VIEWS ON INFECTION

Evening Post, Volume CXXIII, Issue 2, 4 January 1937, Page 3

VIEWS ON INFECTION

ISOLATION IN DISEASE Sir Weldon Dalrymple-Champneys, of the Ministry of Health, delivering a Chadwick Lecture in London, spoke on "Modern views on infection and disinfection.' He said that our views with regard to the duration, of infectivity in various diseases had changed greatly in recent years as the result of both bacteriological and epidemiological investigations, reports an English paper. Scarlet fever was an example of this change. The significance with regard to infectivity of complications involving a discharge from the ear or nose in this disease, as. also in diphtheria, had been recognised for a good many years now, but the bogy of "peeling" had been laid much more recently— and, he was afraid, not yet laid completely. The skin which flaked off in consequence of the preceding rash and when the patient was recovering from the disease was now known to be of very little importance as an infective agent, so that it was now considered unnecessary to isolate the patient until this process was complete or to make him sore by scrubbing or peeling off the flakes which were not ready to separate. Another disease in which the period

of infectivity had previously been much over-estimated was whooping cough. It was still popularly supposed that a patient suffering from this disease was infectious so long as he "whooped," whereas it had been clearly demonstrated that, on the contrary, by the time the "whpop" first appeared the patient had already ceased to be infectious. Much the same story might be told of measles, which was most infectious in the early stages before the rash appeared, soon after which the child probably ceased to be a danger to others. Measles and whooping cough, because they were usually of a trivial nature, were unfortunately still often regarded as of little danger to the infected child, and such ignorance was responsible in a large degree for ths death of about 2000 to 3000 children from measles and 2000 children from whooping cough every year. These children were killed by the pneumonia which often supervened in these diseases and led to a fatal issue. This danger had been pointed out by many concerned with public health, but 't could not be too widely made known, as these diseases were mostly preventive if the danger was realised and good conditions and nursing secured for the child before it was too late. Hospital accommodation could not, of course, be provided for every case of measles or whooping cough, but in his opinion a good many of the isolation beds now used for scarlet fever might, by reducing the isolation period for the latter disease, by the more economical use of beds made possible by the provision of more small wards and cubicles, and by isolating scarlet fever cases in their own homes wherever possible, be made available ' for those cases of measles and whooping cough in which home conditions, the debility of the child, and other factors made the danger of pneumonia especially great.