INFANTILE PARALYSIS.

Stratford Evening Post, Volume XXVIV, Issue 86, 17 March 1916, Page 7

INFANTILE PARALYSIS.

HEALTH DEPARTMENT CIRCULAR. PRECAUTIONS AGAINST ITS SPREAD. The Health Department has issued a pamphlet on infantile paralysis and a circular to health inspectors in connection with same. In a covering letter the District Health Officer says:— "The local authorities should he urge* to take prompt steps in their districts in order that the sanitary condiions may he improved. This will require a house to house inspection in the more crowded localities. In addition, where possible, the watering of the streets should be carried out—preferably with sea water, as frequently as possible. Local authorities should also requisition that all public places, such as theatres, picture theatres, halls, etc., should be disinfected, as also tramcars, taxi-cabs, and other public vehicles. Parents should be urged to keep their children from going to places of . amusement where they will be crowded together and to make liberal use of antiseptic lozenges and eucalyptus for the throat and nose. They should also be advised of the urgent necessity of isolating suspected cases until they are visited by a medical man." The pamphlet is as follows: ACUTE ANTERIOR POLIOMYELITIS—LN PANTILE PARALYSIS. This disease, as you now know, Ls epidemic in the Auckland district and several cases have been notified in different parts of the Werlrrigton district. '■'.:'""'

It is a disease of the spinal cordquite distinct from cerebro-spinal meningitis. I might put it like this to help you to understand the dfference. "Pleurisy is an inflammation of the membrance around lung and corressponds with cerebro-spinal meningitis, which is on **- * nc nienibranes round the brain and spinal cord. Pneumonia is an inflammation of the interim- substance of the lung, and corresponds with 1 Polirnyetitis, which is an inflammation of a particular part of the interior * substance of the spinal cord." It is caused by a minute organism, which is, to all intents and purposes, invisible microscopically. It is supposed that the fgerm enters'the system through the mucous lining membrance of" the-nose and mouth,,and passes* to the spinal cord..lt may also obtain access directly into the blood by means of biting insects. In the spinal cord it causes an inflammation of the .tissue —the prolongation into the spine of the brain matter—with damage or destruction to the nerve cells controlling the muscles: Children are mostly affected, usually the ages of 1 to 10 years. The incubation period is approximately six days, and the infeotivioy of contacts may be placed roughly at about ■■three weeks. .The symptoms are not characteristic in the early.' stages. There is- usually,ia« general feeling of.illness, headache, vomiting, high temperature-; and possible convulsions, stiffness of the neck, and tremour of the muscles occurs not infrequently. Paralysis follows within n day or so, and this may affect any muscle, but usually those of the arms and legs are affected. Within a week the constitutional symptoms disappear and the paralysis of the limbs may improve to a certain extent. There is usually,however,some permanent paralysis. The disease may be spread by healthy carrier, by domestic animals, by biting insects, and by dust. A predisposing cause is frequently found to be sudden chill after bathing, etc. In investigating the case deal with it as for diphtheria, but give particular attention to the following points in your report:—"Movements of the patient for the past month. Has he been jjsea. bathing—sea or public baths. Has he been in the habit of visiting such places as picture theatres. Have there been visitors from infected areas or association with any other case of paralysis. Has he been bitten by flies, mosquitoes, fleas, etc. Are there any

stables, manure pits, etc., adjacent to the premises. Has there been any association will) hay-making. Arc th.ro any household pets. Arc they diseased in any way. Has there been any nasal catarrh in the adults of the family." Give also as nearly as yon can the time from the first symptoms to the paralysis. Give the symptoms as accurately as you can, staging whether or not there is vomiting headache, convulsions, catarrh, stiff neck, diarrohea. Ascertain as nearly as possible the amount of paralysis at the beginning and the subsequent improvement.

Procedure. —The case must be isolated for at'least a month. .Urge removal of case into hospital. All body and bed linen, handkerchiefs, etc., must be disinfected. The parents of the patient during quarantine and for a fortnight after discharge will have been advised by the medical attendant to spray or gargle the throat and nose if the child be old enough—with weak antiseptic and suck some form of formaldihyde throat tablets. You should inquire if this is being done.

