditions of flight, including altitude, 
cold, considerable heat, fuel fumes, oil films, and vibration, in an 
apparently viable state, it has been assumed that only reasonably favor- 
able circumstances were needed to promote growth and implantation in new 
areas. This seemed reasonable in view of the well-known introduction, 
by surface travel, of the cotton boll-weevil into the Southern states, 
of the corn-borer into the Midwest, and of the Mediterranean fruit fly 
and mosquitoes into the Territory of Hawaii, Such introductions into 
California have been estimated to exceed two hundred fifty species, and 
into Hawaii, over one thousand species, so that there was evident no a 
priori reason that the same should not occur in aerial transportation. 
It must be recognized at once that aerial transport does not permit 
the profusion of breeding spaces aboard the conveyance that characterized 
particularly the older vessels, and also that the aerial problem under 
discussion is mainly one of stowaway insects rather than those carried in larval or egg stages, as in the case of the boll-weevil, corn-borer, 
and fruit fly. Yet, it is interesting and challenging that so few 
specific instances have seemed to imply aerial introduction. 
In 1930, Anopheles gambiae, native to Africa, was found in Brazil, 
and proved disastrous as a vector of malaria until its eradication in 
1940, The association of its discovery with the inauguration of trans- 
Atlantic air service suggested this means of introduction. 
The Commission has been impressed by the incomplete knowledge on 
the part of many regarding Anopheles gambiae in Brazil, In April 1944, 
a well known entomologist and authority on economic entomology, stated 
before a conference on pest control that the mosquito was implanted in 
Brazil by the airplane. Because of widespread misunderstanding a brief 
review of the known facts as recorded by Soper and Wilson is presented. 
The epidemic of malaria caused by this species was severe but did 
not embrace the whole country as commonly implied. As a matter of fact 
in Rio Grande do Norte it involved a costal area about 300 kilometers 
long and an average of 50 kilometers in depth. In the adjoining state 
of Ceara, the distribution, with the exception of small isolated spots 
around Quixara and Madalena, was confined to the valley of the Jaguaribe 
river, an area about 300 kilometers long and on an average of 100 kilo- 
meters wide. The total area involved was about 17,500 square miles of 
Brazil’s nearly 3,300,000, or about 0,5 percent. 
As pointed out by Soper and Wilson there is strong evidence that 
the insect was not brought over by planes, for reasons clearly analysed 
by them,but "almost certainly" by French "avisos" (destroyers). The 
insects were likely transported in late 1929 or early 1930, and in March 
1930, Shannon collected over 2000 larvae at Natal, The presence of these 
mosquitoes manifested itself in the almost immediate outbreak of an 
epidemic of malaria in Natal for in less than four months after the esti- 
mated time of the implantation the numbers of patients were counted in 
the hundreds. The epidemic was brought under control, but there began 
almost at once a slow and silent spread to the North and West which 
lasted until 1937 when the more wide spread epidemic began which resulted 
in the undertaking of the now well known control measures. It is' impor- 
tant to note this spread was not by the airplane but fcy surface vessels, 
trains and automobiles, It is also significant to observe that Natal is 
naturally unsuitable for the establishment of Anopheles gambiae and had 
there not existed "man-made dikes built along the river front to trans- 
form the salt-water tidal flats into fresh-water hayfields, gambiae 
might well have failed to secure a bridgehead on the American continent 
The finding of Anopheles gambiae on planes from Africa must be 
carefully evaluated before jimping to the conclusion that they are of 
great significance, Brazilian inspectors have reported the recovery of 
several hundred Anopheles gambiae from the thousands of planes flown from 
Africa to Brazil, From recent knowledge gained by periodically cleaning 
out dust and debris from these planes, it is now evident many of the 
insects found were those which entered the plane and died long--before 
it took off; since thorough cleaning of the planes has been instituted, 
the counts of dead stowaways has greatly decreased. Of all those recovered 
something of the order of ten have been said to have been alive when 
captured. How alive is a matter of great question; there is a well known 
tendency to report as "alive" any insect found on a plane which can even 
25 feebly move one appendage. More recently, after critical study by expert 
entomologists, the conclusion has been reached that some at least, 
formerly labeled "alive" were not viable and never could have recovered 
from the trip* 
In this connection great significance has been placed on the reported 
finding in September 19-43 of five adult Anopheles garabiae in Natal. The 
Commission made every effort to verify this report. It is highly signifi- 
cant that no larvae were found and no other adults taken, in spite of an 
exhaustive local survey, . 
In the Pacific area during the present war, despite occasional rumor 
to the contrary, Anopheline mosquitoes have not been found upon careful 
search by entomologists of the occupying military forces, on any of those 
islands previously free from them. 
In Central America, Anopheles darling! has been noted for years on 
the eastern seaboards of Honduras, British Honduras, and Guatemala. The 
nearest other habitat of this mosquito is along the north coast of South 
America and adjacent Panama. According to Komp, the mosquito has probably 
existed in all these areas from earliest time, and was not transferred 
by traffic. As recently as 1941, competent surveys on the western sea- 
boards of Guatemala, El Salvador, Honduras and Costa Rica, failed to show 
the presence of Anopheles darling!. Yet in 1943 the mosquito was alleged 
to have been identified at Choluteca in Western Honduras. Although aerial 
importation is thus suggested because of limited rail and automobile 
traffic, the identification of the species is in considerable doubt and 
cannot be verified. Even if correct, it is more than likely that as on 
the Eastern seaboard, this represents an instance of the discontinuous 
distribution of an insect which was once generalized. 
The island of Grand Cayman in the Caribbean was reported to have 
been infested with anophelines during current military operations, but 
investigation has revealed knowledge of three anopheline species on the 
island as early as a British governmental survey in 1939, before flights 
were made to that Island, 
On the other hand there are numerous instances of narrow and appar- 
ently insecure boundaries between infestation with and freedom from a 
given insect which have remained intact despite extensive aerial and 
marine traffic. Anopheles albiraanus is as close to Florida as Cuba, 
and Anopheles darling! of Venezuela is within twenty miles of Trinidad. 
Aerial and marine travel between these areas has been common for years, 
including innumerable sraa.ll boats entirely without insect control. Yet 
the mosquitoes have not become established across the narrow gaps. 
In 1904, 131 adult specimens of Anopheles albimanus were found in 
Key West, Florida, but no other specimens have been taken in this region 
to this date. This importation must have been by boat, certainly not by 
plane, and evidently ecological conditions did not permit the species to 
maintain itself, although King believes the temperature of the water is 
suitable for the species as far north as 28 degrees latitude. The species 
is taken annually in the irrigation ditches about Brownsville, Texas, 
which is also south of 28 degrees latitude, but it has never spread from 
that locus nor has it assumed an importance other than of scientific 
interest. It obviously gained access to that place too before the days 
of aerial navigation, and in spite of enormous numbers of aircraft flying 
without disinsectization to other parts of the country, including southern 
states, no evidence appears to indicate dissemination from this locus. More recently interest has been directed to a report by the entomo- 
logical service of the Army of the finding of Anopheles albimanus in a 
drainage ditch 300 yards from the run-way of the air strip at Boca Raton, 
Florida. The circumstances surrounding the report need considerable 
clarification before they can be properly evaluated. On 22 May one 
large larva of the species was said to have been captured. On the next 
day and the day following, 2/XO dips were made in the region and 13 
larvae of Anopheles quadrimaculatus and 8 of Anopheles crucians were 
found. Since then over 6000 dips have failed to reveal any other larvae 
of Anopheles albimanus and search in the region has failed to disclose any 
adults. There is, however, a report that one dead adult was found a year 
ago in a culvert in that region. 
Assuming the identification to be correct without the larva being 
bred out, one may speculate as to where it came from. Only three planes 
have landed on the field, from abroad. Two came from Nassau on April 2J+ 
and May 2 respectively, a region from which it appears unlikely albimanus 
might be transported and the third arrived on 1 May from Puerto Rico, but 
had stopped at Morrison field en route, where presumably it was -d-isinsec- 
tized, in spite of the fact it had taken off from a field in Puerto Rico 
which is almost mosquito free. 
Boca Raton is a south Floridian costal village into which small 
fishing and interisland boats frequently dock and they may have been 
responsible for the transportation of the species as occurred in Key 
West earlier. Up to the present time there is no evidence the species 
has gained a beachhead in that area. 
The fact that Anopheles quadrimaculatus of Florida is not found in 
Cuba or other Caribbean Islands is equally significant, and in the Pacific, 
despite small-boat traffic for generations, many of the islands appear 
not to have had Anopheline mosquitoes implanted in them. It is true that 
in all these places the speed and frequency of Intercourse have become 
greatly increased, but no instance has yet been discovered of implanta- 
tion of mosquitoes. 
The role of natural barriers has frequently been emphasized in this 
connection. Oceans, deserts, mountain ranges, prevailing winds, and 
climatic conditions have been thought to restrict the spread of insects, 
and whether travel is faster, more frequent, or by a wholly different 
mode, these barriers probably remain among the most potent factors in the 
control of insect dispersal. 
Without doubt single or many individuals of various species of insects 
have been carried across a natural barrier, yet have failed to establish 
themselves in a new region. Interesting examples include the instance of 
Aedes vigilax which was found in the Fiji Islands three years ago, and 
which died out in one season and has not been seen there since. Similarly 
a single adult was taken on Eepiritu Santo but during a subsequent 
eighteen months no other specimens have been found. It is not unreason- 
able to suppose in both instances the species was introduced from New 
Caledonia, but finding environment unsuitable, failed to establish itself. 
While both male and female insects have been recovered alive from 
arriving planes in numerous surveys, there is the important difference 
from their transportation by surface carriers that there is no breeding 
en route, and far fewer insects are commonly involved. Thus, the like- 
lihood of fecundation of non-gravid females during or after transportation is tremendously reduced, and even gravid females have questionable like- 
lihood of successful search for breeding places and evasion of natural 
enemies. It is true that certain insects, including some species of 
mosquitoes are fecundated before they leave the immediate surroundings 
of their breeding places and remain fertile for life. Nevertheless, 
many hazards have to be overcome and many conditions have to be fulfilled 
before a second generation of any given insect comes into being, and 
travel by airplane across an ocean, a desert or a mountain range does not 
add to the certainty of this phenomenon. Information concerning the time 
of fecundation in the case of Anopheles gambiae is not available. Trans- 
portation of non-gravid females only, or of males only, may swell the 
count of insects recovered, but can be of no significance in the problem 
of breeding and implantation. This factor of dilution is probably of 
importance comparable to natural barriers in limiting the spread of 
insects. 
The question has been raised as to whether the factor of dilution 
would continue to exert itself in the post war period when there is ex- 
pected such an increase in commercial aerial traffic. It now appears 
that it will take years for commercial air traffic in the South Atlantic 
area to equal the present volume due to requirements of the war. 
In addition to the numbers of insects, the immediate environment at 
the place of their release plays a determinative role in their implanta- 
tion. Although Pemberton, in connection with biological control of 
agricultural pests, has repeatedly and purposely implanted foreign species 
of predator or parasitic insects into Hawaii by the liberation of small 
numbers, and although the accidental introduction of insects there and 
elsewhere in some instances may have resulted from equally small innocula 
into particularly favorable environment, the modern airfield is arid, 
barren, and unsheltered from the standpoint of insect implantation. Ob- 
viously there are exceptions, as those fields constructed in jungles, 
but even there the factors of dilution and biological control are still 
operative, 
It is, therefore, evident that despite the possibility of implanta- 
tion of insect stowaways by aircraft, the actual danger is of a much 
smaller order than has frequently been supposed. The likelihood of 
implantation by means of material heavily infested with eggs or larvae, 
such as fruits,"flowers, vegetables, raw-cotton, or packing material, is 
a far greater risk* A mango containing a hundred larvae of the mango- 
fly is potentially much more dangerous than an adult fly riding a plane 
as a stowaway, even if gravid. 
In this connection great concern is now expressed by the Department 
of Agriculture over the possibility of implantation of noxious pests in 
this country by means of packing around gifts from servicemen overseas. 
It is suggested every package arriving in this country from these sources 
be stamped as follows; "Your Government requests you to-=burn the packing 
contained in this package promptly, in order to prevent the possible 
spread in and around your residence, of insect pests which may be present 
in this package.H 
A factor of uncertain importance is the exact effect of flight condi- 
tions on insects. While it is true that many adults, apparently viable, 
have been recovered, even after long flight, evidence is suggestive that 
if confined under circumstances permitting no rest except upon vibrating surfaces, resulting in the beating of antennae and wings against hard 
structures, death may result during flight of the plane. The extent 
to which reproduction might be damaged by sublethal vibration and other 
effects of air travel remain to be demonstrated, for apparently no 
attempt has been made to breed out catches of insects taken from planes 
after flight, although Mr. Oakley (Department of Agriculture) has ob- 
served flies and roaches depositing eggs after flights on airplanes. 
Despite these favorable considerations, caution is indicated by the 
experience of Pemberton with the intentional release of insects in 
Hawaii. Following introduction, the speed of propogation apparently varies 
widely with the species. In some instances, the seeded and adjacent 
islands became populated with the new form within a single season; in 
others several years were required before successful implantation could 
be demonstrated. Although searches have generally been competent, the 
fact that species newly implanted as a result of recent military and 
aerial activity have not yet been demonstrated, does not mean that such 
implantations may not be discovered in the future. 
Reasonable policy in the control of insect traTtami-ssion by aircraft 
should, obviously, regard transplantation as a potentiality. rather than 
an imminent threat. Control must be directed against the importation of 
viable insects, but failing that must keep the numbers so small that 
successful implantation is prevented. These goals are closely related 
to the sanitation of airfields. 
It must be recognised as unlikely that any method of insect control 
will prevent the entry of all insects into aircraft and consequently 
their recovery after death. Thus the presence of dead insects on a plane 
is no reflection on the method of disinsectization used on the particular 
flight. It is further evident for many reasons that the occasional live 
insect recovered after disinsectization must be expected and is not the 
occasion for undue alarm. The institution of measures to prevent such 
an occurrence is both impracticable and intolerable under the present 
circumstances. 
Importation of disease by infected vectors 
As a rule, even in severe epidemics of diseases transmitted by the 
mosquito, only a small percentage of females is demonstrably infected, 
and a less percentage is infective at any given time, Considering the 
small numbers of insects actually found aboard airplanes, and dialWishing 
this by the improbability that those found would be infected, much leas 
infective, the importance of the stowaway insect as a carrier of disease 
becomes infinitesimal0 This is further emphasized for yellow fever, as 
no flight operations are occurring nor would likely be continued without 
the most strenuous supervision from fields in epidemic areas of the 
disease. It is, of course, possible that, if aboard, an infective mosqui- 
to might feed upon a crew-member or passenger, but this likelihood is 
negligible, and the probability of inducing the disease is even less, 
because everyone bitten by such a vector does not acquire the disease. 
If an infective insect were to escape a plane on landing, there is 
a good possibility that no person would be bitten before the insect died, 
and again even if bitten, a person might not become infected. The pro- 
babilities, therefore, of infection with malaria, filaria, or yellow fever by a mosquito transmitted by airplane, are too small to justify 
special regulations or procedures against them. The importance of a 
guard is recognized particularly in view of public opinion, but it should 
be practical and realistic rather than quixotic. If diseases are intro- 
duced. it will probably be by infected persons. In comparison with the 
possibility of introduction of disease per se, the possibility of estab- 
lishment of new foci of insects capable of acting as vectors of disease 
even though not yet known to have occurred, is a greater potential risk. 
There is evidence to conclude that interest in the transmission of 
insects by plane should be more agricultural than medical, with rare spec- 
ific exceptions, as for example that of Anopheles gambiae in Brazil. 
Moreover, as already noted, control measures effective against agricul- 
tural stowaways would undoubtedly be effective against those of medical 
importance, although the converse does not hold* 
For the quarantinable diseases, significant insects include fleas 
or lice infected with plague or typhus, flies carrying cholera, and 
mosquitoes infected with yellow fever. Of these, the most important is 
Aedes aegypti, since by the nature of personnel usually carried on planes, 
the problem of lice is almost non-existent, and rats or other plague- 
infectable rodents are rare on aircraft. Furthermore, in countries like 
the United States, lice so carried could be considered insignificant 
among a population which for practical purposes is not lousy, and while 
flies may be important in hyperendemic or epidemic cholera areas, these 
areas are so restricted geographically as to require only local policy. 
Yellow fever; Transmission by aerial route 
Special considerations need be given this disease since many 
countries have directed their regulations against it, including the 
assumption already discussed that infective insects night bite while 
on the plane. In addition to the considerations presented above, there 
is evidence to indicate that Aedes aegypti enter planes only under the 
rarest conditions. 
Records of insect recoveries by the U.S. Public Health Service at 
Miami reveal that only a single insect of this species has been found 
in the examination of more than twenty-thousand planes. In nearly a 
thousand planes examined by Sullivan at Accra, only one Aedes aegypti 
was found, and Whitfield could find record of only two others in all 
the reported observations in the world up to 1939. One specimen was 
taken from a plane at Natal in 194-3. The Commission has records now of 
planes examined at Hawaii, San Antonio, Brownsville, New Orleans, 
Washington, Presque Isle (Me.), Liberia and Brazil, and in all of these 
only four Aedes aegypti have been found. Even records from Egypt fail 
to reveal the insect. In all, only nine specimens of this species have 
been recorded as taken from many thousands of planes; all but one was 
dead. 
It would be astonishing, indeed, if Aedes aegypti entered planes 
frequently or in large numbers, for it is a traditional household variety, 
with a flight range usually not over a few hundred feet. To obtain an 
Aedes aegypti infected with yellow fever on a plane under even the worst 
conditions would be, for all practical purposes, impossible. Any program 
based entirely on prevention of this rarity could not be justified in the light of present knowledge. All evidence emphasizes that "Aedes aegypti 
do not ride planes," 
Responsibility for methods of disinsectization 
Certainly in the United States agricultural pests appear of greater 
importance than insect vectors of disease. Effective measures against 
the hardier pest forms, furthermore, would take care of the usual 
disease vectors. To avoid duplication of effort, it would seem advisable 
for the United States Department of Agriculture to administer all control 
of insects in aerial traffic. 
Because of the notion so generally prevalent that there is an enor- 
mous hazard to the public health due to a great probability of transmission 
of Aedes aegypti infected with the virus of yellow fever and of the trans- 
portation of sufficient numbers of Anopheles gambiae frequently enough to 
make implantation of it in the United States a real menace, it may be wise 
at present for the United States Public Health Service to share with the 
Department of Agriculture the responsibility for the control of the trans- 
portation of harmful mosquitoes. The latter organization should, however, 
be encouraged to take more and more control as permitted ty public and 
professional sentiment, and general acceptance of disinsectization of 
airplanes hy the Department of Agriculture should be obtained. 
Hazards to the United States 
The possibility of long non-stop flights has occasioned much concern 
in the United States over the likelihood of introduction into this country 
of Anopheles gambiae, or of Aedes aegypti infected with yellow fever, 
particularly from Africa. Such flights have, it is true, been made but 
only as demonstrations or under pressing and extraordinary military re- 
quirement. Their frequent or regular performance is not to be anticipated 
in military flight, and even less in commercial operations, in view of the 
necessity for intermediate stops from the standpoint of economy« Decreased 
payload and increased deadweight devoted to fuel on such long flights will 
continue to restrict their numbers to a very small figure. Intermediate 
stops will function to protect the United States, particularly when flight 
is made through Brazil which has such an excellent system of disinsecti- 
zation. It may further be noted that transoceanic flights to the United 
States from Africa or South America, even if non-stop, could hardly 
originate from yellow fever areas in those continents at this time. 
f^mighnts-Disinsectants 
A goal has frequently been set of so sanitating airfields that insects 
could not possibly enter planes resting on the fields, which might, there- 
fore, be considered safe oases amid dangerous areas. This has been ex- 
pressed with respect to yellow fever in the concept of "anti-amaryl 
aerodromes”, but in the sense of this term as outlined by the International 
Sanitary Convention for Aerial Navigation, 1933, the goal has not been 
practicable. It is clear that the conference was thinking only in terms 
of Aedes aegypti, and while aerodromes might be kept relatively free of 
this species, and in instances have been, the task is multiplied if there are included all possible vectors experimentally capable of transmitting 
yellow fever. Further, if the concept were broadened to embrace an 
"insect free" field, nothing of the sort could possibly be attained within 
reason. That these opinions are shared by other investigators in the 
field is shown in the recommendations of the quarantine group of the 
United Nations Relief and Rehabilitation Administration that the concept 
of the "anti-araaryl aerodrome" be deleted from the International Sanitary 
Code for Aerial Navigation, 1933. This, of course, does not infer that 
insect control measures about aerodromes should be abandoned, but rather 
is a realistic acknowledgement that such measures cannot be relied upon 
to eliminate the need for other quarantine safeguards. 
If, then,insect-free aerodromes are not feasible, and until the devel- 
opment of new and more effective methods of proofing aircraft against 
insects, present methods of disinsectization of aircraft must be continued 
when the control is considered necessary. 
Several insecticides have been employed in the past. Formaldehyde 
in 1 percent solution has been atomized by handsprayers both within- the 
cabin of the plane, and in the wheel-wells and other spaces of the plane 
opening exteriorly, but the irritating effect and moisture from this sub- 
stance would appear to preclude its use., Hydrogen cyanide has been 
suggested and used occasionally in this and in other countries, but diffi- 
culty in assuring adequate treatment and prompt clearance of the ship and 
the difficulty of keeping it cleared of insects after fumigation until it 
can be loaded and taken off, obviously rule out the procedure. Hangars 
reserved for the treatment of planes as a whole by this or any other 
gaseous fumigant, would be impracticable and wasteful. These substances 
must be reserved for the unusual instances in which dramatic measures 
are required. 
Mechanical cleansing of small planes with limited cabins for the 
removal of insect stowaways might be accomplished, but this is inconceiv- 
able in large planes with multiple sections, especially when unfinished 
on the interior as in the case of cargo and military planes. The removal 
of insects by forced ventilation is also not feasible in view of the 
numerous recesses, the dust and discomfort involved, the equipment 
required, and the temporary duration of the effect. Vibration of resting 
places, while of some lethal potentiality for fragile insects, has not 
been sufficiently tested to be relied upon. 
Rotenone, effective against most insects, has been tested in planes, 
but has proved irritating to human skin. It might be usable in under- 
floor spaces and in cargo spaces, but is unlikely suitable for general 
use in cabins. 
The recently introduced synthetic insecticide, para-dichloro-diphenyl 
trichlorethane (Gesarol, DDT, etc.) has shown great promise in the control 
of certain insects, with the great advantage over other insecticides of a 
long residual effect, persistent for days or weeks after application, and 
the possibility of incorporation into paints or other finishes. It is 
distributed in aerosol, or in solvent or powder* Studies on its use for 
the disinsectization of aircraft, however, are insufficiently advanced 
to indicate more than future possibilities. Persistent effectiveness 
might permit treatment of a plane at the time of mechanical servicing at 
weekly to monthly intervals. Decomposition with the formation of hydro- 
chloric acid, reported to occur at moderate temperatures in the presence of catalytic impurities, if uncontrollable, might reduce its usefulness 
in aircraft. 
Present reports indicate great variability in the persistent effect 
of DDT in planes but as far as experiments have gone, it appears the 
presence of upholstery increases the length of time of the killing effect. 
There is also indication that unsprayed cargo may defeat the effect of 
periodically spraying the interior surfaces of the plane as insects may 
rest on boxes and bags and not be killed. Furthermore, it requires 
several hours to kill insects with DDT when used as a residual spray. 
Of present insecticides, the best are preparations of pyrethrins. 
These are effective against many insects including mosquitoes and flies, 
but some other forms, such as beetles, ants, ticks, and spiders are com- 
paratively resistant. This deficiency is important from an agricultural 
viewpoint, and for effective insect control reinforcement or substitution 
must be sought. Increased effectiveness and economy have been achieved 
by the use of freon as a solvent, and for energizing the spray and atomi- 
zing of the pyrethrins, but difficulties of supply during the war have 
limited the use of both pyrethrins and freon. This bottleneck is being 
broken now. 
The strengths used have been subject to compromise between these 
scarcities of material and acceptable effectiveness. It is to be noted 
that the product has been assayed chiefly against mosquitoes, which are 
among the most susceptible of all insects. Present sprays contain 0.4 
percent pyrethrins in freon, with 8 percent oil of sesame seed as activa- 
tor. There is some evidence that a reduction from 1.0 percent to 0.4 
percent pyrethrins has been accompanied by reduction in practical effec- 
tiveness in field use. 
Methods and times of disinsectization 
Civilian and military planes differ in the character of their in- 
ternal finish, the control of ventilation, draftiness, and the require- 
ments of security concerning their movements« Personnel also differ, and 
all these differences are important in the matter of disinsectization. 
Much discussion has concerned the disinsectization of structural 
spaces outside the cabin. In older aircraft, with wings and tail- 
assemblies readily accessible through fenestrations in their trailing 
edges, many insects collected in them, especially when small, unsanitated 
grassy fields were used. In most modern planes, however, the wings and 
stabilizers are of tightly compartraented structure with only small 
"equalizer" openings to the exterior. An insignificant amount of insect 
debris is now found in them. In some planes, much wing-space is accessible 
from the cabin, but this problem can be solved by directing the insecti- 
cidal spray into the opened space, or by supplying them with snap-on covers 
Outside structures of aircraft are occasionally sprayed with insec- 
ticide. It has been demonstrated that in very exceptional instances, 
insects may survive in advantageous recesses in the nose-wheel compartments 
of certain military planes. In critical routes, such as from West Africa 
to South America, such possibilities should be recognized, but in general, 
and especially in commercial planes, the turbulence of air within these 
spaces eliminates insect harborage, and the spraying of the outside of 
aircraft may be considered unnecessary. Three periods are available for the disinsectization of aircraft: 
Before, during,£arldra;f ter "flight. There are definite considerations 
making for the success or failure of each of these periods.. 
Spraying before flight 
In spraying before flight, the process may be accomplished after 
full loading so that upon its completion the plane may take off immedi- 
ately without re-exposure to infestation; or spraying may be done earlier, 
usually before loading. In some airways operations, planes arriving at an 
overnight stop are serviced, disinsectized, and closed; the passengers and 
cargo are loaded in the morning, and takeoff occurs at least several hours 
after treatment. More commonly, the baggage is loaded and spraying is 
accomplished within twenty to thirty minutes before departure. The longer 
the interval, the less effective must be the spray, and the greater the 
possibility of introduction of insects with loading of baggage or person- 
nel after the effectiveness of the treatment has disappeared. To the 
knowledge of the Commissionr-persistent killing effects of pyrethrin sprays 
have been experimentally demonstrated only in still air in restricted spaces, 
and air currents dissipate lethal concentrations of the material in a short 
time. In fact, it is felt by some that residual effect should not be 
considered to outlast a visible cloud of spray, which will not be longer 
than two or three minutes. 
If disinsectization before takeoff is to be effective and dependable, 
it must be performed immediately prior to departure and after full load- 
ing of all baggage, cargo, crew, and passengers on the one hand, and take- 
off on the other. 
In spraying before takeoff, persons aboard the plane are protected 
against the chance bite of an insect enroute and a closer control of the 
procedure from the ground is permitted, which is of administrative advan- 
tage at times. Flight personnel can perform the act, so that there is 
an automatic supply of personnel regardless of the amount of traffic, 
and the opening of the plane to permit the exit of a ground-crewman can 
be eliminated. However, if spraying is done by a member of the ground 
crew, it is not considered necessary to spray a mist of insecticide into 
the opening during his exit to prevent the possible entrance of insects 
at that time. If a spray does not have that much residual effect, it is 
valueless anyway. 
If done by a member of the aircrew, the act should be evidenced over 
the signature of the pilot in the Clearance Form and log of the aircraft; 
if by a member of the groynd crew, a certificate should be given by the 
sprayer which should be recorded in the log and on the Clearance Form. 
At critical points, when requesting takeoff instructions, the pilot may 
be required to inform the control tower that disinsectization has been 
completed. 
In any event, there is presupposed both ability and training of the 
personnel performing the spraying. Unsatisfactory personnel, resulting 
in unsatisfactory performance was most commonly observed by the Commis- 
sion when the spraying was done by ground personnel from the medical 
corps. If this function is to be effective in the hands of ground crew, 
suitable personnel must be used with disinsectization as their chief 
interest, and with performance guaranteed by training, supervision, and adequate inspection. 
If aircrew are to be used, there is an assurance of intelligence, 
reliability, and interest in the operation of the aircraft, but indoctri- 
nation of such personnel in the purpose and technic of a consistent and 
intelligent policy with regard to spraying will be no less necessary. 
The ship's personnel must understand that, spraying, like every other 
phase of their operation, is subject to unannounced inspection, whether 
by canvassing of passengers, by inspectors, or by any other means. 
In spraying before take-off, a short period of time may be lost, and 
this is occasionally said to prevent the making of a "deadline", but such 
occasions need not occur if careful timing is used, as spraying can be 
done during the warm-up of the engines. 
The responsibility for pre-flight spraying must be distinguished 
from its performance and may be vested in the flight personnel, the ground- 
crew of the carrier, or in public servants.. In commercial operations, in 
contrast to military, it would be most desirable that responsibility reside 
in the local Public Health or agricultural authorities at the port of 
departure. It is questionable, however, that the statutory definition of 
their responsibilities would generally permit this. Otherwise, it should 
remain with the carrier to permit exercise of control in the event of 
remissnesso 
Consideration has been given to automatic spraying devices as perma- 
nent installations in planes. Designs suggested for these have usually 
provided for a master cylinder for the insecticide and distribution lines 
leading to the several compartments of the plane. This mechanism could 
perhaps be actuated automatically on the raising or lowering of the wheels 
of the plane. None of the several conceptions of this idea has as yet 
been given critical trial. 
Spraying daring flight 
Spraying in flight presents the advantage of utilizing time which 
is not at the expense of other operations. The criticism that all flight 
personnel ere too'-oecupied with flight duties to perform this function is 
hardly supportable, for rarely do flight conditions require the attention 
of all the crew all the time. Even in small craft with only the pilot, 
there will, with rarest exceptions, be ample opportunity for spraying in 
flight even on short spans. 
Some discomfort to passengers and crew will exist at any time spray- 
ing is done, and is admittedly a matter of occasional practical conse- 
quence. Relaxation, coolness, and comfort are, however, usually greatest 
aloft, and spraying is probably least objectionable at that time. Air- 
sickness would make any odor obnoxious, and has commonly been confused 
with the effect of the spray; such odors can most rapidly be eliminated 
in flight, after an effective holding time, due to the rapid ventilation 
available. Tobacco smoke is more objectionable to many persons. 
Provision may have to be made for alteration of practice in the 
event of true idiosyncracy to the spray, although wide inquiry has 
revealed only a single alleged case of allergic bronchitis. The cough- 
ing, rhinitis, and mild conjunctivitis more commonly encountered are 
inconsequential from the standpoint of danger, and may be largely 
eliminated by refinement of the pyrethrins and by the use of freon sprays. One limitation of spraying in flight is the difficulty in maintaining 
an effective concentration of insecticide due to air-currents, which 
restricts such spraying to those planes in which ventilation can be com- 
pletely controlled. The average military and commercial cargo aircraft 
are thus unsatisfactory for spraying in air. Another objection is the 
difficulty of access to some compartments in certain planes when in flight; 
these spaces would have to be sprayed before flight or on landing. 
The difficulty of supervising the spraying in air, from an adminis- 
trative standpoint, can in part be overcome by indoctrination of flight 
crews in the reasons for the procedure, and by refusal to approve such 
spraying in the case of carriers in which spot-inspection of the planes, 
questioning of passengers, and observations by inspectors show that 
spraying has been omitted or poorly carried out. Disinsectization during 
the flight should be recorded in the log of the plane and on the Clearance 
Form; 
Spraying on Landing 
Disinsectization after landing should take place before the plane is 
opened if it is to be beyond criticism, and the plane should, of course, 
have landed with ail openings closed, and kept closed until disinsectiza- 
tion has been accomplished. If spraying is to be carried out by ground 
personnel, a mist of insecticide should be directed into the door or 
hatch as it is opened, in spite of the small likelihood of the escape of 
insects at the time the sprayer enters the plane. It is doubtful that 
the aerosol bomb would furnish a sufficient volume of insecticide with 
sufficient force-to-be effective and an air pressure spray would have to 
be usedo 
Spraying on landing is advantageous in that it can be supervised 
by officials of the country primarily concerned, whether the actual 
spraying be by them, by flight or ground-crew of the carrier, or by 
employees of the airfield. If the spraying is not to be done by public 
personnel, it should be performed by the car-r-ier, for the reasons dis- 
cussed in connection with spraying before take-off. In any event, the 
disinsectization should be certified in the flight-log for the inspection 
of interested officials at any time. 
Objections to spraying after landing include waiting in a hot plane 
after a tiresome or uncomfortable or at times hazardous, trip for several 
extra minutes, a consideration more important in fact than upon paper. 
The frequent suspension of spraying in favor of prominent personnel on the 
plane, including high-ranking military officers, is another point difficult 
to control, which lowers the zeal of all those concerned with disinsecti- 
zation. 
The landing of aircraft with ports and windows open should be elimi- 
nated since the flow of air through them is generally outward and insects 
might thus escape. Many pilots habitually open cockpit windows upon 
descent, but only rarely if ever according to aeronautical authorities, 
is this necessary for safe operation of the airplane. After landing, the 
roof-hatches of some aircraft are opened to permit observation of the 
wing-tips during taxiing. This is unavoidable, and insects could perhaps 
escape unless the adjacent compartments were previously sprayed. The 
same problem and solution pertain to hydroplanes where hatches must be opened to permit securing of the buoy-line. 
Responsibility of the carrier 
Any of the three times for spraying can be considered satisfactory 
if its limitations are understood. In the absence of other practical 
arrangements, it is the recommendation of the Commission that disinsec- 
tization should be the function and responsibility of the carrier, which 
is in the best position to determine which time for spraying is most 
adaptable to its operations. 
The carrier should be required to assure the proper public official 
on demand that disinsectization has been performed in accordance with the 
approved technic, and has been noted in the flight-log and on the Clear- 
ance Form, It is to be emphasized that the carrier can properly be 
required only to carry out the prescribed procedure, and its obligation 
should be satisfied by demonstration of that compliance. It should not 
be held responsible for accomplishing an end for which the technic 
prescribed is not competent. In this connection, the Brazilian demand 
that no live arthropod be brought in by plane is considered excessive, 
since the prescribed methods of disinsectization are not effective 
against all arthropods, and the protest of the Brazilian government 
against the chance importation of a tick by Pan American Airways thus 
seems unjustifiable. 
Nevertheless, each demonstrated non-compliance with regulations 
should carry an increasing monetary penalty, and perhaps ultimate sus- 
pension of operating franchise in the country. 
Aircraft passengers1 reaction to spray 
Personal dislike of spraying by passengers has caused some extremely 
unpleasant and difficult situations, Stewards have been threatened with 
blows, and complaints have been sent by irate passengers to the managers 
of airlines. This indicates the failure of passengers to appreciate the 
problem, and any program of disinsectization should include education of 
the traveling public, in both commercial and military aircrafts Tracts 
which are succinct, humorous, and illustrated to be distributed for 
reading during flight, or handed out by the air-port hostesses, would 
do much to dispel objection to spraying, which to a considerable extent 
has become habitual. Properly worded, these pamphlets would even result 
in the demand by passengers that a thorough disinsectization be 
accomplished. 
Emphasis on single spraying 
The details of spraying are ordinarily stated in terms of seconds 
of spray with standard materials and equipment for one thousand cubic 
feet of space. While this is acceptable, it would be preferable to 
specify the actual weight of pyrethrins to be dispersed. 
Even though the cubic content of most planes is determinable, and 
in the case of military planes has been stated on spraying instructions, 
proper timing was rarely encountered by the Commission, Most sprayers 
did not have a watch and reliance was placed upon raising a "moderate mist." This method though defective might be made acceptable through 
training. 
Whatever time or method of spraying is elected, all effort should 
be focused on a single spraying for each span of flight. A single well- 
performed disinsectization done under the conditions outlined above is 
considered more protective than several superficially carried out,, Some 
believe that in flight from one great natural zone to another, a single 
spraying of the plane should not be relied upon, and under such circum- 
stances, it has been proposed that about one-half hour before departure 
the plane be given a particularly thorough treatment, then loaded and 
resprayed lightly just before take-off. The objection to this procedure 
is a waste of effort and spray, and there is actually no very good way 
to predict the departure of planes to within a few minutes. Furthermore, 
insects may enter planes during the loading, and unless the second spray- 
ing were heavy enough, they might not be killed; if the spray were heavy 
enough, no purpose is served by the first treatment except that of satis- 
fying public opiniono 
The question of the advisability of disinsectization in each span 
of flight requires a clear concept of just what it is calculated to inter 
cept in those areas. No disinsectization would be indicated when the 
same insects are present at both ends of a span. Zoning of air-routes 
in terras of insects is desirable, but such maps are not at this time 
available in consolidated form to reveal distribution of insects. 
Furthermore, since disinsectization cannot be reduced to terras of one 
or two insects it is doubtful that such maps would be found to permit 
clear-cut indications for spraying. 
In significant spans, such as to the Hawaiian Islands from any other 
place, the indication for spraying is clear enough, but in routes such 
as from South America or Panama to the United States it would appear 
necessary to spray only when demanded by health or agricultural agencies 
on the basis of carefully evaluated reasons„ Rarely would this require 
the multiple disinsectization carried out at present on some aircraft. 
Searches for insects in planes arriving from abroad has been very 
useful in demonstrating the number and variety of insects carried, but 
further demonstration of the point would appear unnecessary. The occa- 
sional sampling of planes for the presence of live insects should be 
continued to gauge the adequacy of spraying, particularly after each 
modification of technic. Insect surveys are necessary around airfields 
and anchorages, probably on a seasonable basis, to detect any implanta- 
tions of insects that might have occurred despite-preventive measures. 
Routine searching of planes at ports of arrival should, however, be 
discontinued. 
Stowaway animals 
Stowaway rodents have been suggested as important in air-travel, 
considering both the animal and the vermin which they may harbour, and 
particular attention was devoted to this subject by the Commission. 
Rats have been carried on planes, and probably will be more frequently 
transported as air-freight becomes common, but the size of the problem 
is dwarfed by the facts. Several years ago at Brisbane, Australia, a 
rat-nest was found in the wing of a plane which had been idle in India, and two rats were recently reported on a plane before landing at the 
same port, but could not be found on later search. Other instances 
reported by the quarantine officer at Brisbane proved to refer to the 
empty rat nest. At Kelley Field, Texas, two instances were observed 
of rats in planes from Central America, and at other times rats have 
been reported in baggage, but the information has usually been second 
or more handed, obviously uncertain and exaggerated. 
