International Sanitary Convention
Source: Unofficial Text
His Majesty the German Emperor, King of Prussia, in the name of the German Empire; the President of the United States of America; the President of the Argentine Republic; His Majesty the Emperor of Austria, King of Bohemia, etc., and Apostolic King of Hungary; His Majesty the King of the Belgians; the President of the Republic of Bolivia; the President of the United States of Brazil; His Majesty the King of the Bulgarians; the President of the Republic of Chile; the President of the Republic of Colombia; the President of the Republic of Costa Rica; the President of the Republic of Cuba; His Majesty the King of Denmark; the President of the Republic of Ecuador; His Majesty the King of Spain; the President of the French Republic; His Majesty the King of the United Kingdom of Great Britain and Ireland and of the British Dominions beyond the Seas, Emperor of India; His Majesty the King of the Hellenes; the President of the Republic of Guatemala; the President of the Republic of Haiti; the President of the Republic of Honduras; His Majesty the King of Italy; His Royal Highness the Grand Duke of Luxemburg; the President of the United States of Mexico; His Majesty the King of Montenegro; His Majesty the King of Norway; the President of the Republic of Panama; Her Majesty the Queen of the Netherlands; His Majesty the Shah of Persia; the President of the Portuguese Republic; His Majesty the King of Roumania; His Majesty the Emperor of all the Russias; the President of the Republic of Salvador; His Majesty the King of Servia; His Majesty the King of Siam; His Majesty the King of Sweden; the Swiss Federal Council; His Majesty the Sultan of Turkey; His Highness the Khedive of Egypt, in accordance with the powers invested in him by the Imperial Firmans; and the President of the Oriental Republic of the Uruguay:
HAVING DECIDED to modify the provisions of the Sanitary Convention signed at Paris 3 December 1903, in the light of the latest scientific results and medical experience; to establish international regulations with regard to yellow fever; and to extend, as far as possible, the area to which the principles apply which have inspired the international sanitary regulations, have named as their plenipotentiaries:
[Names of plenipotentiaries not listed here.]
Who, having exchanged their full powers, found in good and due form, have agreed upon the following Articles:
PROVISIONS TO BE OBSERVED BY COUNTRIES SIGNING THE CONVENTION ON THE APPEARANCE OF PLAGUE, CHOLERA, OR YELLOW FEVER IN THEIR TERRITORY
Notification and subsequent communications to the other countries
Every Government must immediately notify to the other Governments the first recognised case of plague, cholera, or yellow fever found in its territory.
In the same way, the first recognised case of cholera, plague, or yellow fever which occurs outside the limits of local areas already affected must be immediately notified to the other Governments.
Each notification prescribed in Article 1 shall be accompanied, or very promptly followed, by detailed information as to-
(1) Where the disease has appeared;
(2) The date of its appearance, its source and its type;
(3) The number of known cases and deaths;
(4) The extent of the local area or areas affected;
(5) In the case of plague, the presence of that disease or of unusual mortality among rats;
(6) In the case of yellow fever, the presence of stegomyia calopus;
(7) The measures immediately taken.
The notification and the information prescribed in Articles 1 and 2 shall be supplied to the diplomatic or consular agencies in the capital of the infected country.
In the case of countries not represented there, the notification and the information shall be telegraphed direct to the Governments of these countries.
The notification and the information prescribed in Articles 1 and 2 shall be followed by subsequent communications furnished regularly and in such fashion as to keep the Governments informed of the course of the epidemic.
These communications shall be made at least once a week, shall be as complete as possible, and shall, in particular, indicate the precautions adopted with a view to prevent the spread of the disease.
They must set out with precision (1) the preventive measures taken in the way of sanitary inspection or of medical investigation, of isolation, and of disinfection; (2) the measures adopted in the case of outgoing vessels to prevent exportation of the disease, and, particularly in the case contemplated in Article 2(5) and (6), the measures taken against rats or mosquitos.
It is of primary importance that the foregoing provisions be promptly and scrupulously complied with.
Notification is of no real value unless every Government be itself informed in time of cases of plague, cholera, yellow fever, and also of doubtful cases occurring in its territory. It cannot, therefore, be too strongly impressed on the several Governments that they should make notification of plague, cholera, and yellow fever compulsory, and that they should keep themselves informed as to any unusual mortality among rats, particularly in ports.
It is desirable that neighbouring countries should make special arrangements with the object of organising direct exchange of information between their principal administrative officers, both as regards territories having a common frontier and as regards territories having close commercial relations.
The conditions under which a local area may be regarded as infected or as having ceased to be infected
The notification of a first case of plague, cholera or yellow fever shall not lead to the adoption of the measures prescribed in the following Chapter II against the local area in which the case has occurred.
But when several non-imported cases of plague or yellow fever have occurred, or when the case of cholera constitute a "foyer", the local area may be considered infected.
In order that the measures be limited to places which are infected, the Governments must apply them to arrivals from infected local areas only.
"Local area" means a portion of territory clearly defined in the information that accompanies or follows notification - as, for instance, a province, a "government", a district, a department, a canton, an island, a commune, a town, a quarter in a town, a village, a port, a polder, an agglomeration, etc, whatever may be the extent and population of these portions of territory.
But this limitation to the infected local area must be accepted only on the definite condition that the Government of the infected country take the measures necessary (a) for checking the spread of the epidemic, and (b) in the case of plague or cholera, for preventing the export of the things specified in Article 13(1) and (2) derived from the infected local area, unless previously disinfected.
When a local area is infected, no restrictive measure shall be taken against arrivals from that local area if they have left it not less than five days before the beginning of the epidemic.
In order that a local area cease to be regarded as infected it must be officially established-
(1) That, since the isolation, death, or recovery of the last case, no fresh case nor death shall have occurred during a period of five days as regards cholera or plague, and eighteen days as regards yellow fever;
(2) That all measures of disinfection have been carried out; moreover, in the case of plague that measures have been taken against rats, and in the case of yellow fever against mosquitos.
Measures at infected ports on the departure of vessels
The competent authority shall take effectual measures-
(1) To prevent the embarkation of persons showing symptoms of plague, cholera, or yellow fever;
(2) In the case of plague or cholera, to prevent the exportation of merchandise or articles of any sort which it may regard as infected and which have not previously been disinfected on shore under the supervision of a doctor appointed by the public authority;
(3) In the case of plague, to prevent rats gaining access to ships;
(4) In the case of cholera, to see that the drinking water taken on board is wholesome;
(5) In the case of yellow fever, to prevent mosquitos gaining access to ships.
MEASURES OF DEFENCE AGAINST INFECTED TERRITORIES
Publication of measures prescribed
The Government of each country shall immediately make public the measures which it considers necessary to prescribe with regard to arrivals from an infected country or local area.
It shall forthwith communicate these measures to the diplomatic or consular agent of the infected country resident in the capital, and also to the International Sanitary Boards.
It shall also communicate, through the same channels, the withdrawal of these measures or any modifications of them. In the absence of a diplomatic or consular agency in the capital, the communications shall be made direct to the Government of the country concerned.
Merchandise - Disinfection - Importation and transit - Baggage
No article of merchandise is in itself capable of conveying plague, cholera, or yellow fever. Merchandise becomes dangerous only when contaminated by plague or cholera products.
Disinfection may not be carried out except in the case of plague or cholera, and only such merchandise and things as the local sanitary authority considers infected may be subjected to disinfection.
Provided always, in the case of plague or cholera, that the merchandise or things hereinafter specified may be subjected to disinfection or their importation may even be prohibited, irrespective of any evidence as to whether or not they are infected:
(1) Body-linen, wearing apparel, bedding that has been in use.
But when these things are carried as baggage, or in consequence of a change of abode (household goods), their importation may not be prohibited, but they shall be dealt with as prescribed in Article 20.
Soldiers' and sailors' kits returned to their country after their death are to be regarded as of the nature of the things specified in the first sentence of 1 of this Article.
(2) Rags, save in the case of cholera, rags compressed and carried in bound bales as merchandise in bulk.
The importation of the following articles may not be prohibited: Fresh waste derived directly from spinning, weaving, making up or bleaching establishments; artificial woods (Kuntswolle, shoddy), and new paper clippings.
The transit of the merchandise and things specified in 1 and 2 of the foregoing Article may not be prohibited if they are packed so that they cannot be manipulated on the way. Similarly, when such merchandise and things have been so conveyed that they cannot have come into contact with contaminated articles on the way, their transit through an infected local area must not hinder their importation into the country to which they are consigned.
Importation of the merchandise and things specified in 1 and 2 of Article 13 shall not be prohibited if it be proved to the authority of the country to which they are consigned that they were despatched not less than five days before the commencement of the epidemic.
It rests with the authority of the country to which the merchandise and things are consigned to decide in what manner and at what place disinfection shall be carried out, and what shall be the methods adopted to secure destruction of rats, insects, and mosquitos. These operations must be performed in such fashion as to injure articles as little as possible. Clothes, rags, infected dressings, papers, and other articles of small value may be destroyed by fire.
It rests with each State to settle questions of compensation for damage caused by the disinfection or destruction of the things referred to above, or of rats, insects, or mosquitos.
If on account of measures taken to secure destruction of rats, insects, or mosquitos on board ship charges are levied by the sanitary authority, either directly or indirectly through a company or a private person, the rates of these charges must be in accordance with a tariff made public beforehand, and so drawn up that the State or the sanitary authority shall, on the whole, derive no profit from its application.
