Scarlet Fever

The following rules for the restriction and prevention of scarlet fever have been issued by the Michigan State Board of Health : 1. Scarlet fever 13 believed to be one of the most contagious One attaek usu;illy prevent subsequent attacks. The greatest nuinber of deathsfrom kbUdbeaM are of children under ten years of age. Ailult persons souietlines have the diaMM ; and eveu though they have it in ïnany instanees in a milder tora, yet they may comniunicate the disease in a fatal form to cliildren. The isolation of those miklly sick with, and couvalescent from, scarlet lever is important. 2. Searlet fever is believed to be caused by a special coutagium or poison which may be conveyed, lo persons previously uuaffected by personal contact, by infecteü cloihiiig, rags, hair, or paper, or by any of che discharges from the body oí' a panon aüecled with the disease. 3. The discharges from the throat, nose, and inouth are considered extruinely dangerous, but those from the skin, eyes, t-ars kidneys, and bowels, are also dangerous, and remain so for a considerable time. 4. It is believed that the disease may be comniunicated by a person recoveiing therefrom so long as the usual sabsequeut scaling or peeling of the skin continúes, which sometiines is not completed betore tfae lupse ot suventy or eighty days. The polton may also remain in clothing, etc, for a long üme, possibly foryears, especially it woolen and packed away in drawers or trunks. 5. Filtli, unck'anliness, and imperfect ventllatlon may increusc tlie dauger of spreading the disease. (5. Tlie. interval of Urne which may elapse af ter exposure to the contagium of scarlet lever and dartOg whlcfa a susceptible person so exposed may expect to be takeu sick with the disease, varíes from one to fourteen days. 7. wiuneveia child has sore throat and fever, and especially when this is accouipanied by a rash on the body, the child should Immediately be isolated as eoinpletely as possible trom other members of tlie household, and from other persons, until a physician,has seeu it and delerniined whetlier it lias scarlet fever. All persons knowu to be sick with this disease (even those but niiklly sick) should be proinptly and thoroughly isolated Irom the Dublin. o. f ersons who are attending upon children or other persons suffering irom scarlet fever, and al8o the members of the patient's faiuily, should not mingle with oiher people nor pertnit the enti anee of children into their house. . Plain and distinct notices should be placed on the premises or house in which there is a person sick with som let fever, and no child that has not had the disease should be allowed to enter, or to associate witti persons who do enter such house or room. lu. Children believed to be unintected may be sent uway froni the house in which tliere is scarle t fever to families in which there are no peasons liable to the disease, orto previously disinfected conralescenl wards in hospitals; but in eitlier case they shoulu be isolated trom the public until the expiration of the period of incubation, counting f rom the time of thuir remoyal. 11. lluuseholders and physiciaus must imiuediately give notice of the tirstcase and of every case of scarlet fever, to the heaKh officer or to the board of health, - scarlet fever being plainly a disease "daugerous to the public health,'' within the meaning of the law. 12. Upon receiptof such notice, the local board of health has duties loperforn in tiiking mensures to restrict the spread of the disease, which it is a great violation of public trust for the board to neglect or postpone. The law is very plain as to the nature and the importance of these duties. 14. The local board of health and tlie physiciau in charge of cases of tb. Ie disease sliould co-operate tor lts pestriction. The local board of health should especial It guard against its spread by cases where no physician is employed. 15. The room into which one sick with this disease is placed should previously be eleared of all ueedlessclothing, carpeta, drapery, and other materials likely to harbor the poison of ihe disease, except such articles as areessential to the well-being of the palient, The sick room may have no carpet, or onlypieces which can afterwaid be destroyed. Provisión should be made for the intoduction of a liberal siipply of fresh air find the continual chunge of the air of the iroom without sensible currents or drafts. 17. Ilandkerchiefs, that need to be saved, should not be used by the patiënt; small pieces of rag should be substituted therefor, and after being once used should be nunediately burned. 17. öoiled clothing, towels, bed linen, etc, on reinoval froni the potlent should at once befora removal froni the room, be placed In a pail or a tiib of boiling hot zinc-sohition, made in proportionsasfollows; water, one gallon ; sulphate of zinc, four ounces ; common salt, two ounces. 