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Information At Your Fingertips

May 25, 1951

Note: The Regulations entered into force, October 1, 1952.

Reference: These Regulations is also published in 175 UNTS, p. 215.

THE FOURTH WORLD HEALTH ASSEMBLY

CONSIDERING that one of the principal aims of international co-operation in public health is the eradication of disease; that continued efforts are required to achieve such eradication; that there is a continuing danger of the spread of disease and that international regulations are still necessary to limit the extension of outbreaks of disease;

RECOGNIZING the need to revise and consolidate the provisions of the several International Sanitary Conventions and similar arrangements at present in force by replacing and completing these Conventions and arrangements by a series of International Sanitary Regulations which are more fitted to the several means of international transport and which will more effectively ensure the maximum security against the international spread of disease with the minimum interference with world traffic;

CONSIDERING that, by virtue of such replacement, periodical revisions of international measures will be facilitated, taking into account, inter alia, the changing epidemiological situation, the experience gained, and the progress of science and technique;

HAVING REGARD to Articles 2 (k), 21 (a), 22, 23, 33, 62, 63 and 64 of The Constitution of the World Health Organization;

ADOPTS, this twenty-fifth day of May 1951, the following Regulations which hereinafter referred to as "these Regulations":

PART I—DEFINITIONS

ARTICLE 1

For the purposed of these Regulations—

“Aedes aegypti index” means the ratio, expressed as a percentage, between the number of habitations in a limited well-defined area in which breeding-places of Aedes aegypti are found, and the total number of habitations in that area, all of which have been examined, every dwelling of a single family being considered as a habitation;

"aircraft" means an aircraft making an international voyage;

"airport" means an airport designated by the State in whose territory it is situated as an airport of entry or departure for international air traffic;

"arrival" of a ship, an aircraft, a train, or a road vehicle means—

(a) in the case of a seagoing vessel, arrival at a port;

(b) in the case of an aircraft, arrival at an airport;

(c) in the case of an inland navigation vessel, arrival either at a port or a frontier post, as geographical conditions and agreements among the States concerned, under Article 104 or under the laws and regulations in force in the territory of entry, may determine;

(d) in the case of a train or road vehicle, arrival at a frontier post;

"baggage" means the personal effects of a traveller or of a member of the crew;

"crew" means the personnel of a ship, an aircraft, a train, or a road vehicle, who are employed for duties on board;

"day" means an interval of twenty-four hours;

"direct transit area" means a special area established in connection with an airport, approved by the health authority concerned and under its direct supervision, for accommodating direct transit traffic and, in particular, for accommodating, in segregation, passengers and crews breaking their air voyage without leaving the airport;

"Director-General" means the Director-General of the Organization;

"epidemic" means an extension or multiplication of a foyer;

"first case" means the first non-imported case of a quarantinable disease in a local area hitherto free from it, or in which it had ceased to occur during the period indicated for each such disease in Article 6;

"foyer" means the occurrence of two cases of a quarantinable disease derived from an imported case, or one case derived from a non-imported case; the first case of human yellow fever transmitted by Aedes aegypti or any other domiciliary vector of yellow fever shall be considered as a foyer;

"health administration" means the governmental authority responsible over the whole of a territory to which these Regulations apply for the implementation of the sanitary measures provided herein;

"health authority” means the authority immediately responsible for the application in a local area of the appropriate sanitary measures permitted or prescribed by these Regulations;

"imported case" means a case introduced into a territory;

"infected local area" means—

(a) a local area where there is a foyer of plague, cholera, yellow fever, or smallpox; or

(b) a local area where there is an epidemic of typhus or relapsing fever; or

(c) a local area where plague infection among rodent exists on land or on craft which are part of the equipment of a port; or

(d) a local area or a group of local areas where the existing conditions are those of a yellow-fever endemic zone;

"infected person" means a person who is suffering from a quarantinable disease, or who is believed to be infected with such a disease;

"international voyage" means—

(a) in the case of a ship or an aircraft, a voyage between ports or airports in the territories of more than one State, or a voyage between ports or airports in the territory or territories of the same State if the ship or aircraft has relations with the territory of any other State on its voyage but only as regards those relations;

{b) in the case of a person, a voyage involving entry into the territory of a State other than the territory of the State in which that person commences his voyage;

"isolation", when applied to a person or group of persons, means the separation of that person or group of persons from other persons, except the health staff on duty, in such a manner as to prevent the spread of infection;

"local area" means—

(a) the smallest area within a territory, which may be a port or an airport, having a defined boundary and possessing a health organization which is able to apply the appropriate sanitary measures permitted or prescribed by these Regulations; the situation of such an area within a larger area which also possesses such a health organization shall not preclude the smaller area from being a local area for the purposes of these Regulations, or

(b) an airport in connection with which a direct transit area has been established;

“medical examination” includes visit to and inspection of a ship, an aircraft, a train, or a road vehicle, and the preliminary examination of persons on board, but does not include the periodical inspection of a ship to ascertain the need for deratting;

"Organization” means the World Health Organization;

“pilgrim” means a person making the Pilgrimage, and, in the case of passengers on board a pilgrim ship, includes every person accompanying or traveling with persons making the Pilgrimage;

"pilgrim ship" means a ship which—

(a) voyages to or from the Hedjaz during the season of the Pilgrimage;

(b)carries pilgrims in a proportion of not less than one pilgrim per 100 tons gross;

"Pilgrimage" means the pilgrimage to the Holy Places in the Hedjaz;

"port" means a seaport or an inland navigation port which is normally frequented by ships;

"quarantinable diseases" means plague, cholera, yellow fever, smallpox, typhus, and relapsing fever;

"relapsing fever" means louse-borne relapsing fever;

"sanitary station" means a port, an airport, or a frontier post at which the sanitary measures provided for in Annex A are applied to pilgrims and which is provided with adequate staff, installations, and equipment for the purpose;

"season of the Pilgrimage", in relation to pilgrim ships, means a period beginning four months before and ending three months after the day of the Haj;

"ship" means a seagoing or an inland navigation vessel making an international voyage;

"ship's surgeon", in the case of a pilgrim ship, means a medical practitioner employed on a pilgrim ship as required by Article B 7, or, if there are two or more such medical practitioners so employed, the senior of them;

"suspect" means a person who is considered by the health authority as having been exposed to infection by a quarantinable disease and is considered capable of spreading that disease;

"typhus" means louse-borne typhus;

"valid certificate", when applied to vaccination, means a certificate conforming with the rules and the model laid down in Appendix 2, 3, or 4;

"yellow-fever endemic zone" means an area in which Aedes aegypti or any other domiciliary vector of yellow fever is present but is not obviously responsible for the maintenance of the virus which persists among jungle animals over long periods of time;

"yellow-fever receptive area" means an area in which yellow fever does not exist but where conditions would permit its development if introduced.

PART II—NOTIFICATIONS AND EPIDEMIOLOGICAL
INFORMATION

ARTICLE 2

For the application of these Regulations, each State recognizes the right of the Organization to communicate directly with the health administration of its territory or territories. Any notification or information sent by the Organization to the health administration shall be considered as having been sent to the State, and any notification or information sent by the health administration to the Organization shall be considered as having been sent by the State.

ARTICLE 3

1. Each health administration shall notify the Organization by telegram twenty-four hours of its being informed that a local area has become an infected local area.

2. The existence of the disease so notified shall be confirmed as soon as possible by laboratory methods, as far as resources permit, and the result shall be sent immediately to the Organization by telegram.

ARTICLE 4

1. Any notification required under paragraph 1 of Article 3, except in the case of rodent plague, shall be promptly supplemented by information as to the source and type of the disease, the number of cases and deaths, the conditions affecting the spread of the disease, and the prophylactic measures taken.

2. In the case of rodent plague, the notification required under paragraph 1 of Article 3 shall be supplemented by monthly reports on the number of rodents examined and the number found infected.

ARTICLE 5

1. During an epidemic the notifications and information required under Article 3 and paragraph 1 of Article 4 shall be followed by subsequent communications sent at regular intervals to the Organization.

2. These communications shall be as frequent and as detailed as possible. The number of cases and deaths shall be communicated at least once a week. The precautions taken to prevent the spread of the disease, in particular the measures which are being applied to prevent the spread of the disease to other territories by ships, aircraft, trains, or road vehicles leaving the infected local area, shall be stated. In the case of plague, the measures taken against rodents shall be specified. In the case of the quarantinable diseases which are transmitted by insect vectors, the measures taken against such vectors shall also be specified.

ARTICLE 6

1. The health administration for a territory in which an infected local area, other than a local area which is part of a yellow-fever endemic zone, is situated shall form the Organization when that local area is free from infection.

2. An infected local area may be considered as free from infection when all measures of prophylaxis have been taken and maintained to prevent the recurrence of the disease or its spread to other areas, and when—

(a) in the case of plague, cholera, smallpox, typhus, or relapsing fever, a period of time equal to twice the incubation period of the disease, as hereinafter provided, has elapsed since the last case identified has died, recovered or been isolated, and infection from that disease has not occurred in any other local area in the vicinity, provided that, in the case of plague with rodent plague also present, the period specified under sub-paragraph (c) of this paragraph has elapsed;

(b) in the case of yellow fever outside a yellow-fever endemic zone, three months have elapsed after the occurrence of the last human case, month after the reduction of the Aedes aegypti index to not more than one per cent;

(c) in the case of rodent plague, one month has elapsed after suppression of the epizootic.

ARTICLE 7

Each health administration shall notify the Organization immediately of evidence of the presence of the virus of yellow fever in any part of its territory where it has not previously been recognized, and shall report the extent of the area involved.

ARTICLE 8

1. Each health administration shall notify the Organization of—

(a) any change in its requirements as to vaccination for any international voyage;

(b) the measures which it has decided to apply to arrivals from an infected local area and the withdrawal of any such measures, indicating the date of application or withdrawal.