Letters and correspondence, printed matter, books, newspapers, business documents, etc (not including parcels conveyed by post), shall not be subject to disinfection or to any restriction whatsoever.
In the case of yellow fever, parcels conveyed by post shall not be subject to disinfection or to any restriction whatsoever.
Merchandise, whether it has come by land or by sea, may not be detained at frontiers or at ports.
The only measures that may be taken are those specified in Articles 13 and 16.
Provided always that if merchandise which has come by sea and is either not packed or imperfectly packed has become infected during the voyage by rats ascertained to have plague, and if such merchandise cannot be disinfected, the destruction of the germs may be secured by storing the merchandise during a period not to exceed two weeks.
It is to be understood that the application of this measure shall not in any way delay the ship nor give rise to extra expenses by reason of deficient storage accommodation in any port.
When merchandise has undergone disinfection in accordance with the provisions of Article 13, or has been temporarily stored in virtue of the proviso contained in paragraph 3 of Article 18, the proprietor of such merchandise or his representative has the right to exact from the sanitary authority that has ordered the disinfection or the storage, a certificate showing the measures that have been taken.
Soiled linen, clothing, and articles carried as baggage or as household goods from an infected local area shall not undergo disinfection, except in the case of plague or cholera, and only in those instances where the sanitary authority considers them infected.
Measures at ports and marine frontiers
(A) Classification of ships
A ship shall be regarded as infected if there is plague, cholera, or yellow fever on board, or if there have been one or more cases of plague, cholera, or yellow fever on board within seven days.
A ship shall be regarded as suspected if there have been cases of plague, cholera, or yellow fever on board at the time of departure or during the voyage, but no fresh case within seven days.
A ship shall be regarded as healthy, notwithstanding its having come from an infected port, if there have been no death from nor case of plague, cholera, or yellow fever on board either before departure or during the voyage or on arrival.
(B) Measures in case of plague
In the case of plague, infected ships shall undergo the following measures:
(1) Medical inspection;
(2) The sick shall immediately be disembarked and isolated;
(3) Persons who have been in contact with the sick and those whom the port sanitary authority has reason to consider suspect shall be disembarked, of possible. They may be subjected to observation or surveillance, or to a period of observation followed by surveillance, provided that the total duration of these measures does not exceed five days from the time of arrival. It rests with the sanitary authority of the port, after taking into consideration the date of the last case, the condition of the ship, and the local possibilities, to take that one of these measures which seems to them preferable;
(4) Such soiled linen, wearing apparel, and articles belonging to the crew and passengers as are, in the opinion of the sanitary authority, infected, shall be disinfected;
(5) The parts of the ship that have been occupied by persons ill with plague, or that, in the opinion of the sanitary authority, are infected, must be disinfected;
(6) The rats on board must be destroyed, either before or after discharge of cargo, in such a manner as to avoid, as far as possible, damage to merchandise and to ship's plating and engines. The operation must be carried out as soon and as rapidly as possible, and, in any case, must not last longer than forty-eight hours.
In the case of ships in ballast, this process must be carried out as soon as possible before taking cargo.
In the case of plague, suspected ships shall undergo the measures specified in 1, 4, 5 and 6 of Article 22.
In addition, the crew and passengers may be subjected to surveillance, the duration of which, dating from the arrival of the ship, shall not exceed five days. The crew may during the same period be prevented from leaving the ship, except on duty.
In the case of plague, healthy ships shall be given free pratique immediately, whatever their bill of health may be.
The only measures which the authority of the port of arrival may take as regards these ships are the following:
(1) Medical inspection;
(2) Disinfection of soiled linen, wearing apparel, and other articles belonging to the crew and passengers, but only in exceptional instances, when the sanitary authority has special reasons for regarding them as infected;
(3) The sanitary authority may subject ships from an infected port to a process intended to secure destruction of rats on board, either before or after discharge of cargo, although this measure must not be resorted to as a general rule. This process must be carried out as soon and as rapidly as possible, and, in any case, must not take longer than twenty four hours, and so as to avoid as far as possible damage to merchandise and to the ship's plating and engines, and also so as not to interfere with the coming and going of passengers and crew between ship and shore. In the case of ships in ballast the process, if there be occasion for it, shall be carried out as soon and as rapidly as possible, and, in any case, before taking cargo.
The crew and passengers may be subjected to surveillance during a period which shall not exceed five days reckoned from the date on which the ship left the infected port. The crew may during the same period be prevented from leaving the ship, except on duty.
The competent authority at the port of arrival may in all cases exact a certificate, given on oath, from the doctor of the ship or, in his default, from the captain, testifying that there has not been a case of plague on board since departure, and that unusual mortality among rats has not been observed.
When rats on a healthy ship have been shown by bacteriological examination to have plague, or when unusual mortality among these rodents has been observed, the measures to adopt are as follows:
(1) Ships with rats having plague:
(a) Medical inspection;
(b) The rats must be destroyed, either before or after discharge or cargo, so as to avoid, as far as possible, damage to merchandise and to the ship's plating and engines. The operation must be carried out as soon and as rapidly as possible, and, in any case, must not last longer than forty-eight hours. Ships in ballast shall undergo this process as soon and as rapidly as possible, and, in any case, before taking cargo;
(c) Such parts of the ship and such articles as the local sanitary authority considers infected shall be disinfected;
(d) The passengers and crew may be subjected to surveillance during a period which must not exceed five days reckoned from the date of arrival.
(2) Ships on which unusual mortality among rats has been observed:
(a) Medical inspection;
(b) The rats shall be examined for plague as far and as quickly as possible;
(c) If it be considered necessary to destroy the rats, such destruction shall take place subject to the conditions specified above as regards ships with rats having plague;
(d) Until all suspicion shall have been removed, the passengers and crew may be subjected to surveillance for a period which shall not exceed five days reckoned from the date of arrival.
It is recommended that ships should be periodically subjected to a process of rat destruction at least once in every six months. The sanitary authority of the port where the process of rat destruction has been carried out, shall, whenever requested, furnish to the captain, the shipowner, or the shipowner's agent, a certificate stating the date of the operation, the port where it took place, and the nature of the process employed.
It is recommended that sanitary authorities of ports visited by ships upon which periodic rat destruction is practised should take the abovementioned certificates into account in considering what measures should be taken, especially with regard to measures taken under Article 24(3).
(C) Measures in case of cholera
In the case of cholera, infected ships shall undergo the following measures:
(1) Medical inspection;
(2) The sick shall be immediately disembarked and isolated;
(3) The other persons may also be disembarked and either be kept under observation or subjected to surveillance during a period which shall vary with the health conditions of the ship and the date of the last case, but which shall not exceed five days reckoned from the arrival of the ship. Provided that this period be not exceeded, the sanitary authority may proceed to bacteriological examination so far as is necessary;
(4) Such soiled linen, wearing apparel, and articles belonging to the crew and passengers as are, in the opinion of the sanitary authority of the port, infected shall be disinfected;
(5) The parts of the ship that have been occupied by persons ill with cholera, or that the sanitary authority regard as infected, shall be disinfected;
(6) When the drinking water stored on board is suspected, it shall be emptied out after disinfection and replaced if necessary by a supply of wholesome drinking water.
The sanitary authority may prohibit the emptying of water ballast in port without previous disinfection, if it has been taken in at an infected port.
It may prohibit human dejecta or waste water from a ship from being drained or cast into the waters of a port without preliminary disinfection.
In the case of cholera, suspected ships shall undergo the measures prescribed in (1), (4), (5) and (6) of Article 27.
The crew and passengers may be subjected to surveillance during a period which must not exceed five days reckoned from the arrival of the ship. It is recommended that the crew be prevented, during the same period, from leaving the ship except on duty.
Provided that the measures permitted by the preceding paragraph are not exceeded, the sanitary authority may proceed to bacteriological examination so far as is necessary.
The sanitary authority may prohibit the emptying of water ballast in port without previous disinfection, if it has been taken in at an infected port.
In the case of cholera, healthy ships shall be given free pratique immediately, whatever their bill of health may be.
The only measures that the authority of the port of arrival may prescribe as regards these ships are those specified in (1), (4) and (6) of Article 27.
The sanitary authority may prohibit the emptying of water ballast in port without previous disinfection, if it has been taken in at an infected port.
The crew and passengers may be subjected to surveillance, in respect of their state of health, during a period which must not exceed five days reckoned from the date on which the ship left the infected port. It is recommended that the crew be prevented, during the same period, from leaving the ship except on duty.
The competent authority at the port of arrival may, in all cases, exact a certificate, given on oath, from the doctor of the ship, or, in his default, from the captain, testifying that there has not been a case of cholera on board since departure.
(D) Measures in case of yellow fever
Ships infected with yellow fever shall undergo the following measures:
(1) Medical inspection;
(2) The sick shall be disembarked under protection from the bites of mosquitos and shall be duly isolated;
(3) The other persons may also be disembarked, and may either be kept under observation or subjected to surveillance during a period which shall not exceed six days from the time of arrival;
(4) Ships must be moored, whenever possible, 200 metres from the shore;
(5) If possible the destruction of mosquitos must be carried out on board before discharging the cargo. If this is not possible, all necessary measures must be taken to avoid infecting the people employed in unloading. These people must be subjected to surveillance for a period not exceeding six days from the time at which they ceased work on board.
In the case of yellow fever, suspected ships shall undergo the measures indicated under (1), (4) and (5) of the preceding Article.
In addition, the crew and the passengers may be subjected to surveillance during a period which shall not exceed six days from the time of the ship's arrival.