A report of several rats on a plane at Natal proved to refer to 
the discovery of rat-droppings in the cabin. In Honolulu in the fiscal 
year 1942-1943) six fumigations of planes were done by the U.S. Public 
Health Service, two of which were for rats,* eight animals were reported 
to have been recovered. 
It must be recognized that cargo may harbour rats, but the magnitude 
of the problem at this time is unimpressive. Moreover, no plane will 
probably ever harbour as many rats as have been considered reasonably 
safe on surface vessels. Small danger may exist in some instances in 
which special precautions might be advisable, such as in the case of two 
rats observed on a plane arriving in Montreal from the Azores Islands 
where plague existed at that time; unfortunately the rats were not 
recovered on landing. 
Snakes were reported to the Commission to have been seen in planes 
on three occasions, but this is negligible in comparison with the occa- 
sional introduction of snakes with stalks of bananas, and even this has 
no quarantine significance. 
Disinsectization of marine and terrestrial conveyances 
The disinsectization of vessels and land conveyances must not be 
overlooked. In "the former, chief interest has ordinarily been focused 
on cargo which might harbour larval forms of insects, and extensive 
barriers have been set up by the Bureau of Entomology and Plant Quaran- 
tine of the U.S, Department of Agriculture. The conveyance, by sanita- 
tion and dislrrsectization, can be eliminated as a transmitter of stowaway 
insects —but* this is much less important than the cargo problem, and 
will be a great deal more difficult to accomplish in ships, trains, and 
trucks than in aircraft. In vessels, the more important task, despite 
modern construction, is the prevention of breeding of insects through 
alert ship sanitation, with particular attention to refuse and standing 
rain water. Spraying should be accomplished in accord with the local 
risk, but will generally be unnecessary. 
Disinsectization of military aircraft 
Military personnel, although on the--same airfield, may operate under 
different commands and conditions. Furthermore, there is a point of view 
in military aviation which does not ordinarily include insects, or the 
economic factors vital to the operation of commercial airlines. 
Early in the spraying of United States Army aircraft, disinsectiza- 
tion was held to be a responsibility and function of the Medical Depart- 
ment, but the administrative difficulties of this arrangement required 
change to the present designation of the duty as a command responsibility, 
with medical instruction, supervision, and inspection. The Commission is of the opinion that this was a necessary and desirable change. 
It must be realized, however, that the publication of a military 
directive does not per se assure its accomplishment, and that continuous 
supervision is necessary to establish and continue its provisions upon 
an effective level. Inspection of disinsectization should, therefore, 
be included in Sanitary Reports, and in the cognizance of Medical 
Inspectors and Inspectors General. 
The loose fit of canopies and hatches in military aircraft makes 
it impossible to maintain effective concentrations of insecticide during 
flight, so that spraying should be limited to periods before take-off or 
after landing. In general, it is believed that all effort should be 
concentrated on spraying immediately before take-off. 
In some instances, this may be supplemented by spraying upon arrival 
in compliance with local regulations, particularly when this is accom- 
plished by public personnel as in Brazil, Such re-treatment is not 
thought to be indicated upon arrival of military planes in the United 
States if the procedure has been faithfully performed at the preceding 
designated take-off„ 
Disinsectization should be indicated in the form of a note rather 
than a mere initial, and in the Clearance Form (AAF Form No. 23 or 
BuAer 423) in preference to the AAF Form 1. As the clearance is given 
to the Operations Office at the port of arrival, it becomes a matter of 
record,—and is renewed upon each takeoff, whereas Forms I and la remain 
with the--airplane until it reaches its home station, where it comes to 
the attention of Maintenance rather than Operations„ 
Disinsectization should be done by flight personnel, thus assuring 
an automatic supply in the event of the take-off of more planes Jf-han can 
be covered by any feasible ground crew. This should not preclude iihe 
performance of the spraying by ground personnel of the Medical Department 
at certain critical bases such as the fields in Africa used for take-off 
to Brazil. 
The substitution of this or any other elective or additional measures 
at such points should, however, be approved by higher administration, and 
not be a matter of local option alone. In the event of spraying by 
Medical Department personnel due to the critical nature of the function, 
the pilot should be given a certificate of its accomplishment by the 
person performing the disinsectization. The receipt of this form can be 
noted on the Clearance Form, and can be presented to the Operations Offi- 
cer at the field of arrival. The supervision of disinsectization of 
aircraft should be by qualified entomologists, at least at critical points, 
and at all other points where their services can be obtained. These 
details of the disinsectization of military aircraft are included in the 
revision of AAF Regulations 61-3, suggested by the Commission, (App. Item 
20), 
It is not considered that existing military regulations governing 
disinsectization need essential change, but rather enforcement, with 
selection, supervision, training, and stabilization of personnel involved. 
It should be emphasized again that education of flight personnel and 
military passengers in all grades is as essential for success in military 
as in civilian operations. ADMINISTRATION OF QUARANTINE 
Analysis of this report reveals a number of changes suggested in the 
present execution of quarantine in civil and in military procedure. 
Flexibility of regulations 
Rigid and technical interpretation of regulations may not permit 
sufficient latitude of Judgment to quarantine officers, with resulting 
inconsistent practice as in one place where there was lack of insect 
control in land-planes because regulations in the country specified 
hydroplanes only. In other instances it may be questioned whether lack 
of specific regulations or other reasons was the more important, as in 
the omission in some places of the quarantine processing of planes from 
the Amazon Valley to Coastal cities. To be effective, quarantine must 
be flexible, and its application left to the intelligent Judgment of an 
officer, concerned less with the legal phraseology of regulations than 
with the essential purpose of quarantine. 
Treaty provisions 
Perhaps because a carrier could virtually be excluded from trade 
by excessive quarantine restrictions, international quarantine treaties 
specify in general the maximal control to be permitted rather than the 
minimal, and many Governments consider their provisions advisory rather 
than binding. The result is that such treaties commonly provide no 
effective persuasion toward their goal, and the suspension of traffic 
for which they provide is not invoked. Probably few aerodromes in the 
world are anti-amaryl except by the fortune of their location in a 
country free from yellow fever, or in an area naturally restrictive to 
mosquito breeding; yet international air traffic has been unrestricted, 
despite the provisions of the International Sanitary Code of 1933. 
Another factor is that, although American countries are not signatory 
to the International Sanitary Code for Aerial Navigation, 1933, except 
the United States and Bolivia, no other agreement has adopted similar 
advisory standards in this hemisphere. 
Lack of correlation 
Quarantine regulations have on occasions led to impracticable 
provisions as: 
a. Requiring a quarantine officer to certify that 
passengers from an infected area are "free of cholera” 
when the most any examination could do would be to 
fail to demonstrate cholera; 
b. Requiring train crews to observe the state of health of 
passengers en route as a basis for quarantine at land 
frontiers; 
c. Making a physician responsible for quarantine when he 
has insufficient time for his regular duties, or is do Obligating a carrier to refund the passage and to re- 
patriate an ineligible traveler who was granted passage 
on the basis of a fraudulent health certificate * 
located at too great a distance from the port of entry, 
6a Issuing certain military directives, for the execution 
of which, provision is not made, and which are incon- 
sistent with general policy. 
It was acknowledged at the onset of the war that the United States 
Public Health Service was unable to carry out quarantine in all military 
traffic, and that as a result part of the function must be performed by 
military medical officers. To a limited extent, medical officers of the 
Array and of the Navy were appointed Acting Assistant Surgeons in the 
United States Public Health Service for the purpose of quarantine 
enforcement, but complete use was not made of this mechanism, and the 
implications and correlations of such appointments have not been com- 
pletely worked out. Under this arrangement, functions hitherto performed 
by officers of the United States Public Health Service were assigned to 
military officers directly, by delegation of authority from the United 
States Public Health Service. 
This arrangement was handicapped by lack of clear definition of the 
authority, and of the relationship of the United States Public Health Ser- 
vice officer to the military officer appointed Acting Assistant Surgeon of 
the United States Public Health Service. The military officer was compelled 
to observe censorship regarding shipping and movement of personnel, while 
United States Public Health Service officers at times demanded confiden- 
tial information in order to be assured the delegated function was being 
executed. In some instances, they insisted upon unlimited inspection, and 
upon completed standard forms of the United States Public Health Service, 
These forms cannot be forwarded under military rules of security, for, in 
addition to the non-military status of the Public Health Service that Ser- 
vice has not adopted any system of classification of information. 
Objection was, therefore, offered to compliance with such requests 
of the United States Public Health Service, and local officers of that 
Service were at times embarrassed by procedures necessary to gain entrance 
to military reservations. To avoid this confusion, it is suggested that 
proper officials in the three Services in Washington effect a correlation 
of the duties and responsibilities of their respective officers in the 
field, as outlined later in this report. 
The status of Acting Assistant Surgeon in the United States Public 
Health Service was granted, at first by name and later by position, to 
the senior medical officers of stations for which the appointment was 
asked through channels, but the Commission encountered no specific defi- 
nition and delegation of such authority by Post Surgeons to those actually 
meeting the planes or ships. The work could be improved if Post Surgeons 
would formally delegate their authority to appropriate personnel and 
require periodic reports, or if the authority were in the first place 
granted directly to the boarding officer, through channels. 
The situation to date in the case of the United States is somewhat 
between the extremes represented by the complete delegation of all quar- 
antine authority and responsibility to the Allied military forces by the 
New Zealand Parliament, and the complete reservation of such functions to the Commonwealth quarantine service in Australia. 
The Commission believes that regulations of the Army and Navy should 
specifically implement the quarantine regulations of the United States 
Public Health Service, and assure their satisfactory execution by expansion 
of the appointment system described above. Inter-service correlation 
should be accomplished by consultation between the three Services, the 
quarantine officers of all Services being informed fully of their relation- 
ships and obligations. 
Inadequate codes 
In some countries, inadequacy of quarantine codes may result from 
failure or tardiness of modernization. In Costa Rica, there was submitted 
to the Legislature only in 194-3, a revision of quarantine statutes in ac- 
cord with the Pan American Sanitary Code of 1924, and no aerial codes 
have been formally adopted in Haiti, Dominican Republic, Honduras, El 
Salvador, and many other countries. The International Code for Aerial 
Navigation is based primarily upon protection against yellow fever and 
contains no reference to implantation of new vectors. 
There was a period of time following the attack on Pearl Harbor, 
when the United States Public Health Service was relieved by martial law 
of the responsibility for disinsectization of ships and air-craft, before 
the Navy instituted its program. No clear cut provisions were estab- 
lished for the transfer of such duties. 
Responsibility for quarantine and disinsectization, provided by 
Army Air Force Regulation 61-3, has been executed chiefly by the Air 
Transport Command, which has on the whole set-up an Increasingly effective 
system. There have been, however, some inconsistencies in practice, as for 
example when the Braniff Airways, operating under Air Transport Command, 
performed disinsectization of planes arriving in Brownsville, Texas, but 
not into the Canal Zone, 
Some other sections of the Air Forces are not generally organized to 
carry out disinsectization and quarantine. This has resulted in un- 
certainty as to the performance of disinsectization of planes assigned to 
those sections when landing on fields at which the major traffic and 
responsibility for quarantine belonged to the Air Transport Command, 
Several instances of such incompletely designated duty were noted by the 
Commission, 
In the United States, the Public Health Service met military planes 
at La Guardia Airfield in New York City, but not those landing at Roosevelt 
Field, Mitchel Field and Newark Airport, At San Francisco, the Public 
Health Service was unaware that Array air traffic at times entered Fair- 
field Airport as well as Hamilton Field, and that Navy air traffic 
entered Alameda Air Base as well as Treasure Island. 
In order to designate new airports of entry, an Interdepartmental 
Committee on Authorized Airports has been established. If all proposed 
new airports of entry were cleared by this Committee, the United States 
Public Health Service would be kept informed when the Army or Navy begin 
the use of a new port and could then establish suitable quarantine inspec- 
tion at it. This would avoid situations as noted in the previous 
paragraph„ 
In some military areas, adequate spraying of planes was impeded by the removal of pyrethrin bombs by crews for use in quarters, and in 
commercial airways in the Caribbean area spraying was noted on occasion 
to have been confined to the toilet compartment of the plane. In one 
place, an editorial error from a two minute to a twenty minute holding 
time after spraying in landed planes led to careless performance of the 
entire provision through its impracticability. Adequate supervision of 
quarantine would have detected such irregularities, but inspection was 
not frequently encountered by the Commission. This has resulted in 
unwarranted assumption and assurance that-rergulations were being executed. 
Transportation of animals 
Military carriers, particularly aircraft, have been known to import 
animals into the United States despite civil regulations of the United 
States Public Health Service, of the Bureau of Animal Industry in the 
United States Department of Agriculture, and of the Fish and Wildlife 
Service in the Department of the Interior. This has resulted in avoid- 
able destruction of animal life at ports of entry. Importation has, 
also, occurred into Australia, New Zealand and the Territory of Hawaii, 
where laws are even more restrictive and where rabies does not now exist. 
Army and Navy Airforce restrictions cover fruit and plant quarantine, 
but are not clearly defined in regard to animals. A firm and definite 
stand in the matter would eliminate a vexation to all concerned and should 
be based upon the possibilities of hydatid disease in dogs, tularemia in 
rodents, yellow fever in monkeys, and rabies in several animals. 
An advance has been made by War Department Memo. No.. W850-44> 5 April 
1944, which calls attention to the civil restrictions on importation of 
wild animals and some animal products into the United States, its Terri- 
tories and possessions, but pets are not covered, and will probably 
continue to be transported by air, especially abroad. Pets and mascots 
were forbidden in Army transports and vessels, wholly allocated to the 
War Department, in AR 55-485-C2 of 7 January 1944. 
Divided effort 
Dissociation of effort has led to duplication of personnel employed 
in spray and quarantine functions. At one airfield, each of three groups 
of planes maintained separate spray crews and different methods of com- 
munications with the control tower. Air Transport Command planes at 
Brownsville were met for quarantine and disinsectization by personnel of 
both the Air Transport Command and the United States Public Health Service, 
and at Dallas, two entomologists, one of the United States Public Health 
Service and the other of the United States Department of Agriculture, 
searched the planes for insects of interest to their respective services; 
either could have functioned for the other. 
At La Guardia Airfield, the officer of the United States Public 
Health Service stood by watching the line of passengers from a trans- 
atlantic Air Transport Command plane as they filed through the hangar on 
their way to the Array Airport of Debarkation where each was to be inspected 
later. Such duplication of effort taxes the interest and sincerity of 
personnel and destroys the effectiveness of the procedure. 
Frequent changes of personnel performing or responsible for quarantine prolongs unfamiliarity and inefficiency, and should be minimized.. The 
selection of intelligent personnel interested in the problem and capable 
of judgment should be axiomatic„ Military quarantine officers frequently 
chafe at their work, or are uninterested in it, and it is recognized that 
they have been primarily interested in medical liaison with incoming per- 
sonnel and with the sanitary inspection of the conveyances; quarantine 
has as a rule been incidental. 
SUGGESTED ORGANIZATION 
It is clear that primary responsibility for quarantine in the United 
States, its Territories and possessions should remain with the United 
States Public Health Service in accordance with the obvious intent of 
Congress in the Act of February 15, 1893. Although it might be possible 
to designate military functions as "local1' within the meaning of that 
legislation* and legally usurp the function of the Public Health Service, 
it is considered that unitary responsibility should be maintained. 
Officers in charge of quarantine•in the Armed Services - Liaison 
It is particularly recommended that the Army and Navy each assign 
a medical officer the duty of Officer in charge of quarantine for his 
respective service. These two officers should act as liaison officers 
to the United States Public Health Service and, together with the Chief 
of the Division of Foreign Quarantine of the Bureau of Medical Services, 
serve as an informal interdepartmental quarantine board for the duration 
of its usefulness. They should confer with one another relative to the 
application of policy, the arbitration of differences, and the solution 
of interservice questions arising in connection with quarantine. The 
duties of the individual Officers in charge of quarantine should include 
the administration and inspection of quarantine practice within their 
respective services and submission of appropriate recommendations, 
The Navy officer should be directly responsible to the Surgeon 
General of the Navy and in close liaison with the Medical Inspectors and 
Section of Preventive Medicine. The Array officer should be in such posi- 
tion in the War Department as to permit close and effective liaison with 
the offices of the Surgeon General, of the Air Surgeon, of the Inspector 
General, and with Theater and Air Force Commanders and their Surgeons„ 
The appointments of these officers should be made by letter from the 
respective Secretary, and they should be designated "Consul.tants" by 
the United States Public Health Service, without additional compensation. 
Spheres of responsibility 
The determination of which Service is to accomplish quarantine 
functions in any given traffic should rest upon an evaluation of the 
local problem by the mutual exchange of opinions of the liaison officers, 
and by consultation with the governmental agencies or departments in- 
volved, In general, commercial conveyances and their passengers should 
be processed by Public Health Service personnel, and conveyances owned 
by the Army and Navy should be processed by the military quarantine 
officers, except when determined that greater efficiency may be obtained and expediency served by other personnel, The handling of other convey- 
ances should be subject to mutually satisfactory adjustment, particularly 
recognizing the principle that ships or planes entering Array or Navy 
yards, harbours, docks, slips, or airports should be processed by mili- 
tary quarantine personnel, and if entering non-military areas should be 
processed by the Public Health Service* This arrangement should pertain 
to military carriers of foreign as well as United States registry. 
It is recognized that some situations will require decision in the 
interest of greatest efficiency, economy, expediency, and security, and 
that these goals may require that any Service accomplish all quarantine 
at a given port, or that in view of volume of traffic, spread of areas, 
or other legitimate reason, two or all three services might operate at 
one port * No plan for these purposes should operate to establish a 
duplication of personnel or equipment. The informal board, after such 
considerations as have been outlined, should recommend to the several 
Services a plan for handling the quarantine at each port and aerodrome* 
These general provisions should continue for the duration of the war, 
and for as long thereafter as is mutually desirable* 
The above plan should be accomplished as at present by designation 
of military officers Acting Assistant Surgeons in the United States 
Public Health Service, without additional compensation, for the specific 
function of quarantine, either as full or additional duty depending upon 
the circumstances. 
This designation should apply to the office of medical boarding offi- 
cer rather than to specific individuals or to the Port Surgeon, so that 
the position when assigned and reassigned carries the requisite duty and 
authority. If advisable to make the primary delegation to the Surgeon of 
a port or airfield, tye should formally transmit the status to the officer 
immediately in Charge of the work, in accordance with the terms of dele- 
gation by the United States Public Health Service. Several specific 
functions such as actual disinsectization and ship inspection could be 
carried out by non-medical but trained personnel under the supervision of 
the designated officer. 
Any case of quarantinable disease, and the situation resulting there- 
from, should be the direct concern of the United States Public Health 
Service, and appropriate disposition should be effected in accordance with 
consultation between the military quarantine officer and the nearest 
United States Public Health Service Quarantine Officer, 
The high level of performance of these delegated duties should be 
assured by reference to them in regular Sanitary Reports, and to their 
observance by Medical Inspectors and by Inspectors General. Pertinent 
reports should come to the attention of the Officer in charge of quarantine 
of the Navy, or of the Army, respectively, through appropriate channels. 
The military Officers in charge of quarantine should also conduct inspec- 
tions and observations whenever indicated. Quarantine procedures should 
be subject to inspection by officers of the United States Public Health 
Service, for assurance of correct and efficient performance. 
Periodic reports by the local military quarantine officer should be 
submitted to the United States Public Health Service-through local or 
regional offices of that Service, including unclassified abstracts of the 
bills of health, manifests, and ship inspection reports, (See App. Item 
19 for a suggested suitable report form), Full reports should be forwarded through military channels to the respective Officer in charge of quaran- 
tine. 
The local or regional regular officer of the United States Public 
Health Service, as well as the Officer in charge of quarantine of the 
Army or Navy, as the case may be, should also serve in an advisory and 
consultative capacity to the local military quarantine officer* 
The quarantine system thus outlined would facilitate the extension 
or the withdrawal of military participation in quarantine, either locally 
or generally, as might be expedient. Extension of an established system 
of this type would undoubtedly be welcomed by many governments in foreign 
areas, and would assure continuity of purpose, plan, and effectiveness 
within the Armed Forces. 
While under such circumstances, the basic laws of a territory or 
country would of necessity influence local military practice, unless it 
were a conquered area, the plans suggested and demonstrated by the Mili- 
tary Quarantine Officer might assure closer rapprochement in later inter- 
national councils regarding quarantine. 
In the event of military government under martial law in the United 
States, Allied, or conquered territory, the same system could be adopted 
with minimal modification. It is also possible that in such a quarantine 
system trained and approved military personnel might receive endorsement 
by the United States Department of Agriculture for the enforcement of 
plant quarantine. Specific directions should provide for the inspection 
of personal baggage of any military personnel in this connection. 
As it is not likely that many quarantine positions in the Armed 
Forces would require full time, personnel assigned to them would usually 
be available for additional duty. Thus, the personnel involved in this 
scheme is enlarged over the present only by the Officers in charge of 
quarantine of the Army and Navy, and after the establishment of the system 
they, too, might be available for additional duty. Included in the func- 
tions of the respective Officer in charge of quarantine should be the 
adoption of suitable forms and instructive literature affording maximal 
simplification. 
Selection and training of personnel 
Effect've selection jf per&uxinal for assignment as local military 
officers must depend upon aptitude, and must be followed by instruction 
in technic and in pertinent laws and regulations. A course of training 
for this purpose initiated by the Navy at Pearl Harbor was effective in 
this connection, and might be duplicated if thought necessary. It is 
considered, however, that pamphlet guides, supervision by the respective 
Officer in charge of quarantine, and consultation with local officers of 
the Public Health Service, the United States Diplomatic Corps, and the 
personnel of the United States Department of Agriculture, would fit 
personnel for their tasks. 
The possible role of these officers abroad in granting port documents, 
including Bills of Health, may still further increase their value and 
usefulness in addition to contributing to the security and facility of 
marine and air traffic in those ports. 
Administrators of quarantine must also recognize the necessity for 
education of the general public, and for the instruction and careful supervision of carrier personnel in procedures which constitute feasible 
and effective quarantine. All groups should expect intelligent quaran- 
tine and their expectations will greatly facilitate its accomplishment. 
It is essential that current adaptation and revision of quarantine 
practice be continued in accordance with additional knowledge, increased 
sanitation, and more dependable epidemiological intelligence. Regular 
conferences of quarantine authorities and officials to this end are 
suggested. 
PREVENTION OF QUARANTINABLE AND EXOTIC DISEASES 
IN MILITARY FORCES ABROAD 
By the terras of reference, the Commission was charged with the 
examination of measures used to protect our troops, wherever they might 
be situated, from quarantinable and exotic diseases. The Commission made 
painstaking inquiry into the methods and procedures in use in most areas 
in which the troops are now located, and observed at first hand the appli- 
cation of safeguards in this respect. 
No purpose would be served by the enumeration of all observations 
made. Suffice it to say, it is the studied opinion of the Commission that 
the numerous directives issued by the Chief of the Bureau of Medicine and 
Surgery of the Navy, and by the Surgeon General of the Army, with the coun- 
sel and suggestions of their respective Divisions of Preventive Medicine, 
form a sufficient code of regulations which, if carried out, will afford 
the full measure of protection now known to medical science . 
Because of control afforded by military discipline, it has been 
possible so to immunize American troops and so to protect their general 
health, that it does not appear anything approaching an epidemic of 
quarantinable or exotic diseases need be feared, except under certain 
conditions of actual combat in which malaria, scrub-typhus, and dengue 
may be expected in spite of all efforts to the contrary. 
Since the early stages of the war, medical logistics have greatly 
improved and an appreciation of preventive medicine has spread throughout 
the various commands. In addition, the theaters of operation have moved 
away from some of the more dangerous areas, and although others may be 
entered in the future, organization has been so perfected that there is 
little likelihood of disastrous consequence. 
The Commission has taken cognizance,of the recommendations of the 
Interservice Committee for the control of Exotic Diseases and subscribes 
to their recommendations. It has no additional recommendations to make 
concerning these particular problems except to emphasize the importance 
of a system which will assure prompt distribution of medical intelligence 
concerning exotic diseases, and the indoctrination of Commanding officers, 
medical officers, and all other Army and Navy personnel, first in the 
basic principles of preventive medicine, and second in specific procedures 
to be followed for personal protection. 
In Part III will be found suggestions for correlating the various 
Army, Navy and United States Public Health Service regulations, so as to 
make quarantine procedures consistent throughout the Services. INTERDEPARTMENTAL QUARANTINE COMMISSION 
Final Report - Part II 
10 June 1944 INTRODUCTION 
This part of the Final Report is a summary of the essential provi- 
sions of Part I, which the Commission believes would accomplish adequate 
modernization of quarantine procedures, and integration of civil and 
military interests. 
In view of the magnitude of national military endeavor, it is 
apparent that for the duration of the emergency, quarantine procedures 
related to military movements will, for many reasons, have to be performed 
at times by military personnel. Nevertheless, in the United States, 
national quarantine is a function of the United States Public Health 
Service. It would appear that this apparent but not real conflict in 
interests, could be solved by the creation of an informal quarantine 
board, whose members would act as liaison officers to the several services. 
These officers would be the same persons as those designated as Officers 
in charge of quarantine in the armed services and the Chief of the Division 
of Foreign Quarantine, United States Public Health Service, They would be 
charged with the supervision of quarantine procedures within their respec- 
tive services, and with mutual correlation, integration, and consultation 
as problems arise, to the end of the greatest efficiency in these functions. 
Quarantine in the Army and Navy should be consistent with regulations of 
the United States Public Health Service in so far as compatible with mili- 
tary efforts. 
For purposes of clarity, this Part is divided into the following four 
sections; I, Quarantine with reference to international considerationsj 
II. Quarantine with reference to civilians and commercial planes, entering 
the Unitfed States; III, Quarantine with reference to interstate traffic; 
and IV. Quarantine with reference to the United States Military Services, 
I. QUARANTINE WITH REFERENCE TO INTERNATIONAL CONSIDERATIONS 
It is desirable that following the present conflict, a convention 
be proposed by the United States to consider and agree on international 
quarantine procedure, in the light of present knowledge and with approp- 
riate reference to air travel. The Interdepartmental Quarantine Commission, 
after discussion with numerous public health officials, is convinced such 
a proposal will meet with favor. 
The basic quarantine provisions adopted at such a convention should 
include the following; 
a, A system of weekly radio notification by public health 
officials to a few central stations (e.g., Singapore, 
Alexandria, Moscow, Balboa, and Geneva) of the current 
situation relative to quarantinable disease at ports 
and places involved in international traffic. 
b, A system of re-broadcasting a summary of these reports 
to those concerned. 
c, A system, making use of regular air-traffic communi- 
cations for the immediate reporting of sudden outbreaks 
of dangerous diseases in order to make the information available for use in air travel. 
d. Abandonment of bills of healtho* 
e. The use of radio or signal pratique under specified 
but liberal conditions. 
f. Routine quarantine functions, although under the 
direction of medical officers should be carried 
out by non-medical personnel. However, such person- 
nel should act only within specified limits and 
should be obliged to consult a medical officer in 
any exceptional situation. 
g. The program found so successful in the United States 
of ratproofing ships by "building rats out" of them, 
should be extended and should include military ships. 
These ships should receive special consideration in 
all ports to encourage the wide adoption of this 
practice. 
h. Passengers in international traffic should be re- 
quired to have in their possession an International 
Travel Log, showing their whereabouts for the past 
14 days, and their status in reference to immuniza- 
tions . 
i. International passengers should have proof of valid 
vaccination within designated intervals against 
smallpox; and against yellow-fever and/or cholera 
if the person has been in areas in which these 
diseases occur; and/or typhus if typhus in epidemic 
form has been present in an area visited by him 
within 12 days. Failing this certification, pass- 
engers disembarking should be placed either in 
detention under observation quarantine for a suitable 
length of time or under compulsory surveillance, 
whichever is indicated. If the passenger has been 
traveling a sufficient length of time to exceed the 
recognized time limits of incubation of the disease 
in question, he may be considered to have satisfied 
quarantine requirements. 
j. Ports should be maintained at certain sanitary 
standards with special reference to rats and insect 
vectors, and nations should obligate themselves 
in this respect. Especial attention should be 
given the sanitation of airports, and efforts made 
to prevent the breeding of disease vectors for as 
great a distance around the port as is practicable. 
k. Carriers should be obligated to take effectual 
measures to prevent the embarkation in international 
travel of persons showing symptoms of quarantinable 
occasions, bills of health have been used to control traffic 
when sanitation was not fundamentally involved. This use of the 
document* while fortuitous, is objectionable on the grounds of its 
invalidation as an implement of health. diseases, and to prevent the transmission of disease 
vectors. 
1. Arrangements should be continued for medical examina- 
tion of immigrants and for their rejection on the 
basis of medical examinations. Those immigrants 
intending to remain as residents should be thoroughly 
examined; temporary visitors should be allowed 
entrance on the basis of ordinary quarantine regula- 
tions without, as a rule, undergoing physical 
examinationo 
in. When conveyances arrive at ports of entry from ports 
which are considered infected, or when passengers 
have been exposed to quarantinable diseases on the 
conveyances en route, arrangements should be made to 
inspect and to detain the passengers or to follow 
them under surveillance in accordance with agreed 
basic procedures. In general, if an approved physi- 
cian is aboard a conveyance, his statements concerning 
the ports of departure or call, the conveyance, and 
the crew and passengers, should be taken into consi- 
deration in determining quarantine procedures. 
n. Periodic inspection for rats, and fumigation against 
them, should be provided; valid deratization certi- 
ficates should be required and accepted. 
Oo Special provisions should be made to assure the proper 
disinsectization of aircraft which arrive in a 
country from another whenever it is believed the 
aircraft may transmit noxious insects or disease- 
bearing vectors. 
p. All animals transported bjr any method should be 
subject to regulations designed to prevent their 
carrying diseases into a country. 
q. Special regulations governing pilgrimages should 
be re-examined, adopted, and enforced. 
II. QUARANTINE WITH REFERENCE TO CIVILIANS AND COMMERCIAL PLANES 
ENTERING THE UNITED STATES 
In general, all persons arriving with, suspected of, or exposed to 
quarantinable diseases, should be cared for in United States Marine, 
federal, state, county, municipal, or approved private hospitals, except 
that so long as well, persons may be housed in other suitable buildings, 
or followed under surveillance if warranted. 
All persons not complying with requirements governing vaccinations 
should be vaccinated and followed under surveillance or detained under 
observation for a prescribed period of time. 
Leprosy should be deleted from the quarantinable diseases, but 
continued as a matter of cognizance of immigration officers and local 
health authorities. 
When routine inspection of passengers and crew is indicated, it may be performed by nurses, or other suitable personnel, and inspection of 
conveyances by trained sanitary inspectors. Physicians should act as 
consultants. 
The disinsectization of aircraft and of vessels, where deemed neces- 
sary, should be a function of the Department of Agriculture in close 
collaboration with the United States Public Health Service. If this is 
impracticable, the function should remain with the latter. 
A plane should be considered at this time to have been satisfactorily 
treated if the equivalent of 0.012 grams of pyrethrins in freon with oil 
of sesame has been discharged par 1000 cubic feet provided it is thoroughly 
distributed, and exposure is continued for at least 1 minute. Present 
investigations suggest some improvement may be anticipated in this proced- 
ure. The dosing may have taken place just before flight, during flight 
in regular commercial passenger planes, or upon landing before the dis- 
charge of passengers or crew. Certification by a person, approved by the 
United States Public Health Service, should be accepted as evidence that 
the process has been carried out. Planes should, except when specifically 
exempted, undergo disinsectization before or during flighty or upon 
landing at any United States port if from any other port separated by 
ocean or sea, or if from areas South of middle Mexico, 
III, QUARANTINE WITH REFERENCE TO INTERSTATE TRAFFIC 
In order to protect the several states and territories from the 
introduction of quarantinable disease from another state or territory, 
the United States Public Health Service should extend the general princi- 
ples of federal quarantine to include interstate and interterritorial 
travel,. These regulations should include protective measures against 
disease vectors, when indicated and practical, as well as against 
diseases themselves. It is clearly recognized that owing to the volume 
and speed of travel across state boundaries, little can be done in this 
regard, but under rare conditions it may be necessary and possible to 
limit traffic. The requirement of certain sanitary measures on inter- 
state conveyances has been and is practicable. 
Under certain conditions, the control should extend to communi- 
cable diseases and such regulations should be promulgated from time to 
time by the Surgeon General of the United States Public Health Service, 
IVo QUARANTINE WITH REFERENCE TO U, S, MILITARY SERVICES 
The Navy and the War Departments should each appoint an Officer in 
charge of quarantine in their respective services. A medical officer 
with suitable rank should be appointed to this office with duties of 
organization, administration, inspection of, and consultation upon matters 
of military quarantine performance and interest. In the Navy, he should 
be directly under the Chief of the Bureau of Medicine and Surgery, nomi- 
nated by him, and appointed by the Secretary of Navy* He should maintain 
liaison with the several medical inspectors and with the Division of 
Preventive Medicine, 
The Officer in charge of quarantine in the Army should be nominated 
4 by the Surgeon General, and appointed by the Secretary of War. He should 
be assigned to an echelon assuring effective function with regard to all 
those agencies involved in quarantine matters, and he should maintain 
liaison with the offices of the Surgeon General, of the Air Surgeon, of 
the Inspector General, and with the Theater Commanders. 
Both officers should be the representatives of their respective 
Departments on an informal board, of which the third member should be the 
Chief of the Foreign Quarantine Division of the Bureau of Medical Services 
of the United States Public Health Service. In that capacity, each should 
act as liaison officer between his own and the other two departments. The 
Officers in charge of quarantine in the Array and Navy should also correlate 
the quarantine interests of their services abroad with local quarantine or 
public health organizations. They may be expected to be assigned addi- 
tional temporary duties from time to time. 
While the application of quarantine practices in the United States 
and its possessions is basically a function of the United States Public 
Health Service, the actual procedures pertaining to the Armed Services 
should be carried out, under the Officer in charge of quarantine, by 
service personnel. The Chief of the Section of Foreign Quarantine of the 
United States Public Health Service, or his representative, should have 
the privilege of periodic inspection of the procedures carried out by 
the Armed Services, and should act as consultant on quarantine,. 
The individual Service quarantine officers should be designated as 
Acting Assistant Surgeons in the United itates Public Health Service for 
this purpose, and should make unclassified reports to the local or regional 
United States Public Health Service officer, through the commanding officer, 
and full reports to the respective Officer in charge of quarantine by 
military channels. 
In general, the same fundamental regulations should pertain to mili- 
tary and civilian personnel and conveyances; however, the details of 
application will at times be different. (App. Items 19 and 20). Require- 
ments of foreign countries will be respected, complied with, and considered 
minimal. Because military personnel are required to be protected by vacci- 
nation against the quarantinable diseases they may encounter in their 
duties and because they are under constant medical supervision, especially 
when in a travel status, they should ordinarily require no additional 
quarantine processing when arriving in ports of the United States, its 
territories and possessions. 
As the fundamental procedure, disinsectization of aircraft should 
be performed by flight personnel immediately before takeoff where disin- 
sectization is indicated. At designated stations, it may be done by 
special ground crews from medical corps personnel. The exact process 
and locations should be recommended by the Officer in charge of quaran- 
tine. 
Animals will not be carried by service aircraft except on permits 
granted by the respective Surgeons General in accordance with military 
and civilian regulations. 
The Officers in charge of quarantine should assist the Section of 
Preventive Medicine and Public Health Services where exceptional condi- 
tions warrant, in protecting American service personnel from quarantin- 
able and exotic diseases. SPECIAL SUMMARY 
At the suggestion of Brigadier General J. S. Simmons and Dr. R. C. 
Williams, the Interdepartmental Quarantine Commission herewith submits a 
special outline of its recommendations divided into the following four 
major headings: (I) Immediate coordinate action by the United States Array, 
Navy, and Public Health Service, (II) Immediate action by the United 
States Public Health Service, (III) Immediate action by the Armed Services, 
and (IV) Future action by the United States Public Health Service, 
In order to make the suggestions cover a complete program, some items 
refer to procedures already in partial or complete operation. Reference 
may be made to the text of the Commission’s report for supportive data. 
(I) Immediate coordinate action by the United States Army, Navy, 
and Public Health Service„ 
1. Certain quarantine procedures relative to the armed services and 
prisoners of war, including necessary sanitary measures, such as disin- 
festation of personnel, clothing and conveyances shall be performed in 
the United States, its territories and possessions, by qualified members 
of the Array and Navy, in accordance with plans agreed upon. 
2. Military officers shall 
a. Take steps necessary to prevent implantation of insects 
arriving on aircraft from abroad. 
b. Enforce current federal and military regulations governing 
the importation of psittacine birds and other animals. 
c. Take steps necessary to detect quarantinable diseases 
among persons (military and civilian) arriving by military 
conveyance, and to prevent the spread of these diseases. 
d. Be designated Acting Assistant Surgeons of the Public 
Health Service, without additional compensation, for the 
performance of quarantine duties. The designation shall 
be made directly to, or shall be delegated by a superior 
officer specifically to, the one immediately charged with 
the performance of the duties. 
3o Designated officers of the Public Health Service shall from time 
to time visit Array and Navy units where quarantine procedures are per- 
formed to confer with responsible officers, to insure uniformity and ef- 
fectiveness of measures employed, and to act as consultants and advisors. 
4. Measures to prevent the introduction of quarantinable diseases by 
military airplanes arriving at civilian airports may be undertaken by offi- 
cers of the armed services in accordance with agreements with the Public 
Health Service. 
5. Reports of quarantine activities by officers of the Array and Navy 
will be transmitted to the Surgeon General of the United States Public 
Health Service through the proper military channels and will indicate, 
subject to security regulations, the number of conveyances inspected, the 
cases of quarantinable diseases detected, and other pertinent information. 
6- Vessels of the Array, Navy and Coast Guard will continue to be exempted from quarantine inspection provided the vessel is from a clean 
port and carries a commissioned medical officer. Vessels from ports not 
classed as clean may also be exempted provided a commissioned medical offi- 
cer aboard certifies the behavior of the vessel in the infected port 
precluded the danger of introduction of quarantinable diseases. 
7. The Army and Navy shall each designate one qualified medical offi- 
cer to 
a. Act as liaison officer for quarantine with the United States 
Public Health Service0 
b, Supervise quarantine functions carried out by the respective 
armed service in the United States, its territories and 
possessions, and in other areas in which the armed forces 
may undertake similar responsibilities. These will be known 
as Officers in charge of quarantine. 