2. Any such notification shall be sent by telegram, and whenever possible in advance of any such change or of the application or withdrawal of any such measure.

3. Each health administration shall send to the Organization once a year, at a date to be fixed by the Organization, a recapitulation of its requirements as to vaccination for any international voyage.

ARTICLE 9

In addition to the notifications and information required under Articles 3 to 8 inclusive, each health administration shall send to the Organization weekly—

(a) a report by telegram of the number of cases of the quarantinable diseases and deaths therefrom during the previous week in each of its towns and cities adjacent to a port or an airport;

(b) a report by airmail of the absence of such cases during the periods referred to in sub-paragraphs (a), (b), and (c) of paragraph 2 of Article 6.

ARTICLE 10

Any notification and information required under Articles 3 to 9 inclusive Shall also be sent by the health administration, on request, to any diplomatic mission or consulate established in the territory for which it is responsible.

ARTICLE 11

The Organization shall send to all health administrations, as soon as possible and by the means appropriate to the circumstances, all epidemiological and other information which it has received under Articles 3 to 8 inclusive and paragraph (a) of Article 9 as well as information as to the absence of any returns required by Article 9. Communications of an urgent nature shall be sent by telegram or telephone.

ARTICLE 12

Any telegram sent, or telephone call made, for the purposes of Articles 3 to 8 inclusive and Article 11 shall be given the priority appropriate to the circumstances; in any case of exceptional urgency, where there is risk of the spread of a quarantinable disease, the priority shall be the highest available under international telecommunication agreements.

ARTICLE 13

1. Each State shall forward annually to the Organization, in accordance with Article 62 of the Constitution of the Organization, information concerning the occurrence of any case of a quarantinable disease due to or carried by international traffic, as well as on the action taken under these Regulations or bearing upon their application.

2. The Organization shall, on the basis of the information required by paragraph 1 of this Article, of the notifications and reports required by these Regulations, and of any other official information, prepare an annual report on the functioning of these Regulations and on their effect on international traffic.

PART III—SANITARY ORGANIZATION

ARTICLE 14

1. Each health administration shall as far as practicable ensure that ports and airports in its territory shall have at their disposal an organization and equipment sufficient for the application of the measures provided for in these Regulations.

2. Every port and airport shall be provided with a supply of pure drinking water.

3. Every airport shall also be provided with an effective system for the removal and safe disposal of excrement, refuse, waste water, condemned food, and other matter dangerous to health.

ARTICLE 15

There shall be available to as many of the ports in a territory as practicable an organized medical service with adequate staff, equipment, and premises, and in particular facilities for the prompt isolation and care of infected persons, for disinfection, for bacteriological investigation, for the collection and examination of rodents for plague infection, and for any other appropriate measure provided for by these Regulations.

ARTICLE 16

The health authority for each port shall—

(a) take all practicable measures to keep rodents in the port installations to a negligible number;

(b) make every effort to extend rat-proofing to the port installations.

ARTICLE 17

1. Each health administration shall ensure that a sufficient number of ports in its territory shall have at their disposal adequate personnel competent to inspect ships for the issue of the Deratting Exemption Certificates referred to in Article 52, and the health administration shall approve such ports for that purpose.

2. The health administration shall designate a number of these approved ports, depending upon the volume and incidence of its international traffic, as having at their disposal the equipment and personnel necessary to derat ships for the issue of the Deratting Certificates referred to in Article 52.

ARTICLE 18

As soon as it is practicable, and where it is necessary for the accommodation of direct transit traffic, airports shall be provided with direct transit areas.

ARTICLE 19

1. Each health administration shall designate as sanitary airports a number of the airports in its territory, depending upon the volume of its international traffic.

2. Every sanitary airport shall have at its disposal—

(a) an organized medical service with adequate staff, equipment, premises;

(b) facilities for the transport, isolation, and care of infected persons or suspects;

(c) facilities for efficient disinfection and disinsecting, for the destruction of rodents, and for any other appropriate measure provided by these Regulations;

(d) a bacteriological laboratory, or facilities for dispatching material to such a laboratory;

(e) facilities for vaccination against cholera, yellow fever, and smallpox

ARTICLE 20

1. Every port situated in a yellow-fever endemic zone or a yellow-fever receptive area, and the area within the perimeter of every airport so situated, shall be kept free from Aedes aegypti in their larval and adult stages.

2. Any building within a direct transit area provided at any airport so situated, shall be kept free from Aedes aegypti in their larval and adult stages.

3. Every sanitary airport situated in a yellow-fever endemic zone—

(a) shall be provided with mosquito-proof dwellings and have at its disposal mosquito-proof sick quarters for passengers, crews, and airport personnel;

(b) shall be freed from mosquitos by systematically destroying them in their larval and adult stages within the perimeter of the airport, and within a protective area extending for a distance of four hundred metres around that perimeter.

4. For the purposes of this Article, the perimeter of an airport means a line enclosing the area containing the airport buildings and any land or water used or intended to be used for the parking of aircraft.

ARTICLE 21

1. Each health administration shall send to the Organization—

(a) a list of the ports in its territory approved under Article 17 for the issue of—

(i) Deratting Exemption Certificates only, and

(ii) Deratting Certificates and Deratting Exemption Certificates;

(b) a list of the sanitary airports in its territory;

(c) a list of the airports in its territory provided with direct transit areas.

2. The health administration shall notify the Organization of any change which may occur from time to time in the lists required by paragraph 1 of this Article.

3. The Organization shall send promptly to all health administrations the information received in accordance with this Article.

ARTICLE 22

Whenever the volume of international traffic is sufficiently important and whenever epidemiological conditions so require, sanitary facilities for the application of the measures provided for in these Regulations shall be provided at frontier posts, on railway lines, on roads and, where sanitary control over inland navigation is carried out at the frontier, on inland waterways.

PART IV—SANITARY MEASURES AND PROCEDURE

CHAPTER I—GENERAL PROVISIONS

ARTICLE 23

The sanitary measures permitted by these Regulations are the maximum measures applicable to international traffic, which a State may require for the protection of its territory against the quarantinable diseases.

ARTICLE 24

Sanitary measures and health formalities shall be initiated forthwith completed without delay, and applied without discrimination.

ARTICLE 25

1. Disinfection, disinsecting, deratting, and other sanitary operations shall be so carried out as—

(a) not to cause undue discomfort to any person, or injury to his health;

(b) not to produce any deleterious effect on the structure of a ship, an aircraft, or a vehicle, or on its operating equipment;

(c) to avoid all risk of fire.

2. In carrying out such operations on goods, baggage, and other articles, every precaution shall be taken to avoid any damage.

ARTICLE 26

1. A health authority shall, when so requested, issue free of charge to the carrier a certificate specifying the measures applied to a ship, or an aircraft, or a railway carriage, wagon, or road vehicle, the parts thereof treated, the methods employed, and the reasons why the measures have been applied. In the case of an aircraft this information shall, on request, be entered instead in the General Declaration.

2. Similarly, a health authority shall, when so requested, issue free o charge—

(a) to any traveller a certificate specifying the date of his arrival or departure and the measures applied to him and his baggage;

(b) to the consignor, the consignee, and the carrier, or their respective agents, a certificate specifying the measures applied to any goods.

ARTICLE 27

1. A person under surveillance shall not be isolated and shall be permitted to move about freely. The health authority may require him to report to it, if necessary, at specified intervals during the period of surveillance. Except as limited by the provisions of Article 69, the health authority may also subject such a person to medical investigation and make any inquiries which are necessary for ascertaining his state of health.

2. When a person under surveillance departs for another place, within or without the same territory, he shall inform the health authority, which shall immediately notify the health authority for the place to which the person is proceeding. On arrival the person shall report to that health authority which may apply the measure provided for in paragraph 1 of this Article.

ARTICLE 28

Except in case of an emergency constituting a grave danger to public health, a ship or an aircraft, which is not infected or suspected of being infected with a quarantinable disease, shall not on account of any other epidemic disease be prevented by the health authority for a port or an airport from discharging or loading cargo or stores, or taking on fuel or water.

ARTICLE 29

A health authority may take all practicable measures to control the discharge from any ship of sewage and refuse which might contaminate the waters of a port, river, or canal.

CHAPTER II—SANITARY MEASURES ON DEPARTURE

ARTICLE 30

1. The health authority for a port or an airport or for the local area in which a frontier post is situated may, when it considers it necessary, medically examine any person before his departure on an international voyage. The time and place of this examination shall be arranged to take into account the customs examination and other formalities, so as to facilitate his departure and to avoid delay.

2. The health authority referred to in paragraph 1 of this Article shall take all practicable measures-

(a) to prevent the departure of any infected person or suspect;

(b) to prevent the introduction on board a ship, an aircraft, a train, or a road vehicle of possible agents of infection or vectors of a quarantinable disease.

3. Notwithstanding the provisions of sub-paragraph (a) of paragraph 2 of this Article, a person on an international voyage who on arrival is placed under surveillance may be allowed to continue his voyage. If he is doing so by air, the health authority for the airport shall record the fact on the General Declaration.

CHAPTER III—SANITARY MEASURES APPLICABLE BETWEEN PORTS OR
AIRPORTS OF DEPARTURE AND ARRIVAL

ARTICLE 31

No matter capable of causing any epidemic disease shall be thrown or all to fall from an aircraft when it is in flight.

ARTICLE 32

1. No sanitary measure shall be applied by a State to any ship which passes through its territorial waters without calling at a port or on the coast.

2. If for any reason such a call is made, the sanitary laws and regulation in force in the territory may be applied without exceeding, however, the provisions of these Regulations.

ARTICLE 33

1. No sanitary measure, other than medical examination, shall be applied to a healthy ship, as specified in Part V, which passes through a maritime canal or waterway in the territory of a State on its way to a port in the territory of another State, unless such ship comes from an infected local area or has on board any person coming from an infected local area, within the incubation period of the disease with which the local area is infected.

