be wrung out and put in the wash. Remember, however, that no disinfectant in the occupied sick room can do away with the necessity for abundant fresh air and sunlight. 9. The isolation of the patient should continue for ten days after all trace of the disease has disappeared, and until he has had a disinfecting bath and been clad in garments which have not been in the sick room. No person from a house where there is diphtheria should be permitted to go into public assemblies, and no child from a house where this disease has prevailed should be allowed to attend school without a certificate from the health officer that it is safe to do so. 10. After complete recovery, or death, always thoroughly disinfect the room and its contents, preferably with nascent formaldehyde, or, where this is not availabie, by burning three pounds of sulphur, moistened with alcohol, for each 1,000 cubic feet of space, previously stopping all openings, and dampening the floor, bedding and clothing, and leaving the room tightly closed for twelve hours. The room should then be thoroughly ventilated, and all ledges, woodwork, etc., washed with strong soap and rinsed with a disinfecting solution. 11. In case of death, the body should be wrapped in a sheet saturated in a disinfecting solution and buried without public service. In giving notices of death, newspapers should state that it was from diphtheria, and that children and those having the care of children, should not attend the funeral. 12. To be effective, the precautions herein suggested should be rigidly observed. Imperfect isolation and disinfection are worse than useless, giving rise only to a false and misleading sense of security. 13. County and municipal boards of health have full authority under our laws to enforce these rules, and will fall short of their duty if they fail to do so. Copies of this circular, and of similar ones in regard to scarlet and typhoid fever and consumption, for free distribution, may be had upon application to the Board at Bowling Green. By order of the Board. J. M. MATHEWS, M. D., President. J. N. MCCORMACK, M. D., Secretary. PREVENTION OF SCARLET FEVER. Circular Issued by the State Board of Health of Kentucky. To the Health Officials, Physicians and People of Kentucky: Scarlet fever, scarlatina and scarlet rash are different names for one and the same disease. It is an infectious and dangerous disease, and the mildest case may spread the infection and cause the most malignant cases. Scarlet fever is essentially a disease of childhood, and always results from infection from a pre-existing case. Countries have been free from it for centuries till imported by commerce and trade. Owing to its frequency and fatality, it is of far more importance to the people of Kentucky than smallpox, cuolera, or yellow fever. In view of these facts, the great importance of prompt isolation and thorough disinfection to prevent the spread of the disease are beyond question. The following rules have been prepared with care and should be disseminated and, as occasion requires, observed by all interested in the welfare of children: 1. When a child has sore throat, and fever, and especially when scarlet fever is in the neighborhood, it should be immediately separated from others until a competent physician has seen it and fully determined that it is not affected with a contagious disease. 2. If scarlet fever, maintain strict isolation, in an up-stairs room, if possible, however mild the case may be, until the shedding of the skin is compiete and all branny scales disappear, and, afterwards, until the patient has been thoroughly bathed and clad in garments which have not been in the sick room during the illness. As a rule, in Kentucky, children are released from quarantine and permitted to return to school or mingle with other children before it is safe for them to do so. In giving the disinfecting bath, the hairy scalp should receive special attention. 3. Placard the house, and keep all children, all having the care of children, and all going where children are, away from it. It should be borne in mind that the poison of scarlet fever surpasses that of any other eruptive disease in its tenacious attachment. to clothing and other objects, and in its portability to other houses, or even to distant localities. 4. Burn all discharges from the mouth and nose, and disinfect all other discharges from the patient. Burn all refuse from the sick room. All spoons, cups, glasses, etc., used in the sick room should be washed separately from other dishes and should remain some time in boiling water. 5. Disinfect all bed and body clothing, and everything else used in the sick room, before removing it therefrom, by immersion for six hours in a solution of chloride of lime, four ounces to the gallon of water. They may then be wrung out and put into the wash. Remember, however, that no disinfectant in the occupied sick room can do away with the necessity for abundant fresh air and sunlight. 6. After complete recovery, or death, carefully and thoroughly disinfect the room and its contents. To do this, stop all apertures well, dampen the floor and bedding, and use nascent formaldehyde, or burn three pounds of sulphur, dampened with alcohol, for each 1,000 cubic feet of space, leaving the room closed for at least twelve hours. After wards the room should be thoroughly ventilated, and all ledges, woodwork and walls washed with strong soap, and rinsed with the disinfecting solution. This work should be done thoroughly, otherwise it will give only a false sense of security. 7. In case of death, the body should be wrapped in a sheet saturated in disinfecting solution and buried as soon as practicable, without public funeral service. Newspapers, in giving notice of death, should state that it was from scarlet fever, and that children, and persons having the care of children, should not attend. 8. Physicians attending scarlet fever should use a robe, overalls or other protection for his clothing and person; should wash his hands and face before leaving the house, and take every other precaution to prevent him from carrying the disease to others. 9. The law requires that all cases of contagious disease shall be reported to the city or county board of health, by the head of the family or physician, within twenty-four hours. This law should be observed in every case. Copies of this circular, and of similar ones in regard to the prevention of diphtheria, typhoid fever and consumption, will be furnished, for free distribution, upon application to the Board at Bowling Green. By order of the Board. J. M. MATHEWS, M. D., President. J. N. MCCORMACK, M. D., Secretary. HOW TO COMBAT SMALLPOX. Circular Issued by the State Board of Health of Kentucky. To the Health Officials, Physicians and People of Kentucky: Although smallpox has been stamped out over and over again in nearly every county in Kentucky within the last five years, this Board has official information that the disease has again appeared in several widely-separated sections. It is also prevalent in adjoining States, and everywhere manifests a tendency to break over official control and assume an epidemic form. Since January, 1898, smallpox has prevailed, more or less extensively, in every county in this State, with a total of 21,616 cases and 300 deaths, and costing in cash from our county and municipal treasuries as gathered from official reports, the immense sum of $515,775, and an estimated loss from interference with business and travel of $1,227,435. Judiciously expended, this would be much more than enough to keep every person in Kentucky thoroughly vaccinated for a generation, so that the existence of anything but an imported case of smallpox would be an impossibility. |