INFECTION AND CONTAGION.--These words are often used in such a way that a
wrong impression is made. A disease may be infectious but not contagious.
Malaria is an instance. Infection means an ability to enter the body from
any source, wind, water, food or other persons and produce a
characteristic disease. The agency doing this is known as a germ.
Contagion is properly a poisoning of one individual from contact with a
diseased individual in some way known or unknown. It may be conveyed
indirectly through clothes, etc., or other person; but always comes from
some person sick with the same disease. Diseases may be both infectious
and contagious. Nearly all the epidemic diseases of infancy are both
infectious and contagious and accompanied by fever. In nursing children,
suffering from infectious diseases the mother or nurse should avoid their
breath and handle them as little as possible. All secretion from bowels
and kidneys should fall in a vessel containing a disinfecting solution of
Copperas, bichloride of mercury, etc., and should be emptied into the
sewer or buried. Following are the solutions as made. Copperas:--Put a
lump as big as a walnut in the chamber with one-half pint of water, to
receive feces, urine, sputum and vomited matter from infectious and
contagious patients.
2. Solution of chlorinated soda, four fluid ounces; water ten ounces,
useful for hands and dishes, not silverware. Dissolve eight corrosive
sublimate tablets, also called bichloride, in a gallon of water. This is
used to disinfect floors, woodwork, rubber, and leather, but not metal
parts. Great care must be taken to have the hands washed after handling
such a patient, so as not to infect the food, eyes, mouth, or any small
skin sores.
[INFECTIOUS DISEASES 167]
Diet in Infectious Diseases.--Foods that can be used: Milk, milk-water,
milk and lime-water, Mellin's food, malted milk, imperial granum, albumin
water, rice water, oatmeal water, barley water, egg (white part), and
barley water, arrowroot water, whey, whey and cream mixture, cream and
rice mixture, beef tea, beef extract, mutton broth, beef juice. Chewing
broiled steak and only swallowing the juice, dry toast and soft boiled
eggs, milk toast, dried beef broth, soups, rice, cornstarch, tapioca, etc.
The diet must not consist of solid food in any severe case of fever. Small
quantities of cold drinks can be given, frequently repeated if there is no
vomiting. Frequent washing with tepid water or cool water lessens the
fever and produces sleep. The bowels should be kept open at least once a
day, and castor oil or salts usually can be given. (See Nursing and
Dietetics department.)
Table of Infectious Diseases.
Date of
characteristic Whole
Incubation lasts symptom. duration.
Mumps 7 to 20 days 1st day 7 days or less
Whooping Cough 2 to 7 days 7 to 14 days 2 months
Diphtheria 1 to 12 days 1 to 2 days 1 week to 1 month
Erysipelas 2 to 8 days 1 to 2 days 1 week to 3 weeks
Varioloid 10 to 13 days 1 day 1 week to 3 weeks
Chicken Pox 12 to 17 days 1 day 4 to 7 days
German Measles 1 to 3 weeks 1 day 3 to 4 days
Measles 12 to 14 days 4 days 7 to 9 days
Scarlet Fever 1 to 7 days 1 to 2 days 7 to 12 days
Typhoid Fever 1 to 14 days 7 to 8 days 3 to 5 weeks
Smallpox 10 to 14 days 3 to 4 days 2 to 4 weeks
SCARLET FEVER. Definition.--Scarlet fever is an acute infectious disease,
with a characteristic eruption.
Modes of Conveying.--The nearer a person is to a patient the more likely
one is to take or convey the disease. Clothing, bedding, etc., may retain
the poison for months. Scales from the skin of a patient, dried
secretions, the urine if inflammation of the kidneys (nephritis) exists,
the discharges (feces) from the bowels, are all means of infection. The
longer a person remains near the patient the more likely he is to convey
the disease. Foods handled by those sick of the disease, or by those who
may have been near patients may convey the disease. This is especially
true of milk. Epidemics of scarlet fever have been started by dairy-men
who had scarlet fever in their family. I once attended a family where the
only known cause for it in that family was a long-haired dog of a neighbor
who had scarlet fever in the family. The dog was in the room with the sick
ones, and visited the neighbor's family and played with the children who
afterwards came down with the fever. Discharges from the ear, caused by
scarlet fever, are said to be capable of giving it.