2. The only measure which may be applied to such a ship coming from such an area or having such a person on board is the stationing on board, if necessary, of a sanitary guard to prevent all unauthorized contact between the ship and the shore, and to supervise the application of Article 29.

3. A health authority shall permit any such ship to take on, under its control, fuel, water, and stores.

4. An infected or suspected ship which passes through a maritime canal or waterway may be treated as if it were calling at a port in the same territory.

ARTICLE 34

Notwithstanding any provision to the contrary in these Regulations except Article 75, no sanitary measure, other than medical examination, shall be applied to—

(a) passengers and crew on board a healthy ship from which they do not disembark;

(b) passengers and crew from a healthy aircraft who are in transit through a territory and who remain in a direct transit area of an airport of that territory, or, if the airport is not yet provided with such an area, who submit to the measures for segregation prescribed by the health authority in order to prevent the spread of disease; if such persons are obliges to leave the airport at which they disembark solely in order to continue their voyage from another airport in the vicinity of the first airport, no such measure shall be applied to them if the transfer is made under the control of the health authority or authorities.

CHAPTER IV—SANITARY MEASURES ON ARRIVAL

ARTICLE 35

Whenever practicable States shall authorize granting of pratique by radio to a ship or an aircraft when, on the basis of information received from it prior to its arrival, the health authority for the intended port or airport of arrival is of the opinion that its arrival will not result in the introduction or spread of a quarantinable disease.

ARTICLE 36

1. The health authority for a port, an airport, or a frontier station may subject to medical examination on arrival any ship, aircraft, train, or road vehicle, as well as any person on an international voyage.

2. The further sanitary measures which may be applied to the ship, aircraft, train, or road vehicle shall be determined by the conditions which existed on board during the voyage or which exist at the time of the medical examination, without prejudice, however, to the measures which are permitted by these Regulations to be applied to the ship, aircraft, train, or road vehicle if it arrives from an infected local area.

ARTICLE 37

The application of the measures provided for in Part V, which depend on arrival from an infected local area, shall be limited to the ship, aircraft, train, road vehicle, person, or article, as the case may be, arriving from such an area, provided that the health authority for the infected local area is taking all measures necessary for checking the spread of the disease and is applying the measures provided for in paragraph 2 of Article 30.

ARTICLE 38

On arrival of a ship, an aircraft, a train, or a road vehicle, an infected person on board may be removed and isolated. Such removal shall be compulsory if it is required by the person in charge of the means of transport.

ARTICLE 39

1. Apart from the provisions of Part V, a health authority may place under surveillance any suspect on an international voyage arriving by whatever means from an infected local area. Such surveillance may be continued until the end of the appropriate period of incubation specified in Part V.

2. Except where specifically provided for in these Regulations, isolation shall not be substituted for surveillance unless the health authority considers the risk of transmission of the infection by the suspect to be exceptionally serious.

ARTICLE 40

Any sanitary measure, other than medical examination, which has been applied at a previous port or airport shall not be repeated at a previous port or airport shall not be repeated at a subsequent port or airport, unless—

(a) after the departure of a ship or an aircraft from the port or airport where the measures were applied, an incident of epidemiological significance calling for a further application of any such measure has occurred either in that port or airport or on board the ship or aircraft; or

(b) the health authority for the subsequent port or airport has ascertained on the basis of definite evidence that the individual measure so applied was not substantially effective.

ARTICLE 41

Subject to Article 79, a ship or an aircraft shall not be prevented for sanitary reasons from calling at any port or airport. If the port or airport is not equipped for applying the sanitary measures which are permitted by these Regulations and which in the opinion of the health authority for the port or airport are required, such ship or aircraft may be ordered to proceed at its own risk to the nearest suitable port or airport convenient to the ship or aircraft.

ARTICLE 42

An aircraft shall not be considered as having come from an infected local area merely because, on its voyage over infected territory, it has landed at any sanitary airport which is not itself an infected local area.

ARTICLE 43

Any person on board an aircraft which has flown over an infected local area, but has not landed there or has landed there under the conditions laid down in Article 34, shall not be considered as having come from such an area.

ARTICLE 44

1. Except as provided in paragraph 2 of this Article, any ship or aircraft, which is unwilling to submit to the measures required by the health authority for the port or airport in accordance with these Regulations, shall be allowed to depart forthwith, but it shall not during its voyage call at any other port or airport in the same territory. Such a ship or an aircraft shall nevertheless be permitted to take on fuel, water, and stores in quarantine. If, on medical examination, such a ship is found to be healthy, it shall not lose the benefit of Article 33.

2. A ship or an aircraft arriving at a port or an airport situated in a yellow-fever receptive area shall not, in the following circumstances, be allowed to depart and shall subject to the measures required by the health authority in accordance with these Regulations-

(a) if the aircraft is infected with yellow-fever;

(b) if the ship is infected with yellow fever, and Aedes aegypti have been found on board, and the medical examination shows that any infected person has not been isolated in good time.

ARTICLE 45

1. If for reasons beyond the control of the pilot in command, an aircraft lands elsewhere than at an airport, or at an airport other than the airport at which the aircraft was due to land, the pilot in command or other person in charge shall make every effort to communicate with the nearest health authority or any other public authority.

2. As soon as the health authority has been informed of the landing it may take such action as is appropriate, but in no case shall it exceed the measures permitted by these Regulations.

3. Subject to paragraph 5 of this Article, and except for the purpose of communicating with any such health or public authority or with the permission of any such authority, no person on board the aircraft shall leave its vicinity and no cargo shall be removed from that vicinity.

4. When any measure required by the health authority has been completed, the aircraft may, so far as sanitary measures are concerned, proceed either to the airport at which it was due to land, or, if for technical reasons it cannot do so, to a conveniently situated airport.

5. The pilot in command or other person in charge may take such emergency measures as may be necessary for the health and safety of passengers and crew.

CHAPTER V-MEASURES CONCERNING THE INTERNATIONAL TRANSPORT
OF GOODS, BAGGAGE, AND MAIL

ARTICLE 46

1. Goods shall be submitted to the sanitary measures provided for in these Regulations only when the health authority has reason to believe that they may have become contaminated by the infection of a quarantinable disease or may serve as a vehicle for the spread of any such disease.

2. Apart from the measures provided for in Article 68, goods, other than live animals, in transit without transhipment shall not be subjected to sanitary measures or detained at any port, airport, or frontier.

ARTICLE 47

Except in the case of an infected person or suspect, baggage may be disinfected or disinsected only in the case of a person carrying infective material or insect vectors of a quarantinable disease.

ARTICLE 48

1. Mail, newspapers, books, and other printed matter shall not be subject to any sanitary measure.

2. Postal parcels may be subject to sanitary measures only if they contain—

(a) any of the foods referred to in paragraph 1 of Article 68 which the health authority has reason to believe comes from a cholera-infected local area; or

(b) linen, wearing apparel, or bedding, which has been used or soiled and to which the provisions of Part V are applicable.

PART V—SPECIAL PROVISIONS RELATING TO EACH OF THE
QUARANTINABLE DISEASES

CHAPTER I—PLAGUE

ARTICLE 49

For the purposes o£ these Regulations the incubation period of plague is six days.

ARTICLE 50

Vaccination against plague shall not be required as a condition of admission of any person to a territory.

ARTICLE 51

1. Each State shall employ all means in its power to diminish the danger from the spread of plague by rodents and their ectoparasites. Its health administration shall keep itself constantly informed by systematic collection and regular examination of rodents and their ectoparasites of the conditions in any local area, especially any port or airport, infected or suspected of being infected by rodent plague.

2. During the stay of a ship or an aircraft in a port or an airport infected by plague, special care shall be taken to prevent the introduction of rodents on board.

ARTICLE 52

1. Every ship shall be either—

(a) periodically deratted; or

(b) permanently kept in such a condition that the number of rodents on board is negligible.

2. Deratting Certificate or a Deratting Exemption Certificate shall be issued only by the health authority for a port approved for that purpose under Article 17. Every such certificate shall be valid for six months, but this period may be extended by one month for a ship proceeding to such a port if the deratting or inspection, as the case may be, would be facilitated by the operations due to take place there.

3. Deratting Certificates and Deratting Exemption Certificates shall conform with the model specified in Appendix 1.

4. If a valid certificate is not produced, the health authority for a port approved under Article 17, after inquiry and inspection, may proceed in the following manner—

(a) If the port has been designated under paragraph 2 of Article 17, the health authority may derat the ship or cause the deratting to be done under its direction and control. It shall decide in each case the technique which should be employed to secure the extermination of rodents on the ship. Deratting shall be carried out so as to avoid as far as possible damage to the ship and to any cargo and shall not take longer than is absolutely necessary. Wherever possible deratting shall be done when the holds are empty. In the case of a ship in ballast, it shall be done before loading. When deratting has been satisfactorily completed, the health authority shall issue a Deratting Certificate.

(b) At any port approved under Article 17, the health authority may issue a Deratting Exemption Certificate if it is satisfied that the number of rodents on board is negligible. Such a certificate shall be issued only if the inspection of the ship has been carried out when the holds are empty or when they contain only ballast or other material, unattractive to rodents, of such a nature or so disposed as to make a thorough inspection of the holds possible. A Deratting Exemption Certificate may be issued for an oil-tanker with full holds.

5. If the conditions under which a deratting is carried out are such that, in the opinion of the health authority for the port where the operation was performed, a satisfactory result cannot be obtained, the health authority shall make a note to that effect on the existing Deratting Certificate.

ARTICLE 53

In exceptional circumstances of an epidemiological nature, when the presence of rodents is suspected on board, an aircraft may be deratted.

