HEALTH NOTES

Evening Post, Volume CXII, Issue 8, 10 July 1926, Page 13

HEALTH NOTES

ENTERIC FEVER OR TYPHOID

CONQUEST OF A FORMIDABLE

DISEASE

SIGNAL TEIUMPH OF PREVEN-

TIVE MEDICINE,

(Contributed by Department of Health.)

The reduction in typhoid fever of late years is one of the most signal triumphs of modern sanitary methods and practice. It is common knowledge that a mere generation ago enteric fever, or typhoid as it is more often called, was one of the serious epidemic diseases of New Zealand. In the fiveyearly period 1896-1900 for instance, a total of 511 deaths occurred amongst the European section of the community- from 'this cause. A comparison with the five-yearly period 1921-1925 shows the great -progress that has been made. In the latter period there were only 154 deaths from typhoid fever, whereas if the same rate had prevailed as in the earlier period, there would have been approximately 870 deaths; in other words a quarter century 'a progress in preventive medicine has meant an annual saving of 140 lives from this one dise'asc alono. This,-however, is not th 3 full benefit. For every case which dies there are- about nine cases that recover after a prolonged illness. . It can reasonably be claimed, then, fthat in addition to the actual saving of life 1250 people on an average, in each year are now saved a severe and expensive illness, which 25 years ago they would have been fated to experience. •, NATURE AND MODE OF SPRfiAD. Typhoid fever is a preventable disease that can and should be stamped out. It is an infectious disease due to a red-shaped micro-organism which enters the body by way of. the mouth. The mode of infection has been pithily expressed as by food, fingers,'and flies. Typhoid germs enter the mouth with drinking water or water used in preparing uncooked food, with milk, with raw foods, or are introduced on unwashed fingers. Flies have been proved to carry infection from the excreta and discharges of typhoid patients to milk or food -which has been left unscreened against them. SANITAEY INTELLIGENCE OF THE COMMUNITY. The prevalence of typhoid fever in any community is now generally, accepted as a measure of the sanitary intelligence of such a community. A low typhoid fever rate mean's that the people have safe 'water, clean food, and have a good standard of personal hygient. Steady improvement <hts been.j made in all these matters in New Zealand of late years. The conquest of typhoid ■ fever, hpwever, calls for continued effort and constant watchfulness, as anyjslackening.brings its penalty. It is probably • fresh in the minds of readers that two of the principal cities of this Dominion have experienced typhoid epidemics of recent years. In Wellington in 1919' there was a localised outbreak due to infection of a local milk supply, which resulted in 34 cases with six deaths; while Auckland in 1922 had a more serious epidemic due to the accidental breakdown of the. methods I of purification of unsafe water, which resulted in 216 cases and 31 deaths. HOW TO CARE FOR A PATIENT. When typhoid feven is diagnosed or suspected medical advice should always be sought. . ;, The nurUs, or whoever takes care of the patient, should never come ; in contact with the food for other members of the family, and should always wash her.hands in a disinfectant after attending the patient. All table utensils, bed clothing, and other things that have come into contact with a typhoid patient must be thoroughly disinfected by boiling or by bfher means suggested by the physician. All remnants of food from the sickroom must be burnt. All discharge from the patient must be disinfected and protected from flies. The typhoid patient should have his own table utensils, which should, be boiled after using. TYPHOID TEVER VACCINATION. Typhoid vaccine is made with dead' typhoid fever germs. This vaccine is injected under the skin in three doses, usually at weekly intervals. A slight redness soon appears at the point of infection, but disappears in a few days. In' some, cases a slight headache and a tired feeling^ follows, lasting about a day. In very rare cases, these signs may extend over several days, but the vaccination has proven to be harmless. The history of the British Army, affords a striking illustration of the efficacy of vaccination against typhoid fever. In the South African War typhoid fever killed more than powderand shot, while in the Great War as a result of-routine vaccination, it was. an almost unknown disease amongst' I the troops. , The benefits of the procedure have been clearly demonstrated ■. also in New Zealand amongst the ! Maori section of our people. Recently in Hawkes Bay, an epidemic, which . had. assumed considerable proportions, j was checked by the ordinary sanitary I measures of isolation, disinfection, etc., apd by the routine use of vaccine amongst contacts. The Maori to-day runs a greater risk of typhoid than the European, and although a great deal is being done by the progressive improvement of water supplies ana .drainage in Maori villages, routine vaccination helps, to compensate for deficiencies , which -cannot be remedied right away. HUMAN CARRIERS. An article on typhoid would be incomplete without some reference to the carrier problem. The typhoid carrier is a person, apparently healthy, who carries typhoid germs in his intestines. Many cases of the disease result from personal contact with these carriers. The carrier cannot be detected except by careful bacteriological investigations, and in. some parts of America, where typhoid fever is prevalent, all handlers of food are required to undergo an examination at least once a year tc show that they are not a sourco of danger in this' way. . THINGS TO BEAR IN MIND. . Eemember: Typhoid fever can be controlled by the use of pure water, pasteurised milk, and clean foods; by the proper disposal of sewage; by screening privies and food against flies; by destruction of the fly and its breedingplacea; by search for and care of patients and carriers, and by the general practice of anti-typhoid vaccina- . tion.