[168 MOTHERS' REMEDIES]
Remains in the Room, how long?--It may remain for months in a room, and
extend over two years as recorded by Murchison. We do not yet know how the
poison obtains entrance to the body. Hence, the need for thorough
disinfection.
Age, Occurrence, Susceptibility.--All children exposed to the disease do
not contract the disease. It is less contagious than measles. A person who
is exposed once, and does not take it, may take it at a future exposure.
It occurs at any age and in all countries. It occurs oftener in autumn
(September) and winter (February). Isolated cases occur, and then it is
called sporadic. This disease attacks nursing children less frequently
than older children. It is not often seen during the first year of life.
How Often?--As a rule, it attacks a person only once; yet there are
recorded cases of well observed second and third attacks, but fortunately
these are very rare. I once attended a family where they had it and
claimed to have had it before, but very lightly.
Incubation.--The vast majority of cases develop within three to five days
after exposure. If eleven days elapse without the appearance of symptoms
we may reasonably expect that the danger is past, at least in the great
majority of cases exposed.
Contagiousness.--There is danger of catching the disease during the stages
of incubation, eruption and scaling. It is most contagious in the last two
stages.
Onset.--Sometimes the onset is sudden; there may be a convulsion, preceded
by a sharp rise in the temperature. An examination in such cases may
reveal a marked sore throat or a membranous deposit on the tonsils
preceding the eruption, and nothing more. A chill followed by fever and
vomiting ushers in a large number of cases. These may be mild or severe.
The severity of these symptoms usually indicates the gravity of the
attack.
Rash.--The rash or eruption appears from twelve to thirty-six hours after
the onset, usually on the second day, and looks like a very severe heat
rash, but is finer and thicker. It consists of a very finely pointed
rose-colored rash. In mild cases it is hardly noticeable. Usually it first
appears on the upper part of the chest around the collar bones, spreads
over the chest and around upon the back. Also it is now seen on the neck,
beneath the jaw, behind the ears and on the temples, thence spreads over
the body. There is a paleness about the mouth and wings of the nose, while
the cheeks are flushed with a flame-like redness. There is much itching if
the rash is severe. It attains the full development at the end of two or
three days, and then gradually declines. In some cases the rash is seen
only twenty-four hours.
Fever.--The fever rises rapidly in the first few hours to 104 or 105-8/10
degrees. It remains high except in the morning, until the eruption reaches
its full development and falls with the fading eruption, and in
uncomplicated and typical cases, within six days becomes normal.
[INFECTIOUS DISEASES 169]
Sore Throat.--This we find on the pillars of the fauces, uvula, tonsils,
and pharynx, reddened and inflamed. Sometimes it is very severe, and a
membrane comes on one or both tonsils and pillars of the fauces. There is,
generally a severe sore throat, and this makes swallowing difficult.
Tongue.--The tongue is covered with a coating at the onset, and may
present a slightly reddened appearance at the borders and tip. The
papillae are prominent and covered and look like a strawberry sometimes,
or like the tongue of a cat. In fatal poisonous cases it becomes dry and
cracked.
Scaling.--As the disease subsides the outer layer of the skin dries and
peels off. The extent of this depends upon the severity of the attack. In
some cases the scaling is hardly perceptible, and sometimes it appears
only on certain parts, such as on the toes and inner parts of the thighs.
There is always some scaling. This is called "desquamation." Generally
speaking, scaling begins where the eruption first appeared on the upper
part of the chest and neck. The scales may be fine and branny or as is
most common, the skin peels in large particles. Some scaling is always
present. The length of the scaling time is variable. It usually lasts from
three to four weeks, but often longer. This stage is considered by many as
the most contagious, as the fine scales fly in the air.
Complications. Nose.--The nose is affected at the same time if the "sore
throat" is very severe. A membrane may also form in the nose.