ARTICLE 54

Before departure on an international voyage from a local area where there is an epidemic of pulmonary plague, every suspect shall be placed in isolation for a period of six days, reckoned from the date of the last exposure to infection.

ARTICLE 55

1. A ship or an aircraft on arrival shall be regarded as infected if—

(a) it has a case of human plague on board; or

(b) a plague-infected rodent is found on board.

A ship shall also be regarded as infected if a case of human plague has occurred on board more than six days after embarkation;

2. A ship on arrival shall be regarded as suspected if—

(a) it has no case of human plague on board, but such a case has occurred on board within the first six days after embarkation;

(b) there is evidence of an abnormal mortality among rodents on board of which the cause is not yet known.

3. Even when coming from an infected local area or having on board a person coming from an infected local area, a ship or an aircraft on arrival shall be regarded as healthy if, on medical examination, the health authority is satisfied that the conditions specified in paragraphs 1 and 2 of this Article do not exist.

ARTICLE 56

1. On arrival of an infected or suspected ship or an infected aircraft, the following measures may be applied by the health authority—

{a) disinsecting of any suspect and surveillance for a period of not more than six days reckoned from the date of arrival;

(b) disinsecting and, if necessary, disinfection of—

(i) any baggage of any infected person or suspect, and

(ii) any other article such as used bedding or linen, and any part of the ship or aircraft, which is considered to be contaminated.

2. If there is rodent plague on board a ship it shall be deratted, if necessary in quarantine, in the manner provided for in Article 52 subject to the following provisions—

(a) the deratting shall be carried out as soon as the holds have been emptied;

(b) one or more preliminary derattings of a ship with the cargo in situ, or during its unloading, may be carried out to prevent the escape of infected rodents;

(c) if the complete destruction of rodents cannot be secured because only part of the cargo is due to be unloaded, a ship shall not be prevented from unloading that part, but the health authority may apply any measures, including placing the ship in quarantine, which it considers necessary to prevent the escape of infected rodents.

3. If a rodent which has died of plague is found on board an aircraft, the aircraft shall be deratted, if necessary in quarantine.

ARTICLE 57

A ship shall cease to be regarded as infected or suspected, or an aircraft shall cease to be regarded as infected, when the measures required by the health authority in accordance with Article 38 and 56 have been effectively carried out, or when the health authority is satisfied that the abnormal mortality among rodents is not due to plague. The ship or aircraft shall thereupon be given free pratique.

ARTICLE 58

On arrival, a healthy ship or aircraft shall be given free pratique but, if it has come from an infected local area, the health authority may—

(a) place under surveillance any suspect who disembarks, for a period of not more than six days, reckoned from the date on which the ship or aircraft left the infected local area;

(b) require the destruction of rodents on board a ship in exceptional cases and for well-founded reasons which shall be communicated in writing to the master.

ARTICLE 59

If, on arrival of a train or a road vehicle, a case of human plague is discovered, the measures provided for in Article 38 and in paragraph 1 of Article 56 may be applied by the health authority, disinsecting and, if necessary, disinfection being applied to any part of the train or road vehicle which is considered to be contaminated.

CHAPTER II — CHOLERA

ARTICLE 60

For the purposes of these Regulations the incubation period of cholera is five days.

ARTICLE 61

1. The possession of a valid certificate of vaccination against cholera shall taken into consideration by a health authority in applying the measures proved for these Regulations.

2. Any standard for anticholera vaccines in force in the territory where the vaccination is performed shall be accepted by all health administrations.

3. A health authority may apply the following measures to a person on an international voyage who has come from an infected local area within the incubation period—

(a) if he is in possession of a valid certificate of vaccination against cholera, he may be placed under surveillance for a period of not more than five days, reckoned from the date of his departure from the infected local area;

(b) if he is not in possession of such a certificate, he may be in isolation for a like period.

ARTICLE 62

1. A ship shall be regarded as infected if, on arrival, it has a case of cholera on board, or if a case of cholera has occurred on board during a period of five days before arrival.

2. A ship shall be regarded as suspected if a case of cholera has occurred on board during the voyage, but a fresh case has not occurred during a period of five days before arrival.

3. An aircraft shall be regarded as infected if, on arrival, it has a case of cholera on board. It shall be regarded as suspected if a case of cholera has occurred on board during the voyage but the case has previously been disembarked.

4. Even when coming from an infected local area or having on board a person coming from an infected local area, a ship or an aircraft on arrival shall be regarded as healthy if, on medical examination, the health authority is satisfied that no case of cholera has occurred on board during the voyage.

ARTICLE 63

1. On arrival of an infected ship or aircraft, the following measures may be applied by the health authority—

(a) for a period of not more than five days, reckoned from the date of disembarkation, surveillance of any passenger or member of the crew who produces a valid certificate of vaccination against cholera, and isolation of all others who disembark;

(b) disinfection of—

(i) any baggage of any infected person or suspect, and

(ii) any other article such as used bedding or linen, and any part of the ship or aircraft, which is considered to be contaminated;

(c) disinfection and removal of any water carried on board which is considered to be contaminated, and disinfection of the containers.

2. Human dejecta, waste water including bilge-water, waste matter, and any matter which is considered to be contaminated shall not be discharged or unloaded without previous disinfection. Their safe disposal shall be the responsibility of the health authority.

ARTICLE 64

1. On arrival of a suspected ship or aircraft, the measures provided for in sub-paragraphs (b) and (c) of paragraph 1 and in paragraph 2 of Article 63 may be applied by the health authority.

2. In addition, but without prejudice to the measure provided for in subparagraph (b) of paragraph 3 of Article 61, any passenger or member of the crew who disembarks may be placed under surveillance for a period of not more than five days, reckoned from the date of arrival.

ARTICLE 65

A ship or an aircraft shall cease to be regarded as infected or suspected when the measures required by the health authority in accordance with Article 38 and with Articles 63 and 64 respectively have been effectively carried out. The ship or aircraft shall thereupon be given free pratique.

ARTICLE 66

On arrival, a healthy ship or aircraft shall be given free pratique but, if it has come from an infected local area, the health authority may apply to any passenger or member of the crew who disembarks the measures provided for in Article 61.

ARTICLE 67

If, on arrival of a train or a road vehicle, a case of cholera is discovered, the following measures may be applied by the health authority—

(a) without prejudice to the measure provided for in sub-paragraph

(b) of paragraph 3 of Article 61, surveillance of any suspect for a period of not more than five days, reckoned from the date of arrival; (b) disinfection of—

(i) any baggage of the infected person and, if necessary, that of any suspect, and

(ii) any other article such as used bedding or linen, and any part of the train or road vehicle, which is considered to be contaminated.

ARTICLE 68

1. On arrival of an infected or suspected ship or aircraft, of a train or a road vehicle on which a case of cholera has been discovered, or of a ship, an aircraft, a train, or a road vehicle coming from an infected local area, the health authority may prohibit the unloading of, or may remove, any fish, shellfish, fruit or vegetables to be consumed uncooked, or beverages, unless such food or beverages are in sealed containers and the health authority has no reason to believe that they are contaminated. If any such food or beverage is removed, arrangements shall be made for its safe disposal.

2. If any such food or beverage forms part of the cargo in a hold of a ship or freight compartment of an aircraft, only the health authority for the port or airport at which such food or beverage is to be unloaded may exercise the power to remove it.

3. The pilot in command of an aircraft has the right to require the removal of any such food or beverage.

ARTICLE 69

1. No person shall be required to submit to rectal swabbing.

2. Only a person on an international voyage, who has come from an infected local area within the incubation period of cholera and who has symptoms indicative of cholera, may be required to submit to stool examination.

CHAPTER III — YELLOW FEVER

ARTICLE 70

1. Each yellow-fever endemic zone and yellow-fever receptive area shall be delineated by the Organization in consultation with each of the health administions concerned, and may be altered similarly from time to time. These delineations shall be notified by the Organization to all health administrations.

2. When a health administration declares to the Organization that in a local area which is part of a yellow-fever endemic zone, the Aedes aegypti index has continuously remained for a period of one year below one per cent, the Organization shall, if it concurs, notify all health administrations that such local area has ceased to form part of the yellow-fever endemic zone.

ARTICLE 71

For the purposes of these Regulations the incubation period of yellow fever is six days.

ARTICLE 72

1. Vaccination against yellow fever shall be required of any person leaving an infected local area on an international voyage and proceeding to a yellow fever receptive area.

2. If such a person is in possession of a certificate of vaccination against yellow fever which is not yet valid, he may nevertheless be permitted to depart, but the provisions of Article 74 may be applied to him on arrival.

3. A person in possession of a valid certificate of vaccination against yellow-fever shall not be treated as a suspect, even if he has come from an in infected local area.

ARTICLE 73

1. Every person employed at an airport situated in an infected local area, and every member of the crew of an aircraft using any such airport, shall be in possession of a valid certificate of vaccination against yellow fever.

2. Every aircraft leaving an airport situated in an infected local area and bound for a yellow fever receptive area shall be disinsected under the control of the health authority as near as possible to the time of its departure but in sufficient time to avoid delaying such departure. The States concerned may accept the disinsecting in flight of the parts of the aircraft which can be so disinsected.

3. Every aircraft leaving a local area where Aedes aegypti or any other domiciliary vector of yellow-fever exists, which is bound for a yellow-fever receptive area already freed from Aedes aegypti, shall be similarly disinsected.

ARTICLE 74

A health authority in a yellow-fever receptive area may require a person on an international voyage, who has come from an infected local area and is unable to produce a valid certificate of vaccination against yellow fever, to be isolated until his certificate becomes valid, or until a period of not more than six days reckoned from the date of last possible exposure to infection has elapsed, whichever occurs first.

