HEALTH NOTES

Nelson Evening Mail, Volume LXIV, 20 June 1931, Page 5

HEALTH NOTES

DIPHTHERIA

HOW IT CAN UK PUKVIINTKO (Contributed by I lie Department of Health) Diphtheria is ail infectious disease eausei! by a bacillus or germ which, finding lodgment generally in the throat or nose ul asuseept iblo person, rapidly multiplies producing a greyish membrane and a poison or toxin winch is absorbed into the blood.

Diphtheria, is justly regarded as one ol the most dreaded diseases of childhood, and in earlier years its appearance in the community brought terror. There are now few diseases concerning which we know as much or which we can attempt to prevent and control more hopefully. Yet even to-day diphtheria takes a serious toll of the population. Thus in New Zealand for thc'lasl five years there has been 8148 cases of diphtheria with 346 deaths. Though present in the community tin; whole year round, it is more common in the winter months. It occurs. more frequently among children than among adults, children under fiveyears of age being most readily aHecteih llow Diphtheria is Spread—The chief difficulty in the prevention of diphtheria is the number of healthy people harbouring bacilli in their throats, estimated in the winter season at more than one per cent, of the population), ft is manifestly impossible to detect and isolate all such germ carriers. A susceptible person, especially a child, coining into association with a carrier is likely to fall a victim to diphtheria. The germs enter the body through the mouth or nose. They may he transferred by kissing, or by receiving the mouth spray thrown out in coughing, sneezing, and talking, or they may he carried 1o the lips by the use of a common drinking cup or other utensil or by fingers soiled by touching some object which an affected person has just touched with fingers soiled from his own lips or his infected handkerchief. It is very didicult for a person who lias these germs in his mouth to avoid contaminating his lingers with them. Sometimes those who work in dairies are “carriers," or have the disease. They may sueo/e or cough into the milk pail or the lingers of the milker may transfer the germs to the milk and thus cause an epidemic of diphtheria. Hence the need for, extreme care in handling milk, not only in its production and distribution, but also in the home.

Symptoms and Course of the Disease— Since the usual sites of the disease are the tonsils and throat, Hie most characteristic early symptoms are sore throat, rapid pulse and fever followed by tlio formation of a membrane spreading over the throat. These early symptoms may resemble those of a common cold or of simple tonsillitis so that ail apparently trivial illness may be the beginning ol diphtheria and no time should he lost in calling medical advice. Where the disease attacks the windpipe or larynx the greatest danger is that the membrane formed may block the air passages and choke the victim. The operation of tracheotomy (i.e. Hie introduction of a tube into tile windpipe) may he necessary in order lo prevent suffocation. The delay of on hour in obtaining treatment may determine a fatal result. As the site of the disease is not invariably the throat, the absence of membrane on the throat does not eliminate the possibility of pihtheria ami hence in any doubtful case, especially if diphtheria is prevalent, medical advice should ho obtained early. Another danger in diphtheria, is oil account of the toxin or poison formed by the diphtheria, germs in the body, which circulating to every part has the power of destroying certain tissues, especially nerve tissues and heart muscle. .In defence the body forms a protective substance, anti-toxin, lo neutralise tlio effect of the toxin. The sevorily of an attack of diphtheria and its ultimate conclusion depend on how successful is the fight of anti-toxin against the germ to,Kin. In fatal cases collapse and sudden death may occur when the patient is apparently well on the way to recovery, it is now possible, however, to reintroduce the anti-toxin in the body of the patient by introducing supplies of anti-toxin manufactured without, and thus aid him in his struggle against the disease. The issue is often determined by how soon this reinforcing dose of an-ti-loxin is given to the patient. Were it possible to apply this lemocly in sufficient doses and early enough in alt cases, mortality from diphtheria would almost vanish. As it is, the disease has been robbed of much of its former terror. ilenerat Advice. —There are few diseases where early treatment is so fraught with nope as in diphtheria. There is no disease in which early diagnosis and prompt treatment are iroro essential. If your child or other member of the lamily is sick ill l a sore throat call in your doctor. If he looks like diphtheria the doctor will administer anti-toxin, take a culture from, the throat and isolate the patient. Do not insist on waiting for a culture if the doctor advises anti-toxin. Delay is dangerous.

f’revcution. —Anti toxin is also used as a preventive, being given to contacts (people! who have been exposed to infection) as a protection. Ciiforlmiately, tho protection from inoculation with antitoxin lasts only from two to llncu weeks 7 and at the end of that lime the individual is again susceptible to the disease. I'ui'fuiiateiy, it is now possible, however, to protect from diphtheria, in the same way as vaccination protects against sn allpox. This may be done by giving him an injection of a vaccine (0.g., toxin anti-toxin) at weekly intervals for three weeks which confers with few exceptions practically an immunity to diphtheria. Thousands of children every year in I'mgland and America receive this treatment with the effect that the incidence of diphtheria is greatly lessened thereby. "Health News'’ of the New York Stale department, stales: "Although the goal 'No Diphtheria, by 1930’ was not reached the results have proved beyond doubt that diphtheria can he conuoiled. Some idea of the value of diphtheria prevention work to the State as a- whole may be gained from tho fact that there were 23,326 fewer eases of diphtheria and 1,484 fewer deaths during 1926-30 than in the five-year period 192125 preceding the toxin anti-toxin campaign. In (ho State, exclusive of New York City, deaths from the disease dropped from 537 in 1925 to 144 in 1930. while the number of cases dropped from 4,370 to 1,591. The diphtheria death rate has decreased from an average ot 10.1 per 100,000 population for the period 1921-25 to 3.8 for tho years 1926-30, during which approximately three-quar-ters of a million children were immunised against diphtheria with toxin antitoxin. Of this number over 185,000 wore under five, the age group most susceptible to the disease and most likely lo die from it.”

J u Now Zealand approximately some eleven thousand children have been so treated with beneficial results. It is fell right that this means of defence should l)i> made widely available. Parents should understand that preventive treatment for diphtheria, is a most valuable safeguard. It may be carried out bv the family medical practitioner. Where this arrangement is not practical tie. and parents wish to secure ininmnily against diphlherja for their children, they are advised to apply to the local Medical Olheer of Health or the _Sclir.ti| Medical Oflicer for I lie dialled Diamond Otis! Pure oat food, makes children strong. Cooks in one minute.

Wood's Croat Peppermint Cure for Children’s Hacking Cough.

(rid when arrangements will Vic made to have preventive treatment carried out free ol charge. The doctor and Medical Officer of Health are required by law to perform certain duties for the protection of the protection of the community, and it is the duty of parents to comply witti these r.equireiuqiils. The period of exclusion from school of children suffering from diphtheria as iaid down by regulation, is for at least I lu ce, weeks from the date of onset of the disease and until a- certificate is furnished by the medical attendant that the period of isolation prescribed has been completed. The period ol exclusion from school of children exposed to infection (contacts) is (t) if patient treated at home, until disinfection of house has been carried out; (2) if patient removed to hospital, until seven days after disinfection of liou.se subsequent to removal; (3) in either ease, until a certificate of ilea ranee lias been received from an Inspector of Health. Once more, in conclusion, remember that when a child has a sore throat, call in a doctor at once. Delay is dangerous. Many lives have been lost by failure to follow this advice.