In case of yellow fever, healthy ships shall be given free pratique immediately after medical inspection, whatever their bill of health may be.
The measures prescribed in Articles 30 and 31 concern only those countries in which the stegomyia exists. In other countries they shall be applied to the extent considered necessary by the sanitary authority.
(E) Provisions common to all three diseases
In applying the measures specified in Articles 22-33, the fact of a ship carrying a doctor and disinfecting apparatus (disinfecting chambers) shall receive due consideration on the part of the competent authority. In the case of plague, like consideration shall be given when the ship is provided with apparatus for the destruction of rats.
The sanitary authorities of States that find it convenient to come to an agreement on the matter may dispense with medical inspection and other measures in the case of healthy ships carrying a doctor specially commissioned by their country.
Special measures may be prescribed as regards ships that are in an unsanitary condition or overcrowded, especially bacteriological examination in the case of cholera.
Ships refusing to submit to measures prescribed by a port authority, in virtue of the provisions of this Convention, shall be at liberty to put out to sea. Such ships may be permitted to land goods after the following necessary precautions have been taken, viz:
(1) Isolation of the ship, crew, and passengers;
(2) In the case of plague, request for information as to whether there has been any unusual mortality among rats on board;
(3) In the case of cholera, the substitution of wholesome drinking water for that stored on board, when the latter is suspected.
Such ships may also be authorised to disembark passengers at their request, on the condition that such passengers submit to the measures prescribed by the local authority.
Ships from an infected place that has undergone adequate sanitary measures in a port belonging to one of the countries which adhere to the Convention shall not be subjected to these measures a second time upon their arrival at a new port belonging to the same or to another country, provided that no incident calling for fresh measures has occurred in the interval, and no call has been made at an infected port.
A ship shall not be regarded as having called at a port if she has landed only passengers and their luggage, or mails, without having been in communication with the shore, or if she has taken on board only the mails, or passengers with or without their luggage, who have not communicated with the port or with an infected area. In the case of yellow fever the ship must, in addition, have kept as far as possible from the shore, at least 200 metres, in order to prevent the access of mosquitos.
The authority of the port which imposes sanitary measures shall when requested furnish the captain, the shipowners, or the shipowner's agent, with a certificate specifying the nature of the measures and the cause of their application.
Passengers arriving by an infected ship are entitled to exact from the sanitary authority of the port a certificate showing the date of their arrival and the measures taken as regards themselves and their baggage.
Coasting traffic shall be dealt with by special regulations to be agreed upon by the countries concerned.
The Governments of States bordering upon the same sea, taking into account their particular situation, may conclude special agreements amongst themselves in order to make the sanitary measures prescribed by the Convention more efficacious and less burdensome.
It is desirable that the number of ports furnished with an organisation and equipment sufficient for the reception of a ship, whatever its health conditions may be, should be in each country in proportion to the importance of the trade and shipping. Meanwhile, without prejudice to the right of Governments to make agreements for the establishment of common sanitary stations, every country must provide at least one port on each of its seaboards with the abovementioned organisation and equipment.
Moreover, it is recommended that all large seaports should be so equipped that health ships, at any rate, may be subjected upon their arrival to the prescribed sanitary measures, and may not be sent to another port for this purpose.
Governments shall make known what ports are open to arrivals from ports infected with plague, cholera, or yellow fever, and in particular those open to infected and suspected ships.
It is recommended that there be provided in large seaports:
(a) A properly organised port medical service, and permanent medical supervision of the health conditions of crews and of the population of the port;
(b) An equipment for the transport of the sick, and suitable accommodation for their isolation and for keeping suspected persons under observation;
(c) Bacteriological laboratories, and the buildings and plant necessary for efficient disinfection;
(d) A supply of drinking water of quality above suspicion at the disposal of the port, and a system of scavenging that offers every possible guarantee for the removal of excrement and refuse.
It is likewise recommended that contracting States should take into consideration in their treatment of arrivals from a country, the measures which that country has adopted for dealing with infectious diseases and for preventing their exportation.
Measures at land frontiers
Travellers - Railways - Frontier zones - Waterways
Land quarantine must not be resorted to. Only such persons as show symptoms of plague, cholera, or yellow fever may be detained at frontiers.
This principle does not deprive a State of the right to close a portion of its frontiers in case of need.
It is important that the railway staff keep watch over the state of health of travellers.
Medical intervention shall be limited to inspection of travellers and care of the sick. When this inspection is resorted to, it shall, as far as possible, be combined with the customs examination in order that travellers may suffer as little delay as possible. Only those persons who are visibly ailing shall be subjected to a thorough medical examination.
It is a measure of the greatest value to subject travellers that have come from an infected place, on their arrival at their destination, to surveillance for a period which should not exceed five days in the case of plague or cholera, and six days in the case of yellow fever, reckoned from the date of departure.
Governments have the right reserved to them of taking special measures in regard of certain classes of persons, notably gipsies and vagrants, as well as emigrants, and persons travelling or crossing the frontier in bands.
Railway carriages for passengers, mails, or luggage may not be detained at a frontier. If one of these carriages be infected, or shall have been occupied by a person suffering from plague or from cholera, it shall be detached from the train for disinfection at the earliest possible moment. The same procedure shall apply in the case of goods trucks.
Measures relative to the crossing of frontiers by railway and postal staff come within the scope of the administrations concerned. They should be arranged so as not to hamper the service.
The regulation of frontier traffic and questions connected therewith, as also the adoption of exceptional measures of surveillance, must be left as matters for special arrangement between adjoining States.
The sanitary control of waterways is a matter for special arrangement by the Governments of States abutting thereon.
SPECIAL PROVISIONS FOR THE COUNTRIES OF THE EAST AND FAR EAST
Measures at infected ports on the departure of vessels
Every person taking passage by a ship, the crew included, must be individually examined at the time of embarkation, by day and on shore, during such time as may be necessary, by a doctor appointed by the public authority. The consular authority of the country to which the ship belongs may be represented at this examination.
In exception of this provision, the medical examination may, at Alexandria and Port Said, take place on board whenever the local sanitary authority considers this course to be of service, subject, however, to the reservation that third class passengers shall not afterwards be authorised to leave the ship. The medical examination may be conducted by night in the case of first and second class passengers, but not in the case of third class passengers.
Measures regarding ordinary ships from infected northern ports on their arrival at the entrance to the Suez Canal or at Egyptian ports
Ordinary healthy ships from a port, infected with plague or with cholera, in Europe or in the Mediterranean basin proposing to pass through the Suez Canal shall be granted passage in quarantine, and shall continue their voyage under five days' observation.
Ordinary healthy ships wishing to touch at Egypt may put in at Alexandria or Port Said, where their passengers shall complete the period of five days' observation, either on board or in a sanitary station, as the local sanitary authority may decide.
The measures to be taken as regards infected and suspected ships from a European or Mediterranean port infected with plague or with cholera wishing to touch at an Egyptian port or to pass through the Suez Canal shall be settled by the Egyptian Sanitary Board, in conformity with the provisions of this Convention. The regulations embodying these measures must, to become effective, be accepted by the several Powers represented on the Board; they shall establish the measures to which ships, passengers, and merchandise are to be subjected, and must be submitted with the least possible delay.
Measures in the Red Sea
(A) Measures regarding ordinary ships from the south touching at Red Sea ports or bound for the Mediterranean
In addition to the general provisions comprised in Part I, Chapter II, Section III, concerning the classification of ships as infected, suspected, or healthy, and the measures regarding them, the special provisions embodied in the following Articles shall apply to ordinary ships entering the Red Sea from the south.
Healthy ships must have completed, or must complete, five full days' observation, reckoned from the time of their departure from the last infected port touched at.
They shall be entitled to pass through the Suez Canal in quarantine, and shall enter the Mediterranean continuing the abovementioned five days' observation. Ships with a doctor and a disinfecting chamber shall not undergo disinfection prior to the passage in quarantine.
Suspected ships shall be treated in a manner which shall differ according as to whether they have or have not a doctor and a disinfecting apparatus (disinfecting chamber).
(a) Those that have a doctor and a disinfecting apparatus (disinfecting chamber) that fulfils the requisite conditions shall be allowed to pass through the Suez Canal in quarantine, subject to the regulations prescribed for the passage.
(b) Those that have neither doctor nor disinfecting apparatus (disinfecting chamber) shall, before being allowed to pass through the Canal in quarantine, be detained at Suez or at Moses' Wells for such time as may be necessary for the performance of the disinfection prescribed and for assurance that the health conditions on board are satisfactory.
Passage in quarantine shall be granted to mail-boats or packets specially devoted to passenger traffic that have a doctor but no disinfecting apparatus (disinfecting chamber), if it be officially established to the satisfaction of the local authority that cleansing and disinfection have been properly carried out at the place of departure or during the voyage.
Free pratique may be granted at Suez, on the termination of the procedure prescribed by the regulations, to mail-boats or packets specially devoted to passenger traffic that have a doctor but no disinfecting apparatus (disinfecting chamber), if the last case of plague or cholera occurred more than seven days before and if the health conditions of the ship are satisfactory.
In the case of a vessel that has had a healthy voyage of less than seven days' duration, passengers for Egypt shall be landed at an establishment appointed by the Alexandria Board and isolated for such time as may be necessary for the completion of five days' observation. Their soiled linen and their wearing apparel shall be disinfected. They shall then be granted free pratique.