(II) Immediate action by the United States Public Health Service 
1. Foreign Quarantine Circulars Numbers 77 and 71 should be revised 
in accordance with the preceding principles, and should provide for the 
use of a simplified Aircraft Quarantine Declaration (see form suggested by 
the Commission). They should require disinsectization of planes from all 
places except the United States, Alaska, Canada and its adjacent areas, 
Iceland, Greenland, British Isles, Virgin Islands, Mexico west and north 
of a line running just north of Acapulco and Vera Cruz, the Bahamas, Ber- 
muda, Curacao, Aruba and the Galapagos Islands. All flights to Hawaii 
should require spraying. Spraying should be permitted either at takeoff, 
in flight or on landing, under conditions discussed in the report (fully 
loaded and with ventilation suspended), Planes should inform the traffic 
control tower on arrival that spraying has or has not been accomplished, 
and if not, no unloading should occur until the plane has been properly 
disinsectized. A plane should be considered satisfactorily treated when 
the equivalent of 0.012 grams of pyrethrins per 1000 cu> ft. of space has 
been distributed throughout the plane, with a holding time of two minutes. 
The time of spraying should be noted on the Clearance Form of the aircraft, 
and filed with the operations officer at the airport of arrival. Emphasis 
should be placed on the performance of the spraying by the flight person- 
nel, and on supervision by the Public Health Service or its delegated agents 
The provisions of AAF Reg. 61-3 and Burned Form Letter Number 28, re- 
vised, should be accepted as satisfactory for quarantine and disinsectiza- 
tion in military aerial traffic. Passengers of aircraft should be canvassed 
at times to determine if the proper procedure has been carried out in the 
disinsectization of planes, and inspectors should occasionally check on 
the procedures by riding the route incognito. 
2. Consultation should be held with manufacturers of aircraft regard- 
ing the screening of openings into spaces ofpplanes outside the cabin, with 
a view to satisfactorily protecting them against entrance of insects. 
3. Periodic surveys of insect breeding about airports of entry should 
be continued, and routine searching of planes and identification of recov- 
ered insects should be discontinued, except for periodic sampling. 
4.0 Study of the effect of airplane flight upon viability and breeding 
of insects should be undertaken. This may be done in conjunction with the 
7 Department of Agriculture, Bureau of Entomology and Plant Quarantine. 
5. A notice should be published enumerating those immunizations 
required of travelers before entry into the United States, and the advan- 
tages offered to entrants into this country if immunized. 
6. The traveler, before or on arrival in the United States should 
complete a form showing the character and dates of his immunizations, and 
the places of his travel or residence during the preceding two weeks. This 
form may later be replaced by an International Immunization Record and 
Travel Log (see form suggested by the Commission). 
7, Quarantine procedure should be determined by the history of possi- 
ble exposure, and by immunization records, and with less emphasis on physi- 
cal inspection and taking of temperature. 
B. Non-medical personnel, especially nurses at airfields of entry, 
should be utilized for the performance of quarantine in accordance with 
the principles of the preceding paragraph. Physicians should be utilized 
for consultation when necessary. 
9« Leprosy should be deleted from the list of quarantinable diseases. 
10, Criteria for detention of persons under observation upon entry in 
this country should be restated. 
11. The remaining quarantine hospitals and detention spaces should be 
decommissioned, and provision made for the care of persons under observa- 
tion or treatment for quarantinable diseases in Pterine, federal, state, 
county, municipal or private hospitals or facilities. 
12. Criteria for surveillance should be restated and a revised method 
of surveillance should be instituted. If a bond is not required, the 
system should nevertheless provide a definitive report to the Public Health 
Service, 
13• Physical examination should be performed on only those aliens in- 
tending permanent residence; the procedure in reference to others should be 
reduced to the usual quarantine measures. 
14. A program of education in the light of scientific knowledge, should 
be undertaken relative to quarantine exposure, risks and procedures. Al- 
though directed to the general public this should particularly reach the 
air-traveling public and the personnel of the airways. 
16. Foreign Quarantine Division Circular Number 83 should be repub- 
lished if Bills of Health are required of vessels of the Armed Services. 
15, The American Bill of Health should be discontinued. 
17, Radio or signal pratique should be adopted for vessels arriving 
in ports of the United States, on the basis of the Pferine Quarantine 
Declaration and with liberal approval of carriers. 
18. Discontinuance of the routine use of rat guards should be author- 
ized. 
19. Control of insects on surface vessels should be enforced when 
indicated. 
20, Consultation should be held with the State Department in order 
to promote more frequent and prompt consular reports on health. The 
possibility of routinely sending these by radio or cable should be dis- 
cussed. 
21. Dissemination of quarantine data to quarantine stations by tele- 
gram or teletype should be instituted, reserving the published Public 
Health Report for confirmation, summary and general distribution. 
22o The names of ports and zones considered infected, especially 
RESTRICTED those with yellow fever and plague, should be published every three to six 
months. These areas should be restricted as much as possible in the light 
of information available. Arbitrary periods after infection before an area 
may be considered clean should be eliminated, 
23o Consideration should be given by the Panama Canal Company to the 
substitution of rat inspection, along with fumigation if a sufficient num- 
ber of rats are found, for the routine requirement that all vessels passing 
through the canal be fumigated unless possessing a deratization certificate 
valid within 6 months. 
Many of the above suggestions will be provided in the revisions of 
the United States Public Health Service regulations offered by the Commis- 
sion in Part III of its Final Report„ 
(III) Immediate action by the Armed Services 
1, Each service should appoint, by letter from the respective Secre- 
tary, a qualified Officer in charge of quarantine, with duties of 
a. Liaison with the Public Health Service, These officers, to- 
gether with one from the Public Health Service, should be 
authorized to consider interservice relations and to keep 
their respective services informed on matters of quarantine. 
bo Establishing and supervising quarantine functions within 
the respective armed force, including the instruction of 
military officers performing quarantine duties, the prepa- 
ration of directives and forms, the collection of pertinent 
reports, and the inspection of operations and installations 
concerned with these functionso 
Co Integration of quarantine interests of the armed services 
with health agencies in foreign countries and areas. 
2. AAF Reg. 61-3 and Burned Form Letter Number 28 should be revised 
in accordance with interdepartmental agreement. 
3. Quarantine regulations and directives should be applied to all 
military planes, rather than primarily to those of the transportation 
commands. 
4. Directives clarifying the transportation of pets and animals by 
military aircraft should be published. 
5» Comprehensive and prompt distribution of epidemiological data to 
military quarantine officers should be undertaken. 
6, Consideration should be given to revisions in military regulations 
and directives to be suggested by the Commission in Part III of its final 
report. 
7o Education of ground, flight and passenger personnel should be in- 
stituted regarding requirements and methods of quarantine and disinsectiza- 
tion in international flight. 
(IV) Future action by the United States Public Health Service 
I, An international conference should be proposed to consider uni 
formity of quarantine procedures and adoption of a. The "Singapore system," with a special code, for inter- 
national exchange of epidemiological data. 
b. A system of emergency dissemination of data through the 
airways communications system. 
c. An International Travel Log and Immunization Record, 
d. A corps of international sanitary and health observers 
and reporters. 
2. Routine consular health reports should be abandoned after estab- 
lishment of the "Singapore system." This should not eliminate emergency 
reports of epidemiological data by consuls. 
3. The use of radio pratique should be extended 
A. International agreement should be reached on privileges to be 
extended to rat proofed vessels. 
5o International agreement should be reached on maximal and minimal 
standards of sanitation in marine and aerial ports. 
6. Practice, including disinsectization, should be aimed at accom- 
plishing as much of the quarantine procedure as is practicable before 
departure of the conveyance. XHTERIEPAFIMKISTAL QUARAflTIRE COMMISSION 
Final Report - Part III 
10 June 19*^ Part III 
Table of Contents 
United States Public Health Quarantine Regulations 2 
Urmiashered Circulars. 35 
Quarantine of Aircraft •. .35 
Foreign Quarantine Division Circular #71 . ...?.U0 
#77 
#78 «* 
#83. 
Supplement to #85 t9 
#65..... 50 
United States Array Regulations and Directives .......51 
United States Jfavy Regulations and Directives. ...58 JTOAL BSPGRTc PART XXX 
SUGCdSSTIOHK FOR MODIFICATIOBS OF CDRREHT REOOLATXORS 
In accordance with the tons© of reference, there follow 
suggestions for changes in the current regulations of the 
three services in conformity with the principles of quaran- 
tine procedures discussed in Parte I and II. It Is under- 
stood that the United States Public Health Service now has 
a committee charged with revision of the code of the service, 
and it is trusted that those suggestions may bo of value to 
the ccaattittee. Similarly these suggestions may be of value 
to those charged with the revision of regulations and 
directives in the armed services. 
All these suggestions ere mad© with the primary pur- 
pose of providing regulations which will be consistent 
throughout the throe services Insofar as that Is practi- 
cable, and whole deviations are necessary of assuring a 
pattern consistent with the general a5.210 of federal, 
quarantine being followed. It is evident that these re- 
commendation* vay require modification in accordance with 
official acceptance of the suggestions contained in Parts 
I and II. 
During the detailed review of Anay end Savy regula- 
tions and directives, attention has been given to certain 
disease® which are neither exotic nor quorantinable from an 
International viewpoint. Remarks are in corns instance© 
made in reference to lusaanisatian against the S3 diseases 
for the purpose of facilitating quarantine procedures. It 
is noted that since certificates of ixamnaization fom an 
essential feature of the control of personnel at ports of 
embarkation and entry, minor variations which of themselves 
have no significance sometimes become of admln1 strative 
Importance. I3?miD ST/VEES PUBLIC HEALTH 
QUAR/RTERE RJEGULATIONG, 
19^0 
Sec. 
1131 Quaranti nable diseases. 
Bill of health 
11.11 Bill of health required; exceptions. 
11*12 lasttaace ia Insular possessions and dependencies ef the United 
States. 
inspeetiea ef Inhemd vessels 
11.21 Inspection of vessels hound for United States, possessions or 
dependencies. 
11.2? Required of certain vessels. 
11.25 To include cargo, paesengors, crev, personal effects. 
11.24 Vims* ef ne eeasmunloatien after t*.»peetleriT 
11.29 (4) Vessels to he clean prior to receiving cargo or passengers. 
11.26 (5) Disinfection of vessels 
11.2? (6) Health and comfort of passengers. 
11.28 (?) Articles coming from infected districts. 
!!t?9 Artieles shipped tlireagh in fee ted porter 
11.3© (?8) Regulations regarding introduction of diseases of animals. 
11.33: (§9) Articles shipped from or through infected ports. 
U.52 (p) Undlsinfectable articles. 
41*3$ Division ef passengers into ©lasses* 
H.34 (l) Embarkation at infected ports. 
11.39 (2) Persons suffering from certain diseases. 
H.38 (3} Passengers, etc., from infected localities. 
Requirements at sea 
11.51 Measures by master of vessel, 
H.52 Inspection by ship's physician. 
11.55 Appearance of certain diseases on board ship. 
11.54 Cleansing of hospital. 
11.55 In case of death. 
II.58 Clinical record by ship6© surgeon. 
11.57 Disinfecting solutions. 
Inspection upon entry 
11.61 Quarantine; United States-Canada reciprocal pratique. 
11.62 Certain vessels prior to entry. 
11.63 To be made between sunrise and sunset; exceptions. 
11.64 Extent and method. 
H.65 Boarding of vessels subject to quarantine inspection. 
11.66 Persons with communicable but nonquarant1liable diseases; detention. 
Detention in quarantine 
11.71 Certain vessels to be placed in detention, 
11.72 Durat ion. 
11.73 Detention of pilots; dunnage of pilots. 
11.74 Vessels in quarantine; outside communication. 11.75 Release. 
Release certificate. 
11.77 Presentation, of release certificate to collector of customs . 
H.78 Subject to additional regulations. 
H.79 Starve(Observation) of detained pel-sons. 
11.80 Place of detention; carrying infected ait idea into. 
11.81 Cleanliness and disinfection, 
li 8s Isolation of sick. 
11.85 Minimum of c oh® uni cat ion. 
11*8t Discharge of convalescents„ 
11.85 Suboijstonco at vessels’ expense. 
11.86 Passing of bodies through quarantine. 
Choleras special measures at foreign and Insular porta 
(11,8*7 Release under survei Llance). 
11.101 Water and food supply of vassals. 
11.102 Latrines of vessels. 
11.105 Shipment of foods. 
H.lOh Baggage of steerage passengers. 
11*105 Steerage passengers and crews from Infected districts* 
11.106 Steerage passengers and crews shipping at infected ports, 
11.107 Cabin passengers from Infected districts. 
11.108 Appearance of disease in detention quarters; embarkation of 
passengers. 
Cholera: special measures at domestic ports 
11.111 Appearance on board vessels. 
11.112 Steerage passengers fressi cholera-Infected places to be examined 
upon arrival in United States ports, 
11.113 Detention pending result of examination. 
II,111 Discharge after examination. 
11.115 Detention of exposed persons In lieu of examination. 
11.116 Removal and Isolation of cholera-infected persons« 
11.117 Foods ordinarily consumed in uncooked at&te. 
11.118 Food served to persons in quarantine. 
11.119 Water supply of vesaols in quarantine, 
11.120 Dejecta of quarantined persons, 
11.121 Personal, effects contaminated by dejecta. 
11.122 Parts of ship contaminated by dejecta. 
11.123 Tests prior to release of per seme from quarantine. 
follow fever; special measures at foreign and insular ports 
11.131 Period of incubation. 
11.132 Prevention of introduction of mosquitoes on board vessels. 
11.135 Passengers and crew previously exposed to Infection. 
Yellow fever; special measures at ports of arrival 
Treatment of vessels. 
11. Fumigation of certain vroos©la; detention of personnel. 
Treatment of certain vessels, 
ll.lti Vessels fresa infected ports calling for bunker coal or supplies. 
Traffic without detention allowable under certain conditions. 
Il.lt6 Tjaauna or nonoxpoaed per eons. 
11.it? Method of fuaigatienr (dlsInsectization). 
Plague; special measures at foreign and insular ‘ports 11.151 Rate (mice) and fleas, 
11.152 Fumigation of certain vessels and lighters. 
11*155 Suarda ea eo«»eotlag lines* 
11.154 {%) Cargo. 
Plague; special treasures at ports of arrival 
U.l6l Detention of ships. 
11*162 Fumigation ef plag&e-infested ehipat preventing escape of rats* 
U.I65 (2) Detention of sick persons. 
11,164 (3) Measures in case of pneumonic plague on hoard ship. 
H.I65 (±) Freedom from rats and vermin. 
11.166 (5) Personal effects* 
11.16? (o) Entry of certain vessels subject to provisional pratique. 
11*168 Puaigatiea ef eerfcaln vessels required* 
H.I69 (7) Periodic fumigation. 
11.1?® (08) Fumigation certificate. 
11.171 (|?) Method of fumigation 
11.1?2 ifo) Partial discharge of cargo may he required. 
Smallpox; special measures at foreign and insular ports 
11.l8l IncuhatIon period. 
H.I82 Evidence of immunity or vaccination by passengers and crevj 
baggage. 
Smallpox: special measures at ports of arrival 
11.191 Treatment of vessels with disease on board. 
Typhus; special measures at foreign and insular ports 
11.201 Incubation period, 
11.202 Passengers and crew from infected ports; personal effects. 
H.203 Passengers from infected localities. 
Passengers and crew previously exposed to Infection. 
Typhus; special measures at ports of arrival 
11.211 Vessels on which infection has occurred. 
11.212 Vermin-infested persons. 
11.213 Observation of exposed passengers and crew, 
H.216 Release of personnel. 
11.215 Detention and fumigation of vessels. 
11.216 Cargo compartments. 
3.1.217 Fumigants, (and insectioides) 
Leprosy; special measures 
11*221 Embarkation ef alien lepers fer Waited States ispehihited* 
11*222 -Vessels arriving with disease en heard* 
11*225 Leading alien leper prohibited* 
Anthrax and other disease organisms; special measures, 
11.231 Hair or bristles made into shaving or lather brushes for shipment 
into United States. 
11.232 Disinfection of hair or bristles. 
11.233 Consular certificate to accompany consignment of foreign shaving 
brushes. 
11.234 Living disease organisms and vectors. 
Border quarantine 
11.241 Inspection of travelers at Canadian and Mexican ports. 
11.242 Maritime quarantine to b© applied. 
11.245 Mexican citizens on temporary visit. 11.211 Denial of entry or observation of infected persons* 
11 .215 Infected baggage, 
Persons from ehoiera-tnfeeted ieealitdeor 
YlrZkJ Persona from yeiiwf ever-infected piaeesr 
±ir£l8 Peroono from suatilpox-infeeted-iecftiitieor 
Persons from typhue-infected ieeaiitiear 
11.250 (1£) Infected common carriers. 
11.251 (1?) Merchandise, personal effects. 
II .2$2 (IS.) Entry of persona from countries where quarantlnabla diseases 
reported. 
Fees and enforcement 
11.261 Visitation of vessels. 
11.262 Remanding of vessels to quarantine stations. 
11.265 Seized vessels. 
11.261 Rates to be charged vessels for quarantine services. 
CROSS REFERENCE 
Deportment of State regulations relating to quarantine for vessels, the 
detail of medical officers at consulate, and requiremente for a bill of 
health: See Foreign Relations, 22 CFR 89.575-89*580. 
SECTION 11.1 QUARA3TH?AHLE DISEASES. For the purpose of the regula- 
tions in this part the quarsntinabla diseases ere cholera, yellow fever, 
smallpox, (exanthematous) typhus fever, leprosy, plague, amd anthrax* f 
(Sec. 5* 27 Stat. I5O; £2 U.S.C. 92) [Par. 1] 
*f*The source of § § 11.1 to 11.262, Inclusive, (except for amendments and 
other sources noted In the text,) Is Quarantine regulations of the United 
States Public Health Service, Secretary of the Treasury, Mar. 22, 1920. 
BILL OF HEALTH 
11.11 Bill of health required; exceptions, (a) The master of any 
vessel or aIreraft clearing or departing from any foreign port er any 
pert in the pesooseleas ©r other dependencies ef the Baited State© for a 
port in the Uhlted States or its possessions or other dependencies must 
obtain a bill of health, in duplicate, signed by the proper officer or 
officers of the Baited States as provided by lav, froat the port of de- 
parture and ports of call, except as hereinafter specifically provided 
for. The port of departure shall bo the first port from which a vessel 
clears or departs on a voyage to the United States, ©3* (and) the first 
port at which cargo or percons are taken on board for the United States, 
The port of call shall be any port subsequent to the part of departure at 
which the vessel officially enters or in any other manner has direct con- 
tact with the shore, except that whieh is absolutely necessary fer taking 
on bunkers ©r ether eteres* (For purposes of these regulations oonoact 
with shore is considered to have occurred when loading of sea stores takes place, —} when a parson goes ashore.-, -—j “wion csygo Is loedea, —) 
when a per son, other rhan an official when the gang plank la 
lowered or —) when a hawser ia t?ecured In a plague portTT The “bi32 of 
health shall bo leaned not to exceed hours before th© departure of the 
ehlp to which it is Issued. It i© believed* however* that consular of fl- 
eers aay axereiee (subject to) discretion in this matter to cover unusual 
circumstances constituting emergencies. 
fh) Any vassal ©r aircraft clearing fr«a er leaving any foreign pert or 
place, er from any part ar plaae in the poBseesiene or ether dependencies 
of the United States for a part er plaee in the “Suited States ar its 
possessieae er ether dependencies shall be required t© obtain a bill ef 
healthy in duplicate* signed by the proper officer ar officers ©f the 
Rhited States as provided far by law* exeept as provided for in fsH and 
further provided that eiraraft wsy bo exerted fro® ebtaining-said bills 
of health except during the prevalence ©f any of the quaraHtisabl© diseasee 
at auoh foreign port or plaee* or at such port or plaae in the peaeaecieas 
er other dependent? ieo-ef the United States* 
(b) Vessels operating exclusively between Canadian, (Carribbean 
Islands , Bahaaan, geimidlan and Lower Californian, Hew Foundland, Islands 
of St. Pierre, Miquelon and labrador) ports and ports in the continental 
“United States, Territory of Hawaii and Alaska ore exempted from obtaining 
consular bills of health at Canadian porta and from quarantine inspection 
upon arrival at ports In the continental United States and Alaska. Vessels 
operating exclusively between -perta ia the Republic ©f 9uba and in the 
Bahaas islands and pert a in Fieri day south sf Si° north latitude, and 
vessels operating exclusively between perta e» the west ©east ©f lower 
©alifemia and ports in the State ef ©aliferala, south of 35® north lati- 
tude, are exempted fresa obtaining consular bills of health at 3uban and 
Bahama Islands ports and at pert® on the west ©east «f Isower ©alifernia, 
respectively, and from guarantiee inspection upon arrival at the ports 
designated in the ISnited States, but such vessels may bs subjected to 
inspection to determine rat infestation and, when found rat infested, to 
deratization measures. However* during the-provalenea ©f any ef the 
quaraafciaabla diseases at any foreign pert ef departure er eall, all afore- 
meationed vessels shall obtain at any such infested part or ports frost the 
eensular offieer af the United States * er from the ssediaal affloor of the 
United States, whan such officer has bean detailed by the President* a bill 
ef health, in duplicate, in the ferae prescribed by the Secretary of the 
Treasury, sad such vossole shall be subject t© quarantine inspection upon 
arrive! at any port in the sentlBeatal United States ©r Alaska* 
M A veseel which eaHs at any foreign port for orders or for the 
purpose ef taking oa “blanker eeel, bunker ell, or necessary sea 
in distress or beaauee ©f any ether eaaepgeaey, which does net officially 
enter er clear and has no oentset-vith share exeapt fer purposes herel-n 
specified. and which shall depart within hour© after arrival, shall 
not he required to obtain a hill ©f health at that pert* 
(c) A vessel calling at* ports of the United States for orders or for 
the purpose of taking on “bunker coal, bunker oil, or necessary sea stores, 
or In distress or “because of any other emergency, which dees not officially 
enter, shall not he required to produce Mils of health, provided that the 
vessel, its crew or passengers has no contact with the shore while in the 
United States port, except for the purposes heroin specified. ffI (d) A vessel on a definite voyage to foreign countries and return to 
the United States carrying passengers or soliciting passengers for the 
entire voyage, shall be required to take a bill of health from each for- 
eign port subsequent to its aleeranee ©v departure from the United States, 
provided the voyage la of 30 days duration or less; if of more than 50 
days duration. It shall take a bill of health from the foreign port 50 days 
previous to Intended arrival at the first United States port, and such 
port will be considered the port of departure and all subsequent ports will 
be considered ports of call; Provided, however. That if any cargo es? 
pesseagera for the United States are (1b) taken on at a port entered more 
than JO days before intended arrival at a United States port, this post, 
will be considered the port of departure as already specified. 
(e) A vessel touching at a foreign port whore there Is no consul er 
eensuiar agent (or other authorized officer) of the United States shell not 
he required to present an American bill of health from such port on entry 
into a port of the United States, but a hill ef health nay he Issued by the 
eanaral er eenenlar agent of a friendly geveraaeiit at snoh foreign pert 
antheri»ed te leave anek hills of healthr 
fh) (f) A vessel that has received pratique in the United States port, 
and the proceeds to Canadian ports only and returns direct to a United 
States port, shall be considered ae operating exclusively between United 
States and Canadian ports, and shall not bo required to take a bill of 
health from the Canadian port or ports* 
((g) In lieu of bills of health, vessels departing ports of the terri- 
tories , possessions or dependencies of the United States, shall obtain a 
domestic Port Sanitary Statement when departing for porta of tlie United 
States. Its territories, possessions or dependencies, however, such 
vessels may be subject to> quarantine InspectionT (Secs* 2, 3, 27 Stat. 
38 Stat. 372,Stat. Stat. 809, aec. 7 0>) (5), Wt- Stat. 
572; 1»2 U.S.C. 62, 92, 0.S.C. 177 0>) (5)) Dept. circ. 585, 
Juno 2k, 1927; Pars. 2, 3, Quarantine regulations. Public Health Service, 
June andt. 11, Dec. 22, 1928, andt. 16, May 7, 1957 
Cross References: For Department of State consular regulations requiring 
that a bill of health be obtained from consul for vessels clearing for 
United States ports, see 22 CFR 89.375• For* Bureau of Marine Inspection 
and navigation regulations relating to port sanitary statements, ae© k6 CFB 
5.15A. 
li-riJ? Jfifiraana© in insular pcceeselens and dependencies o9 the United 
States, in order to assure uniform practice a® regards the issuance of 
American bills of health in the insular possessions and dependencies of 
the United States, the following instructions are ioeued: 
M The use of donestio Pert Sanitary Statements In lieu of the use of 
the international standard f«m of bill of health presovibed by the Sec- 
retary of the Treasury and the-Pan Ajasrioan Sanitary Cod®, will not be 
permitted in ports in the insular possessions op dependencies of the 
United States* 
(b} Under ihe Quarantine laws and regulations of the United States 
every vessel leaving or departing from a port in the insular possessions 
or depeadenoies of the United States for a port in the Usitsd Statesr its 
insular possessions or dependencies, is required to take out an Asaeviean bill of health in duplicate. xnnsnaich ae there are no Aas»riCt*m consult 3 
etatio&ed in ports in the insular possessions and decadencies of the 
Halted States such biilo of he with shall ho issued by the quarantine 
officer on duty in aach ports. 
io} Tho issuance of American Mils of health fey each quarantine officers 
is conditioned upon the proper observance of the applicable et&Wtmd 
quarantine requirenenta prescribed in the Quarantine Regal at 4«as 
fey the Public Health Service. Vessels will fe© given bills «f health fey th» 
quarantine officer only when sash appropriate previsions have been properly 
observed* 
4d$ in theee instances in wh< oh the quarantine effieer is «e4 satisfied 
that such requirsaoats have been properly observed? and that the vessel say 
safely enter any port in the Halted States? its possessions or depeKdea- 
cies, without danger of introducing quarantinable disease, sash faarantino 
officer shall refuse to issue a Mil of health and in event of 
of vessel without the required bill of health? shall report by sable to 
tho quarantine officer at the port of destination in the Halted States, 
its possessions or dependencies? that the vessel has boon rofaeod a felll 
of health, and tho reasons-therefor. 
i*) Medical officers in charge of quarantine stations is porta of the 
Halted States, its possessions or dependencies, upon reeoiving notifica- 
tion by cable of the refusal of a Mil of health to a vessel at a port ia 
the insular possessions or dependencies of the HMtod States, shall sub- 
ject that vessel? upon-arrival at the pert of destination, to quarantine 
inspection and such other proscribed quarantine jseasures as asay be 
necessary to prevent the introduction ef quaraatinafele disease into the 
Hhited States, and. shall report the Teasel as having failed to present 
Ids© required bill of health? to the collector ef eusteas fer appropriate 
action. 
if) Collectors of custcas shall refuse entry te vessels frsii port© in 
tho possessions and dependencies of the Halted States which fail to 
present a bill of health? and will reajond cueh vessels to the qusrsatin* 
station for quarantine inspection end such treatBent as Bay b© aeeeesary 
parlor to entry. 
«(§•) ?he in«tTHetion© in this cestika ohall bo o&MSMred in tbs Virgin 
Islands, Puerto Rico? tho PeneaBR Canal Bene? the Hawaiian Islands, the 
Island of Guam, tho Islands of the Aseericcn Baaewn group? and Hake Island, 
which are Insular possess!ms or dependencies ef the "Skited States. Tho 
Philippine Islands are specifically eacawpted frea the previsions appli- 
cable In general to the insular possessions end dependencies of the 
Halted States, and ports In tho Philippine Islands have a status oiHilar 
to that of foreign ports. Ports In Alacsksuavo ox©jaq&ted freouths foregoing 
Uil of health roqulrs®ent« ©accepting during the prevalence ef quarsatin- 
able disease In such* ports? in accordance with previsions ef the quayaa- 
tine laws and regulations governing vessels engaged exclusively in trad© 
between foreign ports on ©r near tho northern frontier ef the Halted 
States and ports In the Waited States-?* LBept. circ. 596, Aug. k, 195§ 
« §§n?ig to inclusive? issued under the authority coataiaed 
In sec. 3, ©tat. 4$©? be H.B.6. 92. INSPECTION OF INBOUND VESSELS 
11*21 Inspection of vessels "bound for United States, possessions or 
dependencies, The officer Issuing the bill of health to vessels leav- 
ing foreign ports and ports %a the paseessfrens er ether depeadesielea e£ 
the Batted States for ports In the Bolted States or Its possessions or 
other dependencies shall satisfy himself, by inspect lea if nesessery; 
that the conditions certified bo therein are true. Be Is authorized, 
in accordance vith law, to withhold the bill of health until he is satis- 
fied that the vessel, the passengers, the crew, and the cargo have com- 
plied with all the quarantine lavs and regulations of the Uhl ted 
States.♦f (Add last two complete sentences from Amendment 19). (jPar. £] 
11.2S Required of certain vessels. Inspection is required of 
(a) All vessels from port© at which cholera, yellow fever, or plague 
In men or rodents prevail, or at which smallpox or typhus fever prevails 
in epidemic form, and at vhleh (if) a medical officer is detailed (to the 
port). 
(t) All vessels carrying steerage (k) passenger a; but need only Include the 
inspection of such passengers and their living apartments if sailing from 
a healthful port.*f* [Par. 5] 
11.23 To include cargo, passengers, cpew, personal effects. Inspec- 
tion of the vessel is such an examination of the vessel, cargo, passengers, 
crew, personal effects of same, including examination of manifests and 
other papers, food and water supply, the ascertainment of its relations 
with the shore, the manner of loading and possibilities of invasion by 
rats and insects as will enable the inspecting officer to determine if 
the regulations in this pert have been complied wlth,*f [Per. 5] 
li.Sk ?4©e iaepeetlea* ae e0aseua4est4en a#ter iHspeetiwa* When aa 
iHspeetlea 4a »»«vi4f«&7 44 should be s&de by daylight* as lat© as ]?$»€e~ 
t4sable be£t>yo sailing* $he vessel ahe*M be Inspected bef©Fe the paeeea- 
gars g© ©beard, 4k© passengers befere eab&»hat4ea* and the a»ew ©a 
deek* ©ad a© ©eaffiasua4eat4s» aheuld be had with th© vessel a£ter eueh 
inspection except by pezetleslen e£ the effleer issuing the kill sf 
[Par. f] 
11.23(h) Vessels to be clean prior to receiving cargo or passengers. 
Vessels, prior to stowing cargo or receiving passengers, should be mechani- 
cally clean In all parts, ©specially in the hold, forecastle, and steerage 
and loose dunnage In unledened compartments shall be so arranged as to 
prevent harborage of [far. 8| 
*Tho Sanitary measureo applicable to second-cabin passengers will bo 
those designated for first-cabin passengers or for steerage passengers, 
according as the arrangements of their quarters and accommodations 
aboard, both sanitary and for association, class them in the opinion of 
the inspecting officer with th© first cabin or steerage. 
♦For statutory citation, see note to I 11.12. 
■faor source citation, sec note to § 11.1. 11.26 (£) Disinfection of vessels. Any portions of the vessel liable 
to have been infected by ary communicable disease should bo disinfected 
the inmice of the bill of health.* 9} 
11*27 (6) Health and comfort of passengers* The air space; ventila- 
tion, food and water supply, hospital accomodations, and all other 
matters mentioned therein proactive of the health and comfort of the 
passengers most be in accordance with the provisions of the Act of Con- 
gress approved August 2, 1882, entitled "An Act to regulate the carriage 
of passengers by sea" (22 Stat. 186; k6 U.S.C. 151-162, (far* 10j 
11.28 (j) Articles coming from Infected districts. Bedding, upholstered 
furniture, soiled veering apparel, personal effects, and second-hand 
articles of a similar nature ccaning from a district known to be infected 
with smallpox or as to the origin of which no positive evidence can he 
obtained, and which the consular or medical officer has reason to believe 
is Infected, should be disinfected prior to shipment. Articles similar 
to the above mentioned, if from a district Infected by plague or typhus, 
should (nay) be inspected, end, if necessary, treated to destroy 
Tomm.*Tgar. 
11*89 Artlei©9 shipped through 4afeeted ports. Articles frea aa un- 
infected district shipped through aa Infected part may be accepted with- 
out restriction if net ©xpeaed te infection in traneit»’i(f j5ar. 12} 
11.59 (28) Regulations regarding introduction of diseases of animals. 
Hothlng in the regulations in this part shall bo construed to modify or 
nullify in any way existing restrictions promulgated by the Secretary of 
the treasury (Surgeon General of the U.S.Public Health Service) at the 
Instance of the Secretary of Agriculture for the prevention of the intro- 
duction of diseases of animals (Par. 3^5] 
11.31 (eg) Articles shipped from or through infected ports. Any 
article shipped, from or through an Infected port or place which the con- 
sul or medical officer has reason to believe infected, should be dlsln- 
fected.*} |Per. 3Sj 
11.52 (0) Uhdisinf©c table articles. Any article presumably infected 
which cannot be disinfected should not be shipped.*f (Articles liable to 
harbor rate or rat fleas should be stored in rat ;proof warehouses or 
means taken to prevent the access of rata. Articles which harbor rats 
or rat fleas should not be shipped unless freed of such vermin by 
chemicals, fumigation or stowage under conditions free of rats for at 
least 30 days.) 
*Por statutory citation, eee note to | 11.12. 
“I* For source citation, so© not© to | 11.1. 11*55 Division ©x passengers inte elaeeca, Passengers j- f«p %h* 
purpeae a# the in "fchis pari, are divided int© two ©lasses, 
eabia and steerage?"* ♦ fPar, 1^3 
II. Jb (1) Embarkation at inf acted ports. So far as possible passen- 
gers should avoid embarking at a port where quarantInable disease pre- 
vails, and communication between the vessel and the shore should be 
reduced to a a in lawn. In such a port the personnel of the vessel should 
remain on board during their Btay.*i* (jar. IT] 
11.55 (2) Persons suffering from certain diseases. Ko person suffer- 
ing from a quarantinable disease, or scarlet fever, measles, diptherla, 
poliomyelitis (infantile paralysis), influenza, chlckenpoiL. or cere- 
brospinal meningitis should be allowed to ahlp.*t |Ear. l8j 
11.36 (£) Passengers, etc., from Infected localities, Passengers and 
crave, merchandise, and baggage, prior to shipment at a noninfacted port 
but coating from an infected locality should be subject to the same restric- 
tions as ore imposed at on Infected port.*f TPar. 19j 
REQUIREMENTS AT SEA 
11.51 Measures by master of vessel. The master of a vessel should 
observe the following measures on board his vessel: 
(a) The water-closets, forecastle, bilges, and similar portions of 
the vessel liable to harbor infection should be frequently cleansed 
and disinfected. 
(b) Free ventilation and rigorous cleanliness should be maintained 
In all portions of the ship during the voyage and measures taken to 
destroy rats, mice, fleas, files, mosquitoes, and all vewain. 
(c) A patient sick of a communicable disease should be isolated and 
eno masher of the crew (personnel) detailed for his car© and comfort, 
who, if practicable, should b© inaaune to the disease. 
(d) Communication between tho patient or hie nurse and other persona 
on board should be reduced to a minimum. 
(0) Used clothing, body linen, and bedding of the patient and cure© 
should be immersed at ease in boiling water ©r in a disinfecting 
eelutiea. (disinfected If indicated). 
(f) The compartment from which the patient was removed (and articles 
liable to convey infection) should be disinfected and thoroughly 
cleansed, (as indicated). Artie4©® liable te eonvoy infestion shewM 
remain in the eeapartasats during the disinfeetien when gaseous diein- 
feetien is used* 
Tfhc Sanitary measures applicable to second-cabin passengers will be 
those designated for first-cabin passengers or for steerage passengers, 
according as the arrangements of their quarters and accommodations 
aboard, both sanitary and for association, class them In the opinion 
of the Inspecting officer with the first cabin or steerage. 
*For statutory citation, see not© to S 11.12. 
tPor source citation, see cote to $ 11.1. (g) Any person suffering from malaria or yellow fever should be kept 
under mosquito bars and the apartment In which he is confined closely 
screened with mosquito netting. All mosquitoes on board should be des- 
troyed by fxmigatieft. Mosquito larvae (vigglers or wiggle-tails) should 
be destroyed in water barrels, casks, and other collections of water 
about the vessel (by dumping or acceptable larvicldes) by the use of 
pebrelemm {kereseneT; where this is not practicable, the receptacle 
should be covered by mosquito netting be prevent the exit ef meaqwtbees 
free eaeb breeding pluses. 
(h) In the case of bubonic plague, special measures must be taken to 
destroy rats, mice, fleas, and other vermin on board, and In case of 
pneumonic plague, the patient should be Isolated, the body discharges 
disinfected, especially sputum, and the attendant should wear a mask. 
(l) In the case of typhus, special measures should be taken to 
destroy vermin. 
(J) In the case of cholera, typhoid fever, or dysentery, the drink- 
ing water {,dishes and utensils) should be belled (sterilized) and the 
food thoroughly cooked. The discharges from the patient should be 
immediately disinfected and thrown overboard.* f [Tar.2'0] 
11.52 Inspection by ship’s physician. An inspection of the vessel, 
including the steerage, should be made by the ship's physician once 
each day.**fr [Par. aj 
11.53 Appearance of certain diseases on board ship. Should cholera, 
yellow fever, smallpox, typhus fever, plague, or any other communicable 
disease appear on board a ship while at sea, those who show symptoms of 
these diseases should be immediately isolated In a proper place; the 
ship's physician should then Immediately notify the captain, who should 
note same in his log, and all of the effects liable to convey Infection 
which have been exposed to infection should be destroyed or disinfected 
In the case of smallpox, the entire personnel should be vaccinated.*! 
I Par. 22] 
11.55 Cleansing of hospital. The hospital should be cleansed as soon 
as it becomes vacant.* [Par. 23J 
11.55 In case of death. The (Those) dead, (of quarantlnable diseases) 
except these dead of yellow fever, should be enveloped In a sheet 
saturated vlth one of the strong disinfecting solutions, vlthout pre- 
vious washing of the body, and at once buried at sea or placed In a 
coffin hermetically sealed.* T (Par. 25] 
Cross Reference; For regulations relating to the passing through 
quarantine of bodies of persons dead from cholera or smallpox, sea 5 11.86. 
♦For statutory citation, see note to § 11.12. 
fFor source citation, see note to § 11.1. 11.57 Disinfecting solutions. Th© following disinfecting solutions 
are recommended for use at sea: 
FORMULAS FOR STRONG DISINFECTING- SOLUTIONS 
Parts 
Bichloride of mercury 1 
Sea water— — — — — 500 
Mix. 
