ASIATIC CHOLERA (a) Infective Agent.—Spirillum cholerce (b) Source of Infection.—Typical and atypical cases and carriers.
(c) Exit of Infective Agent.—In the bowel discharges and vomitus.
(d) Routes of Transmission.—By direct or indirect contact, by food or water contaminated with excrement or by flies.
(e) Incubation Period.—One to five days, usually three, oc casionally longer if the stage of incubatory carrier precedes the onset.
(j) Period of Communicability.—Usually 7 to 14 days or longer, and until the vibrios have disappeared from the bowel discharges as determined bacteriologically. Chronic carriers are not uncommon.
(g) Entrance of Infective Agent into the Body.—By the mouth to the intestinal tract.
(h) Methods of Control. The Injected Individual.—r. Di agnosis: Clinical manifestations, confirmed bacteriologically.
2. Isolation: In a hospital or screened room.
3. Artificial Immunization: Vaccination is still in the ex perimental stages.
4. Quarantine: Contacts should be detained for five days from the date of their last exposure, or longer if one is found to be a carrier.
S. Concurrent Disinfection: Of the stools and vomitus. All objects probably and certainly contaminated should be infected. Food left by the patient should also be disinfected.
6. Terminal Disinfection: Bodies of those dying from cholera should be cremated if possible, otherwise wrapped in a sheet saturated with a disinfectant and buried in water tight caskets. The isolation quarters should be thoroughly cleansed and disinfected.
(a) Attendants must protect themselves and others by rigid attention to scruplous cleanliness, disinfection of the hands each time after handling the patient or touching articles contaminated by dejecta, the avoidance of eating or drinking anything in the room of the patient, and should be prohibited from entering the kitchen.
(b) The bacteriological examination of all contacts to detect carriers, and the isolation of those found.
(c) Water should be boiled if used for drinking or toilet pur poses, or if used in washing dishes or food containers, unless the supply is protected against contamination, or is treated by chlorination.
(d) Careful supervision of food and drink. When cholera is present only cooked foods should be eaten, while after cooking its contamination either by flies or handling should be prevented.
Epidemic Measures.—The following measures should be em ployed in emergencies.
inspection service for the early detection and isolation of cases; the examination of all persons exposed to cholera in in fected centers for the detection of carriers, with the isolation or control of those discovered; disinfection of the rooms occupied by the sick; and the temporary quarantine detention in suitable camps of those desiring to leave for another locality. These before leaving should be examined bacteriologically to detect possible carriers.