18. The discharges I rom thethroat, nose, moiith, and trom the kidneysand bowelsof the patiënt should be received into vessels containing chlorinated lime, (commonlv called "chloride of lime") .or sulphate of iron, or the zincsolutiou mentioned in par agraph 17, and in cities 'where sewers are used.thrown into the water-closet,el8ewlicrc the same should 1 bwiod nt uute u least hm net distant from any well, and should not by any means be thrown uto a running streain. nor intoa cesspool orprivy, except after having been thoroughly .disinfected, Discharges froni the bladder and bowels may. be received on old cloths, which should immediately be burned- or disinfected and buried. All vessels should be kept scrupulously clean and disinfected. Discharges from the nose, ears, etc, may be received on soft rags or pieces of cloth, which should immeiatelv be burned. 19. li the iiUendiiig physiclan sliall tliink best for the patiënt, au effort to prevent the spreading of the contagious partióles thrown oif from the skin muy be made by annointing the body with pil, vaseline, etc, as the physician may direct. '20. All ciips, glasses, spoons, etc,, used n the sick-room, should at once on reraoval from the room be washed in tlie zinc-solution ïnentioned in pwagraph 17, and aterwards in liot water, before being used by any other person. 1. Food and drink that have been in the sick room, or otherwise infected with scarlet fever, should be destroyed or buried. H is best that it should not be put in the swill-barrel. ¦¦2. Perfect eleanliness of nurses and attcndants should be enjoined and secured. As the hands or nurses of neeessity becomc liuqueutly contaminated by the "poison of the disease, a {jood supply of towels and bsins,- one coiitainiiig h Ktiution ofchlorinatedsoda (Labaracque's solution(, chlorinated linie, or the dUlnfeetfeg zinc-solution, and auoiher for plain soap and water - gbpuld always be at hand and Inclv QM& 23. Persons recovering trom scarlet lever should be coiiaidereddangerous, and therefore should not attend school, cliurch, or any public assembly, or use any public conveyance, so long as any scaling or peeling of the skin (see paragraph 4), or soreness of the eyes or air-passages, or symptoms of ilropsy remain. A person recovering from scarlet fever .-hould not thus endaiitfcr the public health nor appear in public until alter having taken four times, at intervals of two hours, a thorough bath. The hair should be thoroughly washed. This clennsing, however, should be detened until the physician in charge considerg it prudent. After recovery trom scarlet lever, no persoo should appear in public wearing the same clothing worn while sick with or recovering from this disciise. cxcept such clothing as has been thoioiighly disinfected, and this without regard to the time which haselapsed since recoveiy. Nor should a p isiin trom premises in which tlieie is or has been a case of scarlet fever attend any school, Sunday school, cliurch, or public assembly, or be perinitted by the healtli authoritics or by the school board to do so, until lifter disinfection of such preauMI and of the clothing worn by such person if it shall have been exposed lo the contagión of the disease. 24. The body of the person who has died of scarlet fever should be wrapped in a clotu wet with a zinc solution of doubl the strength stated in paragraph 17, and with as litlle delay as possible be privately buried. 2". In order to prevent attendance at the funeral or vislts at the house, newspaper notices of such deaihs should state that the deceased person dii-d of scarlet feve r. '6. Burial of the dead from scarlet fever should be private, and the body should not be exposed to view. 27. ('lothinir, carpets, curtaln?, furniture and other MIMUUMM that are to be destroyed should be dealt with in a way to avoid conveying the poison to any person In the process; they should not be sitnply thrown away, or iuto some stream or body of water; and if burned should lie completely bxrned and not partly burned and partly uanni'd or dealt witli in a w;iv to spread the poisou of the disease. K. All infectedsubstunces, wliieh are not dcslroyed, should be eitlier thorourhly bolled, subjected to a dry heat of 250 F.', in u dry oven, or be thoroughly exposed to ruines of burnlng eulphur, and afterwards exposed to open air currents forsome days. liooks and turs that have been used or handled by those convalescing from this di-ease are paiticularly liable to convey tlie poleon to chlldren wlio have never had the dtleuse. Greal are should be used to thoroughly disinfect any such articles that are not destroyed; and cantion should be exeroteed before allowiug children who have not had the scailet tever to handle any auch aitieles that have been used by persons Hable to coinmunicate the disease. 29. Aerial di.