Evening star., 1922-04-01
TYPHOID FEVER.

Some philosopher has said "it is
pleasant to look backward" From
point reached in the ascent of a
mountain the climber by looking
backward may see beauty and gran
deur which were not apparent from
the lower levels. and by reviewing
difficulties overcome and hazards
passed become enlivened with conf
dence to reach greater heights.
By looking backward over the
course Of progress in disease pre-
vention within the last quarter of
century much may be found for
qualification and encouragement.
Some of the progress has resulted
from increased knowledge and some
has resulted from increased use of
previously existing knowledge. Since
the discovery about twenty years ago
Of the mode of spread of yellow fever
that disease has ceased to be Sc
rious menace to the United States 1t
is more remarkable in way that
within the same period. without any
revolutionary discovery as to its
cause and modes of spread, typhoid
fever in this country has been re-
duced in its rate of prevalence by
about Is per cent.
Typhoid Takes Many Lives.
Typhoid fever has had a prominent
place in the bills of mortality of all
civilized countries. From time to time
over wide areas it has prevailed as
veritable scourge. In some of the
wars of modern times it killed more
than bullets killed. For many years
after the cause and modes of spread
and means for the prevention of the
disease were known typhoid fever
was permitted to prevail in the United
States at high rate-several times
as high as that of some of the other
advanced countries. The annual ty-
phoid fever death rate in the United
States twenty years ago was over
40 per 10o, 900 of population. In the
last two years the rate in our regis
tration area (now comprising about
80 per cent Of the populatiomo mas
been under ten. AS late as 1906 the
typhoid fever death rate in the Dis
trict of Columbia was 49.s. whereas
in the two-year period OF 1919 ano
1920 it was under 8.
The cause of typhoid fever is
small poisonous eerm-so small that
the individual members can be seen
only with the aid of a high-power
microscope. Like other plants it de-
pends for its existence upon getting
into favorable soil. The favorable
soil upon which it depends is human
elsewhere for a prolonged period. 1t
reaches human tissue by being .swal-
lowed. In human tissue (of what we
call a susceptible person) suitable
to 1t it multiplies rapidly and pro-
duces a poison which causes the
disease. 1t is discharged from the
body Of the affected person in the
waste matter from the intestines and
kidneys Under insanitary conditions
such waste matter may be conveyed
to other persons through the media
Of water, foods. fingers or flies. A
IN
means that that person recently has
swallowed something contaminated
with waste matter from an infected
person. Some persons (the so-called
''carrierso apparently in good health
carry and discharge from their bodies
typhoid infection.
Sanitation Best Preventive.
The great measure for the preven-
tion Of typhoid fever Is sanitation or
supplies. sanitary sewage-disposal
systems. clean or pasteurisedt milk
supplies, control of f1y-breeding, hy-
gienic precautions at the bedside of
the sick and anti-typhoid vaccination
have been and are the factors to re-
duce typhoid fever prevalence in COM
munities infested with the disease. 1t
is readily within the power of our
average community to bring down
and keep down by reasonable and
economical procedure Its typhoid
fcver rate to or nearly to the vanish
ing point. Among the main armies
engaged in the world war, typhoid
fever was controlled by sanitation and
anti-typhoid vaccination to such a de-
gree that 1t was but a minor cause OF
death and disability. The prevention
Of serious outbreaks of typhoid fever.
oven under the conditions obtaining
in the front-line trenches. was one of
tha reuna rka bile and valuable demon
stratfons OF the world war.
Most of the reduction in typhoid
fever prevalence in the United States
during the last twenty years has re-
suited apparently fromsanitsry prog
ress In our cities. In our rural dis
tricts-the source of our food sup
plies, and now also the source of most
of our typhoid fever infection-sani-
tary progress is being made, but
sloWlY In spots. The lack Of rural