THE PRESENT EPIDEMIC.

Shannon News, 6 March 1925, Page 3

THE PRESENT EPIDEMIC.

By Hygeia. Infantile Paralysis. We have.submitted the following letter, just received from a kindergarten teacher, to the Director of Child Welfare; and as he considers it’ should be published, we do so, along with his comments. The Letter. “Dear Hygeia,—As we are all asked to help in the infantile paralysis epidemical have made a few observations lately which may be 'of use. I was in town and round Oriental Bay on Friday and Saturday, and it was surprising to see the number of children with little or no proper • head-covering. A number of girls were wearing unlined crinoline hats, and boys were wearing small caps—neither providing any protection from the rays of the sun on the spinal cord at the back of the neck, which, I understand, is the vital part; and a nuihber of children were bathing with ho protection on their heads. I thought there would be some cases of paralysis if people were so careless, and in Monday’s paper there were five. Coverings for Head and Back of Neck.

“Could it not be made compulsory for children to have the head and back of the neck covered? I am sure the bobbed hair craze for girls, and small caps for boys, affording no protection to the back of the head—combined with the strong sun—has something to do with the gravity of the epidemic. Nature surely meant children to go about with long hair to protect this vital part. The strong sun, beating down on the back of my neck, has made me feel quite weak myseif, so it must surely weaken children and enable the microbe to establish itself. I have now indulged in a neck scarf, which keeps me beautifully cool. “I heard the other day of two children who were in the hospital with paralysis. I said I was certain they ha, been previously playing in the hot sun, and on inquiry I found they had been. This theory would account for the number of cases of strong children being stricken Avith paralysis, because they would have the vitality to play a long time in the sun, and so have the spinal cord weakened for the germ to enter. This summer the ray 3 of the sun have been exceptionally strong.

“I feel sure that if the Health Department would make it compulsory for children to have the head and back of the neck properly covered, the epidemic would soon cease, as the spinal cord would not then be weakened for the germ to gain an entry. No small caps or crinoline hats should be allowed, and children should have the back of the neck properly covered. Parents don’t seem to understand the importance of such covering, either by a very shady hat or by a scarf —preferably a scarf, if the hair is bobbed. Public money and precious lives are being sacrified, and careless parents should not be allowed to endanger the community. Why should proper head coverings not be made compulsory like other health regulations?—Yours, etc., KINDERGARTENER.”

Dr. Truby King’s Comments. I advise the publication of the letter, not only on account of its frankness and earnestness, but also because it is typical of the best class of anxious 1 communications which cjime from all directions from people who want to lend a helping hand in stopping the , epidemic. \ There is nothing intrinsically unreasonable in the idea that a disease which usually appears at the warmest season of the year is due to heat, and may be due to the sun’s rays acting directly on the central nervous system—as in the case of sunstroke. Is Infantile Paralysis a Kind of Sunstroke of the Neck and Spine. There is certainly a very widespread impression throughout the Dominion that over-exposure to strong sunlight, especially at the seaside during the Christmas and New Year holidays, is a leading cause of infantile paralysis in this country, and it is therefore quite natural for your correspondent to ask, “Would not the measures found effective in preventing sunstroke prove equally effective in regard to infantile paralysis?” Unfortunately there is no such com paratively simple preventive of infantile paralysis. I caunot find a single authority who even mentions solarisation among the factors predisposing to

the disease—much less directly causing With the exception of tuberculosis syphilis, and possibly typhoid fever and malaria, no more patient, prolonged, and competent investigations have been made throughout the last 30 years—and especially during the last 10 years —than the researches into the origin, cause, and prevention of recurrent epidemics of infantile paralysis. Yet Dr. George Draper, the leading British authority on the subject, says in his latest publication: “Little has been added to our knowledge of the epidemioly of ihfantile paralysis since Wickman published his classical studies on the subject 25 years ago. All his observations have been confirmed by subsequent students, and all have come to accept 'human contact,’ direct or indirect, as the means of transmission. At present, practically all observers agree that human contact is the means of transmission. Whether or not adult I immunity (relative)' depends on the! fact that in early youth most of the .human race has been attacked in mild or unrecognised forms is still a matter of. speculation. ’ ’ Dr Draper considers there is much to support this view. For the last 15 years dozens of highly capable special investigators have been engaged more or less continuously in research work with regard to infantile paralysis—the most eminent American workers being Drs. Rosenau, Flexner, and Amoss. The writing recently as Professor of Preventive Medicine at Harvard University, says: “The latest views of Flexner and Amoss are that the virus is regularly present in the nose and throat in cases of infantile paralysis . . . normal nuccous membranes are protective against this as again other infections of the nose and throat . . this is an invaluable defence against infection.” The conclusion is obvious. Keep children in the best possible health. Prevent all conditions which tend to lower general health and make them liable to coughs and colds; because, of course, catarrhs impair the vitality and natural protectiveness ot the nuccous membranes. In other words, keep all children, especially babies and young children, as fit as possible by means of pure air day and night, outing, exercise, regular, simple, and wholesome meals, due rest and sleep, etc. . and, of course, keep them away as far as possible from close contact with other children outside the family circle, especially from crowded gatherings indoors, and unnecessary travelling by trains, trams, or steamers.

At this stage your correspondent may ask:—“ls there then no risk at all from excessive exposure of the head and neck to strong sunlight in hot weather?”

Certainly there is. There is the risk of sunstroke; and no one can say tha! a child unduly exposed to excessive heat in the middle of the day will not have his vitality and resistiveness impaired, so that he would, be more liable to contract any infective disease—such as measles, scarlet fever, whooping cough, or infantile paralysis—indeed the predisposition might be greatest in the ease of the last-named. In a state of nature, all animals tend to seek shade towards noon on scorching, sultry days, for their own cemfort, and We may be sure it i s safer and better for ourselves not to go counter to nature in' such matters. It is not a good thing for anyone unaccustomed to much outing to be suddenly exposed to prolonged overheating, especially when tired and exhausted by overexercise and staying too long in the water. We all know the discomfort of being over-stimulated and overflushed by excess of exposure to h'eat and over-exertion—rand we know how weary, jaded, listless, and sleepy it makes children.

By means of suitable clothing and coverings wc may conform to the injunctions summarised as follows 'in medical books as protective against sunstroke: 1. Avoid excess of exercise and'food. 2. Light clothing—non-active colours, red or yellow preferable. 3. Head, back and neck, and spine to be protected. This does not mean that infantile paralysis is like sunstroke, but merely that injudicious and enervating overexposure of children to sunlight would certainly be a factor in lowering resistiveness to disease. On the other hand, it should never be forgotten that, apart from excessive exposure on very sultry days, sunlight is the most invigorating and strengthening of all natural agencies, and children should be accustomed to more and not less of such exposure than is customary. The children who get upset through exposure to strong sunlight are usually those who have been coddl'ed, or who at any rate have been accustomed to insufficient outing, bathing, and exercise, and who become tempted to sudden excess when ' transported to the seaside for a holiday. Of course, it would be better to go slow at first, and not to over-do it. Lest anyone should still think there is any direct connection between normal exposure to sunlight in summer and infantile paralysis, I may mention that epidemics of the disease have taken place in winter —notably the 1911 outbreak in Sweden of 3840 cases with 380 deaths. In conclusion, let me say that, while I am satisfied that the information and advice published by the Health Department thoughout the epidemic has been sound and sufficient, personal observations and suggestions are always welcome, and I think your corresponded should be thanked for her thoughtful letter. '