-intection or funiigation can be completleiy and entlrely eft'eetual only in the absence of living persons, as heat or fumes strong enöngh for the purpose are destructive of human life. This need not deter frotn doing so niuch as is pöltible, without injury to sick peisons, for the puriticalion of the airs of rooms occupied by them- a liberal supply of pure air should be secured; but af ter the death or reeovery trom scarlet fever, the room in which there lias been a case of this distase, the furniture, and oiherconteutsuotto be destroyed, should be thoroughly exposed for several boon to fumigation by btumlng sulphur. and Uien, if possible, it should for several hours or days be exposed to currents of fresh air. 30. VVhen a room and contents are to be illsintected, all articles therein should be spread out so as to exposé the greatest amou"t OÍ surface to tl. e action of the disinfectiuit, and all opeittngl to the room should be closed. SI. Allliough not so active for tbe deslruction of the contagimn m is ralpharoafl acki fías, pure air, in liberal amount, is vcrv iis.-l'iil for tlie (lilutioii of the poison ut tbe dfsease; it bhould be employed tivclv; l)ut with this as wtth otlier procedures for the safety of the anaffected, great care Bbonld be taken not to increase the danger l those already ek, who are usually eudangeied by expoaüra to drafts of cold air, ftud this is especialty true of persons convalesoing froin scarlet fever. 88. DisinfectkHi of a room always neeessitates vacating it, and sonietimcs makes it Impomible to remata n adjoing rooms, therefere In aome cases t seemsessential to have hospital, tent, or other temporary ihoKer for tbe inmatcs of infected bonset, where batliiug, dlsiofection, and washing can be done wbile such houses are being disiufected and put In order. On this subject local boards of health shonld be'consulted, and shoukl be pre pa red to act. ;.. Avoid the special contagium of the dlseaae. This is etpeclally Important to be observed by children and all whose throats are sore frótn any cuuse. Children under ten vean of age are in greater danger of deatta trom scarlet ferer than are adults; but adult persons often get and xprecd the disease, and sometimes die from it. Mild cases In ndults may thus cause fatal eaMt among ehildren. Becauseof these facts itis fiequently dangerous for children to go where adult persons go witli almost perfect safety to themselves. 34. Do not let a child go near a case of scarlet fever. Do not permit any person or animal to come or anything to be brought directly from a case of scarlet fever to a child. Unleaa vour rvioco arr nowien, keep anay trom the disease yourself. If you visit a case, bathe yourself and change and disinfect your clothing before you go where tbere ia a child. :i.". It is probable that the contagium of scarlet fever may retain its virulence for some time, and be carried a long distance in vai ïous substances and articles in which it may have found lodgmeut. While it is not dctinitely proved thal the germa of scarlet lever are propagated in any substance outside the living human or animal body, it is possible that they may be found to be thus propagated. Therefóre, and because the breathing of air laden witu emanalions trom deoaylng metí, or from sewers, cc-s-pools, sipks, and other receptaeles of iilth is believed to eudanger health, great care should be taken to have the house, premiaos, and everything counected with dwt'llings kept clean and dry; to have sewcr-connections well trappcd, and housedrains constantly well ventilated; and to have all carriers of tllth well disinfected. Do not permit a child to enter a privy or water-closet, or breathe the air from I privy, water-clo3et, cess-pool, or sewer into wli'uli non-disinfeeted discharges from pi-rsons sick with aoarlet fever hare entend, nor to drink water or milk which has been exposed to such air. 36. Do not permit a child to ride in a hack nr other cloaed cnrriage In wliich lias been a person siok with scarlet fever, except the vehicle has since been thoroughly disinfected with fumes of liurning sulphur, as gpecifled ín paragrapha '.'! and 30. 37. All Influencet which cause sore iiiruius prouamy lena 10 promote tne taking and spreading of this dlsease. Among cnriditioiis external tO the body liable to spread tcsriet fcyer, perhapa tlie most comnion are: infectod air, inteeted water, and contact icith infected substances or persons. BecaUM of this, and as a mcan9 of leasenlng the dangér of contracting other disciiscs, the following precauUona should ahvays be taken, but more particularly during the piwaleiice of tnyauoh dlseaae a tcarlet fever. 88, Avoid cxposurcto wind and tobrcatliing ("ld, dry :ür; alM llir use of strong rlnegar nr any other article of food wbicli tcnds to make tlie throat raw or tender. 39. Do not wearor liandlc elothtag worn by persons daling their sickness orconvale8cenee froni scarlet furer. 40. Beware Of any person who luis a ¦on tliroat. Do not kiss sucli a penon, nor take the breath of sueli a penon. Do not drink IVom the same cup, nor use anv arlicle tliat has been used by a peraou (lob with tliis disease. 41. Beware of crowdcd assemblies in unventiluted rooms. 'i. Do not drink water wliich lias a bad taita (ir odor, or whielí eoim-s lrniti a souree that rendéis it liable to be Impura, espcri ally if there s a rrason tu bclieve it may contal n aomethinc derlred (rom a persoñ siek wltb searlet fever.