ARTICLE 75

1. A person coming from an infected local area, who is unable to produce a valid certificate of vaccination against yellow fever and who is due to proceed on an international voyage to an airport in a yellow-fever receptive area at which the means for securing segregation provided for in Article 34 do not yet exist, may, by arrangement between the health administrations for the territories in which the airports concerned are situated, be prevented from proceeding from an airport at which such means are available.

2. The health administrations concerned shall inform the Organization of any such arrangement, and of its termination. The Organization shall immediately send this information to all health administrations.

ARTICLE 76

1. On arrival, a ship shall be regarded as infected if it has a case of yellow-fever on board, or if a case has occurred on board during the voyage. It shall be regarded as suspected if it has left an infected local area less than six days before arrival, or, if arriving within thirty days of leaving such an area, the health authority finds Aedes aegypti on board. Any other ship shall be regarded as healthy.

2. On arrival, an aircraft shall be regarded as infected if it has a case of yellow fever on board. It shall be regarded as suspected if the health authority is not satisfied with a disinsecting carried out in accordance with paragraph 2 of Article 73 and finds live mosquitoes on board the aircraft. Any other aircraft shall be regarded as healthy.

ARTICLE 77

1. On arrival of an infected or suspected ship or aircraft, the following measures may be applied by the health authority—

(a) in a yellow fever receptive area, the measures provided for in Article 74 to any passenger or member of the crew who disembarks and is not in possession of a valid certificate of vaccination against yellow fever;

(b) inspection of the ship or aircraft and destruction of any Aedes aegypti on board; in a yellow fever receptive area, the ship may, until such measures have been carried out, be required to keep at least four hundred metres from land.

2. The ship or aircraft shall cease to be regarded as infected or suspected when the measures required by the health authority in accordance with Article 38 and with paragraph 1 of this Article have been effectively carried out, and it shall thereupon be given free pratique.

ARTICLE 78

On arrival of a healthy ship or aircraft coming from an infected local area the measures provided for in sub-paragraph (b) of paragraph 1 of Article 77 may be applied. The ship or aircraft shall thereupon be given free pratique.

ARTICLE 79

A State shall not prohibit the landing of an aircraft at any sanitary airport in its territory if the measures provided for in paragraph 2 of Article 73 are applied, but, in a yellow-fever receptive area, aircraft coming from an infected local area may land only at airports specified by the State for that purpose.

ARTICLE 80

On arrival of a train or a road vehicle in a yellow fever receptive area, the following measures may be applied by the health authority—

(a) isolation, as provided for in Article 74, of any person coming from an infected local area, who is unable to produce a valid certificate of vaccination against yellow fever;

(b) disinsecting of the train or vehicle if it has come from an infected local area.

ARTICLE 81

In a yellow-fever receptive area the isolation provided for in Article 38 and in this Chapter shall be in mosquito-proof accommodation.

CHAPTER IV — SMALLPOX

ARTICLE 82

For the purposes of these Regulations the incubation period of smallpox fourteen days.

ARTICLE 83

1. A health administration may require any person on an international voyage who does not show sufficient evidence of protection by a previous attack of smallpox to possess, on arrival, a certificate of vaccination against smallpox. Any such person who cannot produce such a certificate may be vaccinated; if he refuses to be vaccinated, he may be placed under surveillance for not more than fourteen days, reckoned from the date of his departure from the last territory visited before arrival.

2. A person on an international voyage, who during a period of fourteen days before his arrival has visited an infected local area and who, in the opinion of the health authority, is not sufficiently protected by vaccination or by a previous attack of smallpox, may be required to be vaccinated, or may be placed under surveillance, or may be vaccinated and then placed under surveillance; if he refuses to be vaccinated, he may be isolated. The period of surveillance or isolation shall not be more than fourteen days, reckoned from the date of his departure from the infected local area. A valid certificate of vaccination against smallpox shall be considered as evidence of sufficient protection.

ARTICLE 84

1. A ship or an aircraft shall be regarded as infected if, on arrival, it has a case of smallpox on board, or if such a case has occured on board during the voyage.

2. Any other ship or aircraft shall be regarded as healthy, even though there may be suspects on board, but any suspect may on disembarking be subjected to the measures provided for in Article 85.

ARTICLE 85

1. On arrival of an infected ship or aircraft, the health authority—

(a) shall offer vaccination to any person on board who, in its opinion, is not sufficiently protected against smallpox;

(b) may, for a period of not more than fourteen days, reckoned from the last exposure to infection, isolate or place under surveillance any person disembarking, but the health authority shall take into account the previous vaccinations of the person and the possibility of his having been exposed to infection in determining the period of such isolation or surveillance;

(c) shall disinfect—

(i) any baggage of any infected person, and

(ii) any other baggage or article such as used bedding or linen, and any part of the ship or aircraft, which is considered to be contaminated.

2. A ship or an aircraft shall continue to be regarded as infected until every infected person has been removed and until the measures required by the health authority in accordance with paragraph 1 of this Article have been effectively carried out. The ship or aircraft shall thereupon be given free pratique.

ARTICLE 86

On arrival, a healthy ship or aircraft, even when it has come from an infected local area, shall be given free pratique.

ARTICLE 87

If, on arrival of a train or a road vehicle, a case of smallpox is discovered, the infected person shall be removed and the provisions of paragraph 1 of Article 85 shall apply, any period of surveillance or isolation being reckoned from the date of arrival, and disinfection being applied to any part of the train or road vehicle which is considered to be contaminated.

CHAPTER V — TYPHUS

ARTICLE 88

For the purposes of these Regulations the incubation period of typhus is fourteen days.

ARTICLE 89

Vaccination against typhus shall not be required as a condition of admission of any person to a territory.

ARTICLE 90

1. On departure from an infected local area, a person on an international voyage, whom the health authority for that area considers is liable to spread typhus, shall be disinsected. The clothes which such person is wearing, his baggage, and any other article likely to spread typhus, shall be disinsected and, if necessary, disinfected.

2. A person on an international voyage, who has left an infected local area within the previous fourteen days, may, if the health authority for the place of arrival considers it necessary, be disinsected and put under surveillance for a period of not more than fourteen days, reckoned from the date of disinsecting. The clothes which such person is wearing, his baggage, and any other article likely to spread typhus may be disinsected and, if necessary, disinfected.

ARTICLE 91

On arrival, a ship or an aircraft shall be regarded as healthy, even if it has an infected person on board, but Article 38 may be applied, any suspect may be disinsected, and the accommodation occupied by the infected person and by any suspect, together with the clothes they are wearing, their baggage, and any other article likely to spread typhus, may be disinsected and, if necessary, disinfected. The ship or aircraft shall thereupon be given free pratique.

ARTICLE 92

If, on arrival of a train or a road vehicle, a case of typhus is discovered, the measures provided for in Articles 38 and 91 may be applied by the health authority.

CHAPTER VI — RELAPSING FEVER

ARTICLE 93

For the purposes of these Regulations the incubation period of relapsing fever is eight days.

ARTICLE 94

Articles 89, 90, 91 and 92 with respect to typhus shall apply to relapsing fever but, if a person is placed under surveillance, the period of such surveillance shall not be more than eight days, reckoned from the date of disinsecting.

PART VI — SANITARY DOCUMENTS

ARTICLE 95

Bills of health, with or without consular visa, or any certificate, however designated, concerning health conditions of a port or an airport, shall not be required from any ship or aircraft.

ARTICLE 96

1. The master of a ship, before arrival at its first port of call in a territory, shall ascertain the state of health on board, and he shall, on arrival, complete and deliver to the health authority for that port a Maritime Declaration of Health, which shall be countersigned by the ship's surgeon if one is carried.

2. The master, and the ship's surgeon if one is carried, shall supply any further information required by the health authority as to health conditions on board during the voyage.

3. A Maritime Declaration of Health shall conform with the model specified in Appendix 5.

ARTICLE 97

1. The pilot in command of an aircraft, on landing at an airport, or his authorized agent, shall complete and deliver t0 the health authority for that airport a copy of that part of the Aircraft General Declaration which contains the health information specified in Appendix 6.

2. The pilot in command on an aircraft, or his authorized agent, shall supply any further information required by the health authority as to health conditions on board during the voyage.

ARTICLE 98

1. The certificates specified in Appendices 1, 2, 3, and 4 shall be printed in English and in French. An official language of the territory of issue may be added.

2. The certificates referred to in paragraph 1 of this Article shall be completed in English or in French.

ARTICLE 99

A vaccination document issued by the Armed Forces to an active member of those Forces shall be accepted in lieu of an international certificate in the form shown in Appendices 2, 3, or 4 if—

(a) it embodies medical information substantially the same as that required by such form; and

(b) it contains a statement in English or in French recording the nature and date of the vaccination and to the effect that it is issued in accordance with this Article.

ARTICLE 100

No sanitary document, other than those provided for in these Regulations, shall be required in international traffic.

PART VII — SANITARY CHARGES

ARTICLE 101

1. No charge shall be made by a health authority for—

(a) any medical examination provided for in these Regulations, or any supplementary examination, bacteriological or otherwise, which may be required to ascertain the state of health of the person examined;

(b) any vaccination of a person on arrival and any certificate thereof.

2. Where charges are made for applying the measures provided for in these Regulations, other than the measures referred to in paragraph 1 of this Article, there shall be in each territory only one tariff for such charges and every charge shall—

(a) conform with this tariff;

(b) be moderate and not exceed the actual cost of the service rendered;

(c) be levied without distinction as to the nationality, domicile, or residence of the person concerned, or as to the nationality, flag, registry, or ownership of the ship, aircraft, carriage, wagon, or road vehicle. In particular, there shall be no distinction made between national and foreign persons, ships, aircraft, carriages, wagons, or road vehicles.

3. The tariff, and any amendment thereto, shall be published at least ten days in advance of any levy thereunder and notified immediately to the Organization.

PART VIII —VARIOUS PROVISIONS

ARTICLE 102

These regulations, and in addition Annexes A and B, apply to the Pilgrimage.