Ships that have had a healthy voyage of less than seven days' duration, and that wish to have free pratique in Egypt, shall be detained at an establishment, appointed by the Alexandria Board, during such time as may be necessary for the completion of five days observation; they shall undergo the measures prescribed by the regulations for suspected vessels.
When plague or cholera has occurred among the crew only, no soiled linen shall be disinfected save that of the crew, the whole of which, however, shall undergo disinfection; the crew's quarters shall also be disinfected.
Infected ships shall be divided into two classes: ships with a doctor and a disinfecting apparatus (disinfecting chamber), and ships without a doctor and without a disinfecting apparatus (disinfecting chamber).
(a) Ships without a doctor and without a disinfecting apparatus (disinfecting chamber) shall be detained at Moses' Wells; persons that show symptoms of plague or cholera shall be disembarked and isolated in a hospital. Disinfection shall be thoroughly carried out. The other persons shall be disembarked and isolated in as small groups as possible, so that, if plague or cholera break out in one group, the whole party will not be affected. The soiled linen and the clothing of passengers and crew, and other articles used by them, shall be disinfected, as also shall the ship.
It is to be understood that there is no question of discharging merchandise, but only of disinfecting the infected part of the ship.
The passengers shall remain five days at an establishment appointed by the Egyptian Sanitary Maritime and Quarantine Board. When cases of plague and cholera have not occurred for several days the term of isolation shall be shortened. Its duration shall vary according to the date of recovery, death, or isolation of the last case. Thus, if six days have elapsed since the recovery, death, or isolation of the last case, the period of observation shall be one day; if only five days have elapsed, the period shall be two days; if only four days have elapsed, the period shall be three days; if only three days have elapsed, the period shall be four days; if only two days or one day have elapsed, the period shall be five days.
(b) Ships with a doctor and a disinfecting apparatus (disinfecting chamber) shall be detained at Moses' Wells. The ship's doctor must state, on oath, which persons on board have symptoms of plague or of cholera. These persons shall be disembarked and isolated.
After these persons have been disembarked, such of the soiled linen of the other passengers as the sanitary authority regards as dangerous and that of the crew shall be disinfected on board.
When plague or cholera has occurred only among the crew, the disinfection of linen shall be carried out only as regards the soiled linen of the crew and the linen of the crew's quarters.
The ship's doctor must also declare, on oath, which part or compartment of the ship was occupied by the sick, and to which section of the hospital they were removed. He must also declare, on oath, which persons have been in relation with the plague or cholera patient since the first appearance of the disease, either by direct contact or by contact with objects that may have been infected. Only these persons shall be regarded as suspected.
The part or compartment of the ship and the section of the hospital that have been occupied by the sick shall be thoroughly disinfected. "Part of the ship" shall mean the cabin of the sick person, the adjoining cabins, the passage to these cabins, the deck, the parts of the deck where the sick person or persons have remained for some time.
If it be impossible to disinfect the part or compartment of the ship that has been occupied by plague or cholera sick without disembarking the persons declared to be suspected, these persons shall either be transferred to another ship specially reserved for the purpose, or be landed and accommodated in the sanitary station without being brought into contact with the sick, who must be kept in the hospital.
This stay on board ship or on shore, for purposes of disinfection, shall be as short as possible, and shall not exceed twenty-four hours.
The suspected persons shall be kept under observation, either on their own ship or on the ship reserved for that purpose, for a period which shall vary according to the circumstances and in the manner set out in the third paragraph of sub-section (a) of this Article.
The time occupied in carrying out the measures prescribed by the regulations shall be included in the observation period.
Passage in quarantine may, if deemed possible by the sanitary authority, be allowed before expiry of the periods of detention indicated above. It shall, in any case, be granted on the completion indicated above. It shall, in any case, be granted on the completion of disinfection if the ship leaves behind, in addition to its sick, the persons classed above as "suspected".
A barge fitted with a disinfecting chamber may be brought alongside the ship with a view to hastening the process of disinfection.
Infected vessels seeking free pratique in Egypt shall be detained five days at Moses' Wells; they shall, in addition, undergo the same measures as are taken in the case of infected ships arriving in Europe.
(B) Measures regarding ordinary ships from infected ports in the Hedjaz during the pilgrimage season
If, during the Mecca pilgrimage, plague or cholera is prevalent in the Hedjaz, ships from the Hedjaz, or from any other part of the Arabian coast of the Red Sea, that have not there taken on board any pilgrims or like collections of persons, and on which there has been no suspicious incident during the voyage, shall be classed as ordinary suspected ships, and shall be subjected to the preventive measures and the treatment prescribed for such ships.
If they are bound for Egypt, they shall undergo, at a sanitary station appointed by the Sanitary Maritime and Quarantine Board, five days' observation, reckoned from the date of their departure, whether it be cholera or plague that is in question. They shall, moreover, be subjected to all the measures prescribed for suspected ships (disinfection, etc), and shall not be granted free pratique until after favourable medical inspection.
It is to be understood that, if there have been suspicious incidents on board during the voyage, the period of observation shall be undergone at Moses' Wells, and shall be five days, whether it be cholera or plague that is in question.
The organisation for securing surveillance and disinfection at Suez and at Moses' Wells
Every ship arriving at Suez shall undergo the medical inspection prescribed by the Regulations. This inspection shall be conducted by one or more of the doctors attached to the station, and shall, in the case of ships from a port infected with plague or with cholera, be made by day. It may, however, in the case of ships wishing to pass through the Canal, take place by night when the ship is lighted by electricity, and in all cases in which the local sanitary authority is satisfied that the ship is sufficiently well lighted.
There shall be at least seven doctors at the Suez station - a principal medical officer and six medical officers. They must hold a recognised diploma, and, in their selection, preference is to be given to medical men who have made a special study of practical epidemiology and practical bacteriology. They shall be appointed by the Minister of the Interior, on the recommendation of the Sanitary Maritime and Quarantine Board of Egypt.
The salary of the medical officers shall commence at 8,000 fr., and rise by progressive increments to 12,000 fr.; that of the principal medical officer shall commence at 12,000 fr. and rise to 15,000 fr.
Should this medical staff prove insufficient, naval doctors of the several States may be employed under the orders of the principal medical officer of the sanitary station.
The supervision and performance of the Suez Canal prophylactic measures at the Moses' Wells and Tor stations shall be entrusted to a staff of sanitary guards.
This staff shall consist of ten guards.
They shall be selected from retired non-commissioned officers of the armies and navies of Europe and Egypt.
These guards are elected, after the Board is satisfied as to their fitness, according to the procedure laid down in Article 14 of the Khedivial Decree of 19 June 1893.
There shall be two classes of guards:
Four of the first class;
Six of the second class.
The yearly pay of these guards shall be:
[sterling]E160, rising by progressive increments to a maximum of [sterling]E200, for the first class;
[sterling]E120, rising by progressive increments to a maximum of [sterling]E168, for the second class;
These guards shall have the status of police officers, with the right to invoke aid in cases where the sanitary regulations are infringed.
They shall be under the immediate control of the administrator-in-chief of the establishment at Suez or Tor.
The passsge of the Suez Canal in quarantine
Permission to pass the Suez Canal in quarantine shall be granted by the Suez sanitary authority; the Board shall be immediately informed when such permission is given.
In doubtful cases the decision shall rest with the Board.
When the permission provided for in the preceding Article has been given, a telegram shall at once be sent to the authority appointed by each Power. The telegram shall be sent at the expense of the ship.
Each Power shall issue an edict subjecting to penalties those vessels which depart from the course declared by the captain and enter without licence one of the ports of that Power. Exception shall be made in the case of circumstances beyond control and when a break in the voyage cannot be avoided.
When the health visit takes place the captain must declare if he has on board gangs of native stokers or hired servants of any description not included in the roll of the crew or the register kept for the purpose.
The following questions in particular shall be put to the captains of all ships arriving at Suez from the south, and shall be answered by them on oath:
Have you any supernumeraries, stokers, or other hands not included in the ship's roll or in the special register? What is their nationality? Where did you embark them?
The medical officers must satisfy themselves as to the presence of these supernumeraries, and, if they find that any of their number are missing, they must inquire carefully into the cause of their absence.
A sanitary officer and two sanitary guards shall go on board. They must accompany the ship as far as Port Said; their duty is to prevent communication, and to see to the execution of the measures prescribed for the passage of the Canal.
All embarkation and disembarkation, and all transshipment of passengers or goods, are forbidden during the passage of the Canal from Suez to Port Said.
Provided always that travellers may embark at Port Said in quarantine.
Ships passing through the Canal in quarantine must make the journey from Suez to Port Said without lying up.
In case of the vessel running aground or being compelled to lie up, the necessary operations shall be carried out by the staff of the ship, all communication with the staff of the Suez Canal Company being avoided.
Infected or suspected transports passing through the Canal in quarantine with troops must do so only by day. If they are compelled to pass the night in the Canal, they shall anchor in Lake Timsah or in the Great Lake.
Ships that pass through the Canal in quarantine are forbidden to stop at Port Said, except as provided for by the second paragraph of Article 75 and by Article 79.
Revictualling must be effected by the means at the disposal of the ship.
All stevedores and others who have gone on board shall be isolated on the quarantine barge, where their clothing shall be disinfected as prescribed by the regulations.
When it is absolutely necessary for ships passing in quarantine to coal at Port Said, they must do so at a place to be fixed by the Sanitary Board, where the necessary isolation and sanitary supervision can be secured. The coaling may be done by the labourers of the port in cases where effective supervision of this operation is possible, and when all contact with the crew can be avoided. At night the coaling place must be lighted by electricity.
