Wednesday, September 24, 2014

Reporting of Communicable disease began as a 1701 maritime law enacted by the Massachusetts General Court. This blog chronicles the evolution of disease reporting in Massachusetts including important federal disease reporting laws and policies of the 20th century.

Year

Issuer

Reportable Disease focus

Impact

1701
State
Ship masters entering Boston harbor[i]
Notify military garrison of on board conditions
1732
State
Householder reporting of smallpox and red flag notification[ii]
Mainland focus caused by increased interstate trade
1742
State
Self reporting of smallpox by strangers entering town[iii]
Response to Newport, RI epidemic
1764
State
Physicians must report when patients are free of smallpox after they have been isolated during their infectious stage.[iv]
Physicians must disclose patient’s health to protect those not exposed to smallpox.
1799
State
Lodging houses to report diseases of sailors in port cities[v]
Boston taverns impacted
1828
State
Physicians required to report smallpox cases[vi]
Reporting to chief elected officials.
1874
State
Those infected with a reportable disease are required to pay for their own treatment, otherwise if unable to pay, the cost is born by the town where the patient has legal residence[vii]
Imposes personal liability for those are infected, thereby discouraging reporting.
1878
Federal
Congress authorizes the forerunner of Public Health Service to collect morbidity reports for use with quarantine measures against pestilential diseases such as cholera, smallpox, plague, and yellow fever.[viii]
Improved disease reporting leads to improved interstate controls over communicable disease.
1883
State
Local Board of Health must report to State Department of Public Health (DPH).[ix]
Smallpox was the initial focus
1884
State
School Committees are prohibited from allowing students with smallpox, diphtheria or scarlet fever from attending school.[x]
Reports of smallpox, diphtheria and scarlet fever in the schools require home quarantine.
1884
State
Householders and physicians are required to report diseases dangerous to the public health  to town selectmen[xi]
Formal communication procedures emerge between creator and receiver of information
1885
State
Diseases dangerous to public health must be reported
Focus on local Board reporting to state DPH
1890
State
Reports of disease reported to Boards of Health rather than Selectmen[xii]
Emergence of government health bureaus to control information flow and quality
1891
State
Written reports of communicable disease from physicians[xiii]
Documented proof of cases
1893
State
Emphasis on timely reporting within 24 hours[xiv]
Physicians held responsible
1893
Federal
Federal government establishes disease reporting from state and municipal sanitary authorities throughout the United States[xv]
Nationwide network of weekly disease reporting created through the auspices of the US Marine Hospital Service (predecessor to the U.S. Public Health Service - USPHS)
1900
Boston
The Boston Board of Health includes tuberculosis on the list of diseases to be reported to the Board of Health[xvi]
Boston Board of Health had relatively early recognition of the dangers posed by TB
1901
State
Towns are required to establish hospitals for dangerous diseases[xvii]
Reporting of disease has financial consequences to all Commonwealth towns.
1902
State
Towns can shift cases of reportable disease to adjoining towns with the consent of the receiving town.[xviii]
Reduces financial impact of creating pest houses in every town in Massachusetts
1905
State
Reporting of contagious eye disease[xix]
Physicians held responsible
1906
State
All towns must appoint school physicians and these physicians must report all cases of smallpox, scarlet fever, measles, chickenpox, tuberculosis, diphtheria, influenza, tonsillitis, whooping cough, mumps, scabies or trachoma.[xx]
Reporting of diseases in the school increases disease reporting dramatically based on administrative efficiencies of reporting cases from a “captive audience.”
1907
State
State DPH authorized to determine what are dangerous diseases to public health. [xxi]
Focus is on regulatory authority of experts.  Law covered tuberculosis for the first time.
1907
State
Mandatory reporting of Tuberculosis cases by householders and physicians after TB is declared by the State Board of Health to be dangerous.[xxii]
Authority to declare it dangerous is vested in the state Board of Health.
1925
State
Required reporting of Syphilis and Gonorrhea[xxiii]
Socially stigmatizing diseases made public
1938
State
Reporting of disease amongst school children[xxiv]
Focus on parental responsibility
1948
State
State authority over venereal disease expands from gonorrhea and syphilis to other venereal diseases as it defines from time to time. Physicians may disclose venereal disease to anyone who has received a promise of marriage without becoming vulnerable for liable or slander.[xxv]
Concerns with liability of physicians who disclose venereal disease information of their patients and protection of victims of venereal disease from public humiliation and discrimination.
1950
State
Disease reporting of workers prior to accepting teaching jobs[xxvi]
Focus on protecting school children
1950
Federal
Concept of surveillance as the monitoring of disease occurrence in populations developed by Langmuir
Population level trends in disease associated with work of the newly created CDC.
1952
State
Children with a disease dangerous to public health must provide a certificate that danger of conveying disease has passed.[xxvii]
Boards of Health must determine “non-communicability” of disease if required.
1966
WHO
First publication of Communicable Disease Surveillance
Reports by World Health Organization[xxviii]
Global understanding of the status of communicable diseases.
1983
State
Required TB reporting to local Boards of Health[xxix]
Reemergence of TB raises epidemic concerns
1988
State
First responder required to report exposures to disease[xxx]
Danger of public health compromised by those on the front lines




[viii] Stephen B. Thacker And Ruth L. Berkelman, Public Health Surveillance In The United States, Epidemiological Reviews, Vol. 10, 1988, 164-190.
[xv] The Statutes at Large of the United States of America, December 1891 to March 1893, Chapter 114, An Act granting additional quarantine powers and imposing additional duties upon the Marine Hospital Service; Approved February 14, 1893, pp. 449-452.
[xvi] Jacobs, Philip P. The Campaign Against Tuberculosis in the United States, Charities Publication Committee, New York, 1908, p. 369.
[xx] Acts and Resolves of the General Court of Massachusetts, 1906, Chapter 502, An Act relative to the appointment of school physicians, June 20, 1906, pp. 680-682.
[xxviii] S. Declich & A.O. Carter, Public health surveillance: historical origins, methods and evaluation, Bulletin of the World Health Organization, 1994, 72 (2): 285-304 (1994)