ARTICLE 103

1. Migrants or seasonal workers, and any ship, aircraft, train, or road vehicle carrying them, may be subjected to additional sanitary measures conforming with the laws and regulations of each State concerned, and with any agreement concluded between any such States.

2. Each State shall notify the Organization of the provisions of any such laws and regulations or agreement.

ARTICLE 104

1. Special arrangements may be concluded between two or more States having certain interests in common owing to their health, geographical, social, or economic conditions, in order to make the sanitary measures provided for in these Regulations more effective and less burdensome, and in particular with regard to—

(a) the direct and rapid exchange of epidemiological information between neighbouring territories;

(b) the sanitary measures to be applied to international coastal traffic and to international traffic on inland waterways, including lakes;

(c) the sanitary measures to be applied in contiguous territories at their common frontier;

(d) the combination of two or more territories into one territory for the purposes of any of the sanitary measures to be applied in accordance with these Regulations;

(e) arrangements for carrying infected persons by means of transport specially adapted for the purpose.

2. The arrangements referred to in paragraph 1 of this Article shall not be a conflict with the provisions of these Regulations.

3. States shall inform the Organization of any such arrangement which they may conclude. The Organization shall send immediately to all health administrations information concerning any such arrangement.

PART IX — FINAL PROVISIONS

ARTICLE 105

1. Upon their entry-into-force, these Regulations shall, subject to the provisions of Article 107 and the exceptions hereinafter provided, replace, as between the States bound by these Regulations and as between these States and the Organization, the provisions of the following existing International Sanitary Conventions and similar agreements.

(a) International Sanitary Convention, signed in Paris, 3 December 1903;

(b) Pan American Sanitary Convention, signed in Washington, 14 October 1905;

(c) International Sanitary Convention, signed in Paris, 17 January 1912;

(d) International Sanitary Convention, signed in Paris, 21 June 1926;

(e) International Sanitary Convention for Aerial Navigation, signed at The Hague, 12 April 1933;

(f) International Agreement for dispensing with Bills of Health, signed in Paris, 22 December 1934;

(g) International Agreement for dispensing with Consular Visas on Bills of Health, signed in Pads, 22 December 1934;

(h) Convention modifying the International Sanitary Convention of 21 June 1926, signed in Paris, 31 October 1938;

(i) International Sanitary Convention, 1944, modifying the International Sanitary Convention of June 1926, opened for signature in Washington, 15 December 1944;

(j) International Sanitary Convention for Aerial Navigation, 1944, modifying the International Sanitary Convention of 12 April 1933, opened for signature in Washington, 15 December 1944, except paragraph 2 of Article XVII;

(k) Protocol of 23 April 1946 to prolong the International Sanitary Convention, 1944, signed in Washington;

(l) Protocol of 23 April 1946 to prolong the International Sanitary Convention for Aerial Navigation, 1944, signed in Washington.

2. The Pan American Sanitary Code, signed at Habana, 14 November 1924 remains in force with the exception of Articles 2, 9, 10, 11, 16 to 53 inclusive, 61, and 62, to which the relevant part of paragraph 1 of this Article shall apply.

ARTICLE 106

1. The period provided in execution of Article 22 of the Constitution of the Organization for rejection or reservation shall be nine months from the date of the notification by the Director-General of the adoption of these Regulations by the World Health Assembly.

2 Such period may, by notification to the Director-General, be extended to eighteen months with respect to overseas or other outlying territories for whose international relations the State may be responsible.

3. Any rejection or reservation received by the Director-General after the expiry of the periods referred to in paragraphs 1 or 2 of this Article shall have no effect.

ARTICLE 107

1. If any State makes a reservation to these Regulations, such reservation shall not be valid unless it is accepted by the World Health Assembly, and these Regulations shall not enter into force with respect to that State until such reservation has been accepted by the Assembly or, if the Assembly objects to it on the ground that it substantially detracts from the character and purpose of these Regulations, until it has been withdrawn.

2. A rejection in part of these Regulations shall be considered as a reservation.

3. The World Health Assembly may, as a condition of its acceptance of a reservation, request the State making such reservation to undertake that it will continue to fulfil any obligation or obligations corresponding to the subject-matter of such reservation, which such State has previously accepted under the existing conventions and agreements listed in Article 105.

4. If a State makes a reservation which in the opinion of the World Health Assembly detracts to an insubstantial extent from an obligation or obligations previously accepted by that State under the existing conventions or agreements listed in Article 105, the Assembly may accept such reservation without requiring as a condition of its acceptance an undertaking of the kind referred to in paragraph 3 of this Article.

5. If the World Health Assembly objects to a reservation, and that reservation is not then withdrawn, these Regulations shall not enter into force with respect to the State which has made such a reservation. Any existing conventions and agreements listed in Article 105 to which such State is already a party consequently remain in force as far as such State is concerned.

ARTICLE 108

A rejection, or the whole or part of any reservation, may at any time be withdrawn by notifying the Director-General.

ARTICLE 109

1. These Regulations shall come into force on the first day of October 1952.

2. Any State which becomes a Member of the Organization after the first day of October 1952 and which is not already a party hereto may notify its rejection of, or any reservation to, these Regulations within a period of three months from the date on which that State becomes a Member of the Organization. Unless rejected, these Regulations shall come into force with respect to that State, subject to the provision of Article 107, upon the expiry of that period.

ARTICLE 110

1. Any State not a member of the Organization, which is a party to any of the conventions or agreements listed in Article 105 or to which the Director-General has notified the adoption of these Regulations by the World Health Assembly, may become a party hereto by notifying its acceptance to the Director-General and, subject to the provisions of Article 107, such acceptance shall become effective upon the date of coming-into-force of these Regulations, or, if such acceptance is notified after that date, three months after the date of receipt by the Director-General of the notification of acceptance.

2. For the purpose of the application of these Regulations Articles 23, 62, 63, and 64 of the Constitution of the Organization shall apply to any non-Member State which becomes a party to these Regulations.

3. Any non-Member State which has become a party to these Regulations may at anytime withdraw from participation in these Regulations, by means of a notification addressed to the Director-General which shall take effect six months after he has received it. The State which has withdrawn shall, as from that date, resume application of the provisions of any of the conventions or agreements listed in Article 105 to which it was previously a party.

ARTICLE 111

The Director-General shall notify all Members and Associate Members, and also other parties to any of the conventions and agreements listed in Article 105, of the adoption by the World Health Assembly of these Regulations. The Director-General shall also notify these States as well as any other State, which has become a party to these Regulations, of any additional Regulations amending or supplementing these Regulations, of any notification received by him under Articles 106, 108, 109 and 110 respectively, as well as of any decision taken by the World Health Assembly under Article 107.

ARTICLE 112

1. Any question or dispute concerning the interpretation or application of these Regulations or of any Regulations supplementary to these Regulations may be referred by any State concerned to the Director-General who shall attempt to settle the question or dispute. If such question or dispute is not thus settled, the Director-General on his own initiative, or at the request of any State concerned, shall refer the question or dispute to the appropriate committee or other organ of the Organization for consideration.

2. Any State concerned shall be entitled to be represented before such committee or other organ.

3. Any such dispute which has not been thus settled may, by written application, be referred by any State concerned to the International Court of Justice for decision.

ARTICLE 113

1. The English and French texts of these Regulations shall be equally authentic.

2. The original texts of these Regulations shall be deposited in the archives of the Organization. Certified true copies shall be sent by the Director-General to all Members and Associate Members, and also to other parties to the conventions and agreements listed in Article 105. Upon the entry-into-force of these Regulations, certified true copies shall be delivered by the Director-General to the Secretary-General of the United Nations for registration in accordance with Article 102 of the Charter of the United Nations.

PART X — TRANSITIONAL PROVISIONS

ARTICLE 114

1. Notwithstanding any provision to the contrary of the existing conventions and agreements, certificates of vaccination conforming with the rules and the models laid down in Appendices 2, 3, and 4 shall be accepted as equivalent to the corresponding certificates provided for in the existing conventions or agreements.

2. Notwithstanding the provisions of paragraph 1 of Article 109, the provisions of this Article shall come into force en the first day of December 1951.

3. The application of this Article shall be limited to any State which, within three months from the date of the notification by the Director-General of the adoption of these Regulations by the World Health Assembly, declares that it does not intend to make any reservation to this Article and to the rules and the models laid down in Appendices 2, 3, and 4.

4. A declaration made under paragraph 3 of this Article may exclude the application of the Article to anyone of the Appendices 2, 3, and 4.

ARTICLE 115

1. A certificate of vaccination issued in accordance with the Convention of 21 June 1926, as amended by the Convention of 15 December 1944, or in accordance with the Convention of 12 April 1933, as amended by the Convention of 15 December 1944, before the entry- into-force of these Regulations snail continue to be valid for the period for which it was previously valid. Moreover, the validity of a certificate of vaccination against yellow fever so issued shall be extended for two years after the date on which it would otherwise have ceased to be valid.

2. A Deratization Certificate or a Deratization Exemption Certificate issued in accordance with Article 28 of the Convention of 21 June 1926, before the entry-into-force of these Regulations, shall continue to be valid for the period for which it was previously valid.

In faith whereof, we have set out hands at Geneva this twenty-fifth day of May 1951.

LEONARD A. SCHEELE

The President of the Fourth World Health Assembly

BROCK CHISHOLM

The Director-General of the World Health

APPENDIX 1 – DERATTING CERTIFICATE
APPENDIX 2 – INTERNATIONAL CERTIFICATE OF VACCINATION OR REVACCINATION AGAINST CHOLERA APPENDIX 3 – INTERNATIONAL CERTIFICATE OF VACCINATION OR REVACCINATION AGAINST YELLOW FEVER
APPENDIX 4 – INTERNATIONAL CERTIFICATE OF VACCINATION OR REVACCINATION AGAINST SMALLPOXAPPENDIX 5 – MARITIME DECLARATION OF HEALTH
(see PTS, Vol. II, pp. 671-676)

APPENDIX 6

HEALTH PART OF THE AIRCRAFT GENERAL DECLARATION

to include information on:

(a) Illness suspected of being of an infectious nature which has occurred on board during the flight.