Blchlorlde of Mercury (1:500) 
Carbolic Acid (5 Percent) 
(Liquor Cresolip compositua or similar compound) 
Alcohol — — 50 
Carbolic acid, pure ——— —-— —— 50 
Mix. 
Then add fresh water— — — 900 
(Chlorinated Lime (1:10000)) 
Chlorinated lime powder (yielding 66# free chlorine) — 1 
Fresh water——— —- —————————-— 6, 66£ 
F9RHBhM FOR WEAK S9LB?i0BS 
Biehleride of Mereury fl*l*©©8^ 
Biehleride ef mercury————— ——-—— ——. 1 
Sea water—— — ——————— — 1*00© 
©arboli© Aeid (8p Pereeat} 
©arboli© aeid, pure— ——— — 85 
Fresh water- — 1*098 
Formalin ($-Per©eat) 
Formalin© 4©r fowsal) — — 5© 
Water — 95® 
It is suggested that a vessel should carry fer every 10© passengers* 
Biehleride ef aereury, 5 pounds; ©arbelie aeid, 10 pounds,-aleehal, 10 
pounds; formalin, 10 pounda; 100 pounds ©f sulphur and 18 Dutch evens, 
about 18 lushes diameter, and an adequate supply ©f fresh vaeelae 
virus. ♦*}* pPar. 86-J 
*Por statutory citation, see note to § 11.12. 
1*For source citation, see note to § 11.1. INSPECTION UPON ENTRY 
11.61 Quarantine; Uhited States-Canada reciprocal pratique 
(a) Every vessel subject to quarantine Inspection, entering a port of 
the Uhited States, Its possessions or dependencies, shall be considered 
in quarantine until given free pratique. Such vessel shall fly a yellow 
flag at the foremast head and shall observe all the other requirements 
of vessels actually quarantined. 
(b) Effective January 1, 1950, vessels from foreign ports (other than 
those on or near the northern frontiers of the Uhited States) which enter 
the international waters of the Straits of Juan do Fuca, Hero, Georgia, 
Rosario, and the Puget Sound, their tributaries and connected waters on 
the west coast, or the international waters of the St. Lawrence River and 
the Great Lakes and their tributaries and connected waters on the east 
coast, which are destined few bath (for only those) Uhited States and 
Canadian ports located thereon only will be required to undergo one 
quarantine inspection to be performed by the quarantine officers of the 
respective Government having Jurisdiction over the first port of arrival 
provided that quarantinable disease has not occurred on board since 
granting the original pratique and was not prevalent in such local ports 
visited. 
Vessels which sake a United States port their first port of arrival 
will undergo the prescribed quarantine inspection and treatment by the 
quarantine officer in that port, and when cleared from quarantine such 
vessels will be Issued pratique in duplicate, the original copy of which 
will be required to bo delivered to the collector of customs for entry 
of vessel and the duplicate copy will be retained on the vessel for 
presentation upon secondary arrival at the first Canadian port. 
Vessels which have first entered a Canadian port and have received 
pratique In duplicate following prescribed inspection and treatment by 
the Canadian quarantine officer of that port, will be permitted to enter 
secondarily the first Uhited States port of call without the formality 
of quarantine reinspection, provided such vessel presents and delivers 
to the collector of customs the duplicate copy of the original Canadian 
pratique duly approved by the Uhited States quarantine officer of that 
(the secondary) port, together with the required American bills of 
health; and provided further, that since receiving such original pra- 
tique quarantinable disease has not occurred on board the vessel and 
was not prevalent in the local ports visited. 
Vessels upon which quarantinable disease has occurred since original 
pratique was granted, or which have visited local ports in which 
quarantinable disease prevails, shall be required to report to the United 
States quarantine station for appropriate treatment and shall present and 
deliver to the collector of customs of the port a supplementary pratique 
granted by the quarantine officer of the port In addition to the other 
required papers, prior to being accorded entry. 
Vessels which have been granted pratique and permitted entry in 
accordance herewith are not thereby exempted from the application of the 
provisions of article 28 of the International Sanitary Convention of 
"•For statutory citation, see not© to § 11.12. 
tFor source citation, see note to § 11.1. Paris, 1926, respecting deratization requirements; those requiring 
deratization under the provisions of the convention or the Quarantine 
Laws and Regulations of the United States administered by the Public 
Health Service will be subjected to the prescribed measures as a condi- 
tion of being granted permission to enter. Vessels so granted condi- 
tional entry will be required to satisfy these requirements before 
being granted clearance.* T [Par. 34, and Dept. clrc. 420, Pec. 20, 1929i 
Cross References: For deratization requirements of the quarantine 
regulations in cases where plague lias appeared on board ship during voy- 
age, see Il.l6l-U.i72, For fee charged for deratization Inspection, 
see §§11.261* (c) (3). 
11.62 Certain resales prior to entry. Vessels arriving at ports of 
the Thai ted States under the following conditions shall be inspected by 
a quarantine officer prior to entry: 
(a) All vessels from foreign ports except those covered by § 11.11 (c) 
Vessels from a foreign port shall be inspected only at first port of call 
in the United States? exeept vessels from ports suspected ef yellow 
fever arriving during the active quarantine season at southern, via 
northern, perta? 
(b) Any vessel with sickness on board. 
(c) Vessels from domestic ports where cholera, plague, or yellow 
fever prevails, or where smallpox or typhus fever prevails in epidemic 
fora,*t (far. 3§ 
H.63 (Substitute Amendment #23) To be made between sunrise and sun- 
sett exceptions? The inspection ef vessels required by the regulations 
In this part shall be made between sunrise and sunset, ezeept la ease 
of vessels In distress. Sxeeptlen may alse be made la the ease of 
vessels earrylng perishable cargoes? and regular line vessels under 
regulations approved by the Secretary of the Treasury?*! Qpar. jSj 
11.Extent and method. In making the Inspection of a vessel due 
consideration shell b© given before granting pratique to the actual 
conditions which exist on board at the time of arrival; also to the medi- 
cal history of the voyage, the sanitary particulars of the passengers 
and crew, the status of the port of departure and ports of call with 
respect to the presence of quarantlnable diseases therein end the con- 
duct of the vessel while in such ports. The bills of health, the derati- 
zation certificate, the clinical record of all cases treated during the 
voyage and when necessary, the passenger and crow lists, cargo mani- 
fests and the ship9a log, shall (may) be examined. The passengers, crew, 
and all other persons on board shall be mustered, examined, and compared 
with their respective lists and with pertinent data on the bills of 
health and any discrepancies found shall b© investigated; provided, 
that on regular line vessels, when classified as "uninfected,” which 
carry a medical officer, the muster and inspection of passengers and 
*For statutory citation, see not© to § 11.12. 
fPor source citation, see not© to | 11.1. 
15 crews may be limited in the discretion of the quarantine officer to the 
examination of persons who have received medical treatment during the 
voyage for sickness accompanied by fever or skin eruption, and such other 
persons as it may bo desirable to [Par. 37, aadt. 
13, Jan. Sh. 1929) 
11.65 Boarding of vessels subject to quarantine inspection. Ho per- 
son, except the quarantine officer, quarantine employees, or pilots, 
shall be permitted to board any vessel subject to quarantine inspection 
until after the vessel has been Inspected by the quarantine officer and 
granted free pratique, except with the perm! os ion of the quarantine 
officer, and any person boarding such vessel shall. In the discretion of 
the quarantine officer, be subject to the same restrictions as those 
imposed on the personnel of the vessel.'* t [Far. 39> amdt. lb, 
Feb. 12, 19371 
Cross Reference: For Bureau of Marine Inspection and navigation regula- 
tions providing that health officers may board a vessel without consent of 
the master, and may detail any person, subject to his orders, to remain 
on board, see b6 CFR 2.1. 
11.66 Persons with comauni cable but nonquarantinable diseases; deten- 
tion. Vhon a vessel arriving at quarantine has on board any of the 
communicable but nonquarant inable diseases, the quarantine officer shall 
promptly inf am the local health authorities of the existence of such 
disease aboard and shall make every effort to furnish such notification 
in ample time, if possible, to permit of the case being seen by the local 
authorities before discharged from the vessel; Provided, That the quaran- 
tine officer aay detain arriving cases of communicable but nonquarantinabls 
diseases, and persons having been exposed to such cases, at the quaran- 
tine stations when local health authorities do not have facilities for 
their isolation and care[Par. bO, aadt. 12, Dec. 26, 1928] 
DKTEBTIOH IB QUARAHTIRK 
11.71 Certain vessels to be placed in detention. Vessels arriving 
under the following conditions shall be placed in detention: 
(a) With quarantlnablo disease on board or having had such disease 
on board during the voyage. 
(b) Any veasel which the quarantine officer considers infected with 
quarontinatle disease. 
4©} A vessel arriving at a pert south of the southern boundary of 
Virginia in the season of aetiv© quarantine, April 1 to Bovoaihor 1, from 
a pert infee tod or suspected of infection with yollew fewer. 
44} Vessels arriving at perts north of this line and south of the 
southern boundary ef Maryland between Maty 15-and 9eteber 1, if from a 
port Infected er suepeeted of infeotlen with yellow fever. 
•apor statutory citation, see note to I 11.12, 
For source citation, see note to $ 11.1, fe} (c) In the case of vessels arriving at a northern port without 
sickness on board from ports where yellow fever prevails, the personnel 
shall be detained under observation at quarantine to couplet© 6 days 
from the port of departure. 
(d) Towboats and other vessels having had communication with 
vessels subjected to quarantine shall themselves bo quarantined if they 
have been exposed to infection.* f I Par. bjj 
11.72 Duration. The duration of detention of vessels or personnel 
herein contemplated will depend upon the quarantinabl© disease Involved 
and will hereinafter be specifically provided for.*t (Par. 
Cross References: For detention of vessels on which cholera has 
appeared during voyage, see§£ Il.li5-U.ll6. Detention of vessels on 
which yellow fever has appeared during voyage, see § H.lUl. Treatment 
and detention of vessels on account of plague, see ll.l6l-ll.172. 
Regulations relating to treatment end detention of vessels with cases 
of smallpox on board, see § 11.191. Special measures to be taken In 
regard to vessels on chlch typhus infection has appeared, see 3$ 11.211- 
11.217. 
11.75 Detention of pilots; dunnage of pilots. Pilots will be detained 
in quarantine a sufficient time to cover the period of Incubation of the 
disease for which the vessel is quarantined, if, in the opinion of the 
quarantine officer, such pilots hare been exposed to infection. The 
dunnage of pilots shall bo disinfected when necessary.* t" (Par. tjj 
Vessels in quarantine; outside communication. Ho direct communi- 
cation shall be allowed between any vessel in quarantine and any person 
or place outside, and no communication whatever,between quarantine or any 
vessel in quarantine and any person or place outside except under the 
supervision of the quarantine officer.* 't jpar. 
11.75 Release. After a vessel has been rendered free from infection. 
It nay be furnished with a fresh crew and released from quarantine, 
while all or pert of the personnel are detained.* t fPar. U5I 
11.76 Release certificate. The form of certificate which shall he 
Issued to a vessel or aircraft when released from quarantine shall h© 
prescribed by the Surgeon General of the Public Health Service, and 
shall embody the statement that the vessel or aircraft has in all res- 
pects complied with the quarantine regulations prescribed by the Secretary 
af the Treasury (him), and that in the opinion of the quarantine officer 
It will not convey quarantinabl© disease, and that said vessel or aircraft 
is granted free or provisional pratique to enter her port of destination, 
the name of which is to be embodied in the blank .*f |ar. h'J, amdt. 1, 
Oct. 22, 1920] 
*For statutory citation, see note to £* 11.12. 
fPor source citation, see note to § 11.1. 
17 11.77 Presentation of release certificate to collector of customs. 
All vessels requiring Inspection under the regulations in this part must 
present to the collector of customs at the porfc of entry the quarantine 
certificate prescribed In | ll.?6.* t (Par. 58] 
U.78 Subject to additional regulations,. Vessels detained at any 
national quarantine will be subject to such additional rules and regu- 
lations as may be promulgated from time to tine by the Surgeon 
General.* Par. U6 
11*79 Surveillance (Observation) of detained persons. Th© persons de- 
tained shall be inspected by the physician twice daily, and be under his 
constant surveillance (observation), and no intercourse will be allowed 
between different groups while in quarantine.*'!' (Par. **8) 
11.80 Place of detention, carrying infected articles into. Ho pre- 
sumably infected articles from an infected vessel shall be carried Into 
the place of detention until disinfected.* t [Per. hgj 
U.8l Cleanliness and disinfection. Cleanliness of quarters and of 
person will be enjoined and daily enforced. Disinfection shall be 
practiced where there is any possibility of infection.*q (far. 5^ 
11.82 Isolation of sick. In any group in which communicable disease 
appears, the sick will be immediately isolated in hospital, and the 
remaining persons in the group and their effects appropriately treated 
and then removed to other quarters. If possible, and the compartments 
disinfected (when indicated) .* t [Par. 5Q 
U.85 Minimum of communication. Conanunication between the physi- 
cian and attendants of the hospital and those detained in other warts of 
the quarantine station shall be reduced to a minimum.**}' (jar. 52j 
11.8** Discharge of convalescents. Ho convalescent shall be discharged 
from quarantine until after a sufficient time has elapsed to insure his 
freedom from infection, and this is to be determined by bacteriological 
examination when necessary and possible.* £ (Par. 53[ 
U.85 Subsistence at vessels1 expense. Passengers and crew from 
vessels in quarantine shall be subsisted at the vessels1 expense. 
Rations and service may be provided at national quarantine stations at 
rates to be fixed by the Secretary ©f the Treasury. (Surgeon General, 
U.S.Public Health Service).* (Par. 5*0 
11.86 Passing of bodies through quarantine. The body of a person dead 
from cholera or smallpox (a quarantinable disease, except yellow fever) 
shall not be allowed to pass through quarantine until (embalmed)' 1 year 
has elapsed since death. The body af a person dead fre® typhus er plague 
*Por statutory citation, see not© to % 11.12. 
fFor source citation, see not© to § 11.1. may be permitted te pass threugk quarantine if free from veioiat if 
dead fyen yellev forey, h© presentteas are required. Bodies of persons 
dying at quarantine stations from quarantinable disease should preferably 
be cremated or burled at station. *t IF"-- 55] 
(11.8? Release under Surveillance. Persons may be planed under sur- 
veillance, If not 111, and if from yellow fever areas leas than 6 days 
and unvaccinated; If from an area of epidemic cholera leas than five 
days and not immunized; If from an area of epidemic exanthematous typhus 
less than 12 days and unvaccinated; and if from an area of epidemic 
smallpox less than lU days and unvaccinated or without valid vaccination 
certificate. Exposure to quarantinable disease on shipboard is con- 
sidered to constitute exposure with such areas as are thus specified. 
All persona released under surveillance shall report by telephone or in 
person to a licensed physician every second day as long as well, and 
Immediately in case of illness. and in person on the last day of the 
prescribed period of surveillance. This interval shall consist of that 
portion of the incubation period of the disease in question which has not 
already elapsed following last contact. Such persons shall deposit the 
sum of $100.00 (one hundred dollars) with a Customs guard, obtaining a 
receipt upon such form as may be prescribed by the Surgeon General, 
U.S.Public Health Service. Upon completion of the terns of surveillance 
this sun shall be refunded.) 
CHOLERA; SPECIAL MEASURES AT FOREIGN AND INSULAR PORTS 
11.101 Water and food supply of vessels. At ports where cholera 
prevails special car© should be taken to prevent the water and the food 
supply from being infected (contaminated). The drinking water, unless 
of known purity, should be beiled (sterilized) and the food thoroughly 
cooked and protected against by flies, etc.* jf (Par. 59l 
11.102 Latrines of vessels. The latrines of vessels must be so arranged 
that they. Including their discharge pipes, can be made and kept mechani- 
cally clean.*t (They must not be cross-connected to the safe water supply, 
nor shall they back-flush.) fPar. 5$J 
II.IO5 Shipment of foods. Certain food products that are ordinarily 
consumed in an uncooked state coming from cholera-infected localities 
or through such localities, if exposed to infection therein, should not 
be shipped. Vegetables ordinarily eaten in an uncooked state when grown 
In districts where cholera prevails, shall not be shipped. Fruits grown 
on trees or on shrubs may be shipped.* f (per, 6lj 
11,10U Baggage of steerage passengers. The baggage of steerage 
passengers shall be Inspected {}) and no food shall be taken aboard in 
sueh baggage.*** [Par. 
♦For statutory citation, see note to § 11.12. 
f For source citation, see note to § 11.1. 11.105 Steerage passengers and crews from Infected districts. Steer- 
age passengers and crew coming from cholera-infected districts should be 
subjected to baeterieiegieai examination, or otherwise detained 5 
in an environment known to be free from any source of infection.[Par. 6J 
11.106 Steerage passengers and crews shipping at Infected ports. 
Steerage passengers and crew from districts not infected with cholera, 
shipping at a port infected with cholera, unless passed through without 
danger of Infection, should be treated as those in § 11.105.*t [Per. 
11.107 Cabin passengers from Infected districts. Cabin passengers 
coming from cholera-infected districts should produce satisfactory 
evidence as to their place of abode during the five days immediately 
preceding embarkation. If it appears that they have been exposed to 
infection, they (should be treated as those in S 11.105*) shall be de- 
tained under medical supervision a sufficient time te sever the period 
ef ineuhatien sines exposure? er otherwise be suhjeeted te baeterie- 
legieal examination.*(Par, 65| 
14.108 Appearance of disease in detention quarters; embarkation of 
passengers. Should cholera appear in the barracks or house in which 
passengers are undergoing detention, no passengers from said houses or 
barracks who have been previously exposed to this new infection should 
embark until they have been (declared safe on the basis)determined free 
rthe infection by baeterielogioal examination, (or detained as in 
11*105) er otherwise isolated for a period ef five ~~{Par* 66j 
CHOLERA; SPECIAL MEASURES AT DOMESTIC PORTS 
11.111 Appearance on board vessels. Special measures shall be em- 
ployed against vessels and persons from a cholera-infected place, as 
likewise when cholera has appeared on board during the voyage.♦'J' [Par. 67] 
11.112 Steerage passengers from cholera-infected places to bo examined 
upon arrival in United States ports. All steerage passengers arriving 
at ports In the United States, its possessions or dependencies, from 
ports or places where cholera prevails, shall b© subjected to baeterio- 
logical examination and shall not be admitted to entry until (they have 
been declared safe.) it has been determined by said examination that they 
are free from ohelera vibrios[Par. 68} 
11.113 Detention ponding result of examination. All persons on 
vessels upon which cholera has appeared during the voyage shall upon 
arrival at quarantine be (examined and) detained until (they are de- 
clared safe.) it has been determined by baoterielegieal examination 
that they are free from ohelera vibriesr* f [Par. 69J 
♦For statutory citation, see not© to § 11.12. 
•fFor source citation, see not© to § 11.1. 11.11*+ Discharge after examination. Persons in detention who are 
proven by bacteriological (declared safe on the basis of)examination 
(performed not less than 2k hours after removal from exposure to infection 
In cholera case or carrier) to be free from ehelera organisms may be 
discharged from quarantine without further detent 1 on.♦‘jr (Par, 7<5} 
11.115 Detention of exposed persons In lieu of examination. in lieu ef 
(if) bacteriological examination (and then only when it is impracticable) 
(is indeterminate) persons exposed to Infection in cholera case or 
carrier shall be detained in quarantine 5 days after being isolated from 
such case or [Par. 7IJ 
11.116 Removal and isolation of cholera-infected persons. If a case 
clinically diagnosed as cholera has occurred on voyage, or if bacterio- 
logical examination should reveal the presence of Infection in any 
person on board, such infected person or persons should he removed and 
isolated. All contacts should be segregated in small groups, and no 
material capable of conveying Infection shall be removed from the 
(far. 72] 
11.117 Foods ordinarily consumed in uncooked state. Fruits and 
vegetables from an infected ship, that are ordinarily consumed in an 
upcooked state, shall be destroyed or rendered harmless by cooking.* f 
jjar. 73} 
11.118 Food served to persons in quarantine. The food served to 
persons in quarantine, unless from a source known to be free from cholera 
infection, shall he cooked.* [per. 7^J 
11.119 Water supply of vessels in quarantine. The water supply of a 
vessel detained In quarantine on account of cholera infection, unless 
determined by bacteriological examination to be free from cholera organ- 
lams or B. coll, shall be sterilized. Otherwise it shall be discharged 
after (Par. 75} 
U.12C Dejecta of quarantined persons. The dejecta of all persons in 
quarantine on account of cholera shall b© disinfected before final 
disposition, and special precautions shall be exorcised in order to pre- 
vent the contamination of food or water supply or the spread of the_. 
Infection through the agency of flies or other Q’ar. 76] 
11.121 Personal effects contaminated by dejecta. Personal effects 
contaminated by dejecta from a cholera oaae or carrier shall be dis- 
infected .♦ jPar. 77j 
11,122 Parts of ship contaminated by dejecta. Any part of the ship 
that has been contaminated by dejecta from a cholera case or carrier shall 
be washed down with a (strong disinfectant) solution, ef biehierfde er 
earbolie aefd.*f (Par. fSj 
*For statutory citation, see note to I 11.12. 
source citation, see note to § 11.1. 11.125 Tests prior to release of persons from quarantine. Carriers 
or recovered cases shall not be released from quarantine detention until 
three bacteriological teste performed on consecutive days shall have been 
proven to be [~Par. 79] 
YELLOW FEVER: SPECIAL MEASURES AT FOREIGN AND INSULAR PORTS 
11.131 Period of incubation. For the purpose of the regulations in 
this part 6 days shall be considered as the period of Incubation of 
yellow fever.* (Par. Soj 
11.152 Prevention of introduction of mosquitoes on hoax'd vessels. It 
is advisable that at ports where yellow fever prevails, precautions should 
be taken to prevent the introduction of mosquitoes, a(A)©des (stegemyla) 
e&lepue (aegypti) on board the vessel. Water tanks, water buckets, and 
other collections of water about the vessel should be guarded In such a 
manner that they shall not become breeding places for mosquitoes. Where 
the vessel has lain in such proximity to the shore at such places as to 
render it liable, in the opinion of the Inspecting officer, to the 
access of a(A)edes (stegemy&a} eaiepus, (aegypti) measures should be 
taken to destroy mosquitoes that may have come on board,* f (Par. 8lj 
11.133 Passengers and crew previously exposed to infection. Passen- 
gers and crew who, in the opinion of the inspecting officer, have been 
definitely exposed to the Infection of yellow fever (1. e., as from a 
house or locality known to be infected), should not be allowed to em- 
bark for 6 days after said exposure. Those immune to yellow fever are 
ezoqpt fro tils provision.* f [Par. 
YELLOW FEVER; SPECIAL MEASURES AT DOMESTIC AND INSULAR PORTS 
OF ARRIVAL 
U.lUl Treatment of vessels. A vessel aboard which a case of yellow 
fever has occurred at any time during the voyage shall be treated as 
follows; 
(a) Careful visual and thermometrlc inspection of all persons. 
(b) The sick are to be imuedlately disembarked, protected by netting 
against the access of etegeayia mosquitoes, and transferred to a place 
of isolation. 
(c) Other persons (unless immune) should be disembarked, if possible, 
and detained under observation for 6 days, dating from the day of last 
possible exposure. 
(d) Persona under observation presenting an elevation of temperature 
above 37.6 C. shall be Isolated in a screened apartment, 
(e) The ship shall be moored if possible at least 200 meters from 
the inhabited shore. 
*For statutory citation, see not© to § 11.12 
fFor source citation, see note to g 11.1. (f) The ship shall he fumigated for the destruction of mosquitoes 
before the discharge of cargo, if possible. If a fumigation be not 
possible before the discharge of the cargo, the discharge of cargo shall 
be under the supervision of the quarantine officer, and may be permitted 
as follows: By (l) the employment of lamune persons for discharging 
the cargo; or (?) if nonimmunes be employed, they shall be kept under 
observation during the discharging of cargo and for 6 days, to date from 
the last day of exposure on board.*if [Par. 
11 Fumigation of certain vessels; detention of personnel. A 
vessel which has lain in such proximity to the shore of a port known to 
be Infected as to render it liable to the access of (Aedes asgypti) 
stegemyia mesquitees shall be fumigated and the personnel,junless Immune) 
held in detention under observation for 6 days.♦ (Bar. 8bj 
11,1*0 Treatment of certain vessels. A vessel arriving at southern 
port (either direct or by way of a northern port of the United States), 
which, although coming from an Infected port or suspected port, has had 
neither death nor case of yellow fever on board either before departure, 
during the voyage, or at the time of arrival, and which the quarantine 
officer is satisfied has not lain in such proximity to the shore as to 
render It liable to the access of etegomyta mosquitoes? (Aedea aegyptl,) 
or which has been fumigated under the supervision of an accredited medi- 
cal officer of the Uhl ted States Immediately before sailing, may, upon 
arrival at a port of destination in the United States with good sanitary 
history and in good condition (including the absence of any exposed 
collection of water in which A. ealepuo (aegyptl) might breed) be sub- 
jected to the following treatment: 
(a) If arriving in 6 days or less, she may be admitted to pratique, 
with or without fumigation, in the discretion of the quarantine officer 
and without further detention than Is necessary to complete the 6 days. 
(All immune persons may be discharged.) 
(b) If arriving after o days she shall be Immediately fumigated 
(unless previously fumigated at a northern port) and may be admitted 
without detention.*4* [Far. 65J 
11,iH Vessels from Infected ports calling for bunker coal or supplies. 
Vessels from ports Infected or suspected of infection with yellow fever, 
calling at southern ports for bunker coed or supplies during the active 
quarantine season may be allowed to take on such cargo after fumigation, 
(if fumigation is Indicated)provided the vessel be anchored In a place 
inaccessible to stegcnyla (Aades aegyptl) and the crew or passengers b© 
detained on board.♦ (Por. 
11.145 Traffic without detention allowable under certain conditions - 
Traffic without detention may be allowed during the active quarantine 
season? from ports infected or suspected of infection with yellow fever, 
to ports in the United States south of the southern boundary of Maryland 
under the following conditions: 
♦For statutory citation, so© note to § 11.12. 
fFor source citation, see note tog 11.1. (a) The vessel must lie at approved moorings in the open harbor; the 
crev must not be allowed ashore at the port of departure. Every possible 
precuation must be taken to prevent the ingress of (Aedes aegypti) 
stagemyia mesquitees and their access to the crev. 
(b) The officer who must go ashore to enter his vessel must be Immune 
to yellow fever. Passengers, unless lianune to yellow fever, must have 
been free from possible exposure to yellow fever for 6 days immediately 
prior to embarking. 
(o) All the above conditions to be certified to specifically by an 
accredited medical officer of the United States.* *| [Par. 87J 
U.lb6 Immune or nonexposed persons. All persons who can prove their 
Immunity to yellow fever or who have not been exposed to possible in- 
fection of yellow fever, may be permitted to land at once.* Par. 88 
11.1*7 Method of fumigation* {disinsectization.) Pep the (There shall 
be a complete) destruction of mosquitoes there shall be a samplete and 
simultaneous fumigation ef (in) all parts of the vessel by (an approved 
insecticide.) sulphur dioxide gas, 2 percent volume gas, 2 hours' ex- 
posure, or by cyanide gas in strength of \ ounce of cyanide per 1,000 
euble feet ef space? ene-half hear exposure** f (far. 89J 
PLAQUE: SPECIAL MEASURES AT FQREIQR AHD HfSULAR PORTS 
11.151 Rets (nice) and fleas. At ports or places suspected of 
plague infection in rodents every precautions) shall be taken to pre- 
vent rats (mice) and fleas from getting jPar. 90J 
Fumigation of certain vessels and lifters. Teasels sailing 
from such ports shall be simultaneously fumigated in all parts, pre- 
ferably when empty, for the destruction of rats. Lighters should be 
free of rats? (,) and this is best accomplished by periodic fumigation* 
*t |?r. 9|j 
11*155 Guards en eenneeting lines* if the vessel lies at a desk all 
©enneating lines should be guarded by inverted ©ones er disks net less 
than 3 feet i» diameter and se fixed as to be always at a right angle 
te the line to vhieh it is attaehed**| £p«r. 9&j 
11.15* (j) Cargo. Articles which harbor or are liable to harbor rats 
or rat fleas should not b© shipped until freed of such vermin, either 
by the use of chemicals, fumigation, or by preventing the access of 
rats. The nature of the merchandise and the place and method of stowing 
prior to shipment must be considered in determining its liability to bo 
a rat or vermin carrier, thus: crated cargo, bags of grain, etc,, so 
stowed as to be used as nesting places for rats would be flea, and might 
be rat, carriers? (J end cargo should preferably have been previously 
stored in rat-proof warehouses* Ar idea of cargo in open orates should 
be carefully inspected to determine freedom from rats and, at the dis- 
cretion of the inspector, nay be rejected for shipment if considered as 
Hunan cases shall be considered as proff of an existent rodent Infection. 
♦For statutory citation, see note to§ 11.12. 
‘f'For source citation, see not© to S 11.1. rodent feafeetadr (infested.) When the cargo of a vessel consists of 
grain or other rat food, extra precautions should be taken to prevent 
rats from going aboard.* ■jr (Par. 
PLAGUE; SPECIAL MEASURES AT PORTS OF ARRIVAL 
U.l6l Detention of ships. Ships on which plague has occurred in men 
or rodents shall be detained in quarantine, the sick, if any, shall be 
removed and Isolated, and the destruction of rats shall be effected as 
soon as practicable.♦ jf [Par. 9§ 
!1t169 Fumigation of plague-infected skipst preventing eaeape of 
ratsr A plague-infected skip shall he fmigated simultaneously In all 
parts fer the destructlen of rater Including these that nay be within 
articles ef oargo7 and ether precautions shall In the meantime be ob- 
served te prevent the escape ef rats from the shlpsr* f {Per. 90 
{Il.l6g Fumigation of plague -infacted ships. A ship from a plague- 
infected port shall be fumigated simultaneously in all parts if inspection 
reveals the presence of rata, or if a person has contracted plague after 
more than seven days has elapsed since the ship left an Infected port, 
or if cargo was loaded at an Infected port and appears likely to harbour 
or to have harboured rats. Prior to fumigation precautions shall be 
observed to prevent the escape of rate from the ship. 
U.I63 Detention of sick persons. All persons sick of plague shall 
be detained in quarantine until well, but no detention of healthy 
contacts is contemplated (except in the pneumonic type of the disease) 
qjther than is incidental to the treatment of vessels or cargo.*^ 
{far. ?j) 
11.164 Measures in case of pneumonic plague on board ship. If 
pneumonic plague has occurred on board ship during the voyage, the (those) 
sick (with it or suspected of having it) shall be renewed and isolated, 
and all crew and passengers that have been exposed to the Infection shall 
be detained In quarantine for a period of 7 days7 (J ary at the dis- 
eretien ef the quarantine officer? until their aeeretiens shall he 
proved te be free frem By pestis.*$ [Par. 98) 
H.I65 Freedom from rats and vermin. The quarantine officer, before 
granting pratique to a vessel that has been detained in quarantine on 
account of plague Infection, shall assure himself that the vessel is 
free from rats and vermin.* f [Par. 9gj 
U.l66 Personal effects. The personal effects in use, and the be- 
longings of crew and passengers, vhich in the opinion of the quarantine 
officer are considered as infected, shall be disinfected and rendered 
free from vermin.**t JPor, 1C§( 
♦For statutory citation, see note to 8 11.IP. 
+For source citation, see note to§ 11.1. 11.167 Entry of certain vessels subject to provisional pratique. 
Vessels from ports (foreign, insular, or domestic) that are known or 
suspected of being infected with plague may, when loaded with cargo, 
the nature of which or manner of storage precludes effective fumigation, 
bo permitted to enter subject to the terms of a provisional pratique. 
When lying alongside wharf or dock at United States ports such vessels 
shall take proper precautions to prevent the passage of rodents. She 
vessel shall he fended eff from wharf er doeh net less than 4 feet? and 
e» all eesmeetlng lines shall he fined rat guards ef sheet metal ef an 
approved design? net less than 3 feet in diameterr All earge nets and 
similar devises extending between the vessel and share structures shall 
he removed at night unless in astual use? as likewise gangways and 
similar devises extending he tween the vessel and share structures shall 
he removed at night unless in astual use? as likewise gangways and 
ladders unless guardedr Any vessel so entering and neglecting to effect- 
ively apply such measures, may, at the discretion of the Surgeon Qeneral 
(quarantine officer), be remanded to the quarantine station for dis- 
charge of cargo, or required to discharge cargo at anchor well removed 
from the [Par. 101, amdt. 9, Mar. 21, 1925] 
11t1££ Fumigation ef eert&in vessels requiredr Vessels from ports 
known te he infested with plague? in man er rodents? which have decked 
er which have net taken precautions necessary te prevent the ingress ef 
rats? and on which effective measures have net heen taken te destroy the 
seme under the supervision ef an accredited medical officer ef the Waited 
States Government? shall? upon arrival at apart in the Waited States? he 
fumigated for the destruetien ef rats.*$ {5av» 102j 
11.169 (8) Periodic fumigation. All vessels engaged in trade with 
foreign porta shall be fumigated not less than one© every 6 months for 
the purpose of destroying rats. This is best don© when the vessel is 
empty; Provided, That the Surgeon General nay prescribe rules under 
which the 6-month period between fumigations may be extended for: (a) 
Vessels plying regularly between ports not infected with plague; (b) 
Vessels whoso construction does not favor the harborage of rats; ((c) 
When ship inspection does not reveal the necessity for fumigation.) 
io37 aiadt : 57I92U 
11.170 (6g) Fumigation certificate. A certificate signed or viseed 
by an accredited medical officer or a consular officer of the United 
States may be accepted by the quarantine officer as competent evidence in 
considering the enforcement of II.I69, except vhen otherwise directed 
by the Surgeon General. Fumigation certificates to be acceptable must 
contain the same, or substantially as complete, information as contained 
in "Certificates of Fumigation, XJ. S. Public Health Service," Form 1939 
or Fom [Par. 10k, amdt. 5, Jan. 16, 1925] 
11.171 (JO) Method of fumigation. In applying plague preventive 
measures, vessels without cargo shall be fumigated simultaneously In all 
♦For statutory citation, see note to § 11.12. 
source citation, see not© to § 11.1. 
26 parts with sulphur dioxide gas, not less than 5 pounds per 1,000 cubic 
feet for 6 hours* exposure; or by hydrocyanic acid gas in the porportlon 
of 5 (2) ounces e# sodium eyanlde per 1,000 cubic feet of space (er equi- 
valent amount ef potassium eyanlde) for 2 (to 4) hours* If the vessel be 
loaded, the time of exposure shall bo doubled.* [Par. 105j 
11.178 (1.) Partial discharge of cargo nay b© required. When necessary 
in the treatment of infected vessels, the quarantine officer may require 
the master to partially discharge cargo for the purpose of effective 
performance of fuaigation.* d [Par. 10Sj 
SMALLPOX! SPECIAL MEASURES AT FGREIOH AMD IRSULAR PORTS 
ll.l8l Incubation period. For the purpose of the regulations in this 
part, lb days shall be considered as the incubation period of small" 
pox.* t E?r- 
11.182 Evidence of immunity or vaccination by passengers and crew; 
baggage. Passengers and crew coning from districts where smallpox pre- 
vails in epidemic form, or who have been exposed to smallpox, should be 
vaeeinated befere (refused) embarkation, unless they show satisfactory 
evidence of having acquired immunity to smallpox by previous attack, or 
successful vaccination within 1 year, (and previous to Ik days), and their 
baggage Inspected and. If necessary, disinfected.* -|""^PBr.~io5]" 
SMALLPOX: SPECIAL MEASURES AT PORTS OF ARRIVAL 
11.191 Treatment of vesoels with disease on board. Vessels arriving 
with smallpox on board, or having had smallpox on board during the 
voyage, shall he treated as follows: 
(a) The sick shall be removed and detained (isolated) until recovered. 
(b) All persons vho in the opinion of the quarantine officer have been 
exposed to the Infection shall be vaccinated, unless pretested by a pre- 
vious attach ef smallpox, and (kept under surveillance) detained In 
quarantine until the vaccination is protective against said exposure (or 
iflpnmlty is demonstrated), or, if they refuse vaccination, detained in 
quarantine for days after last exposure to the infection. 
(c) Those persons that have not been exposed to the Infection Day be 
released. 
(d) All personal effects of passengers and crew that have been exposed 
to Infections shall be disinfected. All compartments that have been 
exposed to the liability of Infection shall b© disinfected.* 
*Por statutory citation, see note to $ 11.12. 
For source citation, see not© to 11.1. TYPHUS : SPECIAL MEASURES AT FOREIGN AND INSULAR PORTS 
11.901 Incubation period. For the purpose of the regulations in 
this part 19 days shall be considered as the period of incubation for 
typhus (Par. lUj 
11.202 Passengers and crev from infected ports; personal effects. 
Passengers and crew from ports infected with typhus shall not be allowed 
to embark unless demonstrably free from vermin, or otherwise treated for 
the destruction of vermin. (In the event of an epidemic, evidence of 
valid iwmunlration should be presented.) The personal effects, wearing 
apparel, ani of those infested with vena In shall be dlsln- 
facted. *f [Par. 112) 
U.2CJ Passengers from Infected localities. Passengers from localities 
where typhus prevails embarking at a port not infected with typhus shall 
be treated as in § 11.202. (Tar. ig 
11.20*1 Passengers and crev previously exposed to Infection. Passen- 
gers and crew who. In the opinion of the inspecting officer, have been 
definitely (directly) exposed to infection ((i.e.t Tfroca a house, barracks, 
or other building in which has occurred a case of typhus) shall not be 
allowed to embark until 12 days after removal from the infected environ- 
ment (or unless evidence of valid Immunization prior to exposure is 
presented. or twelve (12) days has elapsed following imnunlzatlonTT*i 
I par . n y 
TYPHUS: SPECIAL MEASURES AT PORTS OF ARRIVAL 
11.211 Vessels on which infection has occurred. Vessels on which 
typhus infection has occurred shall be detained in quarantine and the 
sick, if any, relieved and Isolated. The clothing, personal effects, and 
baggage of those infected and of those not demonstrably vermin free shall 
b© treated for the destruction of (Par. llj] 
11.212 Vermin-infested persons. All persons found to be vermin 
(louse) infested shall be treated for destruction of llc©.*f [Par. ifSj 
11.213 Observation of exposed passengers and crew. All passengers 
and crew that have been exposed to the infection shall he detained under 
observation (kept under surveillance or unless evidence of valid iamuni- 
zatlon prior to exposure la presented, or 12) days lias elapsed 
following imaunlaation) for a period of 12 days from last exposure to 
Infect ion. ♦’if (Par. lljj 
11.21U Release of personnel. Those of the personnel that are demon- 
strably free from vermin, and have not been exposed to the 
be released without detention or disinfection of baggage (par. 
