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INFECTIOUS DISEASES.

PERIODS OF INCUBATION, QUARANTINE AND INFECTION, AND SOURCES OF INFECTION.

The following summary is condensed from Dr. L. F. Parkes's recent "Handbook of Infectious Diseases," and will be found very useful to boards of health and sanitary officials for reference, as well as to general practitioners of medicine:

DIPHTHERIA.

Incubation period: least unknown; average, 2 days; greatest, 7 days.

Quarantine period: 7 days from last exposure to infection.

Infective period: from the beginning of symptoms, for the whole period of illness.

Sources of infection: 1. From a previous case, acute or convalescent. 2. From a case of apparently simple tonsilitis. 3. From a case of apparently simple nasal ulceration or ozæna. 4. From domestic animals (cats, pigeons, or fowls) suffering from a throat affection of a diphtherial nature. 5. From cows' milk, by human infection of the milk in cow-sheds and dairies, etc. 6. From fomites, that is, infected bedding, clothes, carpets, curtains, books, toys, cups, spoons, forks, etc. 7. From a person who has been in contact with a diphtheria patient, but who has not himself contracted the disease. 8. From defective sanitary conditions; these are probably merely predisposing causes engendering morbid conditions of the tonsils favorable to the growth of diphtheria contagion when implanted thereon.

SCARLET FEVER.

Incubation period: less than 24 hours; average, 1 to 3 days; greatest, 7 days.

Quarantine period: 7 days from last exposure.

Infective period: from earliest appearance of symptoms, till all desquamation has ceased.

Sources of infection: 1. From a previous case of scarlet-fever, acute or convalescent. 2. From a case of sore throat without discernible rash, but merely a mild form of the disease. 3. From cows' milk, either by human infection of the milk in cow-sheds and dairies, or during the milking, or from a diseased condition of the Cows. 4. From fomites. Infection may be carried by persons who are not themselves sufferers, if they have been in contact with patients.

MEASLES.

Incubation period: From exposure to infection to onset of illness; least, 4 days; average, 9 to 10 days; greatest, 14 days. From exposure to infection to appearance of rash: least, 7 days; average, 14 days; greatest, 18 days.

Quarantine period: 15 days from last exposure to infection.

Infective period: from earliest appearance of symptoms till convalescence is well established. The catarrhal stage preceding the eruption is very infectious.

Sources of infection: 1. From a previous case of measles. 2. From fomites.

MUMPS.

Incubation period: least, 14 days; average, 21 days; greatest, 25 days.

Quarantine period: 25 days from last exposure to infection.

Infective period: from onset of prodromal stage for 2 or 3 weeks subsequent to appearance of parotitis. The chance of infection diminishes progressively from the onset of the disease.

Sources of infection: 1. From a previous case. 2. From fomites.

GERMAN MEASLES.

Incubation period: least, 5 days; average, 18 days; greatest, 21 days.

Quarantine period: 21 days from last exposure to infection.

Infective period: from onset of prodromal stage to cessation of desquamation.

Sources of infection: 1. From a previous case. 2. From fomites.

INFLUENZA.

Incubation period: less than 24 hours; average, 3 to 4 days; greatest, 5 days.

Quarantine period: 5 days from last exposure to infection.

Infective period: from earliest onset of symptoms till convalescence is well established.

Sources of infection: 1. From a previous case of influenza. 2. From fomites.

WHOOPING-COUGH.

Incubation period: least, 7 days; average, not determined; greatest, 21 days.

Quarantine period: 21 days from last exposure to infection.

Infective period: the whole period of illness from onset of earliest catarrhal symptoms.

Sources of infection: 1. From a previous case of whoopingcough. 2. From fomites.

SMALL-POX.

Incubation period: least, 9 days; average, 12 days; greatest, 15 days.

Quarantine period: 15 days from last exposure to infection.

Infective period: from the onset of initial symptoms till all scabs have been removed. The period of greatest infectivity is during the acute stage (vesicular and pustular). During the initial illness, and until the appearance of the rash, the liability to impart infection is not great.

Sources of infection: 1. From a previous case of small-pox. 2. From fomites. Infection can be carried by a person who has been in contact with a small-pox patient, but who is not himself a sufferer from the disease. 3. Proximity to a small-pox hospital containing numerous cases in the acute stage.

CHICKEN-POX.

Incubation period: least, 13 days; average, 14 days; greatest, 19 days.

Quarantine period: 19 days from last exposure to infection.

Infective period: from appearance of eruption till this has completely disappeared.

Sources of infection; 1. From a previous case. 2. From fomites. The infection may be carried by those who have been in contact with the disease.

TYPHOID FEVER.

Incubation period: least, 7 days; average, 12 to 14 days; greatest, 23 days.

Quarantine period: 23 days from last exposure to infection.

Infective period: the excreta are infectious through the whole course of the disease, and until convalescence has been established at least a fortnight.

Sources of infection: 1. From water, food, or air contaminated by the specific virus contained in the excretions of a typhoid-fever patient. 2. From fomites. Infection may exist for several weeks in infected clothing and bedding shielded from exposure to light and air.

TYPHUS FEVER.

Incubation period: average, 7 days.

Quarantine period: 14 days from last exposure to infection. Infective period: from beginning of illness to convalescence. Source of infection: From a previous case of the disease. Fresh air and free ventilation rapidly destroy the virulence of the contagion. Fomites probably do not propagate the contagion.

ASIATIC CHOLERA.

Incubation period: least, a few hours; average, 1 to 2 days; greatest, 10 days.

Quarantine period: 10 days from date of last exposure to infec

tion.

Infective period: from earliest onset of symptoms till complete

recovery.

Sources of infection: 1. From water, food, and air contaminated with the discharge of a person suffering from cholera. 2. From fomites. 3. There is reason to believe that the virus contained in the excreta at the time of leaving the body of a patient, and for a short period afterward, is in a less active condition and more easily destroyed by chemical agents than after such excreta have been exposed for a short time to contact with the air.-Boston Medical and Surgical Journal.

TYPHOID FEVER-CAUSATION AND PRE

VENTION.1

BY PROF. VICTOR C. VAUGHAN, M. D., ANN ARBOR, MICH.

Our country has recently been greatly agitated on account of its threatened invasion by that dreadful scourge, Asiatic cholera. With hearts full of pity, we have read the story of death which came to us day after day from the fairest city of Germany. Every ship which has sailed from the mouth of the Elbe since the middle of last August has been regarded as a possible carrier of a poison more subtile and dangerous than any known to the chemist. Anxiously have we scanned the morning papers, fearing each day to learn that the pestilence had alighted upon our shores. Millions of people have watched the work of the health authorities in New York harbor with blended hope and fear. I am sure that no citizen of this country has felt that the national and state authorities have been too zealous in their attempts to protect us from this plague. No one has complained of the amount of money spent. Every one has felt that no expenditure could be too large if made wisely and successfully. "Let everything be done that can be done, spare no necessary expense." These and similar words doubtless would have expressed the universal feeling in regard to this matter. To-day we all feel that the health authorities should not relax the vigilance, that the next congress should make all needful appropriations, and that every important port of entry should be well supplied with

1Read before the Iowa Public Health Association.

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