(b) Any other condition on board which may lead to the spread of disease.

(c) Details of each disinsecting or sanitary treatment (place, date, time, method) during the flight. If no disinsecting has been carried out during the flight give details of most recent disinsecting.

ANNEX A

SANITARY CONTROL OF PILGRIM TRAFFIC APPROACHING OR
LEAVING THE HEDJAZ DURING THE SEASON OF THE PILGRIMAGE

PART I—MEASURES APPLYING TO ALL PILGRIMS

ARTICLE A I

1. The health authority for the port or airport of embarkation, or in the case of transport by land the health authority for the place of departure, shall ensure that every pilgrim before departure shall be in possession of valid certificates of vaccination against cholera and smallpox, irrespective of the area from which he comes or the health conditions in that area; if he has left a yellow-fever infected local area or a yellow fever endemic zone within the previous six days, he shall also be in possession of a valid certificate of vaccination against yellow-fever.

2. On arrival in the Hedjaz, any pilgrim who is not in possession of the certificates required by paragraph 1 of this Article shall be vaccinated against the disease for which he has no certificate and he shall be given a certificate of such vaccination. If the pilgrim refuses to be so vaccinated, the health authority may place him in isolation until the expiry of the relevant period of incubation, or until arrangements can be made in the meantime for his repatriation. In the case of yellow fever, however, a pilgrim who has not been vaccinated shall be kept in isolation until the end of the period of incubation.

PART II—PILGRIM SHIPS

CHAPTER I—PILGRIM SHIPS PASSING THROUGH THE SUEZ CANAL

ARTICLE A 2

Every pilgrim ship passing through the Suez Canal shall proceed in quarantine.

CHAPTER II—PILGRIM SHIPS GOING TO THE HEDJAS

ARTICLE A 3

1. On arrival of a pilgrim ship at Port Said, any pilgrim who is not in possession of the certificates required by paragraph 1 of Article A 1 shall be vaccinated against the disease for which he has no certificate and he shall be given a certificate of such vaccination.

2. If on medical examination of a pilgrim ship at Port Said no case of a quarantinable disease is discovered, the ship shall be allowed to proceed to the Hedjas, without calling at any intermediate port, as soon as the provisions of paragraph 1 of this Article have been complied with.

ARTICLE A 4

Every pilgrim ship going to the Hedjaz otherwise than through the Suez Canal shall proceed to the quarantine station designated by the health authority at Jeddah and shall not disembark pilgrims and their luggage until free pratique has been given.

CHAPTER III—PILGRIM SHIPS RETURNING FROM THE HEDJAZ

ARTICLE A 5

Any pilgrim returning from the Hedjaz who wishes to disembark in Egypt shall travel only in a pilgrim ship which stops either at the sanitary station at El Tor, or at some other sanitary station appointed by the health administration for Egypt.

ARTICLE A 6

The health administration for Saudi Arabia shall notify every diplomatic mission in its territory immediately there occurs in the Hedjaz during a period beginning two months before the day of the Haj and ending two months after that day a foyer of plague, cholera, yellow fever, or smallpox, or an epidemic of typhus relapsing fever.

ARTICLE A 7

1. If there has not occurred in the Hedjaz during the period referred to in Article A 6 a foyer of plague, cholera, yellow fever, or smallpox, or an epidemic of typhus or relapsing fever, any pilgrim ship returning northwards may go from the Hedjaz, without calling at any intermediate port, to Suez, where the pilgrims shall be medically examined.

2. If there has not been a case of a quarantinable disease on board during the voyage, and five days have elapsed, reckoned from the date on which the pilgrim ship left the Hedjaz, the health authority at Suez shall allow it to enter the Suez Canal, even at night. The health authority may allow any such pilgrim ship to enter the Suez Canal less than five days after it left the Hedjaz if the first two pilgrim ships returning from the Hedjaz via El Tor, as well as the aircraft carrying pilgrims who have landed there before the arrival of the second ship, have been found to be free from infection.

3. If there has been a case of plague, cholera, yellow fever, or smallpox on board during the voyage, the pilgrim ship shall go directly to the sanitary station at El Tor.

4. If there has been a case of typhus or relapsing fever on board during the voyage, the pilgrims shall be disembarked at Suez, the pilgrim ship shall be put in quarantine, and the appropriate measures of disinsecting and disinfection shall be taken before it is allowed to continue its voyage.

ARTICLE A 8

If there has occurred in the Hedjaz during the period referred to in Article A 6 a foyer of plague, cholera, yellow fever, or smallpox, or an epidemic of typhus or relapsing fever, every pilgrim ship intending to pass through the Suez Canal shall go directly to the sanitary station at El Tor.

ARTICLE A 9

1. On arrival at El Tor of any pilgrim ship to which paragraph 3 of Article A 7, or Article A 8, applies, the health authority for the sanitary station shall apply the following measures—

(a) if there is a case of plague, cholera, yellow fever, or smallpox on board, every pilgrim shall be disembarked and the suspects submitted to such of the sanitary measures provided for in these Regulations as the health authority considers appropriate; the pilgrims shall be isolated for a period, reckoned from the date when the last case occurred, of not more than five days for cholera, six days for plague or yellow fever, or fourteen days for smallpox;

(b) if there is a case of typhus or relapsing fever on board, every suspect shall be disembarked and he and his baggage shall be disinfected or disinsected;

(c) the appropriate measures for deratting, disinsecting, or disinfection of the pilgrim ship shall be taken if necessary.

2. When the measures provided for in this Article have been applied, any pilgrim who is not an infected person shall be allowed to re-embark and the ship allowed to continue its voyage.

ARTICLE A 10

Every pilgrim ship returning from the Hedjaz and going to a territory on The African coast of the Red Sea shall, without calling at any intermediate port, proceed to such sanitary station as may be appointed by the health administration for that territory.

PART III—TRANSPORT BY AIR

ARTICLE A 11

1. Any aircraft conveying pilgrims returning from the Hedjaz and wishing to land pilgrims in Egypt shall first call either at the sanitary station at El Tor, or at some other sanitary station appointed by the health administration for Egypt.

2. No sanitary measures other than those provided for in these Regulations shall apply to other aircraft returning from the Hedjaz.

PART IV — TRANSPORT BY LAND

ARTICLE A 12

Every pilgrim who wishes to enter Saudi Arabian territory by land shall do so only at a sanitary station appointed by the health administration for Saudi Arabia, where the measures provided for in these Regulations shall be applied.

ARTICLE A 13

If there has occurred in the Hedjaz during the period referred to in Article A 6 a foyer of plague, cholera, yellow fever, or smallpox, or an epidemic of typhus or relapsing fever, the appropriate health authority for the first area adjoining Saudi Arabia which a pilgrim returning therefrom enters may either isolate him at a sanitary station, or place him under surveillance, as it considers necessary, for not longer than the incubation period of the disease which has occurred.

PART V—NOTIFICATIONS

ARTICLE A 14

The health administration for Saudi Arabia shall inform the Organization weekly by telegram of the epidemiological conditions prevailing in its territory during a period beginning two months before the day of the Hedaj and ending two months after that day. This information, which shall take into account the data furnished and the notifications made to that administration by the medical missions accompanying the pilgrims, shall be sent by the Organization to the health administrations of the territories from which the pilgrims come with a view in enabling them to apply the appropriate provisions of these Regulations on the return of the pilgrims.

ARTICLE A 15

During the season of the Pilgrimage all health administration concerned shall send periodically and, if necessary, by the most rapid means, to the Organization all sanitary information they may collect concerning the Pilgrimage. They shall also send to the Organization not later than six months after the annual report thereon. This information shall be forwarded by the pilgrimage Organization to all health administrations concerned.

ANNEX B

STANDARDS OF HYGIENE ON PILGRIM SHIPS AND ON AIRCRAFT CARRYING PILGRIMS

PART I—PILGRIM SHIPS

ARTICLE B I

Only mechanically propelled ships shall be permitted to carry pilgrims.

ARTICLE B 2

1. Every pilgrim ship shall be able to accommodate the pilgrims on the between-decks.

2. Pilgrims shall not be accommodated on a pilgrim ship on any deck lower than the first between-deck below the water-line.

3. The following space provisions shall be made on a pilgrim ship for each pilgrim, irrespective of age—

(a) on the between-decks, in addition to the space provided for the crew, an area of not less than 18 English square feet or 1.672 square metres and a cubic capacity of not less than 108 English cubic feet or 3.058 cubic metres;

(b) on the upper deck, a free area of not less than 6 English square feet or 0.557 square metres in addition to the area upon that deck required for the working of the ship or reserved for the crew, or taken up by temporary hospitals, douches, and latrines.

4. The decks above the upper between-decks on a pilgrim ship shall be wooden decks or steel decks covered with wood or any satisfactory insulating material.

5. Satisfactory ventilation shall be provided in every pilgrim ship. The ventilation shall be augmented by mechanical means, at least in the case of decks below the first of the between-decks, and by port-holes in the upper between decks if the deck is above the water-line.

ARTICLE B 3

1. Every pilgrim ship shall be provided on deck with screened places supplied at all times, even if the ship is lying at anchor, with sea-water under pressure, in pipes which shall be fitted with taps or douches, in the proportion of not less than one tap or douche for every 100 pilgrims or fraction of 100 pilgrims.