♦For statutory citation, see note to § 11.12. 
j[ For source citation, see note to § 11.1. IT.2X5 Detention and fumigation of Teasels, Vessels on which tophus 
has appeared shall be detained and fumigated for destruction of ver- 
min, (including rats),* f llgj 
11.216 Cargo compartments. Cargo ccaapartiaenta of typhus-infected 
vessels need not be fumigated, unless there be exceptional conditions 
that may render them vermin infested.* t &r- 1?S 
11.217 Fumigants fend Insectioidee.) (For the destruction of lice and 
fleas, fumigants or insecticides, approved by the Surgeon General, shall 
be used.) Sulphur dioxide and hydreeyanle aeld gas are effective agents 
for the destrustlen of llee when need In proper strength and exposure.*£ 
[Par. la) 
LEPROSY: SPECIAL MEASURES 
11*991 Bsharkatlon ©f alien lepers far United States prohibited? 
Allas lepers should net be permitted te embark at a foreign pert for a 
pert ef the United Statesj Its possessions ar dependencies** either as 
a passenger er as a member ef the fPar? 199} 
Cress Peferences: For interoetato quarantine regulations relating to 
the travel oi lepers, ee© | 12.5* For regulations of the Immigration 
and Baturall ration Service relating to the procedure of deportation of 
aliens afflicted with leprosy, see 8 CFR 20.50 
Hr22? Vessels arriving with disease en beard? Vessels arriving In 
quarantine with leprosy en beard shall net be granted pratique until 
the leper and his baggage has been removed from the vessel te the 
quarantine 0tePr 190* 
11-9223 landing ef alien leper prohibited. Be alien leper shall be 
permitted te land? and te this end the ease shall be certified as a leper 
and reported to the nearest eessalsslener ef J¥arr 190 
ABTHRAX AKD OTHER DISEASE QRGAIHSMS: SPECIAL MEASURES 
H.25I Bair or bristles made Into shaving or lather brushes for ship- 
ment Into United States. Shaving brushes or lather brushes destined for 
shipment into the United States shall be mad© only from hair or bristles, 
known to be free from anthrax (jar. 12(5j 
Rote: Sections 11.231-11.253 contemplate that anthrax is primarily a 
disease of animals; that the Infection in man is ccesparatively rare and 
under such circumstances is not transmitted from man to man. Inasmuch 
as the infection tends to spread only as an epizootic disease, the res- 
ponsibility for its exclusion and regulations of that Government agency 
♦For statutory citation, see note to 3 11.12. 
fPor source citation, see note to § 11.1. appear to be sufficient for their purpose, and the requirements contained 
herein are merely for the additional protection of persons against pos- 
sible Infection from any animal product in such widespread and, everyday 
use as the shaving brush. 
Cross References For Bureau of Animal Industry regulations relating to 
the Importation of wool, hair and Bristles in the prevention of anthrax, 
see 9 CFR 95-10, 95.11. 
11.252 (Substitute Amendment #21) Disinfection of hair or bristlesr 
Unless known to be free from anthrax spores such hair er bristles? before 
being made into shaving er lather brushes? shall be disinfested by one ef 
the following methods* (a} by boiling for not loss than 3 hours? (b) by 
exposure te steam under net less than 13 pounds gauge for net less than 
3© minutes with a preliminary vacuum of at least 10 by 
exposure te streaming steam for net lose than 6 hoursr* [Fbpt 12?J 
11.255 (Insert Amendment #l8) Sensular certificate te aeeeapany 
eensignment ef foreign shaving brushesr GensigHaeate ©f shaving brushes 
ef foreign manufacture shall be accompanied by a oensular certificate 
containing a statement as te the prevalence ©r nenprevalenee ef anthrax 
in the territory from which the brushes emanate and alee to the effect 
that the materials entering inte the manufacture ef the brushes have er 
have net complied with the requirements of the regulations in this 
£p»rr iS§J* 
Living disease organisms and vectors—(a) Permit for admittance 
of cultures. Infected insects, animals, or plants required. No culture 
of bacteria, or any living virus or collection of organisms, that causes 
or may cause any contagious or infectious disease, nor any insect, animal, 
or plant Infected with such bacteria, virus, or organism, shall b© 
admitted into the United States without a specific permit issued by the 
Surgeon General of the Public Health Service. 
(b) Permit for admittance of insects, animals, or plants capable of 
transmitting contagion required. No living Insect, animal, or plant, new 
to or not theretofore widely prevalent or distributed within and through- 
out the United States, which is potentially capable of transmitting any 
contagious or infectious disease, shall be admitted into the United States 
without a specific permit issued by the Surgeon General. 
(c) Issuance of permitj release from customs custody. The Surgeon 
General may, in his discretion, issue a permit as specified in para- 
graphs (a), (b) when proper safeguards are set up to protect the public 
No article or thing coming within the provisions of paragraphs (a) or 
(b) shall b© released from customs custody prior to the receipt by the 
collector of customs of a permit therefor issued by the Surgeon General, 
which permit shall specify the name and address of the consignee of 
such article or thing. 
See not© to § 11.251. 
♦For statutory citation, see not© to § 11,12. 
For source citation, see note to | 11.1. 
30 (d) "Parrot regulations" continued in force. The provisions of 
paragraphs (a) —(o) shall not apply to birds of the parrot family, as 
defined in l6.1—16.4, which regulations, approved December 20, 1935* 
shall continue to govern the Importation of such birds of the parrot 
family.* Hhurs. 128—A to 128—D, amdt. 17, Mar. 4, 1938, 5 F.R. 555 ! 
Cross References: For regulations relating to parrots, see 12.17 and 
Part l6 * For Public Health Service regulations relating to the importa- 
tion of viruses, serums, and toxins, see Part 22. For Department of 
Agriculture regulations relating to the importation of adult honey bees, 
plants, or plant products by mall, see 7 CFR Parts 321, 322, For Bureau 
of Animal Industry regulations relating to viruses, serums, toxins, and 
analogous products, see 9 CFR Parts 100, 102, 108—121, 131. For customs 
regulations relating to the Importation of viruses, serums, and toxins, 
see 19 CFR 10.15—10.18. For Bureau of Customs regulations relating to 
parrots Imported into the United States, see 19 DFR 10.23. 
BORDER QUARANTINE 
11.241 Inspection of travelers at Canadian and Mexican ports. When 
necessary, travelers arriving at Canadian or Mexican ports, destined 
for the United States, shall bo inspected at the Canadian or Mexican 
port of arrival by the United States aoaeuiar er medical officer, and 
b© subjected to the same sanitary restrictions as are called for bv 
the rules and regulations applicable at foreign ports.* [Par. 12gj 
Cross Reference: For quarantine regulations applicable at foreign 
ports for prevention of cholera, yellow fever, plague, smallpox, typhus, 
leprosy, anthrax, see 11 11.101—11.108, 11.131—11.133* 11.151-11.154, 
H.l8l, 11.182, 11.201—11.204, 11.221, II.23I—H.233. 
11.242 Maritime quarantine to bo applied. Where not otherwise 
specifically stated, the miles and regulations for maritime quarantine 
shall be applied at stations on the Canadian and Mexican frontiers; 
and the methods of disinfection shall be those precrlbed in the regula- 
tions in this part.*,| [Par. 13j5) 
11.245 Mexican citizens on temporary visit. In order to facilitate 
the entry of native-born and naturalized citizens of Mexico,desirous of 
temporarily visiting the United States, the Department of State and the 
Department of Labor have arranged, for Inmlgration purposes, to have 
American consular officers in the interior of Mexico issue to them border 
Identification cards which bear photographs and signatures of the holders * 
It is understood that these cards will be issued by American consular 
officers only to bona fide visitors for business or pleasure who at the 
Ume of issue are apparently free from any communicable disease and have 
either previously had smallpox or have been successfully vaccinated 
against this disease. 
♦For statutory citation, see note to § 11.12. 
I'For source citation, see note to § 11.1. Quarantine officers are authorized to pass the owners of these consu- 
lar cards of identification upon presentation at the port of entry on 
the Mexican border provided they shov no visible evidence of qaaran- 
tinable disease.* |F.Q. Div. clrc., Surg. den., Apr. 11, 193**-, approved 
Sec. Tress. Apr. 12, 193D 
11.24b Denial of entry or observation of Infected persons. If any 
person b© found suffering from a quarantinable disease, or be presumably 
Infected, ho shall be denied entry (except that a citizen of the 
Chi ted States say be permitted to enter under provisions applicable to 
maritime ports'.)sr shall ho kept under quarantine observation so long 
as danger ef eenveytag the infection exists**’i' [par* 131} 
U.2U5 Infected baggage. Any baggage or other effects believed to 
bo Infected shall be refused entry unless disinfected in accordance with 
the regulations in this part,*’|f [Par. 152} 
Il*9b6 Persons from ehelera-infeeted localitiest Persons eeaing 
from lee all ties where cholera is prevailing shall net he allowed entry 
until they have heen preven te he free ef cholera vibrios? by labora- 
tory examination? or otherwise detained 5 days *♦ jj i33} 
ll»2b? Persons from yellow fever-Infected places* Paring the active 
quarantine season persons net positively identified as immune to yells*? 
fever? earning from places where yellow fever prevails? will net he 
permitted t© enter until they have heen away from said locality 6 full 
days? or otherwise hold la quarantine to complete 6 daya** jjarr i$£Tf 
Ilr2b8 Perseas from smallpox-iafeeted leealltlesr Persons eeaing 
from localities where smallpox is prevailing shall not he allowed entry 
without vaccination? unless they are preteeted hy a previous attack ef 
the disease or a recent successful vaccinations--* •J’ £?arr 135} 
Iir8b9 Persons fraa typhus-infeetod localities* Perseas eealng from 
localities where typhus fever prevails shall net he allowed entry unless 
demonstrably free from vermin er otherwise disinfected fer the destruc- 
tion ef vernin» Pis Infection of wearing apparel? baggage 7 and. personal 
offsets fer the destruction of vermin shall bo practiced when neeea- 
sary-T*'!' |Parr I3S} 
11.259 (b6) Infected comon carriers. Ho coaaaon carrier which Is 
infected, or suspected of being infected, shall b© allowed to enter the 
United States until after such measures have been taken as will render 
it safe.*f [Sir. I3T! 
11.25i (by) Merchandise, personal effects. Articles of merchandise, 
personal effects, etc., which are presumably infected, shall not be 
allowed entry into the Thai ted States until after (Far. 13§j 
♦For statutory citation, see not© to § 11.12. 
source citation, see not© to J 11.1. 
32 11.298 (*8) Entry of persona from countries where quarantinable 
diseases reported. Persons shall not enter the United States from 
countries where any of the quarantinahl© diseases are reported except- 
ing at ports of entry, and after inspection by a quarantine officer and 
such necessary treatment as indicated in the foregoing sections u**^ 
(Far, 139} 
FEES AND ENFORCEMENT 
11.261 Visitation of vessels. The Surgeon General, or the officer 
detailed by him as inspector, shall, at hie discretion, visit any Incom- 
ing venal or any vessel detained in quarantine with a view to certify- 
ing, if need be, that the regulations have been or are being enforced, 
[Par. l*g 
11.262 Remanding of vessels to quarantine stations. The Surgeon 
General of the Public Health Service is authorized, when in his dis- 
cretion such action is necessary in the interest of the public health, 
to remand, by &£reeb£ea e£ the Secretary of the Treasury? any vessel 
to the nearest quarantine station provided with proper facilities for 
handling infected [P^r. I*i0 
H.263 Seized vessels. In case a vessel requiring quarantine in- 
spection is seized prior to having passed quarantine Inspection, it will 
he immediately towed or convoyed to a quarantine station for quarantine 
inspection preliminary to any other disposition. The towing or convoy- 
ing vessel shall become constructively In quarantine and shall be sub- 
ject to quarantine inspection and any necessary quarantine measures.9 
|Dept. clrc. 391, Hov. 11, 192?! 
11.26b Rates to be charged vessels for quarantine services. The 
following rates to be charged vessels for quarantine services at 
national quarantine stations are hereby precribed; 
(a) Inspection services; 
(1) Inspection of vessels (including crews and not more than 10 pas- 
sengers) : 
(l) Under 500 not tons— — — — — $5.00 
(ill) Over 5,°00 not tons — 15.00 
(ll) Over 500 and less than 5,000 net tons 10,00 
(2) Inspection of passengers; 
(ll) Bach additional 100 or fraction— -— ~— 5.00 
(l) Over 10 and less than 100 —— 5.00 
(5) Surcharge for inspection after sunset (except vessels 
in distress) 25*00 
(h) Detention services; 
♦For statutory citation, see note to § 11.12 
For source citation, see note to §11.1. 
33 (1)‘ Subsistence, housing, and medical carej 
(i) Cabin passengers and ships officers, per day or 
fraction—— — —— $3*00 
(li) Steerage passengers and crev, per day or 
fraction — —— 2,00 
(ill) On©-half rates will he charged for housing and 
medical care only {i. e. vhen ship furnishes 
subsistence). 
(2) Vaccination, per person — —— — .25 
(3) Special bathing, or delouslng, per person .25 
(k) Disinfection of personal baggage and effects, per 
piece — —— ————— ,2® 
(5) Ho charges vill be made for detention services for 
benef claries of Public Health Service. 
(c) Fumigation services; 
(l) Fumigations 
(l) Chemicals, per 1,000 cu. ft. of space-—-------- ,12 
(ii) supervision———————————— 3.00 
(ill) Labor, per hour per man—-— — .50 
(iv) Transportation (to places other than Quarantine 
Anchorage)-- actual pro rata cost 
(v) Lose of, or damage to, equipment—— 
-----— -actual replacement cost 
(vl) Surcharge for Sunday or legal holidy service (ex- 
cept vessels held in detention— —- 
(2) Quarantine guards (at places other than Quarantine 
Anchorage) each, per day-- — $5»00 
(3) Deratization exemption Inspections (including inspec- 
tions for extension of certificate) except vhen made 
under 500 net tons by the medical officer as part of 
inspection services— — —— 10,00 
(d) Transportation shall be charged for at the actual (mileage) 
cost to the Government vhen transportation is made overland. When made 
on Government station launch or tug, chargee will be based pro rata 
upon dally operating cost of such vessel. Transportation and labor 
charges vill be computed from hour of departure from, station to time 
of return tc station. Charges mad© for loss of or injury to equipment 
will depend upon the character of equipment and the amount of loss or 
extent of damage, and shall be based on the market value of such items. 
(e) Special services for which surcharge is made (night boarding, 
holiday fumigations, etc.) will only bo performed upon written request 
of the responsible agents of the vessel, and all charges rendered to 
collectors of customs for special services shall record the name and 
address of the responsible agent and the date of request upon reverse 
of statement form. 
(f) Charges for quarantine services vill not be Mde vhen rendered 
to armed vessels of foreign nations or to vessels owned by the United States or by Individual States of the Union; such vessels should 
furnish necessary subsistence* 
(g) Thee© reates anal 1 bo effective on April 15, 1928, and thereafter 
until changed. Quarantine officers upon the completion of services 
rendered shall Immediately compute the total cost thereof and send a 
statement to the collector of customs at the port whore the vessel en- 
ters* One copy of all such statements shall be forwarded by quarantine 
officers to the Bureau of the Public Health Service on the same date, 
without letter of transmittal. 
(h) Collectors upon receipt of such statement vlll require payment 
of the charges by the master or agent of the vessel and vlll account 
for the amounts collected tinder the item "Fees for Quarantine Services*” 
(Sec. 1, 40 Stat. 6, sec. 16, 46 Stat. l4$2; 42 U.S*C. 8?, [Sept, 
circ. 398, Mar. 50, 1928, aadt. 1, Hov. 30, 1936, 1 F.R. 209&1 
United States Public Health Service, Foreign Quarantine Division, Un- 
numbered Circular June 9, 1957 
Par. 4, Change "nine" to "six" 
Par. 71 This paragraph should be re-written in conformity 
with Foreign Quarantine Dlv. Circ. 77, revised. 
QUARANTINE OP AIRCRAFT 
Sections 11,501 to 11* 512 deal with various matters concerned with 
certain basic laws of the United Staton and definitions of teras used 
in this code. Regulations also are to be found governing landing re- 
quirements, advance notice of arrival, permission to discharge or de- 
part, emergency or forced landing, clearance of aircraft of scheduled 
airlines, documents of entry, documents of clearance, residue cargoes, 
etc. No particular changes need be made in these sections and hence 
che CoftaeiisBioa has confined Itself to regulations In the paragraphs 
following. 
H.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 bo adequately or safely handled at the air- 
port of first or intended landing shall, be required (requested) to proceed with all passengers and persons employed on board and all mail, 
baggage, cargo, or other contents on board, as may b© designated by 
such officer, to an airport Indicated by such officer to have adequate 
facilities for such treatment as shall be prescribed by him. 
(o) Entries in Journey log book of arriving aircraft.—Any aircraft 
departing for the United States from any place outside thereof shall 
have entered in the Journey log book*- statements as te the eeeurrenee 
ef plague? ehelora? yellow fever? typhus fever? and smallpox in the 
country from which the aircraft departed and in eewntries in which 
landings are made en router There also shall be entered in the Journey 
leg beak statements as to any sanitary measures undergone before de- 
parture or at such landings. These statements shall be verified and 
signed by the offieers in charge ef the airports from which the aircraft 
departed and at which it landed en router In occurrence of any sickness 
among the passengers and persona employed on board and as to any scnl 
tary treatment performed en route. 
(4) Spraying of arriving aircraft,—Any aircraft bound for the United 
States, from any (port separated by ocean or sea, or from any place south 
of middle Mexico,) place in South America or tropical Africa? or from any 
ether region where yellow fever may appear? shall be sprayed during flight 
with an insecticide approved by the Surgeon General ef the Public Health 
Servicer The spraying shall bo performed as seen as possible after de- 
parture 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 prevision applies to aircraft bound fer the mainland ef the United 
States from any United States insular pertr 
(e) Statement of whereabouts of passengers and crew. —(Any person) 
The eesaaader of any aircraft arriving in the United States (by aircraft) 
fraa any pie©© is the Western Hemisphere located within the region 
bounded by 3G degrees seuth latitude and 13 degrees north latitude7 ©r 
frem any place in the Afriean Gentinent located within the regies bounded 
IS degrees south latitude and 16 degrees north latitude? or from any 
ether place where yellow fever may appear? shall {may be required to) 
furnish the quarantine officer with a written statement showing the (his) 
whereabouts ef all passengers and members of the crew for a period of 
6 (it) days prior to embarhatien for (arrival In) the United States (x 
and an acceptable statement of his immunity and his Immunization against 
quarantlnable diseases) 
(f) Importations of living disease organisms and vectors, shaving 
brushes, and parrots. —Importations of living disease organisms and 
iFor this purpose, a Journey log book Is any document or book con- 
taining the following Information: (l) nationality and identification 
marks of aircraft; (2) name and address of owner of aircraft; {3) 
name and address of cosanander of aircraft; (U) 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) re- 
marks; signed by the aircraft comaander.  of shaving or lather brushes,3 and of birds of the parrot 
family1* are subject to the special regulations prescribed therefor. 
(g) Entries in Journey log booh of departing aircraft. —Any aircraft 
clearing from any area for any place outside the United States may ob- 
tain from the quarantine officer for entry in the Journey log book in- 
formation regarding the occurrence of plague, cholera, yellow fever, 
typhus fever, and smallpox in the area (local zone). 
(h) General provisions.—‘Except as otherwise provided in the regula- 
tions in this part (11.501 to U.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 lavs and regulations applicable to vessels so arriving, insofar 
as such lavs and regulation ere applicable to aircraft. 
11.514 General provisions; Entry and clearance.—All navigation lave 
and regulations 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. 
11.515 Penalties.—(a) Relates to violations of customs regulations 
and has no bearing on quarantine. 
(b) Any person violating any public health regulation relating to 
aircraft or any provision of the public health lavs or regulations mad© 
applicable to aircraft by 11.515 shall b© subject to a civil penalty 
of $500? and any aircraft used In connection with such violation shall 
bo 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 U.S.C. l8l (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 Com- 
merce and has no bearing on quarantine. 
(d) Relates to violations of immigration regulations end has no 
bearing on quarantine. 
(©) 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 
lava, and the Immigration laws, under which the regulations in this part 
ere prescribed, shall be separate frcan such liability with respect to 
any other set of such laws. 
•“hiving disease organisms and vectors; Amendment Ho. 17 to Quarantine 
Regulations of the United States, March 4, X93&? Federal Register, 
March 10, 1938, p. 555. 
3Brashes: Amendment Ho. 18 to Quarantine Regulations of the United 
States; Federal Register, March 22, 1939? p. 1287. 
Executive Order 5&6U-, Jan, 24, 1950; Foreign Quarantine 
Division Circular Ho. 67 and amendments; Federal Register, Hay 3? 1939? 
p. 1766, 11.516 Airports of entry.—(a) Airports of entry will bo designated 
after due investigation to establish the fact that a sufficient need 
exists in any particular district or area to Justify such designation 
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 io 
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 compiled with, or if 
It bo found that scan© other location would be more advantageous. 
(d) Airports of entry shall be municipal airports, unless particular 
conditions which prevail warrant a departure from such requirement and 
shall be possessed of a currently effective designation as a "Designated 
Landing Area" issued by the Administrator of Civil Aeronautics. Addi- 
tional requirements say be Imposed as the needs of the district or area 
to be served by the airport may demand. 
(o) Airports of entry shall provide without cost to the Federal 
Government suitable office and other space for the exclusive ue© of 
Federal officials connected with the port. A suitable surfaced loading 
area shall. In each case, be provided by the airport at a convenient 
location with respect to such office space. Such loading area shall bo 
reserved for the ue© of aircraft entering or clearing through the airport. 
(f) Airports of entry shall b© open to all aircraft for entry and 
clearance purposes and no charge shall be made for the use of said air- 
ports for such purposes. However, in cases where airports of entry 
authorize any such aircraft to use such airports for the talcing on or 
discharging of passengers or cargo, or as a base for other commercial 
operations or for private operations, this paragraph shall not be Inter- 
preted to moan that charges say not be made for such commercial or pri- 
vate use of such airports. 
(g) AH 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 discrimination. 
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 sche- 
dule of charges shall be posted in a conspicuous place at the office 
space provided for the use of Federal official connected 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 recoaaoended by the Civil Aeronautics Authority, 
(R.S. 161, 251; sec. 6kh, k6 Stat, 761; sec. 7> kk Stat, 572; eoc. 5, 
27 Stat. 1*51; sec. 23, 39 Stat. 89k; sec. 2k, 1*5 Stat. 166; 5 XJ.S.C. 22; 
19 TJ.S.C. 66, 16kk; 1*9 TJ.S.C. 177; k2 U.S.C. 8 TJ.S.C. 102, 222. 
Secs. 201 (a), 205 (b). President’s Reorganization Plan Ifo. I, sec, 1, 
President’s Reorganization Plan Ho. V; 1* F.R. 2728, 2729, 5 F.R. 2132, 
2225. E.O. 9083, Feb. 28, 7 F.B. 1609.) The Airport of Entry Regulations approved on October 6, 193-1 > by the 
Secretary of the Treasury, the Secretary of Commerce, and the Secretary 
of Labor, published in T. D. (19 CFR 3f.ll), are hereby superseded. 
SEAL 
Paul V. McHutt, 
Federal Security Administrator. 
(The above regulations, designated as "Air Commerce Regulations," 
vero signed also by the administrative heads of the Treasury Department, 
the Department of Commerce, and the Department of Justice.) 
Koto. —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 hi); and In Article 6l of the Pan American 
Sanitary Code (pp. U2 and 3*3), 
QUARANTINE AND IMMIGRATION MEDICAL INSPECTION OF 
PASSENGERS AND CREW OF AIRCRAFT 
In the Final Report are found rococsnendatlons for processing passen- 
gers arriving by aircraft. 3h general they conform to the process 
outlined In this section but tho comitteo on revision of regulations 
of tho United States Public Health Service should consult the Final 
Report - Pert I for suggestions on revising this chapter. QUARAHTUiE TREATME8T OF MILITARY AIRCRAFT 
Federal Security Agency 
TJ. S, PDBLIC HEALTH SERVICE 
Washington 
Revised Beeember 207 
(July 1. 19kk) 
Foreign Quarantine Division Circular No. 71 
To; Medical Officers in Charge, IT. S. Quarantine Stations, and Others 
Concerned. 
Subject: Quarantine Inspection and Treatment of Aircraft of the Military 
Forces of the United States. 
(Quarantine procedures. Including disinsectization of military air- 
craft will be accomplished In accordance with Army regulations , 
*S3S. air force regulation 63T3 and Havy Burned Form Letter Ho. 28 (re- 
vised)T These regulations are considered to express the policy of the 
United States Public Health Service as adapted to military aviation.) 
Tho following measure© will be observed in ©saneotiea with quarantine 
inspection and treatment ©f aireraft ef the military ferees ef the 
Waited Stateo* 
Bias© It in the abseneo of querent in©able diaeases or ©pidost© ©en~ 
ditien© at any port of departure or ©ally flights ef Military aireraft 
©f the Whited State© say b© mad© nenatep t© and from the f©Hewing areas 
without quarantine restrietiens* 
Whited Spates Oaaada 
Puerto Rie© 9ub». end Bahama Islands 
Qanal Zone (All ether island© ef the Barribbean area 
Virgin Islands where Wt St air 'bases may be established 
Alaska sr© iHsludedr) 
Slaes 51? Flight© having esatact with other areanr--The officer in 
charge of the flight should eemuHieat© with the quarantine authority 
in the area where landing is eeatemplated in eaa.pl© time to permit this 
©ffieial te bo en the field and carry out eueh procedures as stay b© 
indieatodr 
All persennel en the flight Hast be eeafined t© the landing field? ©r 
t© aueh area as Bay be designated by the quarantine effieory until released 
by the quarantine ©ffieer? 
Bi©insectieati©a ©f aireraftr—•PiBinseetisatien procedure say be 
carried ant as tho ground imodiately prior te the take-eff frea the last 
field ea rente t© tho Waited States er immediately after landing en 
Waited State© soilr Plane© ©eaing frea areas where yellew fewer is ©a- 
deaio er epideai© should be ©prayed beth en departure from sash areas 
and on arrival in the Waited State a r 
M Being ©©greased air spraying meehsaisa.—Aii enclosed spaces of 
the* p-kaiea* asust- be*,©preyed with- laseeGt-iG-id-®- a afc£esgt& not less than 
etSSSSTdl pypethr-iaa estmst (S gsisas p©» 100 oeatissta'tesa). 
using’ net less than 5 ©ubie eeatisseters ©f the sixtus© psa? 1,000 cubi£ 
feefc of enclosed spacer -Sesapartmejata eeeupied by passeag&ra and aircraft 
personnel should be kept tightly closed for at least 2 aJsautea after the 
3aeoetielde is intredueedr \h) Using kand-typ© spraying maekealgar—whan a hand-pump type of 
spray apparatus la used? the quantity ef Inseetlelde skeuM “be Inoreased 
be net lees than 3 euble ©entlaetars ®f the standard pyrethna® ©xtraat 
per ij-900 ©able foety with the plane elesed far not less than 9 alnafeesr 
Special temporary provisions.-—For the period of the existing national 
emergency, the Surgeon General may in his discretion, when requested by 
the competent military authorities, designate the sealer medical officer(s) 
of an Anqy or a Bavy air base to serve as quarantine officer for the 
inspection and treatment of military aircraftr carrying ealy mili- 
tary personnel? vkleh may be proceeding ea oenfldentlai h1bb4©bs? This 
delegation of quarantine authority will convoy to the military service 
concerned full responsibility (within these duties) for preventing the 
introduction Into the United States of dangerous camnunl cable diseases 
and of insect vectors of disease. 
TB0MAS PAKRAN, 
Surgeon General.  OF COMMERCIAL AIRCRAFT 
Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE 
Washington 
June 15t s* 
(Revised July 1, 19^.) 
Foreign Quarantine Division Circular No, 77 
To: Medical Officers in Charge, U. S. Quarantine Stations, and Others 
Concerned. 
Subject: Disinsectization of Comorcial Aircraft. 
1. Incident to the increase of aircraft traffic with foreign areas 
the danger of the introduction into the Unite i States of exotic insect 
vectors of disease is greatly increased- Ja -\h4e seaaeetieay the SoFrie© 
4b especially interested 4a preventing the iatveduettea ©f Aedes aegypti 
aaatuitoes frem areas 4a whieh yellew-feves? 4e entemie ©r epideate and 
4h eareludiag the Anepheles gaabias? a highly effieleat carrier e§ malaria* 
which as yet has set appeared 4a the United Statesr 
2. Under existing circumstances, sole dependenct cannot be placed on 
inspection to determine whether an aircraft has on board living insects 
capable of transmitting disease and in consequence in in need of disin- 
sectization. 
(Li :.) Aircraft arriving in the United States, flvaa any place separated 
from it by ocean or sea, or from any place south of middle Mexico., shall 
he dielnsectized hy one of the following methods: immediately prior 
to takeoff from the last airport prior to landing in :,he United States, 
after the crew, passengers, baggage, and cargo have been loaded, and all 
openings closed, {b]. during flight between the last port of departure 
prior to landing in the United States and the airp*»rt of entry, with 
all openings closed and ventilation stopped, or ~'(o). upon landing, with 
all openings closed and ventilation stopped, and tie discharge of 
passengers, crew, baggage or cargo. These provisions will not preclude 
the departure or entry of a person, not a member <>f the flight orev, for 
the purpose of disinsectization or after its accoi plishment, provided 
his entrance or exit is accomplished in a minimum of time. 
“nr Disinsectization will be accomplished by; discharging the 
equivalent of 0.012 pga. of pyrethrins in freon with oil of sesame for 
each 1000 cubic feet of cabin, toilet, baggage compartment, and other 
spaces, to be thoroughly distributed and exposure continued for at least 
on© minute. 
C), An entry shall be made in the Joumoy Book of the air- 
craft certifying over the signature of the pilot tiat disinsectization 
has been performed in accordance with the above specificationg» 
Unless the aircraft has been die insect ized as’ described- above no 
door or hatch shall bo opened on lending and no pernon allowed to depart 
the aircraft without the permission of the quarantine officer, who shall 
prescribe the measures of disinsectization required in his discretion. 
The pilot shall notify the control tower if disinsectization lias not been 
accomplished in accordance with par. J above, and it shall be the duty of 
the tower to so Inform the quarantine officer. 5. No provision of these circulars shall preclude the exercise by 
the quarantine officer of additional measures for the control of Insect 
vectors If deemed necessary In Ms opinion. 
6. Dlbinsect 1 zation will not be required of aircraft arriving la the 
United States, its territories or possessions from the following places 
provided they have not originated In other places, and have not stopped 
at other places en route under conditions favoring the entrance of 
insects Into the plane, or for longer than the time required for 
refueling: 
United States (Mainland) 
Alaska 
Canada and adjacent oreao 
Iceland 
Greenland 
British Isles 
Virgin Island a 
North Mexico 
Bahaioas 
Beramda 
Curacao and Aruba 
Galapagos Islands 
All planes flying Into the Territory of Hawaii will be dieinsect!zed.) 
3* (a?Mroraft arriving at United States a-rports located south of 
V© degrees north latitude from points an the South American mainland 
lying north of 5© degrees south latitude or from any point en th© Afrieaa 
ooatineat will he disinseetisod? without preliminary inspection? immedia- 
tely after the disembarkation of passengers and erow and before baggage? 
merchandise? aad nail arc discharged* 
Whoa th© quarantine officer is informed or has good reason to 
believe that yollov fever is epidemic in an area from which an aircraft 
arrives? he is directed te diainsoetiae all compartments of the aircraft 
before the discharge ©f passengers? crew? baggage? merchandise? end sail* 
He person ether than the quaraatise officer er the inspector who does the 
spraying will he allowed on heard until disinseetisatien is completed? 
and the plane will he kept tightly elesed throughout th© procedure* 
{©) The ease treatment shall he applied te aircraft eeoaing nonstop 
frea Africa or any ethor foreign area which may h© designated by th© 
Surgeon General as dangerous ©a asoeuat of th© presence of exotic insect 
veeters of diseaser 
The spssifieati®aa far disiRseetiaatiea set forth ia Foreign 
Quarantine Bivisiea Gireular Her ?1 will he applied whenever aireraft are 
sprayed for the destruotiea of mosquitoes aad other insects* 
it is net intended that the practice of spraying aircraft ia flight 
he dieeeatiauod* Rather its isgcrtaaee is te he and operators 
of eoEsareiai aireraft shouM ho eaeeuraged te spray thsreughly sa a means 
of safeguarding passengers end flight personnel ea hoard* 
THOMAS PARE AN, 
Surgeon General. Federal. Security Agency 
tJ. S. PUBLIC HEALTH SERVICE 
Washington 
April 27, 194? 
Foreign Quarantine Division Circular No. 78 
To: Medical Officers in Charge, U. S. Quarantine Stations, and 
Others Concerned. 
Subject; Delousing of Infested Passengers and Crew Members 
The formulation of precise directions for delousing infested 
persons is impracticable because of the diversity of facilities at 
various quarantine stations. The extent and efficiency of the proce- 
dures instituted will depend largely upon the type of equipment avail- 
able and the ingenuity of station personnel, especially because some 
of the procedures must be carried out on shipboard. 
1. Inspections. Inspections for the presence of lice and nits 
in hair, clothing, and on the body should be made only under optimum 
conditions of lighting, either natural or artificial. As much privacy 
as can be secured should be afforded the subject. 
?. Infestation. 
(is! Insecticidal Powder, etc. 
The body should be liberally dusted, with DPT powder, 
particularly the axillae and pubic areas. The hair of 
the head should be sprayed with a kerosene aolutlon 
of DDT. 
(b) Bathing, etc.) 
Bead Lica> When nits or lice are found In the hair of the 
head, the kerosene emulsion soap* should be applied liberally and 
rubbed in thoroughly, after which the head should be wrapped in a towel 
arranged In turban style. The vermicide should remain for 15 to 30 
minutes and be followed by a rinse during which the resulting lather Is 
slowly massaged into the hair. Kits should be removed with a fine- 
toothed comb. Further rinses should be used to remove the remaining 
lather. 
In cases of heavy Infestation, the hair of the tody and 
head, except eyebrows, should be clipped close, but the subject’s per- 
mission must be secured before this measure is undertaken. * When eyebrows are Infested, the emulsion should bo mas- 
saged. into the brows with the forefinger. The eyes should be protected 
from the vermicide by binding pads of cotton over the eyes during the 
period of application. 
These procedures usually destroy or eliminate head lice 
and a large proportion of nits. When continued observation is required 
and reinspection is possible, the process should be repeated daily until 
complete disinfestation is accomplished. 
Pubic Lice. Lice in pubic or axillary regions should be 
removed by shaving the hair, followed by the free us© of kerosene 
emulsion soap over the area. 
Body Lice. The subject should be bathed, using kerosene 
emulsion soap freely, and, if necessary, repeatedly, after thorough 
rinsing. 
emulsion soap for vermlcidal use. This la prepared by boiling 
one part of soap in four parts of water and then adding two parts of ker- 
osene. The resulting Jelly, when mixed with four parts of water, makes 
a 3.iquid soap of effective vermlcidal qualities. 
5. Infested Clothing. For destruction of lice in clothing, special 
procedures are required, these depending upon the resources of the sta- 
tion at which the work is to be done. 
When apparatus fer steam disinfectlea of elething is available, 
this should senstitute the method ©£ ehelee. In the abeenee ef sush 
equipment, it may be pessibi© to arrange with leeai authorities fsr the 
use ©f apparatus ia a hospital or muaieipal disinfecting plant. 
Methods of disinfesting clothing: 
((a) Dusting with DDT powder. 
(b) Fumigation with methyl bromide. Special chambers or 
bags are required. The amount a of fumigant used must 
be adjusted to time and temperature. ) 
(c) Live steam under pressure, (Warning; Articles of 
or containing leather or rubber are often damaged 
or destroyed by steam disinfesting. Those and 
other articles likely to bo damaged should be 
treated otherwise.) 
(d) Bolling* for five minutes, of articles of apparel not 
susceptible of damage by moist beat. (e) Immersion in water-whits kerosene for 10 minutes. 
[t) lienors ion in 5$ compound creool solution for 30 
minutes. 
(g) Fumigation with chloropicrln, using a concentra- 
tion of 12 ounces to 1000 cubic feet of space for 
a period of one hour, the temperature being not 
less than 70 degrees Fahrenheit. 
(h) Fumigation with hydrocyanic acid gas, using a con- 
centration of 6 ounces to 1000 cubic feet of space 
for a period of on© hour. 
Special notes regarding fumigation: 
Suitable safeguards should surround fumigations. Effi- 
cient gas masks should bo worn by fumigators. Rubber 
gloves should bo worn when handling chloropicrln. 
Fumigations should bo performed on shore whan suitab 
equipment is available. It may be necessary to prepare 
a special leakproof room* box or receptacle in which 
the clothing may be hung while undergoing fumigation. 
Clothing accepted for fumigation should be suitably iden- 
tified so that it may be returned to the proper owner. 
Fumigated clothing should be thoroughly aerated and 
shaken to disperse gas before articles are returned to 
the owners. In cold weather the application of heat will 
expedite removal of gas. 
In the absence of facility©© for carrying out the steps da 
ses&bedy ©3? t® ppovsat la£sst&tieB eubssqueatlyy dusting pewders are 
seastfcass used* 9f these the SfrG-lv pewdePy 0©ntaining-e©snarei&l 
napktkai®sar 9t gBSry sreosetey 3 eery and idefermy 2 gESr- ie tka 
sjsst vtdely known j- hut pewdap — ereesatey 1 eerf sulphury 9r5 
gm*.r and tal®y 20 — is lees irritating and is said ts he Bis 
times as effestivar 
Respectfully, 
THOMAS PARE AN 
Surgeon General 
CVA:5LN 
(lW?) April 21, 19^3 
Foreign Quarantine Division Circular No, 83 
To: Medical Officers in Charge, U. S. Quarantine Stations and 
Others Concerned. 
