DIPHTHERIA.

Taranaki Daily News, 23 July 1918, Page 6

DIPHTHERIA.

- AN INTERESTING STATEMENT. Tlie acting-medical aaporiiiLend.eu Dr. McLtiarmid), at tlic hut meeting o ic llawera Hospital ISoard, made i itlior interesting statement in referenc i tin; diphtheria epidemic. No infection ises arose anew nowadays, ' said tli. uperiutendeiit. There was iio such thin; s spontaneous generation of infection isea.-c. E\ery new ease, must have com ■■om a previous ease. Tlie conditions fo ivoring the .spread of tlie disease wer lore common at certain times of th oar, and the climate liad a marked in nance in come way that was not alwny nderstood at present, ated sanitatio: nd unhealthy conditions generally ha< n influence in favoring; the eontiiiuanc f an epidemic, but these could not star 11 epidemic of themselves. He wished t mpliasiiio i hat no matter how man r-sr-nirs and septic tanks tliere wer bout in a district could not star n epidemic of diphtheria. Even if the rore badly infected they were a very ur il-cly source of infection, as people pre m-ed to keep clear of them. In diphheria infection might lie spread through be medium of bedclothes, eating uteriils, books, and a hundred and one other hings used in a household or school. The merobe was very resistent and a case ad occurred in which the disease was ontracted from a mattress which had eon used six months previously by a iphtheria patient. It was said'that domestic animals might transmit the disase— e.g., cats—and an epidemic has iccn traced to diphtheria sorc3 on a ■ow's udder. Public conveniences might >c a source of infection. This was possibly common in railway carriages, where vindows were shut and people were ivowdcd together, hut it was very imikely in the ease of a motor car. which vas continually open to (ho light and lir. Even if a car were deliberately inrcted it would very quickly become sterile under ordinary circumstances. Diyet Reread by personal contact was hy ar tlie most frequent source of infection, in diphtheria this was manv hundred times more frequent than all the other sources put together. By personal eontact he meant people living under the ?ilniD roof, sharing the same rooms, catnig at the same table, reading the same books, 0t.?.; in short, conditions such as were found in the home and in the school. The crux of tie whole matter was to know which children were infected and which were not, Most infectious MSC3_ were infective before there were sufficient symptoms to make a diagnosis. In diphtheria a lay or so passed in which there was general malaise and perhaps fever, preceded l-.y slight, shivering, hut no sore throat, and patients were highly infective in this stage. Not every individual exposed to infection would develop the disease. The old and the very young were almost immune, and adults were not very susceptible. Diphtheria was essentially a children's disease. Though there were children who wore not susceptible at ali, there were others who took it in such a mild form that they did not feel ill; their throats worn not sore, and they continued to go about. They might have it in the nose without having a sore throat. These early and mild cases were the main source of infection, and. it wa 3 largely duo to these, that the epidemic continued. Ha was constantly seeing cases in which childion bad been attending school with sore throats and which subsequently proved to be diphtheria. He saw a large family of school age lecently in which all the children had had sore throats and had continued attendance at school. The sore throat had gone right through the family until the youngest contracted it. This child, a girl, happened to be pretty bad. and he was sent for. lie found that die was suffering from well-marked diphtheria. He had not the slightest doubt that all the children had had it and had probably scattered the infection far and wide. Some children, although they recovered from the disease quite well, still harbored the germs in the throat, and might do so for months. This held true with regard to mild attacks as well as severe cases. Children, with unhealthy condition of mouth and throat, such as carious teeth, enlarged tonsils and adenoids, were very liable to become carriers. Diptheria often gave rise to a chronic nasal d ; ?charge, which was very infective. Close association greatly favored the chances of infection.

Young children had a habit of putting everything in their months, and at school and .nt home they wer<. constantly exchanging articles which might easily b-.i infected. At home it was not snob, a serious matter, as infection would be

limited to a household, but at school the infection might easily become wide-spread-In churches and theatres, where children were distributed among adults, the danger was not so great. Sunday schools' and children's picture shows were a source of infection. Tlie great troubl.', however, was the carelessness of the parents. There had not been enough deaths to make people realise the seriousness of tlie disease; the low mortality was due to: the early treatment with anti toxin.

There was practically onlV one treatment for diphtheria, and that was the administration of anti toxin. Never onee in -15,000 cases did it do any harm and it was absolutely life-saving.' It had no depressing action on the heart, and did not cause paralysis. Diphtheria might be absolutely prevented by an inaction of a small dose of anti toxin given before tlie disease developed. Unfortunately this immunity was of a very evanescent type, and it only lasted three weeks or a month. The immunity conferred by an attack was more lasting, but it was not permanent, and an individual might suuer from repeated attacks. All schools should be closed for a time till fie epidemi.: was over, and theeonsregation of children anywhere should be prohibited. Children's and young peonle's parties should be discouraced. and chilren should be kept at home and not allowed to piny with children of other fnmilie.3. Parents should not allow anyone to kiss their children, lie they: children or adults. Lending handkerchiefs, besides being a filthy habit, was very dangerous. Every individual under •20 years of age in an infected house should ho strictly quarantined after an outbreak for at least six weeks. This lu-ld true even if the patient went to the hospital. People must Ibe warned o' fi j danger of mild cases, and every easW of illness- should be isolated until *Jiey v..ye sure it was not diphtheria, wn s a means of prevention: of .Tcyes' Fluid could not drown dirt. Some people seemed to think that if there was a saucer full of Jeyes' Fluid somewhere in tlie toullerr all tli« microbe* from all

parts of the house would tumble over each other in their eagerness to get into it. Gargling night and morning was vary useful and might prevent an infection developing into the disease. In all eases of gross neglect where there were cases of diphtheria proceedings should be tafcen against the persona concerned. A bacteriologist would he very useful to the medical profession. Ho ■would give them accurate information as to which children were infected. A bacteriologist, could detect '''carriers," and could discharge a great many peop}.' from hospital much earlier. He could tell, j which homes were free from infection ' and raise the quarantine very much j earlier A bacteriologist would not stop ; tlie epidemic, for the matter was in the j lnnds of the people themselves. They ; must realise that it was largely due to | the ignorance and indifference on the j part of the community that the epidemic continued.—'Star. i