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mined. Should a ward become exposed to infection susceptibles
are immediately protected by means of anti-toxin. Since the
routine use of this method in the hospital no second case of cross
infection from either of these diseases has occurred. In regard to
measles no susceptibility test can be carried out, but patients
who have not already had the disease can be protected by means of
convalescent serum taken from a recently recovered case of the
disease. Arrangements have now been made to have a stock of
this serum readily available in the hospital for administration in
suitable cases.
When, however, such cases as whooping cough, chickenpox
and rubella are epidemic, it is extremely difficult to prevent outbreaks
occurring in the wards, since these diseases spread very
rapidly among hospital patients whose general resistance is naturally
low and who therefore readily succumb if exposed to infection.
All that can be done is to remove the first case to a side-ward
as soon as it is recognised and to put the ward in quarantine until
it is free from infection, or until all the patients in it have been
discharged. As regards whooping cough, an attempt is made to
immunize susceptibles by means of the appropriate vaccine,
in the hope of modifying the disease if it should occur in a second
case. It is hoped that the time is near when our increased knowledge
of these diseases will allow of their being dealt with as effectively
as diphtheria and scarlet fever.
(c) Carriers.
A carrier may be defined as an individual who harbours in
his body pathogenic micro-organisms, without manifesting any
of the usual evidences of infection ; he is capable of transmitting
the organisms to other individuals who may develop the disease.
A carrier may be admitted to hospital suffering from some other
disease and may form an unsuspected source of infection. The
carrier may not be discovered even after a case infected by him
has occurred. The nose and throat of every patient admitted
is swabbed and cultures examined for the presence of diphtheria
bacilli. Occasionally a diphtheria carrier is found in this way,
but carriers may easily escape detection, since the organism is
often lodged in tonsillar crypts or nasal sinuses.