Subject; Bills of health issued by Army or Navy port authorities 
1. The security of American lives and American vessels has 
made it necessary that certain functions, exercised hy the Depart 
ment of State in peace times, he exercised hy American mili- 
tary authorities under the present war conditions. Particularly 
la this true in certain porta of Africa in carrying out the pro- 
visions of Section 2 of the Act of February 15* 1893* as amended 
by Act of February 27* 1921* reading in part as follows: 
, "Sec. 2. That any vessel at any foreign port 
clearing or departing for any port or place in the 
United States or its possessions or other depend- 
encies of any vessel at any port in the possessions 
or other dependencies of the United States clearing 
or departing for any port or place In the United 
States or its possessions or other dependencies 
shall he required to obtain from the consul, vice 
consul, or other consular officer of the United 
States at the port of departure, or from the medi- 
cal officer where such officer has been detailed 
by the President for that purpose, a bill of health 
in duplicate, in the form prescribed by the Secre- 
tary of the Treasury, setting forth the sanitary 
history and condition of said vessel and that it 
has in all respects complied with the rules and 
regulations in such cases prescribed for securing 
the best sanitary condition of the said vessel, 
its cargo, passengers, and crew; and said consular 
or medical officer is required, before granting 
such duplicate bill of health, to be satisfied 
that the matters and things therein stated are 
true; and for his services In that behalf he shall 
bo entitled to demand and receive such fees as 
shall by lawful regulation be allowed, to be ac- 
counted for as is required in other cases." 2. T2i© President, as Caesaander in Chief of the military 
forces, has detailed officers to the foreign ports in question 
to prosecute the war effort completely. Therefore, if th© 
security of American vessels under war conditions demands that 
certain functions be relinquished by the'Department of State 
and bo exercised by th© Anay or Navy port authoritleo, this 
would appeal' to be a reasonable and substantial compliance 
with th© statute involved. 
3. The State Department concurs in this procedure in letter 
of March 17, 1S&5> in the following language; 
"Since the arrangements made at Casablanca were 
made with a viev to the security of American vessels 
under war conditions, the State Department perceives 
no objection to the continuance of such emergency 
security measures at Casablanca and other ports where 
similar procedure may later be followed, provided 
that the United States Public Health Regulations 
are otherwise complied with by the Army medical of- 
ficer countersigning the bill of health issued by 
the army port authority." 
The Federal Security Agency concurs in the procedure 
as entered into for the period of the emergency by the mili- 
tary authorities and the Department of State, and it ia di- 
rected that bills of health signed or countersigned by medical 
officers of th© United States Army or United States Navy and 
otherwise in correct form, be accepted at ports of entry in 
th© United States by quarantine officers. Collectors of Customs, 
and others concerned. 
(Sgd) THOMAS PARRAN 
Surgeon General 
United States Public Health Service 
APPROVED; 
(Sgd) PAUL V. McNUTT 
Admlni strator 
Federal Security Agency 
BGEibh Federal Sesarity Age-iey 
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T©i Medieal ©&iesar« 4a Skayge? 9i S? Omyantia© Stetieas ead 
Otkosfs 86fte©ya©d-s 
Bills a* koaltk iseaed fey Ayay ey j>eyt aatkayitiesi 
F©3rc4@fi Pivieiea Siyealay Se-s §5*s dated Apyil £1? 
autkosfisiag acceptance ©# Mlle-er kealtk tfkea signed ©y 
eettateysigaed fey sedleal ei#ie©ys-ef tk© *3kit©t States Assay ©y 
Baited States Nnyy? is feeysfey yeveked’j S?k© PepaytaseHt ef State 
has sfeeesasaded this aetieas 
V, P, mAPER 
Aetisg S«Fgeea SeaeFal 
-felled Stats© Fafelie Sealtfe Searcies 
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HA9B8K Bt IS2&SR 
A«tlsag Adaiaistratesr 
Federal Ageaey Federal Security Agency 
U. S. PUBLIC HEALTH SERVICE; 
Washington 
(Bathesda Station) 
October k, 19^3 
Foreign Quarantine Division Circular No. 85 
To: Medical Officers in Charge, TJ. S. Quarantine Stations and 
Others Concerned. 
Subject; Treatment of vessels carrying prisoners of war or other 
persons from ports or places Known or suspected of having 
typhus. v 
During the war emergency, and because of that emergency, 
it has become necessary to adopt certain measures to prevent the 
importation of exanthematous typhus into this country. As a result 
of a conference held with appropriate officials of the Office of 
The Surgeon General of the U. S. Army and of the War Shipping 
Administration, the following procedure will bo adopted at all 
Quarantine Stations; 
At the port of arrival, any vessels carrying prisoners of 
war or other persons from a port or place Known or suspected of ha- 
ving typhus is to bo considered potentially louse-infested and. is 
to bo issued a provisional pratique. The provisional pratique must 
require that the compartments utilized for quarters by the prison- ‘ 
era of war or other persons louse-infested or potentially louse- 
infested are to be mechanically or otherwise doloueed, utilizing 
fumigation with lethal gases only if especially indicated. At ports 
of final clearance, vessels arriving under provisional pratique 
because of the necessity for dolousing procedures will not be 
cleared until certification from the War Shipping Administration, 
the Army or Havy, has been received that the provisions of the 
provisional pratique have been complied with. 
THOMAS PARR AN 
Surgeon General 
United States Pub3.ic Health 
Service mnmm states /gag.. 
AR-30-1820(15 Hov.,19^3) 
Ho change© reccigmendsd. 
AR U0-205(31 Dec.,19^2)(incl. C 1,C 2) 
Par. 21 b. (1)- Add sub-paragraph (f) ,fUBe of insecti- 
cides." 
Par. 25, line J, delete "and" 
lino 8, enclose "Verruga Peruviana" in paren- 
theses. 
Par. 28 FGCoEEond expansion of this paragraph to 
include methods of rodent control, or reference 
to proper source of information. 
AB 1*0-210(15 Sept., (Incl. C 1 to 8) 
Par. 2 e.Substitute as follows "Quarantine.-By quaran- 
tine is meant the limitation of freedom of 
movement of persons or animals who have been 
exposed to cocaunicable disease for a period 
of time equal to the longest usual incubation 
period of tho disease to which they have been 
©sposed." 
Par. 7 o-Insert after "patients", a cokes and "carriers" 
Par.10 b.(3) Ho change is recommended, but note is made 
of variation frcsi Navy practice. 
c.(l) Ho change is recommended, but note is made 
that Navy regulations require vaccination to be> 
repeated ©very four years. 
(2) as revised by C 6-Ho change is recommended, 
but note is made that Navy regulations require 
that after one standard course of vaccine a 
booster dose of O.lcc. bo administered Intra- 
cutanoously yearly. 
Par.18 a.(3) Insert after "endemic" the words "and/or 
epidemic”. 
Par.20 a. (l) line 2 Delete "and"; change period to ocwa, 
and add "lethal tesrperatures, and dry storage". 
Par.30 Add "In areas where hydatid disease is prevalent, 
stray doge should bo excluded from stations, ana 
troops warned against handling them. Official, 
dogs and pets should not b© allowed to eat 
unauthorised food". 
Par.tl Delot© "to the control of flies, to the disin- 
fection of minor wounds and abrasions of the 
©kin, and". 
AH 1*0-270(21 April,1923) and C 1(22 Pec.,1923) 
Par. 2 a. (l) Add " (l) Make special note and report on 
measures concerned with internationally quaran- 
tlnabl© diseases at stations receiving interna- 
tional traffic.” b.Ada 1 (9) Haho special note and report on 
measures concerned with internationally quaran- 
tillable diseases at stations receiving inter- 
national traffic." 
AR Bov.,1952) 
Bar. l.c.(7) Add " including report on measures concerned 
with internationally quarantinable diseases at 
stations receiving international traffic." 
AR Dec., (led. C l) 
Par.37 a.Insert after "cholera*1 the word "smallpox". 
Par.38 Lino 6 After "importance", insert n or if it 
includes plague, cholera, epidemic typhus, 
aaallpox, or yellow fever," 
AR Spot.19^2) 
Bo changes recommended. 
AR 55-16M 5 Dec.,19^2) 
Add 
"SECTION 17 
TRANSPORTATION OF OTHER ANIMALS, INCLUDING BIRDS 
The liars and regulations of any country, state, or 
territory regarding the Importation and transportation 
of animls, including birds end animals for experi- 
mental use, will do complied with, and In addition per- 
mit for the transportation of animals for experimental 
us© will ho secured before shipsssnt, from the proper 
authority upon request addressed to The Surgeon General. 
Request for permit will show the species and number of 
animals, type of cage, source, destination and purpose 
for which intended, and the nature of any abnoimiality 
including any innoculations with organisms which aro 
pathogenic. 
Regulations of the United States pertinent to th© 
transportation of animals are issued as follows: for* 
psittacine birds, the U.S.Public Health Service, requiring 
prior permit 1 for other wild anlsslc, by the Fish and Wild- 
life Service of the Dept, of th© Interior, requiring prior 
pezalt; for swine, ruminant end equine animals, the Bur. 
of Aniisal Industry, U. S. Dept. Agriculture, requiring 
©ntrsaco permit. Animals Imported contrary to those 
regulations are subject to seizure and to destruction or 
to return at expense of the owner. 
Although otherwise permissible under these provisions, 
the transportation of any anliaal (except as above pro- 
vided) by military conveyance will not be undertaken 
without a certificate frea a veterinary officer, or 
approved veterinarian, certifying the freedom of the ani ** 
sgil from disease. AR 55-350(14 Sept., 1942) 
So changes reccssasnded. 
AR 55-410(6 Oct.,1942) 
Ho changes recommended. 
AR 55-455( 1 Sept.,1942) 
So changes recoaaaanded. 
AR 55-445(19 Sept.1942) 
Ho changes recommended. 
AR 95-15(3 May,1944) 
No changes recommended. 
AR 500-50(5 April,1937) 
Section II Par,4.f(6) Change "Secretary of the Treasury” 
to "Administrator of the Federal Security 
Agency’5. 
AR 615-250(24 July,1942) 
Ho changes recommended, 
WD. General Orders Ho.4 (5 May,1941) 
Sect.I? Bo changes recoisaendad. 
W.D,Circular Ho. ?8(l6 March,1942) 
Sect.17 Substitute "as revised" for "February 11,1942" 
Ho.276(1 Bov.,1943) 
Ro changes reccssmsnded, except those which have been 
suggested in references. 
No.164(26 April,1944) 
No changes recojsoended. 
W.D.Memorandum Ho. w850-44(5 April,1944) 
Ho changes recosasended. 
W.D.AGO MsEorandua Ho.V40-7-43(ll Feb.,1943) 
Ho changes reccssaonded except as may be required following 
revision of SCO Circular Ltr. Ho. 3-62. 
W.D. ASF Memorsndma Ho, 840-10-43(19 June, 1943) 
Ho changes reccaaeonded. 
Ho. ¥40-16-43(5 July,1943) 
Par. 1, line 2 Delete "grave”. 
Par. 2, line 2 Following "where* insert "louse-bourne. 
Radiogram,AG 720-3(30 Oct.,1945)aB-S(COHTIDSHTIAL) 
Two minor changes, noted on file copy o? radiogrem. W,3)., TB I® 2 (3 January,19^4} 
No changes rec emended. 
W.D., TB mD lh{3 March, 19^0 
Ho changes recommended. 
W.D.,S.G.O.,Circular Ltr. No,22(i6 January, 19^3) 
Par. 6 c Change "1 percent pyrethrins” percent 
pyrethrlne" 
Par. 12 Socaaaend this section be followed by reference 
to W.D,,TB MSD lk(3 March,19kk) 
Circular Ltr. No.53(2 Bsf.,19^5) 
Par.2.f.(k) Add "Sulpha"drugs. 
g. Add to first sentence "end carriers". 
Insert a period after "flies" in second sentence, 
and delete "and quarantine". Thereafter insert 
"The patient should be isolated, protected from 
flies, and those exposed to infection should be 
quarantined for five days from the last exposure 
unless previously imaunlzed." 
After word "endemic" in first sentence of second 
unnumbered paragraph insert "end epidemic". 
5-c. TJoo lower case for "aegypti", and after 
"Philipinos", insert "Territory of Hawaii". In 
third sentence, change "became" to "become". 
?ar.9»b. After "Uhited States" Insert "in the past", 
g. Second sentence, following "depends", insert 
"chiefly upon not living in proximity to infected 
natives, and also ", 
Par.12.g.After the word "excreta” insert "particularly of 
natives." 
Par. 13. g.Delete "native" and substitute " natives and 
their " 
Par.18 Substitute "Bartoaellosis" for"Oroya Fever". This 
will change paragraph msabsre. 
Par.20,c.(3) Preceding "plague" insert "pneumonic"; delete 
"on" and substitute "end that cases of bubonic 
plague may spread infection" 
g. (2),(b).Following "squill" insert " or other 
suitable poisons", and preceding "methyl” insert 
"sulphur dioxide". 
(c) Preceding the last sentence insert "Examine 
particularly all rats found dead from no obvious 
causeV 
(e) Change third sentence to read "Trap and 
poison rats intensively in all areas suspected of 
infestation, and follow at once with ratprooflag 
and destruction of rat harborages." 
h. Delete In first sentence all words following 
"is" and first three words of second sentence; 
insert after "disease", "caused by B. psstis”. 
Par.23.c.Insert "New Guinea, and Southwest Pacific Area" 
following "Sumatra", 
Par.2k.g.(l).(e) Delete “seven to ten days" and {substitute "two to four weeks,, or whenever th© clothing is 
washed,n Add "Clothes impregnated with 
emulsion will remain louse-free for eight wooko 
ovon though washed". Add 
"(f) Dry storage for a minimum of 21 days at ordinary 
temperatures." 
(2) Reccsmend present provisions of this paragraph 
bo made alternative to spraying the head with a 
solution of DDT and dusting the clothes and body 
with DDT powder. 
(5) Delete last sentence. 
(U) No changes racomended, but note is made of 
variation from Navy practice. 
Far.25.g.(l) Insert after "rats", "and rat fleas” and 
delete "and", and add "and fumigation" in first 
sentence. 
Par.31.f. {3) Add the following sentence "Chlorination of 
water to afford 0,2 ppm residual free chlorine for 
30 min. will also be effective." 
Par,52.g.Add 
,:(*0 Streams and zones bordering them within 60 
yards should be avoided during daylight hours." 
Par.55.c.Insert "(kissing)" after "cone-nosed". 
Bar,38.c.Substitute "Uncertain, possibly including "for 
"Dy°. 
g.In second sentence, begin with the word "Cases", 
and insert " rarely" after this word. 
second sentence. Insert "sparsely", after "be51. 
g.(l) In second sentence. Insert "or epidemic” after 
"endemic". 
(3) (c) Chang© "ten” to "six". 
(d) Change "A.aegypti infected" to "Infected 
A. aogypti". 
(g) Second unnumbered paragraph. Change be- 
ginning of third sentence to read "Diesel 
oil No. 2 or its equivalent, or DDT ". . 
W.D.,S,a.O. Circular Ltr, No.111(5 «Tune,19^3) 
No changes recommended. 
N.D.,S.G«0. Circular Ltr. No. 162(28 Nov.,19^2) 
This letter is under revision at present, and hence no 
reco3ssiondationa are made other than those offered 
directly to the revlsors. 
H.D,,0.C.T,,T.C.Circular No.35-7(1 January,l<M) 
Ihclosure 1. Par.l.b.(2) No changes recossaended, but atten- 
tion is called to pending revision of technic due to us© 
of DDT. 
(k) Insert after "steam" or other 
approved methods". 
55 Appendix* 
Section l(l) Change second sentence to read "In 
the usual doloueing procedure* the first say be 
dona by fumigation with methyl bromide gas* 
storage* heat* or DDT* and the second may be done 
by dusting with DDF powder and by spraying the 
head with a special DDT solution". 
(2) Delete entire paragraph. 
(3) Change last sentence to read ”Tho 
louse spray is obtainable upon requisition from 
the quartermaster,” Add "Dusting with DDT powder 
is accomplished by powder blowers with nozzle 
inserted into sleeves* collar* and trouser lege.” 
(4) Substitute "the head,” for "all hair?; 
parts of the body.” Delete fourth and fifth 
sentences. 
Section II(5). Md "or dry storage at ordinary 
temperatures for 21 days. Dusting with DDT may also 
be utilized* provided that contact is maintained 
with the agent for two weeks." 
AAF Rog. No. 25-9(28 July*1942) 
Par.l. Insert "typhus” after "smallpox", and delete para- 
graph after the word "tetanus”* substituting 
therefore " in accordance with S.G.O. Circular 
Ltr. 162 is amended.” 
AAF Reg. No. 55~l8(7 Feb.*1944) 
No changes recommended. 
AAF Reg. Ho. 6l-3(4 Oct.*1943) 
Rscoiaaend complete revision of this regulation. App. Item 20, 
AAF Memorandum Ho. 42(15 -January*1942) 
Ho changes recommended, 
Ltr.* Headquarters * AAF* Air Surgeon’s Office*28 Nov..1942*Subject: Medical 
No changes recommended. 
ATC Regulation Ho,£5-4(31 Aug.*1943) end Ho.25-4a(13 March*1944) 
Section I 
Par.l. Insert after the word "are”* "ssntal and 
physical fitness in accordance with proscribed standards 
including”. 
Par.2.a. Add "except that certification of fit- 
ness issued by a naval medical officer for naval personnel 
may b© accepted in lieu of examination by a Medical Corps 
officer,." Section II 
Ho changes recornmonded except aa my b© required 
following revision of 5G0 Circular Ltr. No. 162. 
Ho.25-4A 
Delete. 
ATC Regulation Ho. 25-7(11 Jan.,192^) 
Par.5*f« Delete "bedbugs". 
57 TOIiED STAFFS NAVY. 
tf.S.N&vy Regulations 
Chapter Section 1 
No changes rocoiaaonded. 
Chapter 52, Section 1, Art.1133 
No changes recommended. 
Art.1152 
No changes reccvamended. 
Art.11?2 
No changes recommended. 
General Orders 
Ho, 29 
No changes reconsaondod. 
Ifo.157 
No changes roconaaencod. 
No.162 
No changes recommended. 
Ho.199 
No changes rocosanondod. 
Manual of Medical Department 
Chapter 17, par. 260*1- 
No changes rocoisaended 
par. 2605 
No changes recoramonded 
par. 2606 
Should conform with Bulled Fori*. Ltr. 
No. 6(25 July, 19^1) 
par.2613 (d) 
Add information contained in Butod 
Ltr. No. 7 
(f) 
Add Information contained in Bul& 
Circ. Ltr. (26 Dec., 19& 
(a),(b),(c) 
M,ls) 
Ho changes recosmonded. 
par, 
No changes recossaendod. 
par. 2675 
No changes recoa©ended. 
par. 2680 
No changes recomondod. 
par. 269k 
No changes reconaEonded. 
Chapter 18 
This chapter deals primarily with 
quarantine, hills of health, and disinfection. The regu- 
lations eontined therein are based on the Code of Regula- 
tions of the TJ.S. Public Health Service at the time of 
preparation of tho Manual. Since then a number of changes 
have been made in the Code, and a special committee of the 
U.S. Public Health Service is now preparing further revisions. 
58 Hence it in suggested no reviewer, cf chapter ha 
made until the Cod© has teen published. 
par. 2b'$k Should ho changed to confers to 
rocomnondations contained in Apr. 
Item 20. 
par. 2865 Should include reference to us© of 
Discoids. 
par. 2886 Should Include reference to aerosol- 
pyrothnzm boerhe. 
par- 2884 and remain 
Ing paragraphs 
Should contain reference to the uoe of 
©ethyl hrooido, DOT, and storage. 
Navy Dept. Bulletins 
43-1616 
Recommended substitution of "Form for Quarantine Report1*, 
Appendix Item 19. 
43-1617 
Annex (E) 
Roconanond 0onformance with naw international standard on 
yellow fever vaccine, which considers valid laraunlty to 
©xtond Prom 10 days to 4 years after vaccination. 
Typhoid i-jaminlzatjon: 00© paragraph 3j> Final. Report. Pert III 
Tetanus ismmlzntion: ee© paragraph 3, Final Report. Fart III 
42-2055 
No change© reccsmondod, hut note is ssado that this bulletin 
furnishes an except ion to T7, S. Public Health Service, 
Foreign Quarantine Division Circular Ho. 32. Pcoomond 
official clearance with United States Public Health Service. 
45-2039 
No changes reccmmeaded, hut noto is made that U.S,Public 
Health Service, Foreign Quarantine Division Circular Ho* 85 
which enabled those provisions has been reacinded. The 
Secretary of Navy has requested tho re sc i salon ho rescinded. 
43-1570 
It is rocoianendod that 10 days ho substituted for 14 days 
and 4 years for 2 years. 
43-29 
No changes recommended. 
43-399 
No change© reoaaaended. 
41-2027 
When re-issued, reoowsend inclusion of time factors for 
validity of yellow fever immunization as reccaaaosndod for 
Navy Bulletin 45-1570, 
41-2029 
Ho changes reccESsendod. Note la ?aade that this regulation 
requires Introcutanoous booster doses in contrast to th© 
Ara?y suheutanoous administration. 
59 *{■1-2030 Ho changes roc amended. 
12-208? Ho chargee roooio^ndod. 
12-2089 Ho changes recoasaended. 
*♦2-2090 Recommend complete revision in accordance with App. Itom 20, 
*♦2-51 Ho changes recommended, 
12- 5 Ho changes roccaaaended. 
*♦3-111 Ho changes recommended. It is assumed that DDT will be 
substituted for the Insecticide referred to in the text. 
Recommend modification of statement In last sentence of 
par. 3 to road. "—when in the opinion of The Burgoon General 
it is deemed advisable.” 
13- No changes recommended. Rote io made that this regulation 
requires a two dose vaccination, and booster doses on 
special occasions only, whereas the Army regulation requires 
three immunising doses, a booster dose at the end of one 
year, and doses on special occasions. 
13-1512 Ho changes recommended. 
I3-HI? Ho changes recommended. 
11-93 Rote is made that vessels having pharmacist's mate aboard 
are authorised to request and under proper circumstances 
be granted pratique, in conflict with Code of Regulations, 
U.S.Public Health Service, and Foreign Quarantine Division 
Circular Ho. 32. Further note is made that no provision 
is specified for the quarantine processing of naval vessels 
which carry neither medical officer nor pharmacist mate, 
nor for those from ports which have had quarantinable 
diseases present. 
II-53I Ho chongoe reccsamsended except that in (d) "ll days” should 
be changed to ”3.0 days” and ”2 years” should be changed to 
”1 years”. Minor differences In thee© regulations and 
those of th© Army ere noted. 
ll-$65 Ho changes recommended. 
BuMed Hews Letter, 1911. Prophylaxlc lenauni sat lone Required in TLS.Havy 
Note is nsx<i& that certain requirements of this publication dlffo: 
from those of the Army as noted in above references. 
60 Fotes on Tropical and Exotic Diseases of naval Importance, flavaJ. Med 
E EMi " 
p 15 "and Territory of Hawaii" should he sdded after "Phil- 
lipine# In 9th line. 
50 Add, at bottom of page, "Insecticidal Powder—An approved 
powder is available, and may be dusted into the seems of 
clothing every tvo to four weeks providing the clothing Is 
net laundered, not only as a delouslng measure, but as a 
prophylactic against infestation. Clothing impregnated 
with a Vfc, solution of WT will remain lousefroe for 6 weeks, 
even though washed. 
"Pry Storage—a minimum of 21 days, at ordinary 
temperatures." 
31 Line 1, add following tho dash "Spray head with approved 
solution, and apply PET powder to body, if available, or-” 
Line 10, change nlkn to ”12". 
52 Line 71 add, after "rats", and their f3.eas", and after 
"ratproof3 ng", add "and fumigation." 
35 Line 6, after "Queensland" add "Hew Guinea and Southwest 
Pacific Area." 
59 After line add " The patient should te isolated and 
protected from flies, and those exposed to infection should 
bo quarantined for five days from the last exposure unless 
previously immunized." 
Lin© 8, change "10" to "6". 
Line 11, transfer the word "infected" to the preceding 
line after the word "tho". 
Line 31, substitute "Pelsel oil #2 or its equivalent", or 
POT" for "Fuel oil". 
43 Par.2(a) Lino 2, after "trap" insert "and poison extensively", 
and delete "ffcom focus of infection outward until no more 
plague infection Is found" and substitute "In all areas 
suspected of infection". 
Line 3, delete "then trap and poison from periphery to 
center, and-" 
53 Tinder "Prevention", insert after "oxcreta","particularly 
of the natives”, and after " materials” insert "earth, 
otc." 
57 Add to lost par., "Chlorination of water, maintaining a 
residual of 0,2 parts froo chlorine per million parts for 
30 nln., will also bo effective". 
61 6l Add to Par. 2, under "Prevention" "streams and zones 
within 60 yards of them should be avoided during daylight 
hours." 
64 Par.3, under "Prevention” insert "natives and-" after 
"with". 
75 Lino 16, change "By" to read "Uncertain, possibly 
including-" 
?6 Under "Prevention and Control", add "Cases have rarely 
been reported in persons of the white race". 
A Manual of Naval Hygiene, Medical Department, U.S .Navy, Chap tarXIV 
SPECIFIC MEASURES FOR DISEASE PREVENTION ON BOARD SHIP. 
No changes recommended, except in regard to immunizations 
as already noted above with reference to differences from 
Army practice, and except the change of "14" days to "12” 
days for quarantine against typhus fever. 
Medical Comp end for Cocaaonders of Naval Vessels, 19^2 
The section on Quarantine, Chapter 9, is based on the 
Cod© of Regulations of the IT.S.Public Health Service at 
the tiis© of publication of the compand. Sine© then Gomo 
changes of a minor nature have been mad© in the cod© and 
a special committee of the U.S.Public Health Service is 
at the present time studying further revisions. It is 
therefore suggested no revision of this chapter be made 
until the revised code has been adopted. 
Attention is directed to more recent quarantine requir- 
msnts in the Navy, to the use of pyrethrum for disin- 
sectization, and to DDT insect powder. 
62 INTERDEPARTMENTAL QUARANTINE COMMISSION 
Final Report - Part IV 
Thin section consists of a list of Items and significant corres- 
pondence collected by the Commission and placed on deposit with the 
Division of Foreign Quarantine, United States Public Health Service 
Some Items classified as CONFIDENTIAL and SECRET have been Indexed 
and have been deposited with the United States Army, Office of The 
Surgeon General, The file of the material as a whole has been 
classified as RESTRICTED. 
10 June 19M LIST OF IT:-j;s COLLECriO BY THE IHT>BT)iJJAB.TnKSTAL QUARANTINE COMISSION 
AND DEPOSITED WITH THE UNITED STATES PUBLIC HEALTH SERVICE 
(CONFIDENTIAL and SECRET matter has been deposited with the United 
States Ax»my, Office of the Surgeon General ) 
Item 
Aden, Instructions to vessels 
Quarantine measures 
Tellow fever regulations , • i 
Aedec aegyptl, Panama ♦ • • 36l 
Aerial navigation, Gold Coast 155 
Supplement to convention *X)0 
Air, certificates of quarantine, Australis 14 
Aircraft, disinsectization,. India ... 134 
India, rules 192 
Insects, Hawaii 175 
Regulations, Anglo -Egyptian S udan 8 
Miami 327 
Spraying, Gold Coast 155 
Airport, Pallsadoea, Jamaica ..— 272 
Airports of entry • 451 
Air transport of insects, Whitfield 338 
Algiers, committee on epidemiology «. •. • — 4 
Oran, quarantine forms .. 5 
Port quarantine «« - 5 
Anglo-Egyptian Sudan, conventions, laws and sanitary regulations .. 
Quarantine matters, aircraft regulation 
Anopheles darling! 222 
Central America • 2?6 
Hondura s . 88# 185 
Anopheles gamblae 18, 39 
Anopheles, Mexico 315 
Mosquitoes 524 
Anophelene mosquitoes, prevention dissemination (C) 437 
Anti-mosquite measures, U, S. America in Far East ................. 439 
Appointment, Acting Assistant Surgeon 45? 
Argentina, Consular request for health reports 
Army airfields, Miami * 329 
Australia, certificates (air navigation) regulations ••<>••••••••.•• 14 
Forms, quarantine • 15 
Form for vaccination * * 11 
Health organization in ports 10 
Instructions regarding military craft a- • — 17 
Instructions for troop transports and hospital ships • 16 
International hygiene, 1935 o 0 13 
Malaria control in U. So Army, 12 Jan 1343 9 *.«•. ....... -....... 12 
Quarantine regulations o * • • • * • 44.0 
Bill of Health, airplane, Iran «,<,». 334 
British . 61 
Morocco (C) — 343 
New Caledonia * 344 Nicaragua .. -... 355, 356 
Salvador .. 383 
Sicily • 385 
Uo So America 514 
Uo S, Public Health Service .. 501 
Brasil, African inspectors 43 
Agreement of Brazil and U« S. Army (C) ... 32 
Anopheles gambiae, 5 Nov 1943 o<>. 44 
Army to Dunnahoo, control in Brazil (C) «. * 30 
Concerning fumigation of airplanes 22 
Conference, 6 Nov 1943, Anopheles gambiae control 
Correspondencef Anopheles gambiae (S) and (C) 33 
Correspondence from Rockefeller Foundation, insects in planes «> 48 
Decree N. 2.538, quarantine of ships* 30 Aug 1940 , 5? 
Decreto K0 3.010, immigration laws, 1938 53 
Decree N„ 5,181, airplane disinsectization 21 
Directives, disinsectization, U« S* Army 52 
Disinsectization of aircraft from Grady. (S) «... 24 
Disinsectization, of Army aircraft, arriving in Brazil 35 
Standard procedures 3? 
Ships 
Form, insects on aircraft 25 
Forms, quarantine 58 
Insect recoveries from planes 42 
Letter, Dunnahoo to Archibald, 9 Dec 1943 49 
Kirk to Parran 30 Oct 1943, .Anopheles gambiae .. 40 
Knies to Magath 10 Kov 1943 (5) 533 
Knies to Walsh 10 Nov 1943 
Leone, disinsectization, 2 Sep 1943 2? 
Leone to Surgeon General 9 Jan 1944 «.... 51 
Mendonca to General Dunham 21 Jul 1943 (S) 26 
Moore to Gilliland 26 Sep 1943 (C) ... 28 
Parran to Barreto 13 Dec 1943 . 
Parran to Kirk, Anopheles gambiae, 7 Oct 1943 . 39 
Sawyer to Parran, 13 Nov 1945 46 
Letters, between Sec8y State-Sec !y War, Anopheles gambiae (C) « 29 
Taylor, Sawyer and State Dep*t„, Anopheles gambiae 41 
Saylor, Sawyer and Kirk Oct 1943 38 
Taylor, Sawyer and Leone, 14 Sep 1943 - 13 Sep 1943 34 
Walsh, Adams and Kerr (S ) 25 
Memo, from Lundeberg, 26 Oct 1943 19 
Mendonca*e report, trip to Northeast Brazil and Africa 31 
Order to dlslnsectlze Export planes 47 
Proposed agreement, aviation, 4 Star 1944 56 
Quarantine regulations, 1942 55 
Recent legislation, sanitary laws, 1931-1942 54 
Second interim report, I Q C, remarks (C) 59 
Unpublished draft of second interim report, I Q G 20 
British air forces, yellow fever control 80 
British Isles form, bill of health «.......... 61 
Influenza (C) 52 British Vilest Indian Islands, quarantine conference, 1943 65 
Barbados, Aug 1942 
Conference report, 15 Nov 1943 
Draft ordinance . . 
First schedule, quarantine maritime traffic 69 
Note, Item 3 agenda ... 75 
Ordinance, quarantine and similar matters .. . 
Schedule amendments . 
Air regulations , 73 
MaratIme regulations 72 
Second schedule, quarantine aircraft. 1944 70 
British West Indies, medical-sanitary data, Lesser Antilles * 64 
quarantine ordinance, 1940 63 
Brucellosis, Mexico 323 
Canada, an act respecting quarantine * 77 
quarantine regulations, Dec 1928 75 
Report, figures on health of seamen, 23 Nov 1943 
Certificates, quarantine Australia 14 
Chile, forms, quarantine 81 
La Bata, Educacion Sanitaria, 1942 80 
Profilaxis Sanitaria Internncional, 1938 79 
quarterly report, 1943 82 
Report, No. 132, regulations quarantine 
Cholera vaccine . 217 
Code, of sanitation, Guatemala * 162 
Sanitary, Honduras 162 
U. S. Public Health Service, suggested changes 517 
Colombia, regulations quarantine 84 
Comite d’hyglene et d*epidemiologic, Algiers, Apr 1944 ..... 4 
Commercial air lines, letter disinsectization, yellow fever zone • 
Mexican border , * * 86 
Consular requests for reports, Argentina 
Co-ordinator Inter-American affaire, A. darlingl, malaria 87, 88 
Costa Rica, medical and sanitary data on Costa Sica, July 1943 .,<> 
Sanitary code, projected revisions, Sept 1943 89 
Cuba, despatch to Secretary of State, visit I q C 94 
Form, Air service 
quarantine regulations, Apr 1944 91 
Regulation civil aviation 92 
Summary medical and sanitary data for Cuba by U„ S* Ariqy 95 
DDT, report on 245, 289, 305 
U. S. Army 425 
Dengue in Hawaii . 313 
Deratization report, Ecuador 134 
Disinfecting aircraft. Gold Coast 158 
Disinsectization 85 
Africa (®) * 477 
Aircraft 4?0 
India 194 
Puerto Rico 379 
Brazil * • 21 Ships. Brazil 36 
Discharge, malaria patients 442 
Dominican Republic, articles 65-75 on sanitation ....... 99 
Letter L, F. Thomen, articles 377-414 on sanitation .coo. 100 
Letters "between Thomen and Dunnahoo, copy sanitary legislation. 98 
Medical and sanitary data on Dominican Republic. XL S, Army 101 
Sanidad y asistencia publlca, 1944 S6 
Status quarantine work In Dominican Republic (C) «e * 9? 
Dunnahoo, cablegram from Surgeon General and interim report 123 
Confidential comment on report, Siraraons (C) «.o.c« 122 
Draft model quarantine ordinance, Trinidad Conference „117 
First interim report of I Q, C «... • - 105 
Letter, appointment, 2 Aug 1943 102 
Bodet, with second interim report, 22 Oct 1943 Ill 
From Parran to Dunnahoo, 2 Aug 1943 103 
Long, 2 Oct 1943 108 
Parraii, 8 Nov 1943, conference in Recife .« 119 
Surgeon General, 12 Nov 1943 107 
19 Sep 1943, first interim report 106 
Nov 1943, to State Department, Passport division •»••.... 104 
Ulio, enclosing radiogram 3 Nov 1943 (C) 115 
Letters, between Long and Dunnahoo 12? 
Vice Consul Venezuela and Dunnahoo, 1S43 109 
Memo, Federal Security Agency 129 
BodetL, 11 Nov 1943 121 
Draperf Williams, Thompson 128 
Lundsberg, 8 Jan 1944 125 
Message, 28 Dec 1943 124 
Leone, 114 
Paraphrase, Radio from Washington (C) 113 
Radiogram, from Adjutant General, 23 Oct 1943 (C) • •«• 115 
Surgeon General (G) .. 112 
Ulio, 8 Nov 1943 (C) 118 
U. S. Public Health Service • « 120 
Report, mosquito control African-Brazilian air traffic 126 
Travel orders (C) 110 
Ecuador, Codlficacloa de reglamentos. 1941 131 
Deratization reports, 1944 . 134 
Laboratory report, fleas, 1944 • 133 
Guayaquil, 1944 135 
Rats, 1944 .. 132 
Ley del serviclo sanitario, 1943 130 
Egypt, form quarantine administration, ships •. 137 
Health control, Suez area •.. 139 
Letter, bubonic plague, 28 Nov 1943 —........ 138 
Memo, despatch, American Consulate, Suez 140 
Modern practice in ship fumigation, Cairo «... * 136 
Embarkation troops . •.. 441 
Entomology, regulations, Hawaii •«•'• • 160 
Equipment, quarantine at El Paso 502 
Far East, report to League of Nations (copy not available) • 140 Fleas, Ecuador . • 133 
Food, regulations, Hew Zealand ....... . * •«• 351 
Form* air service Cuba . 
Bill of health, British 61 
Nicaragua * • 356 
Salvador 382 
Certificate of health, Guatemala 160 
Health and sanitation data, U* S, A.> 452 
Identification, Guatemala 
Insects on planes, Brazil .. 22 
Inspection troop ships *. <, 459 
Passengers leaving Gold Coast 148 
Pratique, Jamaica « * 270 
Rat guards, Jamaica 274 
Sanitary certificate, Bahrain Island ... 3?? 
