In order to prevent the spread of diphtheria to others it is important
always to recognize the presence of the disease, even in mild cases. In
order to do this the doctor makes a culture from the throat and nose of
the suspected individual. He takes a piece of sterile cotton wrapped
around the end of a thin stick of wire and touches this to the throat
and tonsils, especially where there are patches or membranes. Then he
sends this swab to a laboratory, where cultures are planted from it. The
next day these cultures are examined with a microscope to see if
diphtheria bacilli, the germs which cause diphtheria, are present.
Since the diphtheria germs or bacilli grow on the lining of the throat
and air passages, they are easily thrown out from the mouth and nose of
the patient with particles of mucus or spit when the patient coughs,
spits, or sneezes. But even when the patient talks, especially when he
talks loudly, tiny droplets of mucus or spit are given off. These
droplets may have diphtheria bacilli on them. The same is true of
particles of food, no matter how small, falling from the patient's lips.
Eating utensils such as cups, glasses, forks, and spoons that have
touched the lips of the patient may likewise have saliva on them. When
the patient has diphtheria all these droplets of saliva and of mucus
may, and usually do, contain many diphtheria bacilli. Curiously, some
persons may have diphtheria bacilli in the nose and throat and yet
remain entirely well. Such persons are called "healthy carriers." They
are especially dangerous, because there is no outward sign which will
tell them or others that they are carrying deadly disease germs around.
All who attend the patient must be very careful not to get any of the
dangerous discharges from the patient's mouth or nose on the hands. In
fact, it is important for the attendant always to wash her hands
promptly after waiting on the patient. Besides this, care should be
taken that the germs are not carried to others by the use of eating
utensils, such as cups, glasses, spoons, forks, or plates. All of these
should be sterilized with _boiling_ water after each meal.