OUR BABIES

Dominion, Volume 10, Issue 2944, 2 December 1916, Page 2

OUR BABIES

TBY HTGEU.I

Published under tha auspices of thfr ' Hoyal New Zealand Society for the. : Hflalth of Women and Children. It _is' wiser to put a fenco at the ■ top of a precipice than to maintain an ■ ambulance at the bottom." INFANTILE PARALYSIS. The Nature, Marnier of Conveyance,} . and Means of Prevention of infantile Paralysis (tli o liockei'eller Institute' Keport), continued from last week). Practicnl Deductions and Applications. 1. The chief mode of demonstrated 1 . 1 conveyance of the virus of infantile para-' lysis is through the agency of human' beings. Whether still other modes of , dissemination exist is unknown. According to our present knowledge; the, . virus leaves the body in the secretions ' of the nose and throat, and in the discharges from the intestines. The conveyers of the virus include persons iu> with infantile paralysis in any of its' , several forms, and irrespective uf ; whether they are paralysed or not, and) • such healthy persons who may have become contaminated by attendance on or' association with the ill. How numerous the latter class may be is unknown.. i But all attendants on or associates of ' the sick are suspect!. These healthy carriers Tarely themselves fall ill of the-' . disease; they may, however, bo the i source of infection in others. On the ; other hand, the fact that infantile para- ; lysis is very rarely communicated in; 1 general hospitals- to other per.->ons„ whether doctors, nurses, or patients, mI dicates . that its spread is subject to- ! ready control under restricted and super-' , vised sanitary conditions. .2. The chief means by which the seci returns of the nose and'throat-are"dis- : seminated is through the act of. ; coughing, or sneezing; hence during the' [ preyalanee of an epidemic of infantilo paralysis cars should bo exercised to j restrict the distribution as'far-as' pos- • sible through -. these common means.- ; Habits of self-denial, care, and cleanli- ' ness, and consideration tor the public [ welfare can be made to go very far in. . limiting the dangers from these, sources. Moreover, since the-disease attacks by I preference young children and infants," ■ m whom the secretions from. nose and , , mouth are wiped a»ay by mother or I nurse, the fingers of these persons readt ily become contaminated. Through at- . tention on other children, or the pre- ; r paration of -food by those attending; > patients suffering from infantilo paraj lysis, the virus may be conveyed from the sick to the healthy. The conditions, i which obtain in a household in which l a mother waits on a sick child and attends to the wants of the other children aie directly contrasted with those existing in a well-ordered hospital. The one is a menace, the other a protection to the community. Moreover, in homes the practice of carrying small children, about and comforting them is the rule, s through which not only the hands but 3 other parts of the body and the clothing of parents may become contaminated. 3. Plies also often collect about the . nose and mouth of patients ill with in- , fantile paralysis, and feed on the secre- • tions, and they even gain access to tha discharges from tho intestines in homes " unprotected hy screens. This fact rei lates to the domestic fly, which, bei coining grossly contaminated with tha virus, may deposit it on the nose and J mouth of healthy persons, or upon food or feeding utensils. To what extent . the biting stable fly is to be inenm--1 jiated-as >a-'carrier of infection is doubt- . ful; but we already know enough to wish . to exclude from the sick, and hencu c from'menacing the well, all objectionable . " household insects.0 Food exposed for 6ale may become con- , taminatsd by flies or from fingers which i have been in contact with secretions containing the virus; hence food should mot a be,'exposed in shops, and no person in . attendance .upon a case of Infantile Paralysis should be permitted to.handle food r for sale .to the general public. ■i. Protection of the public can be best secured through the discovery and isolation of those.ill with the disease, and the . sanitary control of these persons who '• have associated with the sick, and whose :* business calls them away from home. .' Both these conditions can be secured ■\ without too great interference with the ~ comforts "and rights of individuals. b In the first place, where homes are not . suited to the caro of the ill, sc that other children in the same or adjacent families are exposed, the parent should consent to , removal/to hospital in the-interest, of the . sick child itself, as-well as inthe interest of other children. But this removal or care must include, not only the frank- . ly-paralysed cases, but also the other forms ■of the disease. In. the event of doubtful diagnosis, the aid of the laboratary is to bo sought, since, even in tha '• mildest cases, changes will be detected in ■' the cerebrospinal fluid removed by lumbar puncture. , If-the' effort is to be / made to control the disease bv isolation -- and segregation of the ill, then these - means must be made as inclusive as pos- • sible. It is obvious that in certain homes ", isolation can be carried out as effectively, as in hospitals. ■ " • j But what has been said of the small incidence of cases of the disease among r tho hospital personnel and those with whom they come into contact indicates - the extent to which personal care of the ■ body by adults and responsible people . can diminish the menace which these, ac r \ cidentally or unavoidably in contact with t the ill, are'in the community. Care exercised not to scatter the secretions of the nose and throat by spitting, coughing, and sneezing, tho free use of clean 1 handkerchiefs, cleanliness in habits affectf ing especially the hands and face, changes of clothes, etc., should all serve to diminish this danger. In the end, the early detection and iso- . lation of the ,cases of Infantile Paralvsis in all its forms, with the attendant con--3 trol of the households from which thev t come, will have to ho relied upon lis the chief measures of staying-the progress of _ the epidemic. ...... ] a. The degree of susceptibility of chili dren and other members of the community to Infantile Paralysis is relatively > small, and is definitely lower than to .. such communicable diseases as measles, scarlet fever, and diphtheria. This fact in itself constitutes a measure of control; and while it does not justify the abatement of any practicable means which may be employed to limit and suppress the epidemic, it should tend to prevent a state of over-anxiety and panic from taking hold of tho community. G. A percentage of persons, children particularly, die during the acute stage of the disease. The percentage varies from 5 in certain severe epidemics to 20 in others. The average death-rate of inanv ; epidemics has been below 10 per cent ; A reported high death-rate may not be actual,,but only apparent, since'in every ■ instance the death will be recorded, while _ many cases which recover may not be t reported at all tothe authorities. In the present instance it. is too early in the ; course of the epidemic to calculate the death-rate, which may prove to be con- ■ sulorably lower thnn it now seems to be. We shall conclude the Rockefeller Ee- ; port next week.