Contacts.—These must have no inti-! mate association with other children.! Contact school teachers and men in similar positions must suspend thenwork. All contacts should gargle and douche the throat and nose as indicated above for at least a fortnight. If they are suffering from catarrh, they should be quarantined until this J is better. Handling of foodstuffs must be prohibited. Children from an' feetad house must, not attend school for at least three weeks. j CIRCULAR TO INSPECTORS. The circular to inspectors reads:— It is desirable that all schools should be thoroughly cleaned and disinfected regularly during the a>i;esent epidemic, and the following method js. suggested for a preliminary cleansing by the removal of dust, together with subsequent disinfection. Proceed as folI lows :

Open all doors and windows. Strip the walls of all pictures, maps, and other articles attached to or hanging thereon. Remove these from the building and in the outside air remove all dust. Where the articles would not be injured thereby they should be wiped over with a cloth dipped into antiseptic solution and wrung out so as to be just damp. , -, ; Remove all books from 'the inkrior of desks. Take .the open beat together well to remove all dust. Stack them in the, open, preferably, in a sunny place,, ui}til the, cleaning operations are over.

Take,n long-handled.mop inpist.c,ned ! with antiseptic and, go, ; oyer..the. wall carofully, using a ladder, if necessary to ,r,eaeh' all parts, removing all dust. Particular attention should be paid to treating all window ledges, over architraves of doors, t over mouldings, et., or any place whore dust is likely • to lodgei . 'Start lit the top, of the wa?;s and Work'downwards. After mopping the walls proceed to go over all desks jand forms f first* removing dust and then wiping over the inside and outjsid.e of the:desks and .forms, with ; a [cloth: wetted in antiseptic solution., ~

I Where descks arid, forms are entirely 'moveable, it preferable f jo re- , move'them from room before commencing to sweep *t|ie walls. If. this :is done they should be treated as outside. The best results will be obtained if the desks, etc., are treated in the'room by allowing an interval to elapse between dusting them and wiping them over. Sweep all floors with a Isoft broom. To avoid raising the dust 'again on to furnishings, proceed as ifollows:—Procure some sawdust and wet ifc slightly, just sufficient to make it damp, with some antiseptic. In sweeping the floor, commence at one side or end.of each room. Lay down the sawdust in a long line about a foot broad, or more if the room is very large ; and an inch or so deep. Sweep the sawdust over the floor in front °f the broom, carrying it forward as the sweeping proceeds. When the whole of the floor is thus swept, gather up the sawdust, ,take ifci out of tFic room. and burn it. (Note.—This method of sweeping may be advantageously carried out in all sweeping of the school floors throughout the year). If a vacuum cleaner can be hired, very much of the labor and a good deal of the time occupied in removing the dust from the walls and floors Avill be saved.

All floors should then be scrubbed . with soft soap and hot water. This will complete the preliminary cleansing of the school. FOR THE DISINFECTION. Procure an orchard spray pump with a fine Bordeaux nozzle and one or more extension pipes. Prepare a solution by adding three tablespoonfuls of izal, kerol, and other suitable disinfectant to a gallon of water. The nozzle should be set to produce as fine a spray as possible. With this solution spray all floors, walls as high as possible, j and desks in the order named. The spray should be put on all surfaces as evenly as possible. Starting at the base iof walls, work upwards. But whßn; Spraying of each room is finished", all doors, windows, ventilators. etc., should lie closed securely and kept closed for a'period of at least twelve hours. After that period the doors f windows, and ventilators may be opened and the room be flushed out with fresh air. This flushing with fresh air and sunlight may be advantageously carried out during a vacation at frequent: intervals. For the antiseptic solution for washing desks, etc., a 1 to 2 per cent, solution of kerol, issal, Jeyes' fluid, or similar preparations may be used. For admixture with the sawdust for sweeping out daily similar solutions may be us rid. Where, cases of infections disease have 1 occurred in a school an additional fumigation with . formaline will be carried out by the officers of this department.