Pilots, electricians, agents of the company, and sanitary guards shall be disembarked at Port Said outside the port, between the jetties, and shall be taken thence direct to the quarantine barge, where their clothing shall be disinfected if necessary.
As regards the passage of the Suez Canal, the following advantages shall be accorded to ships of war as hereinafter specified:
The quarantine authority shall accept them as healthy on their presenting a certificate signed by the ship surgeons, countersigned by the captain, and stating on oath-
(a) That there has not been, either at the time of departure or during the voyage, a case of plague or of cholera on board;
(b) That a careful examination of every one on board, without exception, has been made within twelve hours of arrival at the Egyptian port, and that no case of either of these diseases has been detected.
These ships shall not undergo medical inspection, and shall be given free pratique at once, subject to their having completed five clear days since leaving the last infected port at which they called.
Such of these ships as have not completed the requisite period may pass through the Canal in quarantine without medical inspection, provided they produce the certificate abovementioned to the quarantine authority.
Notwithstanding the foregoing provisions, the quarantine authority shall have the right of medically inspecting, by its officers, ships of war in all instances in which it considers this procedure necessary.
Infected or suspected ships of war shall be subjected to the regulations in force.
Only fighting units shall be regarded as ships of war. Transports and hospital ships shall be called as ordinary ships.
The Egyptian Sanitary, Maritime and Quarantine Board may arrange the conveyance, by rail, over Egyptian territory, of mails and ordinary passengers from infected countries in quarantine trains, under the conditions specified in Annex No. 1.
Sanitary control of the Persian Gulf
The sanitary regulations prescribed in the Articles of this Convention shall be applied to ships entering the Persian Gulf by the sanitary authorities of the ports of arrival. These regulations, in so far as they relate to the classification of ships and the measures to be undergone in the Persian Gulf, are subject to the three following modifications:
(1) Observation, for the same period, shall always be substituted for surveillance of passengers and crew;
(2) Healthy ships cannot be granted free pratique unless they have completed five full days since leaving the last infected port at which they have touched;
(3) In the case of suspected ships, the period of five days' observation of passengers and crew shall be reckoned from the time at which there ceased to be a case of plague or of cholera on board.
SPECIAL PROVISIONS REGARDING PILGRIMAGES
The provisions of Article 54, Part II, are applicable to persons and things destined for the Hedjaz or Irak Arabi that have to be taken on board a pilgrim-ship, even when the port of embarkation is not infected with plague or with cholera.
When there are cases of plague or of cholera in the port, embarkation on pilgrim-ships shall not take place until the persons, collected in groups, shall have been subjected to observation sufficient to insure that none of them are suffering from plague or cholera.
It is to be understood that, as regards the adoption of this measure, every Government may take local circumstances and possibilities into account.
If local circumstances permit, pilgrims must prove that they possess the means absolutely necessary for the accomplishment of the pilgrimage, and, in particular, that they have a return ticket.
Only steam ships shall be permitted to carry pilgrims on long voyages. The carriage of pilgrims by other ships on such voyages shall be prohibited.
Pilgrim-ships that are coasters intended for short passages known as "coasting voyages" shall be subject to the provisions of the special regulations for the Hedjaz pilgrimage, which shall be published by the Constantinople Board of Health, in conformity with the principles laid down in this Convention.
A ship which, in addition to ordinary passengers, among whom pilgrims of the upper classes may be included, carries pilgrims of the lowest class in less proportion than one pilgrim per 100 tons gross, shall not be considered a pilgrim-ship.
Every pilgrim-ship, when in Ottoman waters, must observe the provisions of the special regulations for the Hedjaz pilgrimage, which shall be published by the Constantinople Board of Health, in conformity with the principles laid down in this Convention.
The captain must pay all sanitary imposts leviable on pilgrims. These imposts must be covered by the price of the ticket.
As far as practicable, pilgrims who embark or disembark at sanitary stations must have no contact with one another at the landing-places.
Pilgrims who have been disembarked must be distributed in camp in as small groups as possible.
It is necessary that they be supplied with wholesome drinking water, obtained either from local sources or by distillation.
When there is plague or cholera in the Hedjaz, provisions brought by pilgrims shall be destroyed if the sanitary authority consider it necessary.
PILGRIM-SHIPS. SANITARY STATIONS
General conditions applying to ships
The ship must be capable of accommodating the pilgrims in the between-decks.
Over and above the space required for the crew the ship must provide for each person, irrespective of age, an area of 1.50 square metres, equivalent to 16 English square feet, and a height between-decks of about 1.80 metres.
In coasting-vessels each pilgrim must be allowed a space at least 2 metres wide along the gunwales.
On each side of the ship, on deck, a place must be set apart, screened from view and furnished with a hand-pump, for the supply of sea-water for the needs of the pilgrims. One such place must be reserved exclusively for women.
The ship must be provided, in addition to closets for the crew, with latrines, fitted with a flushing apparatus or with a water tap, in a minimum proportion of one latrine per 100 passengers.
Some of these latrines shall be reserved exclusively for women.
There must be no closets between-decks or in the hold.
The ship must have two places for cooking set apart for the use of the pilgrims. Pilgrims shall be forbidden to light fires elsewhere, especially on deck.
Properly fitted hospital quarters, constructed with due attention to safety and health, must be reserved for the accommodation of the sick. They must be constructed so as to allow persons suffering from infectious diseases to be isolated according to the nature of their illness.
The hospital must be capable of accommodating, at the rate of 3 square metres per patient not less than 5 percent of the pilgrims taken on board.
Every ship must carry such medical remedies, disinfectants, and things as are necessary for the treatment of the sick. The regulations framed for this class of ship by each Government must specify the nature and the quantity of these remedies. Medicine and attendance shall be provided for the pilgrims free of charge.
Every ship taking pilgrims must carry a duly qualified doctor commissioned by the Government of the country to which the ship belongs or by the Government of the port where the pilgrims are embarked. A second doctor must be carried when the number of pilgrims on board exceeds 1,000.
The captain must cause notices, in the languages chiefly spoken in the countries inhabited by the pilgrims he is taking, to be posted up on the ship in a conspicuous place, accessible to all concerned showing-
(1) The destination of the ship;
(2) The price of tickets;
(3) The daily ration of food and water allowed to each pilgrim;
(4) The price of articles not included in the daily ration which may be procured on extra payment.
The heavy baggage of pilgrims shall be registered, numbered, and put in the hold. Pilgrims may keep with them only such things as are absolutely necessary. The nature, amount, and dimensions of these things shall be decided by regulations framed by each Government for its own ships.
The provisions of Chapter I, of Sections I, II and III of Chapter II, and of Chapter III, of Part III of this Convention, shall be posted up, in the form of regulations, in the language of the country to which the ship belongs, and also in the languages chiefly spoken in the countries inhabited by the pilgrims to be embarked, in a conspicuous and accessible place on every deck and between-decks of every ship carrying pilgrims.
Measures before departure
The captain or, in his default, the owner or agent of every pilgrim-ship must, not less than three days before departure, declare to the competent authority of the port of departure his intention to embark pilgrims. At ports of call, the captain or, in his default, the owner or agent of every pilgrim-ship must make the same declaration twelve hours before the departure of the ship. This declaration must specify the proposed date of the departure and the destination of the ship.
On receipt of the declaration provided for by the preceding Article the competent authority shall proceed, at the expense of the captain, to inspect and measure the ship. The consular authority of the country to which the ship belongs may be present at this inspection.
Inspection alone shall take place if the captain already has a certificate of measurement furnished by the competent authority of his country, unless it be suspected that the certificate no longer represents correctly the real condition of the ship.
The competent authority shall not permit the departure of a pilgrim-ship until satisfied-
(a) That the ship has been thoroughly cleaned and, if necessary, disinfected;
(b) That the ship is in a condition to undertake the voyage without danger; that she is properly manned, equipped, and ventilated and provided with a sufficient number of boats; that there is on board nothing that is or may become injurious to the health or safety of the passengers; and that the deck is of wood or of iron sheathed in wood;
(c) That there is on board, properly stowed away, over and above the rations for the crew, sufficient food and fuel of good quality for all the pilgrims during the declared duration of the voyage;
(d) That the drinking water is of good quality and from a source free from risk of contamination; that it is in sufficient quantity; that the tanks for drinking water are safe from all contamination and so closed that the water can be supplied only by means of taps or pumps. The water-supply fittings known as "suçoirs" shall be absolutely prohibited;
(e) That the vessel carries a condenser capable of distilling a minimum quantity of 5 litres of water per diem for every person on board, including crew;
(f) That the ship possesses a disinfecting chamber, ascertained by the sanitary authority of the port where the pilgrims embarked to be safe and efficacious;
(g) That, in accordance with Articles 99 and 100, the vessel carries a duly qualified doctor commissioned either by the Government of the country to which she belongs or by the Government of the port where the pilgrims embark, and that she carries medical stores;
(h) That the deck is free from merchandise and all encumbrances;
(i) That the arrangements on board are such as to allow of the measures prescribed in the following Section III being carried out.
The captain may not start without having in his possession-
(1) A list countersigned by the competent authority showing the name, sex, and total number of pilgrims he is authorised to carry;
(2) A bill of health, giving the name, nationality, and tonnage of the ship, the name of the captain and of the doctor, the exact number of persons embarked - crew, pilgrims, and other passengers - the nature of the cargo, and the place of departure.