Ear.--This may be affected in as high as one-fifth of the cases and needs
careful watching and attention. Both ears may be diseased and deafness
frequently results from it. Ten per cent of those who suffer from
"deaf-mutism" can trace their affliction to scarlet fever. The ears
usually become afflicted in the third week. The fever rises and there is
pain in the ears or ear. The onset may not appear alarming and not be
suspected until the discharge makes its appearance This is unfortunate;
these complications are serious, as meningitis and abscess of the brain
may result. The ear trouble (otitis) usually occurs during the scaling.
The patient may be up and around. There is a rise of the temperature to
103 or 104 degrees, the patient begins to vomit food and has a headache.
At night the child starts from its crib and cries as if in pain. They do
not always locate the pain in the ear. The face and hands may twitch. The
fever may fall to normal and rise sharply again. Such symptoms should call
for a thorough examination.
Eye.--Inflammation of the (conjunctiva) red membrane of the eyes, often
occurs.
[170 MOTHERS' REMEDIES]
Kidneys.--There may be a mild form of inflammation in the earlier stages.
The severe form comes, if at all, usually in the third week. It occurs in
five to seven per cent of the cases. It may occur in the mildest case, as
such cases are not so closely watched. The first symptom is a slight
bloating of the eyes and face and spreads over the whole body. Sometimes
the swelling is very slight; at other times it is extreme. The urine
diminishes early and sometimes is wholly suppressed. It may be light
colored, smoky or straw colored. This trouble usually runs for weeks. The
patient may get uremia and result fatally.
Heart.--This also may be affected as the valves may become diseased.
Joints.--Rheumatism also may occur, and other complications.
Chorea.--Follows scarlet fever also, especially in girls from twelve to
fifteen years.
Diagnosis.--In most cases it is easy to distinguish from other diseases.
Dermatitis, inflammation of the skin ("Itis" always means inflammation).
In dermatitis the throat symptoms and strawberry tongue are absent.
From Measles.--By the rapid onset, absence of cold symptoms of the nose,
eyes, and bronchial tubes, blotchy eruptions that occur in measles. There
is no strawberry tongue in measles and no coughing at beginning.
Recovery.--The prognosis is favorable in uncomplicated cases. It also
depends upon the character of the epidemic type of the disease. In England
it varies from thirteen to fourteen per cent. In this country it is
sometimes as low as two to four per cent. The kidney trouble is always
feared for it may result in uremia and death, or the acute may be followed
by chronic nephritis or Bright's disease, which will ultimately prove
fatal.
Sanitary Care of Room and Patient.--If you are exposed to this disease
what can you do? If a child, it must be put in a room by itself. If
several children have been exposed they should be put in separate rooms.
These rooms should have no carpet, curtains, rugs, etc., or any
unnecessary furniture, for everything must be disinfected afterward, and
sometimes destroyed. The clothes worn just before the sickness should be
sterilized in steam or boiled and then aired in the sun. Anyone suffering
from sore throat who has been about the patient should not be allowed to
be near the healthy. All the children must be kept from school. It is well
for them to spray their throats with a simple cleansing solution morning
and night, with a full teaspoonful of boric acid to a glass full of warm
water; or you can use common salt, but not strong enough to irritate the
throat, about one teaspoonful to a glass of water. If you have listerine
or glyco-thymoline or any such disinfectant use them, one teaspoonful to
sixteen spoonfuls of water. Hot water itself is a very good gargle, very
healing and cleansing. Anyone who enters the sick room and comes out again
should wear a sheet all over him. On coming out, he or she should leave
this sheet outside the window of another room. If the person has a beard
he should wash his face with a 1 to 2000 solution of corrosive sublimate,
and the hands also, before leaving the sick room. The one who waits upon
the sick one should remain there, but everyone can not do so. They must
stay away from the healthy if possible.
[INFECTIOUS DISEASES 171]
City and State Supervision.--If you live in the city your physician should
notify the health board who will probably send someone to instruct you
regarding cautions and some cities have private rules, laws, etc., for
them to follow while under quarantine. A copy is usually furnished also to
your close neighbors. Also some of the state departments of health have
made up pamphlets which are circulated free on request dealing with the
sanitary science of infectious and contagious diseases. Some colleges use
these same pamphlets in their study of sanitary science. Much valuable
information is contained in them. Comparatively few people learn of these
pamphlets. For the benefit of those who have not read or seen them we
quote from their scarlet fever subjects as follows: