The Daily Ardmoreite. [volume] (Ardmore, Okla.) 1893-current, 1916-07-20

, pendent upon tne water supply Ihal
on any other single factor. By. pain
stalking effort on the part of city and
state health authorities much may be
done towards the elimination of ty-
phoid. This has been plainly dem
onstrated in New York City, where,
despite the huge foreign population
and crowded, insanitary conditions in
many sections of the city the number
of typhoid cases steadily has decreas-
led The methods followed might be
adopted in many other communities
with good results.
In New York City every case of
typhoid fever reported to the depart
ment of health is visited by a nurse
who makes careful inquiries of the
family into the history of the case
and records the facts elected on a
special history card. These cards are
| then analyzed by the chief of the di-
vision of epidemiology and if neces-
sary additional Investigations are un-
dertaken to learn the source of in.
! fection and to see that further infec-
tions are prevented.
To Prevent Infection.
Each borough of the city is divid-
ed into several sections, in each of
which Is located branch office in
charge of a physician and having at
tached to it district diagosticians
and nurses. When report of case
is forwarded to the borough office it
is telephoned to the branch office of
the district in which the case is 10
Gated. The case is assigned to a dis
trict nurse, who calls at the home of
the patient and interviews a respon-
sible member of the family for the
purpose of obtaining as regards the
patient, the age, the business address,
the date of the onset of the disease,
the beginning of the symptoms and
all the food habits which may be of
service in tracing the infection, in
cluding the milk supply, the water
supply, use of raw oysters or green
vegetables or other raw foods and in
special cases, particular articles of
diet such as ice cream, etc.
There are also noted other things
important in tracing the source of in
fectiOn, as the whereabouts of the
patient for period of one month
preceding the disease; whether there
has been any suspicious illness
among any of the friends or rela-
tives of the patient or in the house
where the patient lives or among the
servants; and whether there has
been any typhoid fever in the family
during recent years. 1t is not neces-
sary to annoy the patient with these
questions as almost invariably the
necessary information can be better
obtained from another member of the
household
The nurse also makes inquiry as to
what measures are being taken to
prevent other persons from contract
ing the disease; whether the patient
has separate room and bed; who
nurses the patient; whether the dish
es are sterilized; and whether every
effort is made to prevent the dissem-
ination of infective material Special
cards of instruction are provided for
the convenience of the family, in
forming them how best to prevent
the spread of infection to other per
sons.
Special attention is given to food
handlers. If the patient has been en-
gagged in the manufacture or sale of
food material, he or she is not per-
mitted to return to work until several
thorough examinations demonstrate
typhoid bacilli. No food handler who
is a member of the household in
which there is a case of typhoid may
continue to reside at home unless the
patient be removed to hospital. The
information collected by the nurse is
forwarded to the division of epi-
demiology on SPECIAL history card
and is carefully studied. A tabula-
ton is made of all cases, with ap-
propriate grouping of the several
items according to their bearing up
on infection.
OF course these methods mean
great deal of work and some consid-
cradle expense. Yet actual exper-
ence has shown that they are both
worth while. This Is proven not only
by the fact that the New York ty-
phoid death rate is extremely low,
but that it has steadily decreased.
In 1900 the typhoid rate in Yew York
was POS per 100000. In 1914 it was
only 6.S. In Chicago, where similar
methods are employed, the rate has
dropped from 1913 in 1900 to &C in