Ship inspector, Milne Bay *. 443 
Surveillance, Gold Coast 149 
Forms, certificate of health , • 304 
Quarantine, aircraft U. S. A. 315 
Algiers 
Australia • • 
Brazil 38 
Chile 81 
Egypt 137 
Palestine 358 
Panama 361 
Tunisia 392 
U, So Public Health Service . «.« 328 
Remand - 313 
Uo S. ports embarkation ............ 495 
Vaccination, Australia 
Fumigation, airplanes Brazil 
1 at Casablanca , 241 
Request for, Sicily 387 
Ships, Egypt 136 
Functions, quarantine, various sections * 44$ 
French West Africa and Senegal, health in Africa (C) 144 
Regulation aerial sanitary police *o. 141 
Regulations relative to control yellow fever, 1933 «•••••••••>• 142 
Vaccination anti-yellow fever, Jan 1942 143 
Fruits, regulations, New Zealand 353 
Gambia, annual medical and sanitary report* 1942 145 
Garden diseases* Hew Zealand 353 
Gold Coast, form* Individuals leaving Gold Coast 148 
Surveillances passenger landing, Gold Coast ....... 149 
Infectious diseases ordinance, 1936 revision • • 130 
Interim report, yellow fever, Dec 1941 146 
Mosquitoes ordinance, 1936 revision 151 
Quarantine and amendments (aerial navigation) regulations ..... 155 
Dues receipt, Lagos, Nigeria 134 
Ordinance* 1936 revision 152 Third interim report (revision first)* yellow fever control ...» 147 
Vaccination ordinance* 1936 revision 153 
Gold Coast, Accra9 form AAF regulation 61-3, spraying aircraft ... 15b 
Instructions disinfecting aircraft, aerosol method 158 
Pilots, forced landing in Africa 159 
Your good health In the tropics * 157 
Guatemala, codigo de sanidad. Mar 1941, decreto Mo* 1877 162 
Form, certificate of health 160 
Medical examination and identification ship passengers ....» 161 
Sanitary data on Guatemala 163 
Haiti, medical and sanitary data on Haiti, Oct 1942 167 
Memo, 4 Sep 1943, parrots, MATS 166 
Regulations of quarantine, Dec 1919 165 
Sur le service de la quarantine * . 164 
Hawaii, Territory of. Army and Mavy regulations 176 
Correspondence, quarantine 1941-1943 (s) . 179 
Procedures, 3.941 ~ 1943 , 0 177 
Guide plant inspection service, 1943 . 170 
Insect identification, aircraft arriving 175 
Letter, 3 Jan 1944, from Pemberton, insects 180 
Observation Insect pests in Samoa * 173 
Public health regulations 172 
Quarantine problems «... 282 
Rats and their control 171 
Regulations, division of entomology, Dec 1941 168 
Wild and domestic animals, May 1940 169 
Report; conference on quarantine regulations (C) ...... 178 
Reports; association of Hawaiin technologists 174 
Health in Africa 144 
Seamen, Canada * . 78 
Honduras, decreto Mo. 104, codigo 182 
Letter, 20 Apr 1944, Van Ho/enberg, Anopheles darlingl 185 
Medical and sanitary data, Honduras, U. S. Array, Sep 1943 ..... 184 
British Honduras, U. S. Array. 1942 183 
Time table T A C A 181 
Hospital ships, Australia 16 
Hydatid disease . 444 
Immunization *« 224 
India, circular to shipping agents Panamanian vessels o........... 191 
Disinsectization of aircraft 194 
Form, malaria questionnaire 189 
P, H. 5, sanitary report from aircraft, yellow fever ....... 188 
Health report by radio for aircraft 186 
Indian aircraft rules, 1940 192 
Indian port health rules, 1938 193 
Letter Sec*y of State to Sec,Jy of Navys yellow fever .......... 195 
Malaria and War, by Covell ISO 
Regulations, yellow fever areas; letter State ........... 187 
Infectious diseases. Gold Coast ........ — 150 
Influenza, British Isles (C) 62 
Immunization Insects, determination of In aircraft 336, 337 
Aircraft, Hawaii .. »«**•- 
Whitfield 338 
Pests, Samoa 173 
Recoveries, Brasil 42 
Insecticidal materials 221, 401 
Insecticides ..... 223 
Repellents, NR C 333 
Inspectors, Brazil 43 
Instructions, to masters of ships, Morocco .. 341 
Vessels, Aden 3 
Interdepartmental Quarantine Commission, clipping newspaper ....... 241 
Interim report to S urgeon Geaei’al; activities I Q, C . 260 
Letter American E*port Lines, 23 May 1944 196 
Annand, 27 Mar 1944 .. 209 
Armstrong Engineering Co., 10 Peb 1944 208 
Auchter, appointment liaison officers to Commission 2o3 
Bodet, to'Bunnahoo, 4 Mar 1944 .« 245 
To Surgeon General , 18 Oct 1943 •« 242 
Brat tain, Eastern Air Lines, 28 Mar 1944 2X0 
Gumming; training students tropical medicine . 220 
Program fifth Pan American conference 213 
Dunnahoo to Lundeberg, 9 Aug 1944 • 227 
Eastern Air Lines, 24 Apr 1944 199 
First interim report of I Q C enclosed 261 
Fitzgibbons, 18 Mar 1944 ..... 215 
Grace Line Inc.. 20 Apr 1944 • . 200 
Hutson, 7 Apr 1944; insecticides 223 
Johnson, 27 Mar 1944, appointment liaison officer «• 201 
Knies, to Bradbury, 19 Peb 1944 235 
CO 8th service command laboratory 238 
Medical director. Pan American Airways 232 
Vender Kuyp. 19 Feb 1944 .. 234 
Komp, 1 Apr 1944; Anopheles darling! . o...... 222 
Land, 7 Apr 1944 205 
Lull to Adjutant General 252 
Magee, 30 Apr 1943, to Secretary of War 248 
Martinez Baez, 28 Peb 1944 *»« 219 
Maugham, American Air Lines, 30 Mar 1944 218 
McCoy, 29 Apr 1943, and "Conference tropical diseases" 246 
McGovran, 5 Apr 1944; Insecticidal materials •. 221 
McNutt to Secretary of War, 23 Apr 1943 . 254 
Merlin, 8 Apr 1944 206 
Metcalf, 19 Apr 1944 226 
Mountin, 25 Apr 1944, conference on diseases 247 
Original draft .first interim report enclosed 254 
Pan American Airways System, 17 May 1944 .. 197 
Patterson, appointment Knies to I Q, C, 28 Jul 1943 .......... 257 
Requesting liaison officer, 18 Mar 1944 ..... 223 
Secretory of Navy, appointment Kagath to I Q, C, 258 
Secretary of War, to Federal Security Agency, 255 Appointing Knles to I Q C .. 256 
Shaw* 6 Apr 1944 «, * 204 
Shiilito, 13 Mar 1944 (C) 212 
Stanton, 11 Apr 1944 . 207 
To Steamship Lines, asking comments, quarantine matters ...« 229 
Tuttle, United Air Lines, immunization 224 
Veldee, 1 Apr 1944, cholera vaccine . 217 
Williams, 15 May 1943, insects, airplanea a . 211 
Winings, 22 Mar 1944, appointing liaison officer . 202 
Letters, between Bradieh and Knles, Mar 1944 214 
Richter and Magath, May 1944 , 240 
Shiilito and Knies, pyrethrin „o. 198 
Transmitting partial final report I Q C, 14 Apr 1944 259 
Memo, 19 Sep 1943, forwarding first interim report I Q. C 262 
Knles to Air Surgeon, AA f, 25 Feb 1944 ... 237 
Army Air Forces regulations No, 61-3 239 
CO, 6th Air Force, 5 Hay 1944 225 
8th Service Command, 14 Mar 1944 , , . 231 
Director Medical Intelligence Division 0O 266 
Fitzgibbon, 16 Mar 1944 , 236 
Travels I QG 265 
Lundeberg, second meeting I Q. C, 26 Jun 1943 249 
Kirk, typhus regulations, 13 Jul 1943 „ 253 
Parran, 20 Oct 1943 ,<>. 263 
Simmons, 10 Jul 1943 ... 251 
Message, Knies to Section on Preventive Medicine, U» 5, Army .. 233 
Paper on Phlaaataxleria (airborne menace) 843 
Pest control . 230 
Preliminary final report, X Q, C, Part® I and XI (0) ......... 268 
Report, preliminary final. Parts I and II 00... 267 
Olson, 14 Mar 1944, mosquitoes * 2X6 
Statement objectives X Q, C, Lundeberg .. 250 
Trip report, Williams, 15 Nov 1S43 344 
Unpublished report on Brazil’. 20 
Visit to Cuba 94 
International hygiene, Australia *• * 13 
Travel requirements wartime 519 
Jamaica, circular 305, rat guards 273 
Form, certificate of pratique 270 
Rat guards 274 
Letter, Doude, mosquito identification 289 
Hawkins, 26 Aug 1943, Pallcadoes airport (C) 272 
Quarantine regulations (C) * * 271 
Knles, letter, Dove, DDT residue .* 889 
Duimahoo, 20 Jan 1944 (G) 281 
To Knies, 9 Dec 1943 278 
9 Feb 1944 283 
Onstott, 31 Jan 1344, Hawaii, Meal and Kanai • <> 282 
To Duimahoo, 30 Hot 1943, Anopheles darllngl 27S 
Enclosing papers, 6 Dec 1943 277 
Hopkins, plane sanitation, 21 Hov 1943 275 Lundeberg, 5 Jan 1944 ....... 285 
Office Sung eon General, 15 May 1944, draft report I Q. C .... 290 
Texas, 16 Dec 1943 279 
Trip, 1 Jan 1944 (C) 280 
Memo, Air Surgeon 15 May 1944, draft report 1 Q.C 288 
Secretary of War, 15 May 1944, draft report I Q.C .... 287 
iarapnrsse radiogram from Adjutant General 25 Kov 1943 284 
Radiogram, 5 Jan 1943 286 
Laws, Anglo-Egyptian Sudan . 
Quarantine, Nicaragua 357 
Panama 360 
U, S. Government . 440 
D. So Public health service 018 
Venezuela 031 
Sanitary, Brazil * 04 
Leishmaniasis, Mexico * 322 
Leprosy, Pan American Sanitary Conference 374 
Leptospiroses, Martinique • • 309 
Magath, courier designation, 12 Feb 1944 (C) 298 
Letter, Dove, 23 May 1944, DDT residue • • 305 
Dunnahoo to Magath, 9 Feb 1944 296 
Kirk to Cftief of Staff, U. S. Army, I Q C reports 302 
To Adams, USB, 16 May 1944, draft report I Q. C .. 301 
Division preventive draft report I Q C 300 
Sawyer, Rockefeller P ounclatlon, 24 May 1944 .« 304 
Secretary of Bavy, 16 May 1944, draft report 1944 »...... 299 
Memo, American Consulate, Dakar 293 
From Carter, 29 Apr 1944 o.. 306 
Message, from Dunnahoo .... 291 
To U. S. Ambassador, Brazil, 25 Oct 1943 (S) 294 
Haval radio, Hatal, Brazil, 28 Feb 1944 297 
Orders 295 
Radio, from War Department, Brazil .. 292 
Reports, Pan American Sanitary Conference 303 
Malaria, among prisoners 429 
Control, Australia • « 
Southwest Pacific Area 438 
Form, India • l8^ 
Latin America 
Management of, U, b, Army 421 
Martinique 3X0 
Mexico 322 
Survey, Salvador 384 
War, India 190 
Martinique, Leptoslroscs, 1939 309 
Letter Secretary of State, quarantine regulations 1926-1929 ... 312 
Martinique quarantine regulations, 1926 307 
Paludisme, 1936 310 
Supplementary quarantine 1929 308 
Typhus fever * 311 
Merck, letter Williams 14 Dec 1943, dengue In Hawaii 313 Merchant ships, regulation Sicily ... 389 
Mexican border .. 86 
Mexico. Anopheles en la Frontera de Mexico y Guatemala. 1942 ..... 315 
Ausencla de flebre amarllla 324 
Datos opidemiologicos acera de la nulcera de los chlcleroe ...«• 318 
Epidemlologlcos de paludlsmo y leishmaniasis 322 
Dietribucion geografica de la flebre amarllla .. 317 
Esperanza d© vida ... 319 
Forms, quarantine 314 
Investigacion serologica d© fiebre tlfoidea brucelosls sifllls 323 
Mortalidad de menores 316 
Saneamineto entre los Mayas 321 
Una nueva rickettsiosls en Mexico . 320 
Miami Area Airports, letter Strong. 28 Oct. 1943 (C) .. 325 
Letters between Medical officer, quarantine, and Bunnahoo 327 
Spencer and Dunnahoo 328 
List Army fields A T C, 9 Aug 1943 . 529 
Memo, Joint security control, report committee Jul 1943 o...... 331 
Report on security conditions at Miama, Florida (C) 330 
U. S. Naval Air Station, 7 Aug 1943 «. 326 
Military craft, Australia . 17 
Miscellaneous, Air transport, insects and disease 338 
Determinations of Army medical museum 336, 337 
Letter, Office of Strategic Services, health in Axis countries 335 
Minutes N E C, insecticides and insect repellants 333 
Report on result trials with mosquito repellants (C) . 334 
Roster, American Society of Tropical Medicine 332 
Tropical diseases, world maps .. 339 
Morocco, bill of health for USS Stiirdebant, 10 Kov 1943 (C) 343 
Cases of plague 1928 through Sep 1943. Furclow*© report ....... 340 
Letter, Kettles, 30 Oct 1943, fumigation rtPasteurM ... 341 
Plague and plague quarantine in Morocco9 with appendices 342 
Morrison field,, quarantine inspectors 328 
Mosquito, control Waller field .. 414 
Identification, Jamaica «. 269 
Ordinance, Gold Coast . 151 
Repellants, British report 334 
Mosquitoes, eradication in aircraft. Panama «... 364 
Prevention malaria dissemination by aircraft (C) 436 
Submitted for identification .. 216 
New Caledonia, bill of health for U. S. Navy ships 344 
Outline U. S. Public Health Department 347 
Rat control. 26 Jan 1943 345 
Sanitary regulations, 16 Jan 1944 346 
Hew Zealand, Act, orchard and garden diseases . 353 
Correspondence relative to quarantine (C) 350 
Health act, 1920 and regulations 349 
Letter, Childs, enclosing data 27 Jan 1944 348 
Regulations, of fruits and plants 352 
Specifications governing food, U. S. Armed Forces 351 
Nicaragua, bills of health * 355 Form, bill of health 356 
Medical and sanitary data on Nicaragua# U. S. Army 354 
quarantine laws .......... 357 
Oran* Algiers, quarantine forms . 
Orchard diseases, New Zealand 353 
Organization for health, Australia .. 10 
Pacific, health in South and Southwest Pacific 450 
Palestine, forms, quarantine 358 
Quarantine rules 359 
Panama, Panama Canal, Aedes aegyptl • » 362 
Hradication mosquitoes in aircraft 364 
Form, quarantine 361 
Quarantine laws and regulations 360 
Rat autopsies. Sep 1942 to Aug 1943 . 363 
Pan-American Sanitary Bureau, Committees 374 
International quarantine agreement 370 
Letter from Simmons, Fifth Pan-American Conference 368 
Transmitting I Q C report • 376 
Model Pan-American sanitary code 373 
Monthly report Mar 1944 .... 36? 
Program, Fifth Pan-American Conference, Apr 1944 355 
Proposal of delegate from Haiti .. 371 
Relation to other international organizations «. 375 
Remarks, Gumming, 24 Apr 1944 •. ..» 359 
Report No. 13, diseases of Western Hemisphere 366 
Summary of meetings 372 
Parrots* Haiti 133 
Persia, sanitary certificate for Bahrain Island 377 
Pest control 230 
Pilgrim passengers 395 
Pilgrims, S ues area 14° 
pilot’s instruetions. Gold Coast 139 
Plague, Lgypt 138 
Morocco 340, 342 
Tunisia • • • 391 
Plant inspection, Hawaii . • 1?$ 
Quarantine, U. S. Department Agriculture • 398 
Plants, regulations. Hew Zealand . 352 
Posts, unhealthful ». 446 
Presque Isle, quarantine regulations 311 
Public health reports, Vol. 55, #28<; ?ol. 59, #11 525 
Puerto Rico, blue prints, trailer 381 
Letter Khles to Surgeon, Station hospital 378 
Navy procedure, disinsectization aircraft 379 
Quarantine service recommendations .« 380 
Pyrethrins, dosage 406 
In spray 193 
Quarantine, agreement, international 370 
Canada 
Clba Symposia • 
Conference, Barbados 37 British West Indies 0 . 66, 75 
Air regulations . 73 
Amendments ......... , . 71 
First schedule . 69 
Maritime . 72 
Second schedule 70 
Draft, Trinidad 68 
Ordinances 74 
Trinidad 00 65 
Dues, receipt, Gold Coast 154 
Forms, Mexico 314 
Turkey. Iran, Iraq 393 
Haiti 164 
Measures, Aden 2 
Ordinance, Gold Coast 152 
Practices, Palermo 386 
Port, Algiers 5 
Recommendations, Puerto Rico 380 
Regulations, Canada 76 
Tunisia 390 
Radio, health reports, India 186 
Hat, autopsy, Panama 363 
Control, Hew Caledonia 345 
Guards, Jamaica 273 
Rats, Chile 80 
Ecuador 132 
Hawaii 171 
Regulations, Aden, yellow fever 1 
Aerial police, French West Africa . 141 
Aircraft, Anglo-Egyptlan Sudan 8 
Animals, Hawaii 169 
Army and Navy, Hawaii 176 
Civil aviation, Cuba 92 
Health, Hew Zealand 349 
Naval vessels, Sicily — 3s8 
Public health, Hawaii 172 
Quarantine, aerial navigation treaty , s 499 
Australia .. 440 
Brazil 55 
Chile 83 
Colombia 84 
Cuba 91 
Department of Agriculture 399 
Haiti 165 
Martinique . o. 307, 308, 312 
Sanitary, Anglo-Egyptian Sudan ,. 7 
Code, Ecuador », 131 
Typhus, U> So A. 253 
• Various, Hew Zealand 348 
Yellow fever. French West Africa 142 Richettsiosis, Mexico » 220 
Rules, Port health, India , 192 
Quarantine* Palestine « .... •. 359 
Salvador, codlgo de sanidad, 1930 - 1931 . 383 
Form, hill of health 382 
Malaria survey 284 
Samoa, insect pests . 172 
Sanitary code, Costa Rica »•••• 89 
Data, British Honduras .. . 183 
Costa Rica 90 
Cuba 92 
Dominican Republic 101 
Guatemala .. 122 
Haiti 167 
Honduras 184 
Lesser Antilles «... 64 
Hicaragua . * * •» 354 
Trinidad and Tobago 64 
Venezuela 53 2 
Legislation, Dominican Republic 98 
Regulations, Hew Caledonia 345 
Report, A, gpmbiae 146 
Ship log. U. S. Public Health Service 522 
Sanitation, Chile 79 
Data 452 
Security, Miami airfields 330 
Report, Miami - 331 
Ship, inspection, Sicily • 386 
Quarantine, Brasil «. 57 
Sanitation 523 
Shipping agents, circular, India «• 191 
Ships, quarantine form, Egypt 137 
Sicily, fumigator for quarantine work .. . 38? 
Port inspector, ship inspection .. 36b 
Quarantine practices in Palermo 386 
Regulations,, merchant ships 389 
Haval vessels 388 
Smallpox, Africa, Europe, Middle Bast .. 455 
Suez, health control 139 
Tobago, quarantine 63 
Trailer, quarantine Puerto Rico o. 381 
Trinidad, quarantine • 63 
Troop transports, Australia * 16 
Tropical diseases, maps . • 244, 339 
Tunisia, forms quarantine • • • 392 
Quarantine and Inspection facilities 390 
Summary cases of plague ........ 391 
Turkey~Iran~Iraq, carnet de pelerinage . 995 
Form, bill of health for airplanes (Iran) 394 
Forms, quarantine • «. 393 
Loi Ho. 1693, sur 1» hygiene publique, 1936 «... 396 Typhoid fever, Mexico ... . 325 
Typhus fever, Martinique . . 311 
Memo to Dyer 533 
Precautions 410 
Regulations U« S. Army .. 411 
U. S« Commission 454 
U. S. Army port precautions 420 
Ulcer de las chlcleros, Mexico 318 
U. H. R« fi, Ae, report Commission on quarantine, Apr 1944 ....... 397 
U, S. Agriculture Department, bureau animal industry..... 403, 404, 405 
Diseases dogs and cats, Mediterranean and S. W„ Pacific areas . 407 
Dosage pyrethrlns for planes 406 
Laboratory results with new Insecticidal materials 401 
Letter, Secretary of War to Secretary of Agriculture .. 408 
Plant quarantine .. 398 
Quarantine regulations . 399 
Text Federal laws relating to protection of wildlife * 402 
Various plant quarantine regulations . 400 
U. S, Army, Army regulations related to quarantine ....... 419 
Hospitals South Pacific (s) . 534 
Immunization of U. S. Army personnel 413 
Letter Elsenhower, 5 Feb 1943, yellow fever (C) 415 
Memo, Africa, Middle East Wing ATC, 27 May 1943, yellow fever., 418 
Army regulations No. 95-15, A A F, 3 May 1944 433 
Lundeberg to Kirk* 13 Jul 1943 .. 410 
Mosquito control 414 
Paraphrase radiogram, 30 Oct 1943, Adjutant General 432 
Preparation for overseas movement, second edition ............. 430 
Procedure for return of individuals by water 431 
Quarantine laws and regulations of the U. S.s typhus 411 
SGO letter # 33, treatment and control tropical diseases ...... 422 
T C Circular letter No. 36-7, 1 Jan 1944, typhus fever 420 
War Department, Army regulations Ho. 95-15, AAF 435 
Circular letter Ho, 22, military malaria control 423 
Ho. Ill, malaria cases 421 
Ho. 162, immunization 426 
General orders. Ho. 4, 5 May 1941 434 
• Memo, assignment military personnel, Ho, W600~83-43 428 
Disinfestation louse-infested personnel, Ho. W40-16-43 .. 427 
Malaria among prisoners of war. Ho. S40-10-43 429 
Pamphlet Ho. 8-2,, 1943 409 
Technical bulletin, T B-MKD-2, 3 Jan 1944 424 
DDT. 425 
Yellow fever immunization 412® 416 
Precautions West African routes certificates of urgency .... 41? 
U. S. Army In Far East, hydatid dieease9 serial 2568 444 
Malaria and anti-mosquito measures, 13 Apr 1943 439 
Control in Southwest Pacific area? zoning in Australia ..... 458 
Medical section, Surgeon of Port, embarkation troops .......... 441 
Notification upon discharge malaria patients from hospital .... 442 
Prevention dissemination Anophel ®ae mosquitoes (C) ............ 457 Malaria mosquitoes by aircraft (C) , .« 436 
Quarantine regulations, Commonwealth of Australia 440 
Ship Inspection form, Milne Bay .. 443 
U, S, Government, Various Agencies, airports of entry ...... . 451 
Form, health and sanitation data, foreign service U. S. A* 452 
Functions of various sections 449 
Health committee, foreign relief and rehabilitation operations 447 
Precautions South and Southwest Pacific *.« 450 
Letter Assistant Secretary of the Treasury, 15 May 1943 448 
Wildlife Research Division to Knies, 11 Apr 1944 463 
List of unhealthful posts 446 
Do S0 America typhus commission . 454 
U» So Navy, appointment officer for aircraft quarantine 456 
Maritime quarantine 457 
BuMed Mews letter, Vol. 3, No. 5, 3 Mar 1944 460 
Vol. 1, Noe. 4 - 5 - 7 465 
Form letters, BuMed and Surgery 464 
Medical inspection troop snips 459 
Health precautions for personnel on detached duty 467 
Letter, Sheldon to Dunnahoo, 31 July 1943 461 
Manual Medical Department, Chapter 14 466 
Chapter 18 462 
Medical Compend for Commanders naval vessels 468 
Message, Secretary of Wavy, 7 Mar 1944, smallpox vaccination 455 
Regulations, Chapters 32 and 40 463 
Yellow fever vaccine, directions for use 456 
U. S, Navy and Army Air Forces, aerosol disinsectization (C) . o«,.o 478 
Air transportation of animals •. -. 485 
Army Air Forces regulations, Moa 61-3 484 
Directive, disinsectization Central Africa (0) 477 
Disinsectization of aircrafts 470, 471, 472 
Form ICW, ATG 479 
Plying outside the U. S.» establishment clearing stations ..... 483 
Form, passenger Information, Naval Air Priorities Office ...... 474 
AAF 23, aircraft arrival report 493 
Immunization Air Fore© personnel departing overseas theatres 490 
Instructions to airplanes before landing 476 
Medical briefing 492 
Quarantine inspection northbound planes 482 
Requirement before departure overseas military aircraft .... 491 
Mental and physical fitness overseas duty 488 
Operations; briefing for aircraft flights 459 
Quarantine inspection and treatment of aircraft 475 
Regulation, AAF No. 25-9 486 
Ho. 55-18 48? 
Ho. 61-3 489 
No. 60-17, Pacific Wing, ATC 481 
Servicing American i&port planes «...... • 473 
Spraying airplanes in Caribbean area 480 U, S. Ports of Embarkation, duties of transport surgeons 496 
Forms 495 
Radiogram, typhus immunization Navy personnel .. 494 
U» S, Public Health Service, amendment 22, quarantine regulations 508 
Anopheles mosquitoes of the Caribbean region 524 
Bill of health (C) 505 
Vessels clearing port . 514 
Certificate of health for vessels of U. So or Allied Nations .o 604 
Ciba S ymposla «0 «. 526 
Correspondence between Hopkins and Dunnahoo, Mar 1944 506 
Data on health conditions in Germany .. 50? 
Equipment, quarantine operations at El Paso 502 
Foreign quarantine division circulars . 497 
Forms, quarantine », . 528 
International sanitary convention for aerial navigation «. 600 
Letter Dunnahoo to Surgeon General 509 
Minutes on conferences post-war diseases .. 52? 
Outline of ship sanitation procedure, 1939 ....... 523 
Pamphlets 520 , 521 
Paper by Metcalf, and comments ,. 516 
Port sanitary statement . 512 
Prevalence quarantinable diseases countries in war zone ....... 610 
Quarantine forms, aircraft .. 515 
Laws and regulations of the U.> So 499 
Revised Jun 1920 . 518 
Presque Isle, Maine, facilities 511 
Procedures, airport San Juan, P. E« .. 603 
Remand forms 513 
Sanitary reports and bills of health »• 501 
Ship sanitary log. Instructions 522 
Suggested changes In code .. 517 
Summary, diseases arriving at U. S. ports, 1924-1943 .. 498 
Wartime, International travel requirements 519 
U, 5. State Department, quarantine laws Co S« Government 445 
Vaccination ordinance. Gold Coast 153 
Venezuela, medical and sanitary data 532 
Memo, Moleady to Knies 529 
Quarantine laws .. 531 
Vessels 530 
Vessels, certificate of health 504 
Quarantine, Venezuela . 530 
War Department, memo to Dyers typhus (C) 633 
Wildlife o 453 
Yellow fever, Aden 
Areas, India regulations 187 
Control, British Air Forces 60 
Gold Coast . 147 
Disinsectization 85 
Form, aircraft, India 188 
Gold Coast 146 Letter, Secretary of States India ........... 195 
Mexico 317, 324 
Regulations French West Africa .. 142 
U. S. Army immunisation 412 
Use of vaccine 456 
Vaccination, French West Africa 143 
(C) - Confidential; (S) - Secret 
I Q C ~ Interdepaitmental Quarantine Coraralnslon ADDENDUM 
Aerial opera t Ions -standard procedure * - •533 
Anopheles albimanus in Florida (Spenoer report <*534 
DDT- Outline of experiments on .. 535 
Endorcomeat of report of I Q, C by Air Surgeon 
Interdepartmental Quarantine Ccamisalon-IUrtial Final Report* •. • • • .53? 
Special Sunmaryv . . *.».».53^ 
Memoranda from Bodet.... *539 
Memorandum, draft, from R. C. Williams »540 
Final, from R. C. Williams . ....-.<.541 
Letter, from American Expert Airline, -542 
Bonne Nether laud Indies *543 
Braniff Airlines. .544 
Brown, concerning I Q C Final Re port-Draft <>345 
Canadian National Steamships 54& 
Cunning 547 
de la Rue. .. • * • • .•. <>•548 
IXmnahoo, concerning A. darling! «349 
McFarland.«... . .55° 
Concerning Oakley. .55* 
Fladness.. * •*•*••—•••• • »552 
Johnson. ...•*« •. .-0-.553 
Kimball, suggestions »554 
Macgowan. .555 
Olasen. »55^ 
Ihrren to Kirk....... ...357 
Sasscer. *558 
Sawyer, .559 
Sawyer, Anopheles gambiae in Brazil...» .5&0 
State Department.. .5& 
Stovall •........562 
To various carriers asking for suggestions .563 
Letters transmitting the I QC Reports to Barron ......564 
Oakley on »Sowaway insects. .3&5 
Hant quarantine-AAF Memo 25-10. -• «5&& 
Department of Agriculture. *5&7 
Quarantine manual for boarding officers, D.S.P.H, Service..... •• ...568 
Tallow Fever precautions-North Africa. * • •«*569 nraRCEPAR'rMKTfTAL QUARANTINE COMMISSION 
Final Report - Appendix 
10 June 19^ APPEHDIX 
Table of Contents 
Items 
1. Memorandum, Dr. Dimnahoo to Dr, Barren. 
2. Letter, Federal Security Administrator to the Secretaries of Army and Nrvy. 
3. Letter, Secretary of Navy to Federal Security Administrator 
k. Letter, Appointment of Captain Magath. 
5. Letter, Secretary of War to Federal Security Administrator. 
6. Letter, Assistant Secretary of War to Federal Security Administrator 
7* Letter, Appointment of Major Shies. 
8. Letter, Appointment of Dr. Dimnahoo. 
9. Letter, Federal Security Administrator to Secretary of Agriculture. 
10. Letter, Assistant Secretary of Agriculture to Federal Security Administrator 
11. Itineraries, members of Commission. 
12. Transparency for use with Item 13, 
13. International Individual Travel Log and Immunization Record, 
lU. Surveillance bond. 
15. Bill of Health. 
16. Quarantine Declaration-Aerial, 
17. International Cod© for Epidemiological Reports. 
18. International Code for Epidemiological Reports by Airways Communications, 
19- Report on Quarantine and Sanitary Condition of Vessel. 
20, Quarantine of military aircraft and personnel, based on AAF Reg. 61-3. Item 1 
Federal Security Agency 
U, S, PUBLIC HEALTH SERVICE 
Washington 14 
{Bethesda Station) 
March 26, 19^3 
MEMORANDUM FOR THE SURGEON GENERAL: 
By means of air travel, it is possible to reach practically any 
point on the earth from any given point within slightly over two days8 
flying time. This increase in speed of travel, together with the 
rapidly increasing numbers of arrivals, has posed new problems for the 
Quarantine Division. 
Many of the epidemic diseases that now and in the future may harass 
our military efforts — as malaria, typhus, yellow fever, filariasis, 
plague, and others — are carried by insect vectors. These vectors can 
be transmitted great distances during a day’s flight. Since Dr. Griffitta 
demonstrated in 1931 that aircraft can transport living mosquitoes, the 
Service has had the problem under continued observation to perfect the 
disinsectization technique and prevent the movement of insects from on© 
section to another by aircraft. 
All persons arriving from foreign areas are subject to examination 
under established quarantine laws. As tin air traffic Increased, the 
Service steadily Increased its facilities and carried out quarantine 
procedures on all incoming aircraft. 
During the latter part of it became evident that it was im- 
practical to meet all military aircraft, as many were on confidential 
missions, often arriving with little or no notice, and it was not feas- 
ible to keep Public Health Service quarantine officials on duty in 
military posts. To meet the situation, Ik Navy and 26 Army senior 
medical officers at certain military posts have been designated as 
quarantine officer with its attendant responsibilities. 
The movements of aircraft are now such that there is considerable 
uncertainty as to where they aro entering, whore they are from, and 
whether they aro in fact being handled properly to prevent the entry 
of insect vectors of disease, new species of insects, or human cases 
of the quarantinabl© diseases* Appropriate representatives of the Army 
and Navy have shown extraordinary cooperation on these problems, at all 
times evidencing sincere interest, and have issued strict regulations 
concerning the handling of aircraft. However, with the far-flung air 
routes, there is & great deal of uncertainty as to how well these in- 
structions are being carried out and whether or not the instructions Issued are adequate to beat handle the problem., The following unre- 
lated episodes illustrate the serious potential and actual hazards that, 
hare to be considered; 
The Anopheles gambiae mosquito was brought to Natal, Brazil, frew 
Africa and became widely disseminated along ihe northeast coast. Afte 
an Intensive campaign over a period of sever; il years, this species ap- 
pears to have been eliminated from Brazil, brt the cost has been esti- 
mated by one authority as at least 20,000 dead, a quarter of a million 
persons sick, and a cost of approximately t)ree million dollars to 
perform the eradication work. 
The Anopheles darling! mosquito was recently discovered In British 
Honduras and Guatemala. This virulent malt rial vector had not previously 
been identified north of the area around Colombia and Venezuela. (Koaro) 
The Deinocerites spanius mosquito wae reported first around the 
Brownsville airport sector in 1959, and ii is understood this mosquito 
is now found throughout the Brownsville a ©as. (it is believed not to 
be a disease vector.) 
The Hava Ian, Gilbert, Midway, Wake, Marshall, and adjacent islanc 
areas in the Pacific are free from Anopf.ilin© mosquitoes and malaria. 
It is now known that mili tary pianos aro bringing into this area 
Anopheles mosquitoes, all dead accordlrg to available reports. 
The Islands of Hawaii are free frem rabies, and to maintain this 
status have a rigid 120-day quarantine against animals that are brought 
into the territory. It has been reported that pilots vere bringing in 
dogs and other animals from the South Pacific Islands and taking them 
to their quarters without the knowledge of the quarantine officials. 
This was promptly discontinued u;on its discovery. 
Transport pilots began bringing parrots from Africa against Quaran- 
tine regulations. Because of tb© psittacosis danger, these wore promptly 
sacrificed on arrival, and the practice was discontinued. 
It seams an appropriate tlwe for on© or more representatives of the 
Army, Kavy, and Public Health Service to travel the prinicpal foreign 
air routes and inspect the major airports that are now in use and study 
the situation for the preparation of a report . The following factors 
should be considered; 
(1) At© prescribed protect It© measures In fact regularly 
observed? 
(2) If not, make recommendations to insure adequate ccmfoin- 
anc© with existing regulations. (3) Should emphasis be placed on treatment of the aircraft, 
sanitation of the airport sectors, or both? 
(4) Report on the quarantine laws regularly enforced b 
various countries as veil as the laws on record that may be 
enforced. 
(5) Report on quarantine restrictions to movements of air- 
craft that may be unnecessary in light of present knowledge. 
(6) Report on special measures to prevent the introduction 
of certain exotic diseases to areas where they do not now exist. 
The man-hours and transportation involved in obtaining these data 
may be repaid many times over in arriving at the best measures for the 
protection of our military forces and civil population. 
(Signed) G, L. DIOTAEOO 
Assistant Surgeon General 
Foreign Quarantine Division Item 
April 23, 19^3 
THE FEDERAL SECURITY ADMINISTRATION 
Washington 
Dear Mr. Secretary; 
The global war has given a great impetus to the us© of aircraft in 
connection with military, naval, and commercial operations. The flying 
time from remote parts of the world has been reduced until it is now pos- 
sible for epidemic and tropical diseases contracted In any other part of the 
world to be transported by travelers to any other part before the condition 
becomes evident. Insect vectors of yellow fever, typhus, plague, malaria 
and other infections can be transported by aircraft with equal facility. 
In recent years there have been reported several instances of the discovery 
of harmful insects In new areas. An example, with serious health and eco- 
nomic consequences, was the Introduction of the Anopheles gambiae mosquito 
from Africa to Brazil, 
Under the quarantine laws of the United States, the Public Health 
Service has the responsibility of preventing the introduction of certain 
dangerous communicable diseases into the United States. Sine© the be- 
ginning of th© present emergency the medical department of the Army lias 
cooperated actively in enforcing quarantine procedures in respect to ships 
and aircraft under th© control of the War Department. Moreover, quarantine 
procedures have been devised to meet the new factors developed by the expanding 
air routes. These measures have been effective up to now but there ia an 
increasing number of unscheduled arrivals of aircraft and occasionally a plan® 
on a confidential mission, or for other reasons, will land at an unscheduled 
port of entry. 
I am advised that this general subject recently has been discussed 
in detail by the three Surgeons General and that they are agreed in re- 
commending the establishment of an Interdepartmental Quarantine ConaaisBlon 
composed of a representative of th© Federal Security Agency, of the War 
Department, and of the Wavy Department. Consideration is also being given 
to asking that a representative of th© Department of Agriculture be a 
member of th© CoEsalssion. I approve fully of this reccomendatlon of the 
Surgeons General and if you concur, I will appreciate your appointing a 
member to represent your department. 
It ia suggested that the terns of reference and authority of the 
Commission be substantially as follows: 
1. By Joint action of the Federal Security Administrator, the 
Secretary of War, and the Secretary of Havy, an Inte departmental 
Quarantine Commission is established, composed of one medical officer 
from each of th® three departments, appointed by the head of the depart- 
ment, and in connection with the duties of the Commission, authorised to 
represent th© head of the department. <2. The Commission is instructed to examine into existing quar- 
antine laws, regulations and enforcement procedures, both at ports 
of arrival in this country and at foreign ports of departure, including 
sanitary conditions at ports of departure and of craft on route. 
3. The Commission will recommend changes or modifications in ex- 
isting lavs, regulations and methods of enforcement which may be deemed 
necessary to protect the interests of the United States and of our mili- 
tary and naval personnel in other countries against danger of the in- 
troduction of quarantlnable and other exotic diseases which may threaten 
military and civilian health and consequently impede the war effort. 
k. The Commie si on is authorized to travel to such places as may 
be necessary in order to carry out the foregoing duties. 
5. The Consul os ion vill keep the Federal Security Administrator, 
the Secretary of War, and the Secretary of the Havy, informed in regard 
to the program of its tudies, will subjit a final report end recommen- 
dation as soon as practicable, and vill perform such other duties as 
from time to time may be assigned to it by competent authority* 
If you vieh to discuss the matter further, I shall ho glad to 
talk it over with you. 
Sincerely yours 
/0/ Paul V, McHutt 
Mmlni otrator 
The Honorable, 
The Secretary of War, 
Washington, i. C. Item 3 
TEE SECRETARY OF THE RAVI 
Washington 
SOil- 26 203 
May 15, l<m 
dear Hr. McNutt; 
The Navy Department appreciates and is cognizant of 
the potential dangers to which the people of the United 
States, as well as those of other countries, will be ex- 
posed if adequate precautions are not taken to enforce the 
quarantine laws and regulations now extant, and to promul- 
gate additional control measures if deemed advisable. 
In accordance with your letter of April 23, 19^3# 
I wish to state I concur with your plans anl am heart Ily- 
in agreement that the Commission should he represented by 
the Federal Security Agency, the War Department, and the 
Navy Department, as well as the Department of Agriculture. 
Captain T. B» Magath, MC-7(S), U.S.N.R., Bureau of 
Medicine and Surgery, Navy Department, Washington, D. C., 
is appointed the Navyve representative on this Commission. 
Sincerely yours 
(Signed) FRANK KNOX 
Honorable Paul V. McNutt 
Administrator, Federal Security Agency 
Washington, D. C. Item 
DEPARTMENT OF THE NAVI 
OFFICE OF THE SECHETAR 
WASHINGTON 
MXJ 2 - 19^3 
From? 
To : 
Th© Secretary of the Navy. 
Captain T. B. MAGATH, MC-V(S), UBNE. 
Subject 
Interdepartmental Quarantine Com 
sslon 
Reference: 
(a) SecNav Itr of 15 May, 19*0> 26 205 
1. By reference (a) you were appointed the Navy representa- 
tive on the Interdepartmental Quarantine Commission. Tou will carry 
out duties in this connection which may b© assigned you either through 
the Office of the Administrator of the Federal Security Agency or th© 
Bureau of Naval Personnel. 
2, The Secretary of the Navy has been informed Doctor G. 
