Norwich bulletin., 1916-10-06

| associated with one i'll with the dis ease. It has also been isolated from dust, taken from the SICK room and from articles recently handled By person i'll with the disease.
 TfZ manner in which poliomyelitis | is transmitted constitutes a problem | that epidemiologists have been work ing hard to solve. Monkeys can be l infected by rubbing the virus on the uninjured nasal mucous membrane as | well as by injection into the brain and 1 stomach, the most contrast being the nasal route. Therefore. contact with | secretions from one suffering with l poliomyelitis would naturally be con- l sidered the predominating mode of | transmission.
 1 Persons who have been in contact with the patient may be carriers" by l nasal secretions or contaminated | clothing.
 | Dust which has been infected by se-
 cretions from 1ne patient and articles 1 recently handled may at times infect | well persons.
 l While these modes of transmission | will account for the majority of cases, 1 there is a sufficient number of iso- | lated cases to lead us to believe that | there are still other means of trans l mission. Flies, mosquitoes bugs of
 all sorts, domestic animals, milk and | money have all been under suspicion, l but so far nothing has been proven. I | bottles contaminated in the sick room | may, in rare instances, transmit the
 disease. It is sincerely hoped that when the statistics and studies of the | present epidemic are compiled, more | definite information along this line 1 will be available.
 We fully believe that the period of | incubation will be definitely deter i mined when the data collected during | the present epidemic is available, but
 it is generally conceded that the av | craze period is from five to ten days
 usually eight. As in all other dis l eases. longer and shorter periods are ! noted and in some well studied cases | of poliomyelitis, the period of incuba- | tion has been given as five weeks, but 1 for practical purposes we believe that under tow weeks should be the time 1 considered.
 Various authorities have variously l described this malady, but from a1i l epidemiological standpoint, there are but two prominent types paralytic
 and non-paralytic.
 The non-paralytic type is rarely rec | ognized and yet is believed by many i to far nutnumber the paralytic type. : A child becomes slistless and drrwsy, l has headach@j and Sfever5 Slight diges- 1 tive disturbance, may have slight nasal 1 discharge, sore throat or muscular l weakness and then suddenly returns to | normal health. This you will recog-
 1Ize as what is usually described as the 'aborti>a'' type of the disease, but ] we believe the non-p -paralytic type | should be cCS sidcred the usual or com l mon form Of the disease.
 | The paralYtic type: The initial symp- l toms of this type are identical with l those just given; but instead of recov- ! cry, paralysis develops in one or more | groups of muscles, depending upon the ] location and extent of cord invOlv- | ment. Paralysis may develop with or | immediately following the initial or ] systemic symptoms, Tor ia may appear
 systemic symptoms or it may appear | after the patient has apparently re-
 sumner normal health. The onset of paralysis is usually accomplished by l fever and the occurring in cases of | delayed paralysis, has led to the de- 1 sCription oS a remissive type. Many
 such cases have been reported during 1 this epidemic. During the i@vestiga- | tions conducted in this state, in almost | every instance where a case of the paralytic type was reported. other chil- drcn were found with symptoms or his l tories which led us to believe they
 were suffering or had suffered from | the non- -paralYtic type of the disease. ! Tn some cases where we were fortu-
 nate enough to be able to make spinal | punctures. our suspicious were con- | firmed
 Unfortunately spinal puncture is
 the only method of making a positive | diagnosis in the -para1ytic type of cases. As it is obviously impossible
 to secure spinal punctres in the ma
 jority of these cases, very few will be | recognized and they will continue to
 act ats the greatest disseminators of l the disco SC. ''
 Experiments have shown that the
 secretions of those who have had pol
 iomyelitis will, at times, show viru =
 lence for weeks or even months. but l fI,a of +I,o iO
 1t is believed that the disease, as a rule is contagious for a few cays only, that is, just preceding and during the feb-
 rifle stage.
 It must be ad.Iitted. however that
 | as in other contagious diseases, occa-
 sioral cases will remain infective fol
 indefinite l'eniods. .-5-.- F;pidemics of poliomye1itis, ever 1 where no effort has been made to check are usually self-limiting. Statistics show that one case to every 1000 pop ulation is the usual instance. In ru- raI communities one case for every 50( is rot uncommon. The present epi 7 demic in Connecticut sustains thest 5 figures and in a few instances the ra !. tio hSs been as low as one to 200 A 3 a state, the ratio has been one to 1,500 7 It is estimated that 10 per cent. O t the total population represents chil g dren under five which is the period O V gre1test susceptibility. Of every thou ] sand population, therefore, there mus t be 100 children of the susceptible az l and yet. according to the rule, but on l. of these 10o children develop the dis = ease in a recognizable form.
 = Allowing well for the unrecegnize' = n-paralytic cases we should still hav f probably 95 per cent. Of these childre1 s unafflicted in any stated epidemic. Thi s large number of immunes is compose of two classes the natural immune = and the acquired. There Is no ques
 ton but that this disease shows y larger number of natural immunes tha = the ordinary contagious diseases an l. undoubtedly. there are many who hay = suffered mild attacks in past years an = who have thereby acquired immunity d l. So many factors enter into the stud d of epidemics that it will probably b - a long time before this problem 0 solved, but at the present time tw 0 factors are being studied with prom @ ise, namely, increased vtrulency of spe
 kcif1c organisms under certain condi 5, ! tions and the reduced resistance of tn l. | human body to : infection because 0 5, ! habit or environment. u Tn conclusion will say that it IF | fha exnartanca of all who have at