FOR PHYSICIANS Infectious Diseases INGIAJDING TUBERCULOSIS, TYPHOID FEVER, VENEREAL DISEASES WITH THE QUARANTINE RULES and REGULATIONS of the STATE and of the CITY AND A DIRECTORY of the OFFICES, CLINICS and CULTURE STATIONS of the BOARD OF HEALTH 1917 BOARD OF HEALTH CITY OF NEWARK NEW JERSEY FOR PHYSICIANS Infectious Diseases INCLUDING TUBERCULOSIS, TYPHOID FEVER, VENEREAL DISEASES WITH THE QUARANTINE RULES and REGULATIONS of the STATE and of the CITY AND A DIRECTORY of the OFFICES, CLINICS and CULTURE STATIONS of the BOARD OF HEALTH 1917 BOARD OF HEALTH NEW JERSEY CITY OF NEWARK 2 Department of Health Reporting of Diseases The State Sanitary Code and the Sanitary Code of the City of Newark require every physician and institution to report to the Board of Health within twelve hours the fol- lowing diseases: Anthrax, Chickenpox, Cholera (Asiatic), Diphtheria and Membranous Croup, Dysentery (Amoebic and Bacillary) Glanders, Leprosy, Malaria, Measles, German Measles. Menin- gitis Epidemic (Cerebro Spinal), Ophthalmia Neonatorum, Para-Typhoid Fever. Plague, Acute-Anterior Poliomyelitis (Infantile Paralysis), Rabies (Hydrophobia), Scarlet Fever, Smallpox, Varioloid, Trachoma, Trichinosis, Tuberculosis, all forms, Typhoid Fever, Typhus Fever (Brill’s Disease), Whoop- ing Cough, Yellow Fever, Pneumonia, Lobar and Bronchial, Mumps, Erysipelas, Tetanus, Puerperal Fever, Puerperal Septi- caemia. The Sanitary Code also requires every physician and insti- tution to report to the Board of Health every person affected with any of the following diseases within twenty-four hours: Epilepsy, Mental Deficiency, Arsenic Poisoning, Lead Poisoning, Mercury Poisoning, Phosphorous Poisoning, Com- pressed Air or Caisson Disease. Cases must be reported on the postal cards furnished by the Board of Health upon requisition. When a positive diagnosis of a communicable disease has been made by the Laboratory of the Board such positive result must be reported by the physician in the ordinary way. Cases of Scarlet Fever, Diphtheria, Poliomyelitis, Cerebro-Spinal Meningitis and Smallpox are placarded upon all the public entrances of all dwellings, dwelling houses, apartments, apartment houses or other places. All cases of Whooping Cough are required to wear the arm band according to the City Ordinances before going upon the streets or in public places. Every case of Scarlet Fever, Diphtheria, Cerebro-Spinal Meningitis, Acute Anterior Poliomyelitis, Typhoid and Para- Placards Department of Health 3 Inspection by the Board Typhoid Fever, Smallpox, Measles, German Measles and Whooping Cough is visited by an inspector of the Contagious Disease Division, who takes a history of the case and obtains assurance of quarantine and isolation, gives written and verbal instructions as to the same, excludes susceptible school children or teachers from school, makes inquiries as to the handling of milk and food stuffs by persons living in the infected premises or the performance of home work, such as tailoring in the rooms or family. Cases of pulmonary tuberculosis under the care of private physicians are visited by the tuberculosis nurses on physician’s request. Quarantine After the first visit cases in which isolation is satisfactorily observed are visited at frequent intervals only. Those in which isolation measures cannot be depended upon are kept under close supervision. The inspector does not interview the patient except when special complaint has been made with regard to isolation procedures or to terminate quarantine in cases of scarlet fever. No inspector is allowed to comment upon diagnosis, prognosis or treatment. Violation of Quarantine Should a case of Scarlet Fever or Diphtheria be found in a room in the rear of or communicating with a store and proper means of isolating the case be absent the family are given the choice of closing the store or of permitting removal to a hospital. All school children and school teachers are for- bidden to attend school during the quarantine period of small- pox, scarlet fever, diphtheria, measles, epidemic meningitis, infantile paralysis, chickenpox and German measles. W hen violations of quarantine or isolation measures are observed which the family cannot or will not correct the Health Officer requests the