The Bridgeport evening farmer., 1916-09-01

| infantile paralysis is a most difficult
 problem. In orde- to obtain any re-
 suits we must utilize our knowledge to the utmost: measures should be com 1 prehensive, definite and rigid. Infantile paralysis is produced by
 minute Infectious agent which cannot
 be isolated. cultivated or identified by
 the usual bacteTiologic method. The
 virus is present in the secretions of
 the nose, throlt rnl iEtestnes of the sick, and has been found in the noses
 and throats of healthy contacts, who
 may remain hsal:ny clrriers.
 The virus can ne carried OH the sur
 face and in the intestines of the com mon house fly. It is probable that
 other insects, verIain and domestic
 animals may similarly carry and dis
 seminate the virus.
 Accurate data has not been obtained
 on the duration Of living virus in the
 nose and throat of the sick or In heal thy contacts. In monkeys the virus
 las heen found in the mucous mem i brare of the ncse and throat as long
 as six months after the occurrence of paralysis. It is very probable that
 carriers of this disease, as in meningo- coccic meningitis, group themselves | into the larger group of temporary | transient carriers. and a smaller group | of permanent carriers or carriers over
 a longer period of time.
 | The virus has been found in the dust of rooms containing patients with l infantile paralysis. It is unusually re- sistant to drying, summer tempera- lures and the action of 0.5 per cent. l phenol (carbolic acid) and glycerin. The virus may therefore he d;ssem- | mated by the sick. by healthy carriers, by the fly, insects or othe- animal car- riers, and through the agency of dust,
 dirt, food, garbage or refuse which mas become accidentally contaminated | with the virus. This can readily occur through the coughing. sneezing, or
 promiscuous splitting of carriers. Studies of the present and previous epidemics indicate that the disease is transmitted along the route of human | travel and intercourse: that the dis ease is transmitted principally through the agency of health carriers. Two factors are necessary for the occurrence of infectious disease:
 highly virulent infectious agent and susceptible individual. Infantile para
 lysis is always sporadic in this coun- try. It has been suggested that the virus f1uctuates in virulence and may suddenly assume excessively v.ruIenr
 properties. For an epidemic of any
 disease to occur, there must be gener- al lowered resistance to the disease.
 In time of epidemic, on account of general exposure, it is probable that a
 widespread and high immunity devel- ops. In periods free from epidemic,
 this immunity probably gradually dies
 cut.
 The introduction of a highly viru-
 ier- virus during a period ;of general lowered resistance can explain epi-
 denies, recurring in cyclic manner. General and widespread nasophar- yngeal catarrh would offer a ready | means of widespread production of
 carriers and dissemination of an in fectious agent. The past writer m
 this country was unusually severe. and
 epidemics of grip were general and alarming: few persons escaped a few
 days disability from nasopharyngeal catarrh.
 It is obvious that infantile paralysis is h,.h'y contagious disease, with all
 
 Unlike the other tagious disc Ascs, as scarlet fever. measles, and dipthe- ria, easily controlled by suitable quar- antine, this disease is extremely diff ficult to control. Few who are ex- posed actually develops the disease This epidemic teaches that sporadic cases at all times should have the most rigid quarantine of the sick and the healthy contacts. With .he outbreak of a 'arge. ap. parently uncomfortable epidemic of
 infantile paralysis in New York city, there was ample cause for alarm in
 neighboring cities in close business re- lationship with New York. The im- mediate outbreak Of cases in these cities, and large epidemics in some, in- dicated that the most rigorous meth
 ods would have t, he immediately em- ployed to prevent epdemi,s in these cities An especially serious problem was the Hooking of thousands of chi1- dren from New York to the surround ing country.
 The preventive camp1'rn as planned and rigidly carried out in Bridgeport may be classified follows: 1. Quarantine of the sick and healthy contacts.
 2. Exclusion of probable carriers from New York and ajoinine cities iN which the disease was epidemic. 3. Establishment of a special central hospital to which was enforced com pulsory removal of all patients with infantile paralysis.
 4. Organization of a special medical
 "poliomyelitis diagnosis squad" 5. Repeated standardization of the physicians, calling attention to abor- tive cases and the preparalytic stage
 of the disease.
 6. Mobilization and enlargement of all sanitary forces covering the street cleaning department, garbage depart
 ment, police and fire departments, re- gular sanitary inspectors. and the staff
 of nurses
 1. Quarantine.-Quaran ntine of the sick should be rigid, and. until we learn more about the disease, should cover the probable period of the opi- demic. about eight w. eks. Rigid quar- antine means removal of the patients from their homes except in special but rare instances in which ouaran- tine can be carried out at home All patients were kept at the poliomveli- ts hospital for a period of eight weeks.
 Families in which the disease oc-
 cured were ouarantined for ten days. In every instance an officer was sta tioned at the outside door during the entire period of the quarantine Each