L. Dunnahoo represents the U. S. Public Health Service and Major P. 
T* Shies, the War Department and “that the Commission may, in carry- 
ing out its assignments, travel either separately or together. It 
has been requested by the Surgeons General of the three services and 
approved by the Secretaries of War and Navy and the Federal Security 
Administrator, that each of you be directed to inspect the facilities 
controlled by each service in so far as they are concerned with mat- 
ters caning under the terms of reference and authority of the Comia- 
sion, which are as follows: 
(l) By Joint action of the Federal Security Adminis- 
trator, the Secretary of War, and the Secretary of the Navy 
an Interdepartmental Quarantine Commission is established, 
composed of one medical officer from each of the three de- 
partments , appointed by the head of the department, and in 
connection with the duties of the CosaaiBsion, authorized to 
represent the head of the department. 
(2) The Commission Is instructed to examine into 
existing quarantine laws, regulations and enforcement pro- 
cedures, both at ports of arrival in this country, and at 
foreign ports of departure, Including sanitary conditions 
at porta of departure and of craft enrouto, 
(3) The Commission trill recommend changes or 
modifications in existing lairs, regulations and methods 
of enforcement which may ho deemed necessary to protect 
the interests of the United States and of our military 
and Naval personnel in other countries against danger of the introduction of quarantinabl© and other erotic dis- 
eases which may threaten military or civilian health and 
consequently impede the war effort. 
(4) The Commission is authorized to travel to 
such places as may bo necessary in order to carry out the 
foregoing duties. 
(5) The Commission will keep the Federal Security 
Administrator, the Secretary of War and the Secretary of the 
Ifavy informed in regard to the progress of its studies, vlll 
submit a final report and recommendations as soon as prac- 
ticable, and vlll perform such other duties as from time to 
time nay be assigned to it by ccrapetent authority. 
/s/ James Forrestal Item 5 
May 11, 19*3 
Admlni strator, 
Federal Security Agency, 
Washington, D. C. 
Dear Mr. Administrator: 
Deference Is mad© to your letter of April 23, concerning 
the measures to be taken to prevent the spread of epidemic and 
tropical diseases by now factors introduced by tho war. 
The traditional policy of the War Department is to insist upon 
full compliance with the quarantine laws of the United States. Therefore, 
I concur in the principle expressed in the plan of procedure as outlined 
in your letter. However, I feel that paragraph of the plan as outlined 
should incorporate an additional thought substantially as follows3 
"The Commission is authorized to travel to such 
places as may be necessary in order to carry out the fore- 
going duties. Travel to and in Theaters of Operation will 
be coordinated with and subject to the control of the Theater 
Commander concerned." 
Lieutenant Colonel Karl E, Lundeberg, Medical Corps, Office 
of The Surgeon General, is designated to represent the War* Department 
on the projected Interdepartmental Quarantine Comolsslon. 
It is my opinion that a speclaliot from the Department of 
Agriculture should also be included in the Comalssion. 
Sincerely yours 
/a/ Henry Lo Stimson 
Secretary of War. Item 6 
Admin i atrator. 
Federal Security Agency, 
Washington, D. C, 
Dear Mr. Administrator: 
On 11 May > Lieutenant Colonel Karl R. Limdober, 
Medical Corps, Office of The Surgeon General, was desig- 
nated to represent the War Department on the Interdepart 
mental Quarantine Commission. Du© to the pressure of hi 
duties in the Office of Tho Surgeon General, ho is unabl 
to continue on this duty, which is a full-time Job. 
Major Philip T, Khies is designated to represent th 
War Department vice Colonel Lundoherg. 
Sincerely yours 
Secretary of War. Item 7 
WAR BEPARTMEBT 
Washington 
July 28, 19^5. 
From: The Secretary of War. 
To: Major Philip T. Khles, Medical Corps 
Subject: Interdepartmental Quarantine Commission 
1. You are hereby appointed the Anqy Representative on the Inte; 
departmental Quarantine Commission. You will carry out duties in 
connection which may be assigned you either through the office of 
Administrator of the Federal Security Agency or The Adjutant Gene; 
2. It la understood Dr. G. L* Dunnahoo represents the XI. S. Public 
Health Service and Captain T. 3. Mageth, the Navy Department, and that 
the Commission may, in carrying out its assignments, travel either sepa- 
rately or together. It has been agreed by The Surgeon General of the 
three services and approved by the Secretaries of War and Navy and the 
Administrator of the Federal Security Agency, each of you ia directed to 
inspect the facilities controlled by each service insofar as they are 
concerned with matters cosing under the terms of reference and authority 
of the Commission, which are as follows: 
a. By Joint action of the Federal Security Administrator, the 
Secretary of War, and the Secretary of the Wavy, an Interdepartmental 
Quarantine Commission is established, composed of on© medical officer 
from each of the three departments, appointed by the head of the depart- 
ment, and in connection with the duties of the Comal salon, authorized to 
represent the head of the department. 
ho The Commission is instructed to examine into existing 
quarantine laws, regulations and enforcement procedures, both at ports 
of arrival in this country and at foreign ports of departure, including 
sanitary conditions at ports of departure and of craft enroute. 
c. The Commission will recomend changes or modifications in 
existing laws, regulations and methods of enforcement which may he deemed 
necessary to protect the interests of the United States and of our* mili- 
tary and naval personnel in other countries against danger of tha intro- 
duction of quarontinable and other exotic diseases which may threaten 
military or civilian health and consequently imped© the war effort. . d« Th© Cofeaisalon la authorized to travel to such places as 
may be necessary in order to carry out the foregoing duties. 
a. The Conaaission vill keep the Federal Security Administrator, 
the Secretary of War, and the Secretary of the Navy informed In regard 
to the progress of its studios, will submit a final report and re- 
commendations as soon so practicable, and will perform such other 
duties as from time to time may bo assigned to it by competent authority. 
/s/ Kotert P, Patterson 
Acting Secretary of War Item 8 
FmmL security agehcy 
Washington 
August 2, 194-5 
(Through The Surgeon General) 
Dear Doctor Dunmhoo 
By Joint action of the Federal Security Administrator, the 
Secretary of War and the Secretary of the Havy, and Interdepart- 
mental Quarantine Coaaaiaeion has been established. The Commission 
is composed of one medical officer from each of the thro© de- 
partments, appointed by the head thereof. The representative of 
the Federal Security Administrator will act as chairman. Each 
representative is authorized to represent the head of the depart- 
ment concerned In connection with the duties of the commission. 
You are hereby appointed the representative of the Whited 
States Public Health Service and the Federal Security Agency 
an this Interdepartmental Quarantine Commission, As the rep- 
resentative of this Agency, you will act as chairman and carry 
out duties in this connection as outlined below. You will alao 
perform such other duties as fresa time to time may be assigned 
to you by competent authority. 
The Secretary of War has designated Major P. T, Shies to 
represent the War Department, The Secretary of the Havy has 
designated Captain T* Bo Magath to represent the Havy Depart- 
ment* 
In accordance with the egresaaent reached by The Surgeons 
General of the Army, Havy, and Public Health Service, approved 
by the Secretaries of War and the Havy and by the Federal 
Security Administrator, it is directed that each member of the 
cosaalsslon, traveling separately or together, inspect the 
facilities controlled by each department or agency, insofar as 
they are concerned with matters coning under the authority of 
the Commission, which are ae follows: 
(l) The Commission is Instructed to examine into existing 
quarantine laws, regulations and enforcement procedures, loth 
at ports of arrival In this country end at foreign porta of 
departure, including sanitary conditions at ports of departure 
and of craft enroute* \2) The CosiMlsslcn will recommend changes or modifications 
la exieting laws, regulations and methods of onforcrasnent which 
niAy be deemed necessary to protect the interests of tho United 
States and of our military and Naval personnel in other countries 
against danger of the introdxictlon of quarantinablo end other 
exotic diseases which may threaten military or civilian health 
and consequently impede tho war effort. 
(3) *Che Coisaisaion is authorized to travel to such places 
aa may be necessary in order to carry out the foregoing duties« 
(4) The CoBaulseioa will establish contact with the War 
.Research Service of th© Federal Security Agency and advise with 
its Director regarding defense measures relating to War Be search 
Service responsibilities assigned it by Presidential directive. 
(5) The Commission will keep the Secretary of War, the 
Secretary of the Wavy, and the Federal Security Arimini strator 
informed in regard to the progress of its studies and will sub 
salt a final report and recamjaandations ae soon as practicable. 
Sincerely yours 
Signed) PAWL V. 1C MOTT 
Admlnl stratoi 
Assistant Surgeon General 0. L. Dminahoo, 
U* S„ Public Health Service, 
Washington, D. C* 
GLD;H:MES;ref 
cc, War Department and Navy Xtepartsant Item 9 
FEDERAL security agency 
Washington 
May 25, 1W 
Dear Mr, Secretary 
X am enclosing herewith a copy of a letter which 
I addressed to the Secretary of War and to the Secretary 
of the Navy, outlining a proposal for a joint commission 
to study th© problems connected with the spread of epidemic 
and tropical diseases by the rapidly accelerating use of 
aircraft. Replies have been received from both the Secretary 
of War and the Secretary of the Navy, each concurring in the 
principle expressed in the plan of procedure. 
We are all In agreement that the Department of 
Agriculture may he concerned in th© matter, and if you con- 
cur, I shall appreciate your appointing a member to represent 
your Department. 
Sincerely yours. 
(Signed) WATSON B. MILLER 
Acting Administrate! 
The Honorable 
The Secretary of Agriculture 
Washington, D. C. Item 10 
DEPARTMENT OF AGRICt 
Washington 
June 8, 19^5 
Hon0 Paul V. McNutt 
Administrator, Federal Security Agency 
Washington, De C. 
Dear Mr. McNutt; 
Wo have Mr. Watson B* Miller's letter of May 25, 19*0, enclosing 
a copy of your letter of April 23, addressed to the Secretary of 
War and to the Secretary of the Navy, outlining a proposal for an 
Interdepartmental Quarantine Commission to study problems connected 
with the spread of epidemic and tropical diseases by the rapidly 
accelerating use of aircraft. 
The problea as outlined in the communication referred to is 
seemingly confined to an investigation and study of Public Health 
quarantine matters and does not include plant quarantine activities 
participated in by this Department under the authority contained in 
the Insect Pest Act of 1905 and the Plant Quarantine Act of 1912. 
If it is intended that these studies shall Include possible intro- 
duction of insects and plant diseases likely fco be injurious to 
cultivated crops or domestic animals, we would be pleased to have 
a representative on this Commission. It should be understood,, 
however, if the studies in question are confined to Public Health 
problems, the specialists of this Department who may be in a posi- 
tion to contribute will stand ready to cooperate, upon request, to 
the fullest extent. 
Sincerely, 
(Signed) GSROVSR B. HILL 
Assistant Secretary Item 11 
ITINERARY OF COMMISSION AE A WHOLE 
JvSoA. 
Puerto Rico 
New York 
Miami and area 
Washington 
West Palm Beach and area 
San Juan 
Borinquli 
St, Thomas 
Charlotte Amaili© 
Cuba 
Havana 
Batista 
Cienfuegos 
San Antonio 
Cam&guey 
Santiago 
Antilia 
Guantanamo Bay 
Preston 
Martinique 
Fort d© France 
Barbados 
Seaollff 
Trinidad 
Port of Spain 
Waller 
Edinburg-Xer©o 
Piarco 
Naval Air Station 
•Jamaica 
Kingston 
Goat Island 
Fort SiiTOons 
Haiti 
Brazil 
Port au Prince 
Bolam 
Fortaleza 
Natal 
Recife 
Dominican Republl 
Trujillo City 
Senegal 
French Morocco 
Casablanca 
Port, Lyautoy 
Rabat 
Atar 
Tlndouf 
Dakar 
Eknes Field 
D5 Yoff Fiol 
British Guiana 
Atkinson Yield (Georgetown 
French Guiana 
Cayenne Field 
Surinam 
Zandry Field .additional Tzmmmy: ov doctor domahoq 
Yonoauola 
jfexlco 
LaGuiara 
Caracas 
Maracay 
Maracaibo 
Mexico City 
Juarez 
Brazil 
Rio d© Janeiro 
Columbia 
Baranquilla 
Bogata 
.frencn Morocco 
Marraokoch 
Curacao 
Ecuador 
Vi11lamstad 
American Air Base 
Guayaquil 
Peru 
Aruba 
American Air Baa 
Lima. 
Panama 
Chile 
Santiago 
Valpariso 
Cristobal 
Panama City 
Argentina 
Canal Zone 
Buanoa Aires 
Colon 
Balboa 
Jruquay 
*• *uwwh«I:«k»*hv’w> 
Montevideo 
TJoS.Ao 
El Paso 
Brownsville 
Guatemala 
Guatemala City ABLttT IOIIAJL XrmSBim OF CAPTAIN T» B, HAGA33I 
J»S „ A. ‘ 
Sm* 
Baluchistan 
Jackonsvillo, Florida 
(H.A.S.) 
Cairo 
Port Said 
Suez 
Alexandria 
Gwada 
Assam 
Chabua 
din slaw 
Brazil 
San Luis 
Palestine 
Surinam 
Jerusalem 
Tel Aviv 
Tel Levinaky 
Haifa 
Jaffa 
India 
Karachi 
New Delh 
Calcutta 
Paramaribo 
French Morocco 
F6z 
Sale 
Lebanon 
China 
Kunming 
Chengkun 
Beyrouth 
Saida 
Tyre 
Glhralta 
Gibralta 
Arabia 
Syria 
Mosolhah Island 
Salala 
Algieria 
Pansae 
Alepc 
Tripoli 
Algiers 
Mon 
Aden 
Tunisia 
Tunis 
La Goulett© 
Bizarte 
Iraq 
Baghdad 
Basra 
Fritrea 
Asmara 
Tripoli 
2s*®z 
Ankara 
Hydrapasha 
Istanbul 
Anglo Egyptian Sudan 
Khartoum 
Malta 
Algeria 
Kano 
Lagos 
Fide tie. 
Iran 
Khooramahehr 
Abadan 
Tehran 
Sharjah 
Gold.Coast 
gjc.ag 
Takored 
Accra 
Catania 
Palermo 
Liberia 
Italy 
Persian Gulf 
Heberts Field 
Fisherman*b Lake 
Hoborta Port 
Bari 
Naples 
Taranto 
Bahrain Island 
Sandi Arabia 
Bhahran ADDITIONAL ITINERARY OF LIEDT, COLONEL P T, KHIES 
Mexico 
Mexico City 
Vora Cruz 
Merida 
Juarez 
Matamores 
Hew Zealand 
Auklond 
Wellington 
Venezuela 
LaGuiara 
Caracas 
Maracay 
Maracaibo 
Hew Caledonia 
Tontouta Air Base 
Noumea 
Plain de G iliac 
Columbia 
Baranqullla 
Turbo 
Bogata 
U.S .A. 
Hew Orleans 
Houston 
Galveston 
Brownsville 
Mataaores (Max). 
San Antonio 
Dallas 
El Paso 
Juarez (Mox). 
San Francisco 
Hamilton Field 
Ft. MacDonald 
Ft. Stonemn 
Treasure Island 
Boston 
Presque Isle, Mo. 
Washlngton 
Fiji 
Handn Air Base 
Curacao 
Willi emet ad 
American Air Base 
Canada 
Montreal 
Ottawa 
Aruba 
American Air Base 
Brazil 
Rio d© Janeiro 
Manaus 
Panama 
Cristobal 
Panama City 
David 
French Morocco 
Harrackech 
Canal Zone 
Colon 
Balboa 
Liberia 
Roberts Field 
Wright Field, Dayton, Ohio 
LeGuardla Airfield, NYC, 
m, APOE 
Costa Rice 
San Jcgg 
Gold Coast 
Accra 
Territory of Hawaii 
Honolulu 
Pearl City 
Pearl Harbour 
Hickham Field 
Kaneohe Air Station 
Hlcarague 
Managua 
Corinto 
Ascension Island 
Army Air Base 
Honduras 
Teguc igalpa 
El Salvador 
San Salvador 
La Libertad 
Canton Island 
Australia 
Brisbane 
Townsville 
Sidney 
Canberra 
Guatemala 
Guatemala City 
San Jose 
Puerto Barrios 
Hew Guinea 
Port Moresby 
Hiln© Bay 
Oro Bay 
Dobadurrs DESCRIPCION INDIVIDUAL DE VIAJE INTERNACIONAL Y REGISTRO DE IMMUNIZACION 
Nombre 
Direccion 
Residencia, y lugares vis- 
itados durante las dos se- 
manos antes de este viaje 
Fecha 
partido 
Residencia, y lugares vis- 
itados durante las dos se- 
manos antes de este viaje 
Fecha 
partido 
Si es necessario, continue en el reverse 
REGISTRO DE IMMUNIZACION 
Anotaciones hechas por oficial de Salud o otro oficial representative de 
linea de transportes. Esto certifies existencia de certificados originales 
por medicos autorizados. 
I 
j Enfermedad 
Fecha del ultimo 
certificado vaiido 
Medico 
Copia certifi- 
cate por* 
de 
transportes 
Varioloid© 
(Reaccidn pri- 
marie o immune) 
Tifo 
llevado por 
piojos, no 
fiebre 
tifoidea) 
Fiebre 
amdlrilla 
Colera 
Hecho por 
Plaga 
*Sellos oficiales de validez se ponen en el reverse, raonstrando las fechas. INDIVIDUAL INTERNATIONAL TRAVEL LOG AND IMMUNIZATION RECORD 
Name 
Address 
Residence, and places visit- 
ed, beginning two weeks be- 
fore travel. 
Date 
departed 
Residence, and places visit- 
ed, beginning two weeks be- 
fore travel. 
Date 
departed 
If necessary, continue on reverse side 
VACCINATION RECORD 
Entries to be made by public health official, or official representative 
of the carrier. This certifies existence of original certificates from 
authorized physicians. 
Disease 
Date of last 
valid certificate 
Physician 
Certificate 
copied by* 
Carrier 
Smallpox 
(Primary or im- 
mune reaction) 
Typhus 
(Epidemic; 
louse-borne; 
not typhoid 
fever) 
Yellow fever 
Cholera 
Manufactured by 
Plague 
validating stamps to be placed on reverse side and dated by 
the certifying agency. Item 14 
United States Public Health Service 
To the Physician, 
The person named below, an international traveler, has been in- 
structed to consult a physiclan at intervals until end on a certain 
date for medical surveillance. This Is required by regulations of the 
U.S.Public Health Service because of the recent possible exposure of 
this traveler to 
PLAGUE,EPIDEMIC TYPHUS SMALLPOX CHOLERA YELLOW FEVER 
(Quarantine Officer to encircle proper word) 
It is requested that upon proper consultation you complete the 
attached card, which will terminate the surveillance- 
KINDLY REPORT BY TELEGRAM COLLECT TO THE SURGEON GENERAL, U.S, 
PUBLIC HEALTH SERVICE, WASHINGTON, D.C» IF THE PERSON DEVELOPS, OR IF 
YOU SUSPECT, THE DISEASE ENCIRCLED 
Thomas Parran, Surgeon General 
UNITED STATES OF AMERICA 
Treasury Department 
U.S. Customs 
MEDICAL SURVEILLANCE BOND 
No 
194- 
Received of. 
Address 
the sum of $100,00, in accordance with U.S.Public Health Service Reg. 
Ho. (x), as a surety that the above named person will report by tele- 
phone or in person every second day, until, and in person on 
o..194.., to an authorized physician for examination 
because of recent possible exposure to a quarantinable disease. 
When this receipt is returned to this office properly signed by 
the authorized physician, the sum of $100.00 will be refunded. 
(U.S.Customs Agent) 
I, a physician licensed to practice medicine In the State of 
,, certify that the above named recent traveler 
completed the period of medical surveillance on the specified 
terminal date in accordance with the above noted regulations, and 
(no) evidence of quarantinable disease was found. 
•M.D 
(Title If any, or License Ho, UNITED STATES PUBLIC HEALTH SERVICE 
Quarantine Station 
To th© Traveler, 
The circumstances of your travel requires that you be kept 
under medical surveillance for a short time for the protection of 
yourself and those with wham you come in contact, because of your 
recent possible exposure to a quarantinable disease. This will 
require you to report by telephone or in person every second day, 
and in person on the terminal date, to an authorized physician 
(Federal, state, country, or city public health physician, or licensed 
private or clinic physician). On the terminal date he will sign the 
Medical Surveillance Bond, which you will then mall to the Customs 
official who issued the bond, and who will return your deposit to 
the address thereon. Bf THE EVEHT OP ILLNESS REPORT TO YOUR PHYSIC- 
IAN AT OUCE. 
Thomas Parran. Surgeon General. 
(Frank) 
Name of Customs Official 
Office of TJ.S.Customs 
Port  
UNITED STATES OF AMERICA 
BILL OF HEALTH 
Name or designation of vessel ...Nationality 
Port departed. .. Date 
19** 
Number of persona embarked 
Quarantinable diseases in port or vicinity during past 60 days; 
CHOLERA PLAGUE,. BUBONIC PLAGUE, PNEUMONIC PLAGUE, RODENT 
SMALLPOX,EPIDEMIC TYPHUS,EPIDEMIC YELLOW FEVER (encircle proper words) 
Wbat other ccaiDBunicable diseases were epidemic t 
If plague in man or rodents Is present, answer the followings 
a. Was the vessel alongside?.„.•- b« Wash the vessel anchored offshore?. 
c. Was cargo taken on? 
Is the sanitation of the vessel satisfactory?. If not, specify 
Was the drinking water supplied the vessel potable?. 
Consular or authorized medical officer. Item 16 
UNITED STATES OF AMERICA 
QUARANTINE DECLARATION--A2BCRAF1 
Airport of Entry 
Date 
Aircraft limber 
Ownership. ,Ho. of Crew 
Aerodrome 
Aerodromes* From Which The Aircraft Departed 
Ho.passengers 
boarding • 
Date 
Aerodrome 
Ho.passengers! 
hoarding 
Date 
Ho. of passengers disembarking .Ho. ill,disembarking 
Was there any illness, other than airsickness,during flight t 
Were living an Inals, birds, caged insects, bacterial cultures aboard during 
this flight ? 
WHERE AHD WEEN WAS PLANE LAST DD5IHSECT37ED ?. 
(Aircraft Cosasander) 
Hour of arrivals,. Was plane dieinsectir.ed after landing ? 
Disposition of dieembarkoessFree pratique....Surveillance.•.Quarantine. 
Details on reverse side) 
Immigration examinations: Passed.... .Examined.... .Certif led: A.... ,B 
Name 
Nationality 
Class 
Defect 
(Quarantine Officer 
include all aerodromes encountered in the flight, beginning at its 
farthest point and progressing toward the port of entry, irrespective of 
overnight stops. Item 1? 
nmRMTlOKAL CODE FOR EPIDEMIOLOGICAL REPORTS 
DISEASES (Quarantinabla) 
Symbol 
DISEASES (Communicable) 
Symbol 
Plague - 
Bubonic 
Pulmonary 
Rodent 
Cholera 
Smallpox 
Typhus - 
Epidemic louse-borne 
Other 
Yellow Fever 
Meningitis 
Encephalitis 
Poliomyelitis 
influenza 
Scarlet Fever 
Dlptherla 
Measles 
Chickenpox 
Leprosy 
Hone 
I 
J 
K 
L 
M 
H 
0 
P 
Q 
Z 
A 
B 
C 
D 
E 
F 
a 
H 
Order of Message; 
1. Place—in standard code. 
2. Casea-as numeral before cod© letter for disease. 
3- Disease—in cod© letter. 
*1-, Deaths—in numeral after code letter for disease 
Clearance from disease to be Indicated by code-letter 
without numerals. 
Non-quarantinable diseases to be reported only If epidemic 
Example 
The following message concerning diseases present at Paramaribo, Surinam, 
(call letters "P2Y") is shown below in the condensed form permitted by 
the above code. 
Data? "There are 16 cases of bubonic plague in man, with six deaths In 
past week; also 55 cases of smallpox, with 10 deaths; and cases 
of poliomyelitis with no deaths." 
Cod© Message; ”P2YX16a6X55®10X5^K/' Item 18 
1RTERNATIQBAL CODE FOR EPIDEMIOLOGICAL REPORTS BY AIRWAYS CCMMCWICATIOMS 
DISEASES 
1 Case 
Few Cases 
Many Cases 
(Quarantinable) 
Plague - 
Bubonic 
Pulmonary 
Rodent 
Cholera 
Smallpox 
Typhus - 
Epidemic, lousebome 
Endemic, murine 
Yellow fever 
A 
D 
G 
H 
B 
E 
I 
C 
F 
J 
K 
L 
M 
P 
H 
0 
DISEASES 
(Communicable) 
Meningitis 
Encephalitis 
Poliomyelitis 
Influenza 
Scarlet Fever 
Dlptherla 
Measles 
Chickonpox 
Q 
R 
S 
T 
U 
V 
W 
X 
The above codo-lotters may b© of designated significance in "fixed-position” 
messages, such as weather reports, or may be preceded by "Q” in open messages Item 19 
REPORT OH QUARANTINE AND SANITARY CONDITION OF 7ESSEL 
TO: Medical Officer in Char go, U.S. Quarantine Station 
SUBJECT; Report of entrance of a (1) U.S.Naval vessel,or (2) merchant vessel. 
1. A vessel, arrived this port on 
(Ham© or number) (Date Hour ) 
2. The crew and passengers were examined* and none was found to he 
suffering or suspected of suffering from a quarantinable disease except 
as follows: 
5. The vessel is (not) considered infected and was (not) granted free 
pratique. (Ho compartments were infested with lice) (lice infested compartments 
were (not) deloused). 
h* There were (no) pslttaclno birds aboard. (Those present wore destroyed) 
(Those present will not be landed). 
5. The vessel (not) free of rats. (Request is made for inspection by 
the U.S.Public Health Service). 
6. Duplicate bills of health(are forwarded herewith) (wore not available). 
Signed. 
U.S.Naval Quarantine Officer or 
ship's doctor. 
*Tho examination may be based on personal observation or on the statements 
mad© by the captain or other responsible officer of the ship relative to 
the health of the crew and passengers* 
RESTRICTED 
- 28 - Item 20 
DRAFT 
S^L 
Page 1 
AAF R3KSQLATI0H 
Ko, 61-5 
WAR DEPARTMENT 
BKADQBABtESRS, ARMY AIR FORCES 
Washington, 
njnns outside tbb united states 
QUARARTIKE 
Paragraph, 
General, Responsibility"——————— —— 1-2 
Section I, Quarantine of Personnel— * —-—«—--3-5 
Section II, Quarantine of plants, anlisalo, and their products-6-11 
Section III, Disinsectization of aircraft ——--—-—--—--12-15 
General; Responsibility; 
1. Compliance with the provisions of this regulation, in accordance with 
AR Section I, Par, 1, b- (15), is a responsibility of each ccsHsam 
concerned. This responsibility Includes both the training of personnel 
and the provision of supplies required under this regulation, as veil an 
the establishment of liaison with pertinent local, quarantine authorities. 
The responsibility will bo discharged with the technical advice of the 
surgeon. Surgeons will conduct inspections ns necessary, Including the 
search of baggage,to inauro that the provisions of this regulation are 
being carried out, A copy of this Regulation will be carried in all air- 
craft to which its provisions apply. 
8a In exceptional cIrcumatancoa the provisions of this regulation may be- 
amended in a aanner acceptable to local military and public health service 
officials after written approval by the Ccssianding General, Army Air 
Forces. 
Section I, Quarantine of personnel; 
5. In order to prevent the introduction of the quarentimble diseases of 
jean by air traffic, provisions of this Section will apply to all personnel 
carried by aircraft under the Jurisdiction of the Arny, The quarantimble 
diseases concerned are, by international convention, cholera, plague, 
ascallpox, typhus (louse-boras), and yellow fever°9 and, in addition, leprosy, 
with reference to the United States, it© territories and possessions. 
h, Travel in aircraft under the Jurisdiction of the Army will he contin- 
gent on the satisfaction of imumlzeXicn requirsmentc of the War or Kavy 
Department, and on freedcaa frcsa vermin. Civilians not subject to field 
service with the armed forcee of the United States, military personnel 
of foreign countries, and persons bearing valid certificatesof urgency 
approved by the Secretary of War, Havy or State will not bo required to 
be so Immunized* Such individuals should be advised of the advantages of 3 Ibiges 
Peg© 2 
immunization, and say bo liisauaized upon their request. Persons will not 
be aceeptod for transportation if, in the opinion of the Surgecn of the 
carrier echelon, their transportation would imperil the health of other 
personnel, or if It is contrary to tho requirements placed upon the car- 
rier by countries of entry or of destination. Ho parson will be trans- 
ported by air who is ill with pneumonic plague, or whose last possible 
contact with pneumonic plague has bean within seven (7) days 
5. All personnel will be exibject to the quarantine regulations of the 
countries entered; these requirements will bo supplemented It considered 
inadequate for the protection of the interest of tho United Statae Army., 
The quarantine requirements of the United States Public Health Service 
(See App. Ill) will b© satisfied by freedom fro© vermin and quarantinable 
disease, and compliance with the Immunization requirement* of the Uar or 
Hevy Departments. The pilot of the aircraft will bo notified In writing 
that all persons aboard, unless otherwise indicated, have met these require- 
ments. It will b© the responsibility of the pilot to notify the ccsmand- 
Ing officers of airfields entered, who will notify the quarantine authori- 
ties of the country concerned in accordance with the requirements of that 
country. The movements of persons will be restricted In accordance with 
the quarantine regulations of the country concerned. 
Section IIo Quarantine of plants, animals, and their products 
6o In order to avoid the transmission of animal or plant diseases and 
pests, and In order to observe strictly all pertinent civil and salutary 
regulations, no animal or plant product likely to convey disease or sub- 
ject to quarantine or other restrictive regulations, and no living plant 
or animal (mesaaal, reptile, bird, fish, etc.), will he carried across 
national boundaries by an airplane under the jurisdiction of the Array 
except upon specific permit. This permit will be secured In advance from 
the proper civil authority of the country Into which importation is in- 
tended with the approval of the appropriate theater commander or tho 
Ckaaasading General, Army Air Forces. Pertinent regulations of the United 
States, its territories and possessions are noted in Appendix II, 
7* Such permits will be requested only for plants, animals, or plant or 
animal products intended for scientific, educational, or military purposes. 
Bequests will show the species and niaaber, type of container, source, des- 
tination, purpose for which intended, and the nature of any pathologic 
state. 
8. It will be the responsibility of the shipper properly to pack, crate,, 
tie, administer sedative drugs when necessary, and arrange for care of all 
animls during flight. Written instructions for care, including feeding, 
watering, sxarclse, etc,, will bs attached. Conspicuous labels, contain- 
ing Instruction® for full protection of handlers, will bo attached to all 
cages containing animals infected with pathogenic organ!ssna, or the aniffiale 
will be accompanied by & person responsible for their carol proper disposl- 
tioa will be specified for bedding, dejecta, and other material liable to 
be c ontaminated, 5 Pagea 
Bags 3 
y * ®vsn though otherwise authorIzed, no animal Hill be transported oy 
aircraft unless certified by a qualified veterinarian to be free from 
disease, except as provided In pare. 7 and 8. 
10. Pathogenic cultures or tissues, or animals infected with pathogenic 
organisms may be carried by aircraft only accord with the provisions 
of pars. 6, 7, and 8. 
II. Saw meat end dressed poultry, or kitchon waste containing scraps there- 
of, will not be landed by aircraft except in accordance with pertinent 
military and civil regulations. Particular attention is directed to 
restrict lone pertaining to the use or sale of such material for animal 
feeding. 
Section III* Disinsectization of aircraft 
12. In view of the danger of introduction of Insects which are economic 
hazards or vectors of disease, aircraft under Army Jurisdiction will be 
dlelnsectlzed as follows; 
a. Aircraft entering the United. States, its territories or possessions, 
will, when required by civil regulations, be dioinsect!zed in 
accordance with pars. 13 and The United States Public Health 
Service has agreed that these provisions fulfill it« requirements. 
b. Aircraft entering a foreign ares will comply with the rsquirem&ntr 
of the country concerned for disinsectization. These requirement?, 
if considered inadequate to protect the interest of the United 
States Army, will bs ©miplemented. by tho measures provided by 
paragraph Ip. 
15. Disinsectization, except os noted in pare. 12b end will be 
carried out immediately before the last take-off prior to the entry con- 
cerned, using Aerosol Insecticide or a substitute e.a described in 
Appendix I. Disinsectization will be accomplished; 
a* by the pilot of the aircraft or under Ms direction by personnel 
of the flight-crew; 
b. after full loading of fuel, baggage, cargo, passengers and crew, 
and during or pi'ior to the warm-up of the engines; 
Cc with all doors, windows', hatches, and other openings closed dur- 
ing spraying, and until take-off, which shall not be sooner than 
two (2) minutes after spraying with aerosol bomb, or five minutes 
after spraying with hand sprayer; 
d. in all cabin, cockpit end compartments, and ether places 
deemed necessary if any are inaccessible fresa within the air- 
plane, they will bo sprayed when leaded; 5 Pagss 
Page 
e, and will be certified in the Clearance \AAF Form Ho* 25) of the air* 
craft, as veil as signaled to the control tower. 
Aircraft will not be cleared for take-off until the disinsectization has 
been indicated to the control tower. Operations officers will maintain 
appropriate records* 
Ifc. Die insect izat ion trill not be required of aircraft arriving in the 
Tblted States, its territories or possessions from; 
Continental G. S. Alaska Canada aad adjacent areas 
Iceland' Greenland British Isles 
Bahamas Bermuda Mexico, Federal District 
Curacao and Aruba St. John's, Y,I. Galapagos Islands, 
If flight has originated In other areas or stops have been made at other 
places on route between sunset and sunrise or under conditions favoring 
entrance of Insects Into the planes, disinsectization will be performed* 
All plansg will be dislnsactlzed immediately prior to the last take-off 
before arrival in the Territory of Hawaii, 
15» Civilian pilots of aircraft under Amy Jurisdiction, not complying 
with these provisions, will be suspended fron further flight pending 
action by the Ccaeaanding General, Array Air Forces. 
APrarou I 
A, Use of Aerosol Insecticide; (such as QM Issue, stock Ho. 51*1-159) 
1, To prepare dispenser for operation, invert, band capillary tubs 
backwards and forwards until broken off at bass, and lasssdlately 
screw on cap, 
2o To operate, hold dispenser nozzle-down, unscrew cap, and turn 
upright, 
5* Spray ell ccsapsrtmonts end spacer, dividing proportionately 
the overall tlise indicated la the table below, 
U, Do not hold closer than 1 foot to any stainable article, 
5, To stop apnsy, invert dispenser and screw on cap. 
Bo Alternate Jnaecticlde 
In lieu of Aerosol Insecticide, dieIneec11 z at ion map bo acccEEplislted 
by fins vapor i sat ion frcsa a hand * or other sprayer of a 1 to 5 dilation 
la kerosene, etc,, of standardised pyrethrua extract as pyrethru® 
concentrate, 20 to 1 strengths pyrsthrusa extract standardized; pyrethrum 
extract lb, 20s pyrethrum concentrate Ho, 201 or Bo. 20 extract standardised 
Approved Insecticide and hsndsprayer isay be obtained from Quarternster, 
and should be need in accordance with the table below. 5 Pages 
Pag© 5 
c. 
of Aircraft 
Asrosol 
(Hold 2 atn.) 
EandspreT 
(Hold 5 lain.) 
Single-Saat Planes 
5 sec. 
5 cc. 
B-lS, B-29, or equivalents 
20 sec. 
10 cc. 
B-25, B-26, C-46, B-17, etc. 
50 sec. 
15 cc. 
C-». C-87. etc. 
90 sec. 
cc. 
A watch with second hand will b© used by all sprayer®. 
APPENDIX II 
The importation into the Chi ted States, Its territories or possessions 
of peittaelne birds (parrots, parakeets, lovebirds, etc.), of certain pro- 
ducts likely to be contaminated with spores of anthrax, and of living 
disease organisms and vectors Is subject to regulation by the Chi ted States 
Public Health Service (Sxscutive Order Bo. 526h, 2k Jan. 1930 for psitta- 
cine birds; 9 Code of Fed-- Regs., 95-1C* 95-H for anthrax; Amendment 
Ho. 1?, Quarantine Begs, of D.S. for living disease organisms and vectors) . 
Importation of other wild animals is regulated by the Fish and Wildlife 
Service of the Department of the Interior, (Lacey Act, 25 May, 1900, 31 
Stat. 187-18 tJ.S.C. 395/ amended, for wildlife). Importation of domestic 
animals (evine, equine, ruminant) is regulated by the Bureau of Animal 
Industry of the Department of Agriculture (3.A,I. Order 356 D.SoD.A* 
1 Aug., 1955 and B.A.I. Order 368 D.S.D.A. l6 Jan., 1959 amended, for 
domestic livestock; B.A.I, Order 573 U.S.D.A. 26 Oct., for animal 
products). The Importation of certain plants and plant products ie 
regulated by the Bureau of Sntoaaology and Plant Quarantine of the Depart- 
ment of Agriculture (Service of Regulatory Amendments, U.S,D.A0, 
published annually; Order Bo. 1, Board of Consaiesionerc of Agriculture 
and forestry, T.H., D.A.I., 2? May, 19**D). Animals, plants, and their 
products arriving contrary to these regulations are subject to seizure and 
destruction or to re-export at the expense of the owner c Pots liable to 
rabies are subject to quarantine for 120 day© in Hawaii at owners© expense. 
(Begs. Dlv. of £nt«, Board of Coasaiosloners of Agriculture and Forestry, 
T.H., 1 Dec,, 19*1). 
Ref .s V.D.Meoo w850-*h, 5 April, 19*&| WoD.Circ. No. 17, Jan., 
W.D.Oen. Order Bo. 52, 20 April, which states “no plant, plant 
product, animal or anlml product shall be carried by an Army airplane, 
vessel, or by Army personnel into the Doited States, Hawaii, Puerto Bico, 
or Alaska unless a permit is secured*..” 
APPENDIX III 
Code of Federal Regulations, Title k2. Public Health, Sections 11. - 
11.516, end U.S. Public Health Sallee, For., Quar. Div. Cir. 71, Quarantine 
Treatment of Military Aircraft • The provisions of the latter exempt from 
quarantine all persons flying non-stop to and frcn the following areas, in 
the absence of qisarant Inabls disease, including epidemics of smallpox and 
typhuss United States, Puerto Rico, Canal Zone, Tirgin Islands- Alaska, 
Canada, Cuba and Bahama Islands, and all other Islands of the Caribbean 
area whore 0. S. airbases my b© established, Hewfcuadlaad, St. Pierre, 
Miequelon, and Brlsith Isles • Persona®! assy not be exempted if travel 
has originated elsowh©re within days. FINAL REPORT 
INTERDEPARTMENTAL QUARANTINE COMMISSION 
10 June 19AA 
Washington, D. C.