2. A sufficient number of such places shall be for the exclusive use of women.

ARTICLE B 4

1. In addition to closet accommodation for the crew, every pilgrim ship shall be provided with latrines, fitted with flushing apparatus or water-taps in the proportion of not less than three latrines for every 100 pilgrims, provided that, for existing ships in which it is impracticable to provide that proportion, the health authority for the port of departure may permit the proportion to be not less than two latrines for every 100 pilgrims or fraction 100 pilgrims.

2. A sufficient number of such latrines shall be for the exclusive use of women.

3. No latrine shall be situated in the hold of a ship or in a between-deck which has no access to an open deck.

ARTICLE B 5

1. Every pilgrim ship shall be provided with satisfactory hospital accommodation situated on the upper deck unless the health authority for the port of departure considers that some other situation would be equally satisfactory.

2. Such hospital accommodation, including temporary hospitals, shall be of sufficient size, allowing not less than 97 English square feet or 9.012 square metres for every 100 pilgrims or fraction of 100 pilgrims, and so constructed as to provide for the isolation of infected persons or suspects.

3. Separate latrines and drinking-water taps shall be provided exclusively for such accommodation.

ARTICLE B 6

1. Every pilgrim ship shall carry medicaments and appliances for the treatment of the sick pilgrims, as well as disinfectants and insecticides. The health administration for the territory in which the port of departure is situated shall prescribe the quantities of such substances or articles to be carried.

2. Every pilgrim ship shall be provided with anticholera vaccine, antismallpox vaccine and any other vaccine which may be prescribed by the health administration referred to in paragraph 1 of this Article, and such vaccines and substances shall be stored under suitable conditions.

3. Medical attendance and medicines shall be provided free of charge to pilgrims on a pilgrim ship.

ARTICLE B 7

1. The crew of every pilgrim ship shall include a properly registered medical practitioner with experience of maritime health conditions, as well as a nursing attendant, employed for medical service on the ship.

2. If the number of pilgrims on board exceeds 1,000, the crew shall include two such medical practitioners and two nursing attendants.

3. Every such medical practitioner shall be so recognized by the health administration for the territory in which the port of departure is situated.

ARTICLE B 8

Each State may apply to pilgrim ships embarking pilgrims for the Hedjaz In its port requirements additional to those prescribed in Articles B 2 to B 7 inclusive, which are minimum requirements, if the additional requirements conform with its national legislation.

ARTICLE B 9

Each pilgrim on board a pilgrim ship shall keep with him only such light baggage as is essential for the voyage.

ARTICLE B 10

Every pilgrim shall be in possession of a return ticket or shall have deposited a sum sufficient to pay for the return journey. The sanitary charges which he will normally incur throughout his voyage to and from the Hedjaz shall be included in the price o£ that ticket or in that sum.

ARTICLE B 11

1. The master of every pilgrim ship or the agent of the shipping company shall notify the health authority for each port at which pilgrims are due to be embarked for the Hedjaz of the intention to do so at least three days before the ship leaves the port of departure and at least twelve hours before it leaves any subsequent port of call.

2. A similar notification shall be made to the health authority for Jeddah at least three days before the ship leaves that port.

3. Every such notification shall specify the proposed date of departure and the port or ports of the landing of the pilgrims.

ARTICLE B 12

1. The health authority for a port, on receiving a notification provided for in Article B 11, shall inspect the ship, and may measure it if the master cannot produce a certificate of measurement by another competent authority, or if the inspecting authority has reason to believe that such certificate no longer represents the actual conditions of the ship.

2. The cost of any such inspection and measurement shall be payable by the master.

ARTICLE B 13

The health authority for a port at which pilgrims are embarked shall not Permit the departure of a pilgrim ship until satisfied that—

(a) the ship carries as part of the crew a properly qualified and registered medical practitioner or practitioners, as well as a nursing attendant or attendants, as provided for in Article B 7, and sufficient medical stores;

(b) the ship is thoroughly clean and, if necessary, has been disinfected;

(c) the ship is properly ventilated and provided with awnings of sufficient size and thickness to shelter the decks;

(d) there is nothing on board which is or may become injurious to the health of the pilgrims or crew;

(e) there is on board, properly stowed away, in addition to the requirements of other persons on board, sufficient wholesome food for all the pilgrims during the voyage;

(f) the drinking-water on board is wholesome and sufficient;

(g) the tanks for the drinking-water on board are properly protected from contamination and so closed that the water can be drawn from them only by means of taps or pumps;

(h) the ship carries an apparatus capable of distilling not less than five litres of drinking-water per day for each person on board;

(i) the ship has a proper and sufficient disinfecting chamber;

(j) the deck allotted to the pilgrims is free from merchandise and unencumbered;

(k) any appropriate measure provided for in this Annex can be applied on board;

(l) the master has obtained—

(i) a list, countersigned by the health authority for each port at which pilgrims have been embarked, showing the names and sex of the pilgrims embarked there and the maximum number of pilgrims which may be carried on the ship;

(ii) a document giving the name, nationality, and tonnage of the ship, the names of the master and ship's surgeon or surgeons, the exact number of persons embarked, and the port of departure; this document shall include a statement by the health authority for the port of departure, showing whether the maximum number of pilgrims which may be carried has been embarked, and, if not, the additional number of pilgrims the ship is authorized to embark at subsequent ports of call.

ARTICLE B 14

1. The document referred to in sub-paragraph (ii) of paragraph (l) of Article B 13 shall be countersigned at each port of call by the health authority for that port, which shall enter on such document—

(a) the number of pilgrims disembarked or embarked at that port;

(b) the sanitary conditions at the port of call.

2. If any such document is altered in any manner during the voyage, the ship may be treated as infected.

ARTICLE B 15

Pilgrims shall not be permitted to cook food on board a pilgrim ship.

ARTICLE B 16

During the voyage of a pilgrim ship, the deck allotted to pilgrims shall be kept from merchandise and unencumbered and reserved for their use at all times, even at night, without charge.

ARTICLE B 17

The between-decks of a pilgrim ship shall be properly cleansed every day during the voyage at a time when they are not occupied by the pilgrims.

ARTICLE B 18

Every latrine on a pilgrim ship shall be kept clean and in good working order, and shall be disinfected as frequently as necessary and in no case less than three times daily.

ARTICLE B 19

1. Not less than five litres of drinking-water shall be provided daily, free of charge, to each pilgrim, irrespective of age.

2. If there is any reason to suspect that the drinking-water on a pilgrim ship may be contaminated, or if there is any doubt as to its quality, it shall be boiled or sterilized, and it shall be removed from the ship at the first port at which a fresh and wholesome supply can be obtained. The tanks shall be disinfected before being filled with the fresh supply.

ARTICLE B 20

1. The ship's surgeon shall daily visit the pilgrims on a pilgrim ship during its voyage, give medical attention to them as may be necessary, and satisfy himself that hygienic standards are being observed on board.

2. The ship’s surgeon shall, in particular, satisfy himself—

(a) that the rations issued to the pilgrims are of good quality and properly prepared and that the quantity is in accordance with the carriage contract;

(b) that drinking-water is provided in accordance with paragraph 1 of Article B 19;

(c) that the ship is always kept clean, and that the latrines are cleaned and disinfected as required Article B 18;

(d) that the pilgrim's quarters are kept clean;

(e) that, in the case of the occurrence of any disease of an infectious nature, the appropriate measures of control including those of disinfection and disinsecting, have been carried out.

3. If there is any doubt as to the quality of the drinking-water, the ship’s surgeon shall draw the attention of the master, in writing, to the provisions of sub-paragraphs (f), (g), and (h) of Article B 13 and paragraph 2 of Article B 19.

4. The ship's surgeon shall keep a day-to-day record, which shall be daily countersigned by the master, of every occurrence on board relating to health, including any preventive measures taken, during the voyage. If so requested by the health authority for any port of call or for the port of destination, such record shall be produced for inspection.

ARTICLE B 21

The ship's surgeon shall be responsible to the master of a pilgrim ship for all necessary measures of disinfection or disinsecting on board, which shall be carried out under the supervision of the ship's surgeon, and for the measures specified in paragraph 2 of Article B 20.

ARTICLE B 22

Only the persons charged with the care and nursing of patients suffering from any disease of an infectious nature shall have access to them. Such persons, other than the ship's surgeon, shall not come in contact with any other persons on board if such contact would be liable to convey the infection.

ARTICLE B 23

1. If a pilgrim dies during the voyage, the master shall record the fact opposite the name of the pilgrim on the list required by sub-paragraph (i) of pargraph (l) of Article B 13 and he shall also enter in the ship's log the name of the pilgrim, his age, the place whence, he came, and the cause or assumed cause of his death.

2. If the pilgrim has died at sea from any disease of an infectious nature, the corpse shall be wrapped in a shroud impregnated with a disinfecting solution and shall be buried at sea.

ARTICLE B 24

This Annex does not apply to pilgrim ships engaged on short sea voyages, accepted locally as coasting voyages, which shall conform with special requirements agreed between the States concerned.

PART II—AIRCRAFT

ARTICLE B 25

The provisions of the Convention on International Civil Aviation (Chicago 1944) and of the Annexes thereto, governing the transport of passers by air, the application of which may affect the health of such passenger, shall be equally enforced whether an aircraft is carrying pilgrims or other passengers.

ARTICLE B 26

A health administration may require aircraft carrying pilgrims to land only at airports in its territory designated by it for the disembarking of pilgrims.

The Philippines accepted the Regulations subject to the following reservations:

Persons on an international voyage arriving from an infected local area, within the incubation period of the disease, may be required to submit to stool examination subject to the conditions:

(a) that the reservation constitutes no derogation from the provisions of Articles 34 and 61 or any other articles of the Regulations;

(b) that the period within which a person may be submitted to stool examination does not exceed five days, reckoned from the date of the departure of the person from the infected local area;

(c) that the measure be used with discretion and only in case of absolute necessity.

Parties to the Regulations as of December 31, 1965: (See PTS, Vol. II, pp. 687 & 688)