assistance of the attending physician. Should these measures fail and the patients’ or parents’ consent for removal to hospital be refused, the case is forthwith removed to an isolation hospital in accordance with the City Ordinances 4 Department of Health on the ground that the patient is a menace to the health of the community. No work, such as tailoring, etc., may be done in houses where a case of communicable disease exists. Diagnosis Where the attending physician wishes assistance in the diagnosis of a case of communicable disease the services of a diagnostician will be arranged for by application to the Health Officer. Isolation No home treatment of any case of communicable disease will be permitted unless proper isolation can be carried out upon the premises. The patient shall be isolated in a room separated from other dwelling apartments by a room or passage. The nurse or attendant who is caring for the case shall do nothing else and before leaving the sick room shall carefully cleanse the hands in a disinfectant solution. No dishes or articles of clothing or bedding must leave the sick room before being soaked in a disinfectant solution. No person except the nurse or at- tendant shall be permitted to enter the room of a person suffering from communicable disease and only clothing such as may be washed in boiling water may be worn by nurse or patient. Nurses and attendants shall carry out continuous disin- fection of all discharges of a case of communicable disease throughout the period of quarantine. In poliomyelitis, scarlet fever, diphtheria, measles, whooping cough, meningitis, the material from the throat and the nose is infective and should be thoroughly disinfected before final disposal. In typhoid fever the intestinal discharges and the urine should be so dis- infected. No library books shall be allowed in the sick room and no milk bottles shall be collected from quarantined houses until after final disinfection has taken place. Attendants and relatives may be protected from diphtheria by antitoxin and from typhoid fever and whooping cough by vaccines which are provided free by the Board of Health. Department of Health 5 Removal to Hospital Suitable cases of scarlet fever and diphtheria and typhoid fever will be removed to the Essex County Isolation Hospital upon request, which should be made to the Superintendent of the Hospital, at Soho. Only exceptional cases are removed at night. It is advisable, where any doubt exists, with regard to the diagnosis of a communicable disease, that confirmation be made by a diagnostician from the Board of Health. No com- municable diseases are taken to the City Hospital or to any private hospital in the city. Termination of Quarantine The quarantine period is terminated by the Board of Health upon recovery, death or removal to hospital or change of diagnosis (on receipt of written statement from the physician that the original diagnosis was in error). Disinfection Fumigation will be carried out by the Disinfecting Inspectors of the Board in all cases of scarlet fever, diphtheria, poliomye- litis, cerebro spinal meningitis and tuberculosis. After the fumigation the occupants of the premises are required by the Sanitary Code of the city forthwith to air such premises and to carry out a thorough mechanical cleansing and scrubbing of all woodwork, floors and furniture of such rooms with a solution made of one-quarter pound of washing soda to each gallon of hot water and one pound of soap. It is desirable also that the walls of the sick room be cleansed with a disin- fectant and subsequently calcomined, repapered or repainted, and the woodwork and floors cleaned, repainted or revar- nished. Upon completion of the quarantine period of any communicable disease and after the case has been declared by the attending physician to be free from infection the patient shall be given a bath, including a thorough cleansing of the hair and dressed in clean clothes throughout. All infected articles shall be soaked in a disinfecting solution, for one hour and then boiled in soap suds for one hour. Destruction of books or toys used by the patient shall be carried out. 6 Department of Health Placards will be removed by the Disinfecting Inspectors at the termination of the quarantine