VI. CONTROL OF INFECTIOUS DISEASES. A. Reduction of the incidence of disease. 1. By measures calculated to prevent the exposure of persons to infectious material. (a) Isolation of persons ill with infectious disease during their period of infectivity and of nonimmunes who have been exposed during the incubation period of the disease. (1) Isolation of the ill person serves the following purposes: (a) Destruction of infectious material at its source. (b) Prevention of exposure of patient to other infection. (2) Isolation of exposed persons during the period of incubation is most effective in the prevention of the spread of diseases, such as measles and whooping cough, which are infectious during the early and often unrecognized stages. (3) Isolation, unfortunately, does not eliminate the carriers and mild unrecog nized cases which act as sources for a number of diseases. (b) Social measures. (1) Elimination of overcrowding and promiscuous contact which favors" droplet" infection and gives the carriers opportunity to spread disease. (2) The development in the person of a "social conscience," so that he voluntarily attempts to prevent the spread of even so common an infection as the cold. (c) Use of pure water and food, milk in particular. 2. By measures calculated to increase the resistance of the individual. (a) Building up general well-being. (1) Prevention of anæmia, overfatigue, and exposure to wet and cold. (2) Preservation of normal healthy condition of the nose, throat, and mouth. A. Reduction of the incidence of disease-Continued. 2. By measures calculated to increase the resistance of the individual-Continued. (a) Building up general well-being-Continued. (3) Establishment of a healthy environ ment. (a) Plenty of fresh air and sun shine. (b) Freedom from dust. (c) Avoidance of overheated dwellings. (b) Production of immunity by inoculation when possible. B. Reduction of the mortality. 1. By careful nursing and general care. 2. By prompt and vigorous specific treatment when applicable. C. Such preventive and therapeutic control is made effective by1. An efficient community, State, and Federal health administration, supported by legislation. (a) To require the immediate reporting of all cases of contagious diseases. (See The Notifiable Diseases.) (b) To require satisfactory isolation at home, or in a hospital. (c) To investigate the sources of contagion and take all necessary measures to prevent its spread. (1) Isolation for a suitable period of nonimmune persons who have been ex posed. (2) Prevention of the spread of contagion through food and milk handlers. (3) Provision for medical inspection of schools and playgrounds. (d) To provide for the inspection and sanitary regulation of the water and food supplies. (e) To provide experts in the diagnosis and treat- 2. An intelligent and cooperative public which is— 50850°-21-17 READING REFERENCES VI. The Control of Communicable Diseases, U. S. Public Health Service, Reprint No. 436, 1918. HUBBARD, S. DANA: Infectious Diseases, Their Administrative Control in Different Cities of the United States, Department of Health of the City of New York, Reprint Series No. 35, October, 1915. KERR, J. W. and MOLL, A. A.: Communicable Diseases, An Analysis of the Laws and Regulations for the Control Thereof in Force in the United States, U. S. Public Health Service, Public Health Bulletin No. 62, 1914. The Notifiable Diseases: Diseases and Conditions Required to be Reported in the Several States, U. S. Public Health Service, Reprint No. 501, 1919. PREBLE, PAUL: Public Health Administration, U. S. Public Health Service, Reprint No. 390, 1917. OUTLINE 4. COMMON COMMUNICABLE DISEASES OF CHILDHOOD. The early recognition of infectious disease is important both for the treatment and future well-being of the patient and the protection of the community. A general idea of the common infectious diseases their manifestations, course, and control-will enable the mother, nurse, or teacher to know when to take the first steps for the benefit of the sick child and the protection of his associates. I. THE SO-CALLED " CHILDREN'S DISEASES." A. The eruptive fevers, or exanthemata-measles, German measles, scarlet fever, smallpox, chicken pox. They have in common the following characteristics: 1. The occurrence of an eruption, or exanthema on the skin. 2. No known causative organism. 3. Definite communicability. B. Acute infections of the nervous system: 1. Acute cerebrospinal meningitis. 2. Acute anterior poliomyelitis. C. Unclassified: 1. Diphtheria. 2. Whooping cough. 3. Mumps. A tabulation of the most important facts concerning these diseases is given in Table XXI. TABLE XXI.--Important facts concerning so-called "children's diseases." Onset sudden with fever, Strict isolation of cases TABLE XXI.-Important facts concerning so-called "children's diseases"-Continued. Disease. Cause. Prevalence. Susceptibility. Mode of infection. Period of infectivity Incubation Salient features. Measures of control. be weakness without Carrier problem at Isolate patient during Measles (rube- Unknown. ola). Winter and |