BACILLARY DYSENTERY (a) Infective Agent.—Bacterium dysenterie, all types.
(b) Source of Injection.—Typical and atypical cases and carriers.
(c) Exit of Infective Agent—.In the feces and bowel discharges.
(d) Route of Transmission.—By direct or indirect contact, by contaminated food or water, and by flies.
(e) Incubation Period.—From two to seven days.
(j) Period of Communicability.—During the "dysenteric" period of the disease and until the bacilli are absent from the bowel discharges, as determined bacteriologically. Chronic carriers may develope.
(g) Entrance of Infective Agent.—By the mouth to the intes tinal tract.
(1z) Methods of Control. The Injected Individual.—r. Di agnosis: By clinical manifestations, confirmed by serological tests and bacteriologic examination of the stools.
2. Isolation: Of infected persons until they no longer dis charge the bacilli.
3. Artificial Immunization: Vaccines give considerable im munity. Owing to severe reactions their use is not universal, nor should it be made compulsory except in an extreme emer gency.
4. Quarantine: None.
5. Concurrent Disinfection: Of bowel discharges and all objects soiled therewith.
6. Terminal Disinfection: Thorough cleaning.
General Measures.—i. Rigid attention to personal prophy laxis by the attendants upon infected persons.
2. No milk or food should be sold from premises where exists a case of dysentery, nor should the patient's attendants be food handlers for others.
3. Protection of drinking water by boiling or chlorination, and the safeguarding of the supply from fecal contamination.
4. Protection of food from flies.
We next have to consider hookworm disease or uncinariasis. It is questionable whether hookworm disease is ever spread by contact, hence its inclusion in this group is not proper. How ever it does have one characteristic common to all other dis eases of this group, inasmuch as its infective agent leaves the body in the feces. Hence its consideration here. Hookworm infection is the only helminthic infection widespread in the United States and producing sufficient systemic disturbances to demand detailed consideration.