period and only after satis- factory fumigation has been accomplished where such is re- quired. Funerals The bodies of persons dead of communicable disease shall be placed in a hermetically sealed casket. All such funerals must be private and burial will be required to be carried out within twenty-four hours in the manner prescribed by the Board. Exclusions from School Other children in the family who have not had the disease are excluded from school and if they remain, on the premises until termination of the case cannot return to school until after the expiration of the incubation period of the disease. Special permits to return to school will be issued to teachers or children upon receipt of evidence of previous attack of the disease in question providing isolation or residence is changed. Also in case of diphtheria in school teachers who show a negative swab from the throat and who have resided in a new address for the period of incubation of the disease. Major Infectious Diseases Smallpox, Cholera, Plague and Typhus Fever. The Board of Health immediately assumes full charge of all cases of the above diseases. Scarlet Fever: The incubation period is seven days. Quarantine thirty days, provided that all abnormal discharges from the nose and throat or suppurating glands have ceased. The case is placarded and suscepiible members of the family remaining on the premises are excluded from school until after recovery of the patient. Measles: Incubation period, fourteen days. Department of Health 7 Quarantine period fourteen days after appearance of erup- tion and until all abnormal discharges from the nose, ears and throat have disappeared and cough has ceased. Susceptible children are excluded from school. Diphtheria: Incubation period, two to five days. Quarantine period until two successive negative cultures have been obtained from both the nose and the throat at intervals of not less than twenty-four hours, or until the bacilli present have been shown to be non-virulent. When the quarantine period is less than seven days, the interval between two nega- tive cultures shall be forty-eight hours. Cases placarded. Cases reported by postal card will be considered as diphtheria even though culture from the laboratory be negative, unless otherwise requested by the physician. No case will be terminated unless the two negative cultures from the nose and the throat have been taken as aforesaid. Trial cultures should be made from all members of the family, for it is very frequently the case that an unknown carrier of diphtheria is the cause of the infection. After isola- tion procedures are properly carried out children and teachers who have been properly immunized by diphtheria antitoxin may be regarded as free from possible means of infection. Im- munization of all other members of the family is recommended. The antitoxin for this purpose is supplied free by this Board. Antitoxin can be obtained at any of the culture stations of the Board (see directory) upon application of physicians where the patient is unable to pay for the same. Cerebro Spinal Meningitis: Incubation period, five days. Quarantine period, two weeks. It is advised that the diagnosis of this disease be confirmed by lumbar puncture and the treatment followed up by the injection of anti-meningococcic serum. Poliomyelitis: Incubation period, five to ten days. Quarantine period, three weeks and until the temperature of the patient has become normal. 8 Department of Health Health Literature, Etc- Literature, circulars of information for physicians regarding isolation and quarantine rules and for tuberculosis, etc., will be sent upon request. Minor Infectious Diseases German Measles, Mumps, Chickenpox, Whooping Cough On receipt of a report from the physician, inspectors of the Department will visit and inform householders of the proper isolation and quarantine measures as to the precautions to be observed, etc. No placarding. German Measles: Incubation period, two weeks. Quarantine period, one week. Mumps: Incubation period, twenty-one days. Quarantine period, until two weeks after onset and until all swelling shall have disappeared. Chickenpox: Incubation period, twenty-one days. Quarantine period, until twelve days afier appearance of eruption and until all