HEALTH NOTES

Hokitika Guardian, 27 June 1931, Page 6

HEALTH NOTES

DIPHTHERIA. HOW IT CAN BE PREVENTED. (Contributed by Department of Health). Diphtheria is an infectious disease caused by bacillus or germ which, finding lodgment generally in the throat or nose of a susceptible person, rapid; ly multiplies producing a greyish membrane and a poison or toxin which is absorbed into the blood.

Diphtheria is justly regarded as one of the most dreaded diseases of childhood, and in earlier years its appearance in the community brought terror. There are now few diseases concerning which-we know as much which we can attempt to prevent and control more hopefully. Yet even to-dav diphtheria' takes a serious toll of the populaeion. Thus in New Zealand for the last five years there lias been 8148 cases of dipthoria with 346 deaths. Though present in the community flic whole yea round it is more common in the winter months. It occurs more frequently among children than among adults, children under five years of age being most easily affected.

HOW DIPHTHERIA IS SPREAD. The chief difficulty in the prevention of diphtheria is the number of healthy people harbouring bacilli in their throats (estimated in the winter season at more than one per. cent of the population). It is maniiestly impossible to detect and isolate all such germ carriers. A susceptible person, especially a child, coining into association with a carrier is likely to fall a victim to diphtheria. The germs enter the body through the 'mouth or nose. They may be transferred bv kissing, or by receiving the mouth spray thrown out in coughing, sneezing and talking or they may be, curried to the lips by tli use of a common drinking cup or other utensil or by fingers soiled by touching’some object which an affected person has just touched with fingers soiled from his own lips or his infected handkerchief. It is very dfficnlt for a person who lias these germs in his mouth to avoid contaminating his fingers'with them.

Sometimes those who work in dairies are “carriers” or have the disease. Tiie.v may sneeze or cough into tlie milk pail or the fingers of the milker may transfer the germs to the nv'lk and thus eau.se an epidemic of diphtheria. Hence the need for extreme car in handling milk, not only in its production and distribution hut also i:i the homo.

i SYMPTOMS AND COURSE: - OF THE DISEASE. i Mo-.irnon in ire* -i ri i vr V i ‘illv.n Since the usual sites of the disease are the tonsils and throat the most characteristic early symptoms are sore throat, rapid pulse and fever .followed by the formation of a membrane spreading over the throat. These early symptoms may resemble those of a common cold or of simple tonsillitis so that an apparently trivial illness may be the beginning of diphtheria and no time should he lost in calling medical advice. Where the diseast attacks tit windpipe or larynx the greatest danger is that the membrane formed may block the air passages and choke the victim. The operation of tracheotomy (i.e. the introduction of a tube into ehe windpipe) mav ho necessary in o-'W to prevent suffocation. The delav of an hour in obtaining treatment may determine n fatal result. As the .site of the disease is not invariably the throat, the absence of membrane on the throat does not eliminate the possibility fo diphtheria

and hence, in.aifiy doubtful case, especially if uiplitiTuffa -is prevalent, median advice should be obtained early. .An other danger, in diphtheria is on account of the toxin or poison formed by lie diphtheria germs in the body, which circulating to every part has the power of destroying certain tissues, especially nerve tissues and. heart muscle. In defence the body forms a protective substances anti-toxin to neutralise the effect of the toxin. The severity "of an attack of diphtheria and its ultimate conclusion depend on how successful is the fight of anti-toxin against the germ toxin. In fatal cases collapse and sudden death may (oceur when the patient is apparently well on tlie way to recovery. It is now possible, however, to reinforce the, antitoxin made in the body of the patient by introducing supplies of < anti-toxin manufactured without, and thus aid him in his struggle againsL’the disease. The issue is often determined by how soon this reinforcing dose of anti-toxin is given to the patient. Were it possible to apply this remedy in sufficient doses and early enough in all cases, mortality from diphtheria - would almost vanish. As it is the disease has been robbed of much of its former' terror.

GENERAL ADVICE. There arc lew diseases where eiu i,y treatment is fraught with hope as in diphtheria. There is no disease in which early diagnosis and prompt treatment are more essential. 11 your child or other member of the family is sick with a sore throat call in your doctor. If it looks like diphtheria- tlie -doctor will administer anti-toxin, take n : cub ture from the throat and isolate the patient.' Do n»t insi£t T oh’ waiting for a cult ure if the doctor! advises antitoxin. „ Delay is dangerous.

RR ICY 1C NT LON

Anti-toxin is also used as a preven-

ti\o, being given to contacts v people who have been exposed to infection) as a protection. Unfortunately, the protection from inoculation with antitoxin lasts only from two to three weeks and at the end of that time the individual is again susceptible to the disease. Fortunately, it is now pssible, however, to protect, from diphtheria in the same way as vaccination protects against smallpox. Ibis may he done bv giving him an injection ot vaccine (e.g. toxin anti-toxin) at weekly intervals for three weeks which confers with few exceptions practically an immunity to diphtheria.

Thousands of children every year in England and America receive this treat incut with the that the incidence of diphtheria is greatly lessened thereby.

“Health News” of the New YorkState Department, states Although the goal “No Diphtheria by 1930” was not reached the results have proved beyond doubt that diphtheria can be controlled. Some idea of the value of diphtheria prevention work to the State as a whole may he gained from tliivt' tTrere' uffiret2B(326 fewer eases of diphtheria and 1,484 lower deaths during 1926-30 than in the fiveyear period 1921-25 preceding the toxin anti-toxin campaigns. In the State, exclusive of-New...York. City, deaths from the diseafie decreased from 33" in .1925 c tq "'''l44 in 1930 while the number of cases dropped from 4,370 to 1,594. The diphtheria death rate has decreased from an average oi 10.1 per 100,000 population for the period 1.921-25 t 0.3.8 for the years 192030 during which 1 approximately threequarters of a million children were immunised against diphtheria with toxin anti-toxin. ’Of this number ever 185,000 were under five, tlie age group most susceptible to the disease and most likely to die from it.” In New Zealand approximately some eleven-thousand children have been so treated with beneficial results. ' It is felt right that this means of defence should be made widely available.

Parents should understand that preventivetreatment for • diphtheria is a most) "valuable safeguard. It may be . ■; „ . , .- « S'*!. ..." .. carried out by the fali|iß: mediea 1 practitioner. Where this arrangement is not practicable and parents wish to se •_ ure immunity against diphtheria for their/pliildren, they are advised to apply to the local .Medical Officer of Health or the School .Medical Officer for tliby.clistrirt when arrangements will be made to have preventive treatment carried out free of charge. The doctor and Medical Officer of Health are required by law to perform certain duties for the protection cf the community, and it is the duty or parents to comply with these requirements.

The period of exclusion from school of children suffering from diphtheria as laid down by regulation, is for at least three weeks from the date of onset of the disease and'until a certificate is fur“ nijjhod 'by the medical attendant that tlui period of isolation prescribed has been completed. 'Pile period of exclusion from school of children exposed to infection (contacts) is (1) if patient treated at home, until disinfection of house has been carried out;-(2)-if patient removed to hospital, until seven days after disinfection of house subseouent to removal; G 3) in either ease until a certificate of clearance lia« bem received, from an Inspector of Health.

Once more, in conclusion remember that when a child has a sore throat, call it) a doctor at qno'e. Delay is dangerous. Mnnv lives bn'm been lost by failure, to follow- this advice.