The term quarantine was originally applied to the forty days during
which a ship suspected of being infected with a contagious disease was
held before those on board were allowed to come into contact with those
on shore. In present conditions a better term to use is isolation which
varies in length and severity in different diseases. The period of
isolation in diphtheria is until the person is free of the germs which
cause the disease. As it is possible to cultivate and recognize the
diphtheria germs the period of isolation can be accurately determined.
At times it is only a few days; at other times it must be extended to
weeks or even months. In the case of scarlet fever and diphtheria the
attendant who is liable to carry infectious materials is isolated with
the patient.
In scarlet fever the isolation is four or five weeks and until all
discharges have ceased. Discharges from the nose and ear after
scarlet fever are apt to contain the cause of the disease, and so are
dangerous. Epidemics of scarlet fever have been started in communities
by the coming of a child who still had a running ear following scarlet
fever many weeks previously.
The danger of transferring measles is quickly over, and patients may be
released after the fever has been absent two or three days.
In chicken pox the separation of all scabs is the measure of the
isolation period.
Whooping cough is released when the characteristic paroxyms cease.
If measles or whooping cough appears in a child in a family, other
children may be sent from home in hope that they have not been
infected. They must not be sent where there are children who may be
infected if the disease develops.
In diphtheria and scarlet fever the separation of the sick must be
absolute. No communication must be allowed between the sick and well.
The patient and attendant should be in a separate building, or in
a room which can be shut off from the rest of the house. Nothing
should pass from the sick room that is not sterilized at once. All
discharges should be collected on pieces of gauze, and these with
surgical dressings, portions of food, fruit or other material which
the patient may have handled may be placed in paper bags and burned
without opening. All sheets, towels, pillow covers and bed clothes
should be boiled in water before being washed. The same disinfection
should be used for eating utensils. After recovery the patient and
attendant should be given a thorough bath in warm water with soap. The
hair also is washed. In a clean room fresh clothing is to be put on.
After the isolation room is emptied of its occupants all its contents
are disinfected as thoroughly as possible. This can be accomplished by
boiling everything which can be treated in this way, by burning things
which have little value and which cannot be boiled such as books,
toys, mattresses and pillows contaminated by secretions, by thoroughly
washing with warm water and soap all wood work, floors and furniture,
and by thoroughly airing and sunning the bedding. The fumigation which
was formerly generally used has been largely discontinued. Much more
can be accomplished by washing, painting, and removal of paper and
replacing by new. A safe rule is to burn everything which can not be
boiled in water or thoroughly cleansed with warm water and soap. Fresh
air and sunshine are most efficient destroyers of germs. Children
recently relieved from isolation after diphtheria and especially after
scarlet fever should not sleep with well children for a week or two,
and should not be kissed.
The disinfection required after measles, whooping cough and chicken pox
is limited and consists of thorough airing and sunning.
It is not desirable to confine children with whooping cough. They
may be taken out of doors, but must not be allowed to play with well
children. Diphtheria carriers may also be allowed to be out of doors
provided provision is made for keeping them from well persons. Their
eating utensils, toys, etc., must always be treated as are those of
persons with active diphtheria.
The closing of schools at the times of outbreaks of the contagious
diseases is of doubtful value. It does not prevent contact between the
children when at play. Most favorable conditions for dissemination of
contagious diseases exist in Sunday schools since children too young to
attend school as well as older children are here brought together. If
closing of schools is to accomplish any good in controlling contagious
diseases it must be combined with separation of the families of
children at home, and the prevention of children coming together in
picture shows and other places.
It is hardly necessary to state that no child who is acutely sick
should be sent to school. So many contagious diseases are impossible
of recognition at the beginning that each case of sickness must be
considered suspicious until it is shown to be harmless.