crusts have fallen and scars completely healed. in all cases of chickenpox in adults, the diagnosis should be confirmed by a diagnostician of the Board of Health. Whooping Cough: Incubation period, fourteen days. Quarantine period six weeks or until “whoop" has entirely disappeared. The patient is required to wear the yellow arm band prescribed by the City Ordinances and supplied by this Board for use when the patient is allowed upon the public streets. Whooping Cough vaccine is provided free by the Board for purposes of treatment of cases and immunization of susceptible children. Tuberculosis Physicians are required to report all cases of tuberculosis, Department of Health 9 irrespective of previous reports by other physicians. The Tuberculosis Record of the Board of Health is confidential and subject to inspection only upon Court order. Cases reported by private physicians as under their care are visited by the tuberculosis nurse3 only upon request, except where physicians fail to inform the Board that proper melhoiTs are being taken by the patient and family to prevent the spread of infection. Physicians are asked to report promptly all changes of ad- dress, removal to hospital or out of town, recovery or other causes foi discontinuance of treatment. Open cases of tuberculosis with positive sputum where the necessary precautions cannot, or will not, be observed and others, especially children, are exposed to infection, are re- quired to be removed at as early a date as possible to a tuberculosis sanatorium. School children or teachers with tubercle bacilli in the sputum are not allowed to attend school until two successive examinations of the sputum fail to show tuberculosis bacilli. Such children are admissible, however, to day camps or open air schools, where they may continue their studies. Premises previously occupied by consumptives are fumigated and subsequently ordered to be cleaned and renovated. Clinics for tuberculosis are held in the Board of Health Dispensary on the following days: Children, including glands and joints, Mondays, at 3:30 P. M. Pulmonary Tuberculosis, for adults, on Tuesdays, at 3 o’clock. Laryngeal Tuberculosis, on Wednesday, at 4 o’clock. Pulmonary Tuberculosis, for adults, on Wednesday, at 3 o’clock. Pulmonary Tuberculosis, for adults, on Thursday, at 3 o’clock. Children, Pulmonary Tuberculosis, on Thursday at 4 o’clock. Pulmonary Tuberculosis, for adults, Friday at 3 o’clock. Admission to a suitable tuberculosis sanatorium or hospital 10 Department of Health may be secured by referring patients to the City Dispensary on the following days: For Verona Sanatorium, Monday, at 10 o’clock. Verona, Verona Township, Essex County, Telephone 5437 Verona. Information of requirements for patients going to Verona are given on application to the Division of Tuberculosis of the Board of Health, Health building, William and Plane streets. Incipient cases only received. For Glen Gardner, Wednesday, at 10 o'clock. Informa- tion of requirements for patients going to Glen Gardner can be obtained at the Newark Anti-Tuberculosis Society, 45 Clinton street. ’Phone Mulberry 1107. Incipient cases only- received. For Soho Hospital, Thursday, at 10 o’clock. Information of requirements for patients going to Soho can be obtained at the Division of Tuberculosis Board of Health, Board of Health building, Plane and William streets. Also on appli- cation at the Soho Hospital, Belleville. ’Phone Branch Brook 146. All classes of patients received. In addition, the City Hospital has a United number of beds for tuber- culosis patients, and St. Michael’s Hospital has a limited number of beds for women patients only. Typhoid Fever All cases of Typhoid Fever should be reported as soon as possible without waiting for results of laboratory examination in order to assist the Board in determining the source of the infection. Residences of patients are visited by an inspector, who obtains information with regard to probable source of infec- tion, sanitary condition of premises and other information of assistance to the Board. If proper precautions are not observed the case may be kept under continual supervision and removal to hospital may be enforced. Convalescents, if their occupation has to do with the sale of food under the State Law, cannot return to work until the excreta are shown to be free from typhoid bacilli. Immunization against typhoid fever is recommended in all cases where susceptible persons are exposed. Typhoid Department of Health 11 vaccine is provided free by the Board in all cases. Physicians are strongly urged to see that this immunization is carred out in such cases. Venereal Diseases Physicians are required, according to the State Law of 1917, to report all cases of venereal disease directly to the Stale Board of Health, at Trenton. Such reports are treated as absolutely confidential. In the Serological Division of the Laboratory specimens of blood are examined free of charge for the Wassermann reaction for syphilis, and of pus for the gonococcus. Examinations are made only upon request of physicians and the patient is not informed of the result. Deg Bites and Rabies All cases of dog bites are required to be immediately re- ported to the Board of Health when investigations will be made by the inspectors and veterinarians to determine whether a dog is rabid or vicious in which event the dog is ordered to be destroyed. Dogs suspected of rabies should be securely confined until the inspector of the Board arrives to make an investigation. Anti-rabic treatment will be given by Dr. Con- nolly, Bacteriologist of the Board, to which ail persons bitten by animals suspected of rabies should be immediately referred and where full information may be obtained. Should a phy- sician wish to administer the treatment himself, he will be supplied with the virus free. Diagnosis Laboratory The Board of Health provides free diagnoses for phy- sicians in the Laboratory of the Board for Tuberculosis, Diph- theria, Typhoid Fever, for the piasmodium of malaria and of the spinal fluid for meningeal cocci, for the Wassermann re- action in syphilis, for Gonorrhoea and for Ophthalmia Neonatorum. Outfits for obtaining specimens may be obtained at any of the drug stores acting as culture stations. Full in- formation and directions are given with every outfit. For further information apply to ihe Bacteriological Laboratory, City Hospital, or to the Board of Health. 12 Department of Health DIRECTORY OF OFFICES, LABORATORIES, CLINICS, CULTURE STATIONS OF THE BOARD OF HEALTH, NEWARK, N. J. Offices Headquarters, Health building, William and Plane streets. Telephone 8550 Market. Laboratories Bacteriological Laboratories, Hospital building, 116 Fair- mount avenue. Telephone 9300 Market. Pathological and Serological Diagnosis, Palhololgical De- partment, City Hospital building, 116 Fairmount avenue. Telephone 9300 Market. Clinics for Venereal Diseases City Dispensary, William and Plane streets. Genito Urinary, Monday and Thursday, at 10 o’clock. Syphilis, Wednesday, at 3 o’clock. City Hospital, for treatment of all diseases, with the excep- tion of contagious diseases, Fairmount avenue. All cases suitable for treatment are admitted upon certificate of practicing physician of the city. Telephone 9300 Market. Division of Contagious Disease and Disinfecting Corps All information with regard to quarantine and isolation methods, placarding of houses and the discontinuance of quaran- tine may be obtained by communicating with the Board of Health, William and Plane streets, Newark, N. J. Telephone Market 8550. Department of Health 13 Directory of Culture Stations Culture Stations are distributed throughout the city in the various drug stores and are used both as supply and collect- ing stations. They are visited by the culture collectors of the Board of Health daily, who take specimens left in these stations by physicians, to the bacteriological laboratory for diagnosis. Culture stations are visited daily, including Sun- days and holidays, for the purpose of collecting samples. Culture stations are supplied with outfits and with antitoxin in sufficient quantities for emergency requisition. Application for unusual amounts of outfits or antitoxin should be sent directly to Dr. Connolly, at the Bacteriological Laboratory, City Hospital, Fairmount avenue. 14 Department of Health Antitoxin and Culture Stations by Wards Ward STATION Street and Number Telephone No. First .. 1430 B. B. 1142 B. B. First .... Second Precinct Police.... Summer and Seventh Aves 5400 Market Second . St. Michael’s Hospital Central Ave. and High St. 7610 Market Second . City Dispensary Plane and William Sts 8550 Market 1312 Market 914 Mulberry 291 Mulberry 5400 Market C W Menk Second . First Precinct Police Court and Washington Sts Third .... St. Barnabas’ Hospital.... 681 High St 6616 Market Third ... Beth Israel Hospital High and West Kinney Sts 324 Mulberry 3908 Market 1514 Mulberry 1539 Market 9300 Market 4633 Market 25 Wallace PI 3205 Market Eighth Ellwood Pharmacy 190 Washington Ave 1091 B. B. Eighth Oriental Pharmacy 289 Belleville Ave 453 B. B. Eighth H. T. Quin 187 Bloomfield Ave 269 B. B. (Continued on page 17) Department of Health 15 Hospitals in Newark The following hospitals are open for the reception of medical and surgical cases and for the treatment of dispensary cases: The Babies’ Hospital—High and Bank Streets. 324 Mul. Newark Beth Israel Hospital—High and West Kinney Streets. 7766 Mkt. Hospital for Women and Children—Central Avenue and Tenth Street. Mkt. 3886. St. James’ Hospital—Jefferson and Elm Streets. 9516 Mkt. St. Michael’s Hospital—304 High Street. 7610 Mkt. The Presbyterian Hospital—13-19 South Ninth Street. 5141 B. B. Homeopathic Hospital of Essex County—137 Littleton Avenue. 1791 Mul. Hospital of St. Barnabas—963 High Street. 6616 Mkt. Newark German Hospital—430 Bank Street. 8721 Mkt. Home for Crippled Children—Clifton and Fifth Avenues. 1785 B. B. Newark Charitable Eye and Ear Infirmary—77 Central Avenue. 53 Mul. Newark Maternity Hospital, 108 Montgomery Street. 3055 Wav. Newark City Hospital, 1 16 Fairmount Avenue. Mkt. 9300. Contagious Diseases Essex County Isolation Hospital, Soho, N. J. B. B. 146. 16 Department of Health City District Physicians The District Physicians and the boundaries of their dis- tricts are as follows: 1st District—Dr. Charles F. Hill, 180 Polk Street (phone Mkt. 6849)—Avenue F from City Line to Adams Street, Market Street, Broad Street, Fulton Street and City Line. 2nd District—Dr. Mary Broadnax, 79 Clinton Avenue (Mkt. 8133)—Clinton Avenue from City Line to Broad Street to Tichenor Street to Adams Street to Avenue F and City Line. 3rd District—Dr. W. F. L. RoDEMANN, 64 Prospect Street (Mkt. 9161)—Adams Street, Tichenor Street, Broad Street and Market Street. 4th District—Dr. Samuel Hirschberg, 239 Littleton Avenue (Mkt. 9413)—Broad Street from Central Avenue to Clinton Avenue, High Street, South Orange Avenue, Bergen Street, Warren Street, Sussex Avenue and Cen- tral Avenue. 5th District—Dr. William Fischer, 167 South Seventh Street (Mkt. 5739)—Clinton Avenue from City Line to High Street, South Orange Avenue, Bergen Street, Warren Street, Central Avenue and City Line. 6th District—Dr. Meyer Jedel, 125 Fourth Street (B. B. 3216)—Fulton Street, Central Avenue, Sussex Avenue, Warren Street, Central Avenue and City Line. Department of Health 17 Antitoxin and Culture Stations by Wards (Continued from page 14) Ward STATION Street and Number Tciephcne No. Eighth Ninth Ninth T.-ntli Eighth Precinct Police... fleo. Einnett & Bro G. F. Tempel Washington Ave 77 Lincoln Park 210 Clinton Ave 5400 Market 3034 Mulberry 818 Waverly Eleventh ... Eleventh ... Twelfth ... Twelfth ... Twelfth ... Twelfth ... Thirteenth Thirteenth Thirteenth Fourteenth Fourteenth Fourteenth Fifteenth ... Fifteenth ... Fifteenth ... Sixteenth . Sixteenth . Sixteenth . Sixteenth . T. B. Foster Fifth Precinct Police...., Orange St. and Roseville Ave.. Orange and Sixth Sts 151 B. B. 5400 Market 4343 Market 10244 Market 10104 Market 5400 Market 2878 Mulberry 2444 Waverly 5400 Market 2494 Waverly 1534 Waverly 5400 Market 3301 Market 1651 B. B. 1319 Market 2468 Waverly 1103 Waverly 2871 Waverly 5400 Market O. Von Gerhen.. Bowery Pharmacy Third Precinct Police A. Marquier A. Reuch Seventh Precinct Police. F. R. Feind Aug. Koelble Fourth Precinct Police... 200 Ferry St. 28 Fleming Ave Van Buren St 1041 South Orange Ave 661 Springfield Ave - South Orange Ave 76 Belmont Ave 362 Springfield Ave Seventeenth Ave 398 Central Ave E. Hagny .-. C P Moll Central Ave. and Fifth St 166 Central Ave 531 Clinton Ave 191 Avon Ave W. J. Witt Sixth Precinct Police 821 Clinton Ave Hunterdon and Bigelow Sts CULTURE COLLECTORS John F. Dunn 65 South Seventh Street William J. Foyle 142 Hudson Street