The competent authority shall note on the bill of health whether the number of pilgrims permissible under the regulations has been embarked or not, and in the latter case the additional number of passengers the vessel is authorised to embark at subsequent ports of call.
Measures during the voyage
During the voyage the deck must be kept free from encumbrances; it must be reserved night and day for the passengers, and placed at their disposal without charge.
The between-decks must be carefully cleansed and rubbed with dry sand mixed with disinfectants every day while the pilgrims are on deck.
The latrines allotted to the passengers as well as those for the crew must be kept clean, and must be cleansed and disinfected three times a day.
The excretions and dejecta of persons showing symptoms of plague or of cholera must be received in vessels containing a disinfecting solution. These vessels shall be emptied into the latrines, which must be thoroughly disinfected every time this is done.
All bedding, carpets, and clothing that have been in contact with the sick persons referred to in the preceding Article must be immediately disinfected. The observance of this rule is specially enjoined in respect of the clothes of persons who have been near the sick, and which may have been contaminated.
Such of the abovementioned articles as are of no value must be either thrown overboard, if the ship is not in harbour or in a canal, or else burnt. Other articles must be carried to the disinfecting chamber in impermeable bags washed in a disinfecting solution.
The quarters occupied by the sick, referred to in Article 98, must be thoroughly disinfected.
Pilgrim-ships are compelled to undergo measures of disinfection in accordance with the regulations on this subject that are in force in the country under whose flag they sail.
Not less than 5 litres of drinking water must each day be put at the disposal of every pilgrim irrespective of age, free of charge.
If there is any doubt as to the quality of the drinking water or any reason to suspect that it may possibly have become contaminated, either at its source or during the voyage, it must be boiled or otherwise sterilised, and the captain shall be responsible for seeing that it is thrown overboard at the first port of call at which he can procure a purer supply.
The doctor shall visit the pilgrims, tend the sick, and see that the principles of hygiene are observed on board. He must in particular:
(1) Satisfy himself that the rations issued to the pilgrims are of good quality, that their quantity is in accordance with contract, and that they are properly prepared;
(2) Satisfy himself that the provisions of Article 115, regarding the distribution of water, are observed;
(3) If there by any doubt as to the quality of the drinking water, call the attention of the captain, in writing, to the provisions of Article 116;
(4) Satisfy himself that the ship is always kept clean, and particularly that the latrines are cleansed in accordance with the provisions of Article 110;
(5) Satisfy himself that the pilgrims' quarters are kept wholesome, and, in case of the occurrence of infectious disease, that disinfection is carried out in accordance with Articles 113 and 114;
(6) Keep a diary of all occurrences relating to health during the voyage, and submit this diary to the competent authority at the port of arrival.
Only the persons charged with the care of plague or cholera patients shall have access to them, and these persons must not come in contact with the other persons that have been embarked.
In the event of a death occurring during the voyage, the captain must enter the fact opposite the name of the deceased on the list countersigned by the authority of the port of departure, and must also enter in the log the name of the deceased, his age, the place from which he came, the supposed cause of death, according to the medical certificate, and the date of death.
In the event of a death from infectious disease, the corpse, wrapped in a shroud impregnated with a disinfecting solution, must be committed to the deep.
The captain must see that all preventive measures taken during the voyage are entered in the log. The log shall be submitted by him to the competent authority at the port of arrival.
At each port of call the captain must cause the list drawn up in accordance with Article 107 to be countersigned by the competent authority.
In the event of a pilgrim disembarking during the voyage, the captain must note the fact on the list opposite the pilgrim's name.
In the event of persons embarking, their names must be entered on the list in accordance with the foregoing Article 107. This must be done before the competent authority, as in duty bound, again countersigns the list.
The bill of health given at the port of departure must not be changed during the voyage. It shall be countersigned at each port of call by the sanitary authority, who shall enter:
(1) The number of passengers disembarked or embarked at the port;
(2) Anything that has happened at sea affecting the life or health of the persons embarked;
(3) The health conditions of the port of call.
Measures on arrival of pilgrims in the Red Sea
(A) Sanitary control of ships from an infected port, going from the south to the Hedjaz with Mohammedan pilgrims
Pilgrim ships from the south, bound for the Hedjaz, must, in the first instance, put in at the Kamaran sanitary station, and shall be dealt with as provided by Articles 123-125.
Ships found, on medical inspection, to be healthy shall be given free pratique on completion of the following procedure:
The pilgrims shall be disembarked; they shall take a shower bath or bathe in the sea; their soiled linen and any portion of their personal effects or their baggage, open, in the opinion of the sanitary authority, to suspicion, shall be disinfected. The duration of these operations, including disembarkation and embarkation, must not exceed forty-eight hours.
If no recognised or suspected case of plague or of cholera be discovered during these operations, the pilgrims shall immediately be re-embarked and the ship shall proceed to the Hedjaz.
In the case of plague, the provisions of Articles 24 and 25 regarding rats shall apply in the event of there being rats on board.
Suspected ships which have had cases of plague or of cholera on board at the time of departure, but no fresh case of plague or of cholera within seven days, shall be dealt with as follows:
The pilgrims shall be disembarked; they shall take a shower bath or bathe in the sea; their soiled linen or any portion of their personal effects or their baggage, open, in the opinion of the sanitary authority, to suspicion, shall be disinfected.
In time of cholera the bilge-water shall be pumped out.
The parts of the ship occupied by the sick shall be disinfected. The duration of these operations, including disembarkation and embarkation, must not exceed forty-eight hours.
In no case or suspected case of plague or of cholera be discovered during these operations, the pilgrims shall immediately be re-embarked and the ship shall proceed to Jeddah, where a second medical inspection shall take place on board. If the result be favourable, and if the ship's doctor certifies in writing and on oath that there has been no case of plague or of cholera during the passage, the pilgrims shall be landed forthwith.
If, however, one or more recognised or suspected cases of plague or of cholera prove to have occurred during the voyage or on arrival, the ship shall be sent back to Kamaran, where she shall again be dealt with as infected.
In the case of plague, the provisions of the sixth paragraph of Article 22 shall apply in the event of there being rats on board.
Infected ships, that is to say, ships with cases of plague or of cholera on board, or that have had cases of plague or of cholera on board within seven days, shall be dealt with as follows:
Persons suffering from plague or from cholera shall be disembarked and isolated in hospital. The other passengers shall be disembarked and isolated in as small groups as possible, in order that, if plague or cholera break out in one group, the whole party may not be affected.
The soiled linen, clothing, and personal effects of the crew and the passengers shall be disinfected, as also shall the ship. The disinfection shall be carried out thoroughly.
Provided always that the local sanitary authority may decide that heavy baggage and merchandise need not be unloaded, and that only part of the ship need be disinfected.
The passengers shall remain at the Kamaran station five days. When no cases of plague or of cholera have occurred for several days the period of isolation may be shortened, and may vary according to the date of occurrence of the last case and the decision of the sanitary authority.
The ship shall then proceed to Jeddah, where every one on board shall undergo a thorough medical examination. If the result be favourable the ship shall be given free pratique. If, however, recognised cases of plague or of cholera have occurred on board during the voyage or on arrival, the ship shall be sent back to Kamaran, where she shall again be dealt with as infected.
In the case of plague, the measures specified in Article 22 regarding rats shall be adopted in the event of there being rats on board.
Every sanitary station intended for the reception of pilgrims must be provided with a skilled and experienced staff, in sufficient number, together with all the constructions and plant necessary for ensuring the complete application of the measures to which pilgrims are liable.
(B) Sanitary control of ships from the north going to the Hedjaz with Mohammedan pilgrims
If it be not established that there is plague or cholera at the port of departure or in its neighbourhood, and if no case of plague or of cholera has occurred during the voyage, the ship shall be granted free pratique forthwith.
If it be established that there is plague or cholera at the port of departure or in its neighbourhood, or if a case of plague or of cholera has occurred during the voyage, the ship shall be dealt with at El-Tor in the manner prescribed for ships coming from the south and stopping at Kamaran. The ships shall thereafter be granted free pratique.
Measures for pilgrims returning home
(A) Homeward-bound pilgrim-ships going north
Every ship from a port in the Hedjaz or from any other port on the Arabian coast of the Red Sea, carrying pilgrims or any like collection of persons and bound for Suez or a Mediterranean port, must proceed to El-Tor, there to undergo the observation and the sanitary measures specified in Articles 133-135.
Ships bringing back Mohammedan pilgrims to the Mediterranean shall not pass through the Canal save in quarantine.
Agents of shipping lines and captains of ships are warned that, on completion of their period of observation at El-Tor sanitary station, only Egyptian pilgrims will be permitted to leave the ship definitely in order to return to their homes.
Only pilgrims with a certificate of residence, issued by an Egyptian authority and made out in the form prescribed, shall be recognised as Egyptians or inhabitants of Egypt. Specimens of this certificate shall be deposited with the consular and sanitary authorities at Jeddah and Yambo, where they may be seen by shipping agents and ship captains.
Non-Egyptian pilgrims, such as Turks, Russians, Persians, Tunisians, Algerians, inhabitants of Morocco, etc, may not, after leaving El-Tor, be disembarked at an Egyptian port. Agents of shipping lines and ship captains are therefore warned that the transshipment of non-Egyptian pilgrims at Tor, Suez, Port Said, or Alexandria is prohibited.
