The Birmingham age-herald., 1914-06-28
|D|PHTHER|A Is THE SUBJECT OF TENTH HEALTH BULLETIN Is a Communicable" Dis ease Which Does Not
 Require Contact BACILLUS ENTERS
 MOUTH OR NOSE Not Long Lived Outside the Body, But Virulence Varies in Different
 Cases-To Discuss Scarlet
 Fever Next

"Diphtheria" Is the subject of health bulletin, No. 10, issued yesterday by pr. R. M Cunningham. city health of ficer The next bulletin will treat ol scarlet fever, the children's disease which Is much dreaded. Today's bulle- tin follows:
 Bulletin No. 1O-Diphtheria.
 ''In the former bulletins the dis eases discussed have been largely those depending upon insanitary conditions with the exception of smallpox
 "The following diseases: Diphtferia scarlet fever. measles, whooping cough, cerebro-spinal fever and chicken pox. all of which prevail endemical1y, some times epidemically, in all large centers of population are known as communi- cable or contagious diseases. The etymology of the word signifies con- tract. This, however Is not all the meaning of contagious. The term Is now usually employed to express com municability or "catching." There are many 'catching" diseases which do not require contact or even near contact. It means, however, communication of a disease from one person to another by contact. near contact or at some dis
 
 of something that has been In contact with the sick person and then comes in contact with a we'll persona hand kerchief, spoon, glass, books or cloth ing.
 Is Easily Communicated
 "Diphtheria is one of these. The spe- cifc cause Is the Klebs-Loeffler bacillus. This bacillus is usually introduced through the mouth or nose and finds lodgment in the nose, throat. tonsils, larynx (Adam's apple) windpipe or upper air passages. It will also cause diphther- itic action if it falls upon an abraided surface on the skin or mucuous mem- brane-sometimes 1t gets in the eye, and almost invariably destroys 1t. It leaves the body of those affected in the mouth and nose discharges. It can be communicated directly from person to person or through carriers-flies, spoons, handkerchiefs, books, etc, or by the fingers. There are also human carrie~s-those who have had the dis ease but entirely recovered and even those who have been exposed and have the bacilli in their nasal cavities or throat, but do not develop the disease but may transmit 1t to others of a more susceptible tendency. The bacil- Jus is not long lived outside of the body; it soon dies. It Is easily destroyed
 
 virulence varies in different cases and epidemics. Sometimes the disease is so mild as to escape attention. When buried in the false membrane or other albuminous substance they may re- main virulent for some months"
 There are many predisposing causes; it is a disease of the fall and winter; 1t more often affects children after the first year; girls are more often affected than boys. Singular as it may seem, it pre- vails more in the country. However, there are outbreaks in schools, prisons on shipboard and other places where people are crowded. It prevails mostly in the temperate climates, and rarely occurs in the tropics.
 Distribution of the Infection
 Unlike many germs it remains local, that is does not circulate in the blood. It forms a thick, tough membrane at the site of the bacillus lodgment, in which membrane the tissues below and in the discharges 1t IS found. If the person has sore throat diseased tonsils, adenoids, nasal catarrh, imperfect nasal passages from any cause, etc., the Judgment and ac- tivity of the bacillus Is favored Wher- ever lodged 1t produces locally the mem- brane and manufactures toxin or poison which circulates in the blood and causes the general symptoms and destroys life in
  larynx, windpipe or bronchial tubes it may mechanically destroy life by obstruc- tion to the breathing. There are various sequels of diphtheria, such as paralysis. These are caused by the toxins.
 Prevention of Diphtheria
 "Isolation of the patient and strict quarantine of the room and house. Not only the patient but the attendants as we'll The best place is an appropriate hospital Everything used by the patient or attendants should be destroyed, boiled or disinfected. It is the duty of the at- tending physician to send secretions of the throat and in some cases the nasal secretions to a laboratory for culture and thus microscopically settle the question of diagnosis Patients exposed should taxe a preventive dose of antitoxine. which creates short lived immunity. After convalescence the patient should remain in quarantine until the throat cul- lures are negative, and such of the at- tendants as show positive" after labora- tory examination. should also remain iso- lated
 Tn the next bulletin scarlet fever will be discussed.
 "R. M. CUNNINGHAM. M. D.,
 City Health Officer"