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96
A "Provisional Memorandum upon Precautions advisable at times
when Epidemic Influenza threatens, or is prevalent," was also drawn
up by me in January, 1892, and was issued by tbe Board to local
Sanitary Authorities.
The further study made by the Medical Department as to the
natural history of influenza, and as to its clinical and bacteriological
characteristics, goes to show that it is a disease against which it is most
difficult to apply measures of prevention with any substantial prospect
of success.
Influenza is highly infective from person to person; its infectious
quality is often manifested before the disease is fully recognised; its
incubation period is one of the shortest of all infectious diseases; it
varies so much in intensity that many cases are never diagnosed at all;
one attack confers no marked immunity against another; and the
infection is largely eliminated by means of the lungs, the sputa of the
sick being invariably charged, during the acute stage] of the disease,
with its pathognomonic micro-organism. The disease calls primarily
for measures of isolation and of disinfection, but there are difficulties in
making any measures universally applicable. Wherever they can
be carried out, the following precautions should, however, be
adopted:—
1.—The sick should be separated from the healthy. This is
especially important in the case of first attacks in a locality or a
household.
2.—The sputa of the sick should, especially in the acute stage of the
disease, be received into vessels containing disinfectants. Infected
articles and rooms should be cleansed and disinfected.
3.—When influenza threatens, unnecessary assemblages of persons
should be avoided.
4.—Buildings and rooms in which many people necessarily
congregate should be efficiently aerated and cleansed during the
intervals of occupation.
It should be borne in mind that the liability to contract influenza,
and also the danger of an attack, if contracted, are increased by
depressing conditions, such as exposure to cold, and to fatigue whether
mental or physical. Attention should hence be paid at epidemic