Vessels carrying pilgrims belonging to the nationalities mentioned in the preceding paragraph shall be treated according to the rules for such pilgrims, and shall not be permitted to enter any Egyptian port in the Mediterranean.
Egyptian pilgrims shall undergo at El-Tor, Suakim, or any other station appointed by the Egyptian Sanitary Board observation for a period of three days and medical inspection before being given free pratique.
If it be established that there is plague or cholera in the Hedjaz or at the port whence the ship has come, or that either of these diseases has occurred in the Hedjaz during the pilgrimage, the ship shall be dealt with, at El-Tor, in the manner prescribed for infected ships at Kamaran.
Persons suffering from plague or cholera shall be landed and isolated in hospital. The other passengers shall be landed and isolated in as small groups as possible in order that, if plague or cholera break out in one group, the whole party may not be affected.
The soiled linen, clothing, and personal effects of the crew and the passengers and such baggage and merchandise as are suspected of being infected, shall be landed for purposes of disinfection. These articles, and also the ship, shall be thoroughly disinfected.
Provided always that the local sanitary authority may decide that heavy baggage and merchandise need not be unloaded and that only part of the ship need be disinfected.
The provisions of Articles 22 and 25 regarding rats shall apply in the event of there being any rats on board.
Whether it be plague or cholera that is in question, all the pilgrims shall be kept under observation for seven clear days, reckoned from the day on which the measures of disinfection were completed. If a case of plague or of cholera occur in a section, the period of seven days for that section shall be reckoned from the day on which the last case occurred.
In the circumstances provided for in the foregoing Article, Egyptian pilgrims shall, in addition, be kept under observation for a further period of three days.
If it be not established that there is plague or cholera in the Hedjaz or at the port whence the ship has come, or that either of these diseases has occurred in the Hedjaz during the pilgrimage, the ship shall be dealt with, at El-Tor, in the manner prescribed for healthy ships at Kamaran.
The pilgrims shall be landed; they shall take a shower bath or bathe in the sea; their soiled linen and any portion of their personal effects or their baggage, open, in the opinion of the sanitary authority, to suspicion, shall be disinfected. The duration of these operations, including disembarkation and embarkation, must not exceed seventy-two hours.
Provided always that a pilgrim-ship, belonging to a country that has given its adhesion to the provisions of this Convention and of previous Conventions, if she has had no case of plague or of cholera during the voyage from Jeddah to Yambo and El-Tor, and if it be established by medical examination, conducted at El-Tor after disembarkation of every one on board, that she has no such case, may be permitted by the Egyptian Sanitary Board to pass through the Suez Canal in quarantine, even by night, subject to the fulfilment of the four following conditions:
(1) That, in order to secure medical attendance of persons on board, the ship carried one or more doctors, commissioned by the Government of the country to which she belongs;
(2) That the ship is provided with disinfecting chambers, and it is established that the soiled linen has been disinfected during the voyage;
(3) That it is proved that the number of pilgrims is not in excess of that permitted by the pilgrimage regulations;
(4) That the captain undertakes to sail direct to a port in the country to which the ship belongs.
The medical examination, after disembarkation at El-Tor, must be made with as little delay as possible.
The sanitary tax, payable to the Quarantine Administration, shall be the same as the pilgrims would have had to pay if they had remained in quarantine for three days.
In the event of a suspicious case occurring on board during the voyage from El-Tor to Suez, the ship shall be sent back to El-Tor.
Transshipment of pilgrims at Egyptian ports is strictly prohibited.
Ships from the Hedjaz, carrying pilgrims bound for the African coast of the Red Sea, shall be permitted to proceed direct to Suakim, or such other place as the Alexandria Sanitary Board shall appoint, there to undergo the same quarantine measures as those at El-Tor.
Ships from the Hedjaz, or from a port on the Arabian coast of the Red Sea, with a clean bill of health, not carrying pilgrims or like collections of persons, and without suspicious incident during the voyage, shall, on favourable medical inspection, be given free pratique at Suez.
When it is established that there is plague or cholera in the Hedjaz:
(1) Caravans of Egyptian pilgrims must, before proceeding to Egypt undergo strict quarantine at El-Tor for seven days, whether it be plague or cholera that is in question; they must thereafter be kept under observation at El-Tor for three days, after which they shall not be granted free pratique until after favourable medical inspection and disinfection of effects;
(2) Caravans of pilgrims from other countries, returning home by land, shall undergo the same measures as Egyptian caravans, and must be accompanied by sanitary guards to the borders of the desert.
When plague of cholera has not been reported to have occurred in the Hedjaz, caravans of pilgrims coming from the Hedjaz by way of Akaba or Moila shall, on their arrival at the Canal or at Nakhel, undergo medical inspection and disinfection of soiled linen and personal effects.
(B) Homeward-bound pilgrims going south
The ports of embarkation in the Hedjaz shall be provided with buildings and plant for sanitary purposes sufficient to permit, in the case of pilgrims homeward-bound to the south, the taking of the measures rendered compulsory by the provisions of Articles 10 and 54, on the departure of these pilgrims from ports beyond the Straits of Bab-el-Manded.
These measures shall be optional - that is to say, they shall not be carried out unless the consular authority of the country to which the pilgrims belong, or the doctor of the ship by which they propose to go, considers them necessary.
Any captain convicted of a breach of his contract for the supply of water, food, or fuel shall be liable to a fine of [sterling]T2. This fine shall be paid to the pilgrim who has suffered from the breach of contract on proof that he demanded its fulfilment without effect.
Any infringement of Article 101 shall be punished by a fine of [sterling]T30.
Any captain who commits, or knowingly allows to be committed, any fraud with respect to the list of pilgrims, or of the bill of health, provided for by Article 107, shall be liable to a fine of [sterling]T50.
Any ship captain arriving without a bill of health from the port of departure, or without its having been countersigned at the ports of call, or unprovided with the prescribed list, duly kept in accordance with Articles 107, 120 and 121, shall be liable in each instance to a fine of [sterling]T12.
Any captain convicted of having, or of having had, on board more than 100 pilgrims without a commissioned doctor, in accordance with the provisions of Article 100, shall be liable to a fine of [sterling]T300.
Any captain convicted of having, or of having had, on board more pilgrims than he is permitted by the provisions of Article 100 to carry shall be liable to a fine of [sterling]T5 for each pilgrim in excess of the proper number.
The pilgrims in excess of the proper number shall be disembarked at the first station where there is a competent authority, and the captain is bound to provide the pilgrims so disembarked with sufficient money to enable them to reach their destination.
Any captain convicted of having disembarked pilgrims at a place other than their destination, unless with their consent, or from unavoidable cause, shall be liable to a fine of [sterling]T20 for each pilgrim wrongfully disembarked.
Any other infringement of the provisions relating to pilgrim-ships shall be punished by a fine of from [sterling]T10 to [sterling]T100.
Any known infringement during the voyage shall be entered in the bill of health and in the list of pilgrims. The competent authority shall prepare a statement of the case and submit it in the proper quarter.
All agents required to assist in carrying out the provisions of this Convention regarding pilgrim-ships shall be liable to punishment, in accordance with the laws of their respective countries, for any failure on their part in carrying out the aforesaid provisions.
Administration and control
I. The Egyptian Sanitary, Maritime and Quarantine Board
The provisions of Annex III of the Venice Sanitary Convention of 30 January 1892, regarding the composition, the functions, and the manner of discharge of the functions of the Egyptian Sanitary, Maritime and Quarantine Board, as provided by the decrees of His Highness the Khedive under the dates of 19 June 1893 and 25 December 1894, and also by the Ministerial Order of 19 June 1893, are confirmed.
The said decrees and order are appended to this Convention (Annex II).
The ordinary expenses arising out of the provisions of this Convention, and in particular those due to increase of the staff employed by the Egyptian Sanitary, Maritime and Quarantine Board, shall be defrayed by an additional yearly contribution by the Egyptian Government of a sum of [sterling]E4,000, which may be paid out of the surplus of the lighthouse dues remaining at the disposal of that Government.
Provided always that from this sum shall be deducted the amount produced by an additional quarantine charge of 10 P.T. (piastres tariff) on each pilgrim, to be levied at El-Tor.
In the event of the Egyptian Government finding difficulty in bearing this proportion of the expenses, it would be for the Powers represented on the Sanitary Board to approach the Khedivial Government with a view to securing part of these expenses being borne by the latter.
It devolves upon the Egyptian Sanitary, Maritime and Quarantine Board to bring into harmony with the provisions of this Convention the regulations it now applies to plague, cholera, and yellow fever, and also the regulations regarding arrivals from Arabian ports in the Red Sea during the pilgrimage season.
If necessary, it shall revise, to the same end, the general sanitary, maritime and quarantine police regulations now in force.
To become effective, these regulations must be approved by the several Powers represented on the Board.
II. The Tangier International Board of Health
In the interests of the public health, the High Contracting Parties agree that their representatives in Morocco shall again direct the attention of the Tangier International Board of Health to the necessity for carrying out the provisions of the Sanitary Convention.
III. Various provisions
The sums realised by sanitary charges and fines may not, in any instance whatever, be used for any purposes other than those under the control of the Boards of Health.
The High Contracting Parties undertake that their Public Health Departments shall frame a set of instructions intended to enable ship captains, particularly when there is no doctor on board, to carry out the provisions of this Convention regarding plague and cholera, and also to carry out the regulations regarding yellow fever.
ACCESSIONS AND RATIFICATIONS
The Governments which have not signed this Convention are allowed to become parties thereto at their request. Such accession shall be notified, through the diplomatic channel, to the Government of the French Republic, and by that Government to the other signatory Governments.
