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1918
13
Undoubtedly, the discussions which took place some years ago
on the phenomena of the return case and the prolonged
infection of some cases have proved of value. The causes of
the return case were investigated and attention was focussed
more upon the individual and less upon his belongings and
surroundings. The importance of enlarged tonsils and adenoids
and unhealthy nasal passages was recognised ; operative
measures are being taken to remedy any unhealthy conditions
of the upper respiratory passages; a strict examination is made
of every convalescent child before resumption of school attendance.
It is on these lines that success will probably be attained
in the prevention of such diseases as Scarlet Fever and Diphtheria,
and not upon the elaborate ritual of disinfection which
has been observed in the past. During the past four years the
amount of disinfection which we have carried out after Scarlet
Fever has been reduced to a minimum. Formerly all the
clothing and bedding were removed to the steam disinfector,
the rooms were elaborately and systematically sprayed and
fumigated. Now, we simply disinfect those articles which
have been exposed to the infection of the fomites, and the
fumigation done is more for the sake of obtaining a thorough
cleansing of the room than with the object of destroying any
pathogenic germs. An inquiry was carried out in Providence
U.S.A., in 1903-1909, and Dr. Chapin, the Health Officer there,
came to the conclusion that the elaborate disinfection which
was carried out there was unnecessary. It is unfortunate that
an inquiry on a large scale is not made by a central authority
into the efficiency of disinfection as carried out by local
authorities. Large sums of money are being spent annually,
not only on disinfectants but also on labour. If a simpler
method is sufficient, then a vast sum of money is unnecessarily
spent by local authorities.
Diphtheria.
There is again a decrease both in the number of cases
uotified and in the number of deaths. From an examination
of the history of the disease in the district, fours years ago,
I predicted that we were probably entering then on a period
of minimum prevalence and we may expect this period to
continue for another '2 or 3 years. For about 40 years the