The present Convention shall be ratified and the ratifications thereof shall be deposited at Paris as soon as may be practicable.
It shall come into force as soon as it shall have been published in accordance with the laws of the signatory States. As regards the relations between the Powers which may ratify or become parties to it, it shall replace the International Sanitary Conventions signed on 30 January 1892, 15 April 1893, 3 April 1894, 19 March 1897 and 3 December 1903.
The previous Conventions above cited shall continue in force in the case of Powers which, having signed or become parties to them, do not ratify or become parties to this Convention.
IN WITNESS WHEREOF the respective Plenipotentiaries have signed the present Convention and have affixed thereto their seals.
DONE at Paris, the 17th January, 1912, in a single copy, which shall remain deposited in the archives of the Government of the French Republic, and of which copies, certified as being correct, shall be transmitted through the diplomatic channel to the Contracting Powers.
[Signatures not reproduced here.]
(See Article 82)
REGULATIONS REGARDING THE CONVEYANCE OF PASSENGERS AND MAILS FROM INFECTED COUNTRIES THROUGH EGYPT BY QUARANTINE TRAIN
Should the Egyptian Railway Executive wish to run a quarantine train in connection with ships arriving from infected ports they must give notice thereof to the local quarantine authority not less than two hours before the time of departure of such train.
The passengers shall land at a place appointed by the quarantine authority, with the consent of the Railway Executive and the Egyptian Government, and shall proceed, without any communication, direct from the ship to the train, under the supervision of a transit officer and of two or more sanitary guards.
The passengers' personal belongings, baggage, etc, shall be conveyed in quarantine by the means at the disposal of the ship.
In so far as quarantine measures are concerned, the railway staff shall obey the orders of the transit officer.
The carriages employed in this service shall be corridor carriages. In each carriage there shall be a sanitary guard, whose duty it shall be to keep watch over the passengers. The railway staff shall not hold any communication with the passengers.
A doctor on the quarantine staff shall go with the train.
The passengers' heavy baggage shall be put in a special van, which the transit officer shall seal before the train starts. Upon arrival, the seals shall be removed by the transit officer.
Transference of passengers to another train, or taking passengers during the journey, is prohibited.
The closets shall be furnished with pails, containing a certain amount of antiseptic, for the reception of the passengers' dejecta.
No one, except the staff absolutely necessary, shall be allowed on railway platforms at which the train may have to stop.
Every train may have a restaurant-car. The remnants of meals shall be destroyed. The staff of the restaurant-car and such other railway servants as have come in contact, from any cause, with passengers, shall undergo the same measures as the pilots and electricians at Port Said or Suez, or such measures as the Board may consider necessary.
Passengers are absolutely forbidden to throw anything whatever out of the windows, doors, etc.
In every train a hospital compartment shall be kept empty so as to secure isolation of the sick therein, should such contingency arise. This compartment shall be fitted up in accordance with the directions of the Quarantine Board.
If plague or cholera appear among the passengers, the sick person should immediately be isolated in the special compartment, and on the arrival of the train shall be removed forthwith to the quarantine lazaret. The other passengers shall proceed on their journey in quarantine.
In a case of plague or of cholera occur during the journey, the train should be disinfected by the quarantine authority.
In all instances the vans carrying baggage and mails shall be disinfected immediately after the arrival of the train.
The transference of passengers, baggage, etc, from train to ship shall be effected in the same way as on arrival. The ship that takes the passengers shall immediately be put in quarantine, and any incident that may have occurred during the journey shall be noted on the bill of health, with specific mention of any persons that may have been in contact with the sick.
The expenses incurred by the Quarantine Administrative body shall be debited to whoever requisitioned the quarantine train.
The President of the Board, or his substitute, shall have the right to exercise supervision over the train during the whole of its journey.
The President may, moreover, entrust the duty of such supervision to a high official (above and beyond the transit officer and the sanitary guards).
This official shall have access to the train on his showing an order signed by the President.
(See Article 153)
KHEDIVIAL DECREE DATED 19 JUNE 1893
KHEDIVIAL DECREE OF 25 DECEMBER 1894
MINISTERIAL DECREE OF 19 JUNE 1893 CONCERNING THE WORK OF THE MARITIME, AND QUARANTINE MEDICAL SERVICES
[Texts not reproduced here.]
PROTOCOL OF THE DEPOSIT OF RATIFICATIONS OF THE INTERNATIONAL SANITARY CONVENTION SIGNED AT PARIS ON 17 JANUARY 1912
In execution of Article 160 of the International Sanitary Convention, signed at Paris on 17 January 1912 on behalf of the United Kingdom of Great Britain and Ireland, Germany, the United States of America, the Argentine Republic, Austria-Hungary, Belgium, Bolivia, Brazil, Bulgaria, Chile, Colombia, Costa Rica, Cuba, Denmark, Ecuador, Spain, France, Greece, Guatemala, Haiti, Honduras, Italy, Luxemburg, Mexico, Montenegro, Norway, Panama, the Netherlands, Persia, Portugal, Roumania, Russia, Salvador, Servia, Siam, Sweden, Switzerland, Turkey, Egypt and Uruguay, the undersigned have assembled at the Ministry of Foreign Affairs at Paris in order to proceed, on the following conditions, to the first deposit, in the charge of the Government of the French Republic, of the ratifications of the said Convention of the Governments which they represent.
The representative of the British Government has declared that
"The stipulations of this Convention shall not apply to any of the colonies, possessions or protectorates of His Britannic Majesty, including the Indian Empire. The British Government, moreover, reserves to each of these colonies, possessions and protectorates, including the Indian Empire, the right to adhere to the Convention whenever it shall so desire, and also the right to withdraw from it separately without being bound by the decisions of the British Government with reference to the United Kingdom. Whenever one of the British colonies, possessions or protectorates adheres to the Convention or withdraws from it, a notification to that effect will be sent to the Foreign Ministry of the French Republic by His Britannic Majesty's representative in Paris, in the name of the said colony, possession or protectorate.
It is understood by the British Government that the right to withdraw from the present Convention, as well as the right of the Powers to confer together with a view of modifying the text of the Convention, still remains in accordance with the provisions of the Convention of Venice, 1897, and that of Paris, 1903."
The representative of the Government of the United States of America has declared that his Government has ratified under the reserve that nothing in Article 9 of the Convention will be considered as prohibiting the United States from taking special quarantine measures against the infection of their ports which unusual sanitary conditions may render necessary. Whilst making this reserve, the Government of the United States does not contemplate any infringement of the basic regulations of the Convention.
The representative of the Spanish Government has declared that his Government reserves the right to interpret paragraph 2 of Article 9 in the widest sense and according to the scientific principles of modern hygiene in such manner as to prevent as far as possible the introduction of plague and yellow fever into Spanish ports, but it declares that it has no intention of refusing to adhere to any of the fundamentals of the Convention.
The representative of the Government of Panama has declared that his Government has ratified under the reserve that the stipulations contained in Article 9 do not prevent the Government of Panama or that of the United States, in compliance with the treaty between the two countries signed on 18 November 1903, from prescribing the quarantine measures which the circumstances may render necessary in the ports of the canal zone and in those within the jurisdiction of the Republic of Panama.
The undersigned take note of the reserves expressed above and declare that their respective countries reserve to themselves the right to claim their benefit in regard to arrivals from the United States of America, Spain and Panama.
The instruments of ratification now produced, after examination, having been found in good and due form, are confided to the Government of the French Republic to be deposited in the archives of the Ministry for Foreign Affairs.
As regards the ratifications by the Powers signatories of the Convention which are not in a position to deposit them today, the Government of the French Republic will receive them later and will notify all the contracting Powers.
IN WITNESS WHEREOF the present procès-verbal has been drawn up, a certified copy of which will be forwarded by the Government of the French Republic to each of the Powers signatories of the Sanitary Convention of 17 January 1912.
DONE at Paris, the 7th October, 1920.
[Signatures not reproduced here.]
 A "foyer" exists when the occurrence of a case of cholera outside the immediate surroundings of the initial case proves that the spread of the disease has not been limited to the spot where it made its first appearance.
 "Observation" means isolation of travellers either on board a ship or in a sanitary station before they obtain free "pratique".
 "Surveillance" means that travellers are not isolated; they receive free pratique immediately, but the authorities of the several places whither they are bound are informed of their coming, and they are subjected to medical examination with a view to ascertaining their state of health.
 "Crew" means persons forming or having formed part of the crew or staff of the ship, and includes stewards, waiters, cafedji, etc. The word must be interpreted in this sense in all instances in which it occurs in this Convention.
 The sick shall, as far as possible, be landed at Moses' Wells; the other persons may be kept under observation at a sanitary station appointed by the Egyptian Sanitary Maritime and Quarantine Board (pilots' lazaret).
 It is to be desired that every ship be provided with the chief immunising agents (anti-plague serum, Haffkine's prophylactic, etc).
 At present the competent authority is: in British India, an officer appointed for the purpose by the local Government ("Native Passengers' Ships Act, 1877", Article 7); in the Dutch Indies, the master of the port; in Turkey, the sanitary authority; in Austria-Hungary, the port authority; in Italy, the captain of the port; in France, Tunis, and Spain, the sanitary authority; in Egypt, the sanitary quarantine authority.
 Exception is made in the case of Governments without commissioned doctors.
 A Turkish pound is of the value of 22 fr. 50 c.