Appx. XIX.

Investigating, etc., of infectious disease.

     Children of infected families should be kept from attending school
for 22 days.

PLAGUE.

     32.    Spread.—Bubonic plague is a disease of rodents, and is trans-
mitted to man by means of infected fleas. Epidemics in human beings
are preceded by high mortality in rodents. The spread of the disease
follows trade routes, infected fleas and rats being conveyed in personal
belongings and food-stuffs. Fleas have been shown to be infected for
a period of six weeks.

     Pneumonic plague though caused by the same organism, is intensely
and directly infectious from man to man by means of " droplet "
infection, as in coughing, talking, etc.

     Septicaemic plague also occurs. Diagnosis is sometimes difficult
owing to its rapidly fatal course.

     33. Preventive measures .-I. Bubonic plague.—Systematic rat
destruction, rat proofing of grain godowns and food stores. Evacua-
tion-of rat infested quarters.

     Patients should be isolated, and disinfestation as indicated in
para. 554 carried out at the earliest opportunity, contacts should be
disinfected and medically examined daily for 10 days.

     Men disinfesting or working in infected houses should wear over-
alls fitting tightly at the wrists and ankles, gumboots, gauntlet-gloves
and caps. These should be disinfected and disinfested daily.

     Effective measures for the treatment of quarters are as follows:—

        (a) By burning mealie straw (" patai "): the straw is spread on
                the earth floor to a depth not exceeding 4 inches and is
                then ignited; the resulting sheet of flame, which does not
                exceed 2 feet in height, effectively destroys all fleas.

        (b) Floors may be coated with one of the following emulsions:—

                (i) Hard soap, 1 lb. (or soft soap, 11/2 lbs.) dissolved in hot
                        water, 1 gallon, and made up to 5 gallons by crude
                        kerosene added gradually with continued heating
                        and shaking.

                (ii) Cresol, 5 parts and soft soap, 20 parts, added gradually
                        to 75 parts of continuously-shaken hot water.

        (c) Textiles may be freed from fleas by spreading flat in a tropical
                sun at midday for an hour.

     II. Pneumonic Plague.— Both patients and attendants should
wear masks impregnated with disinfectant. Sputum should be
received in an antiseptic solution and destroyed.

     All attendants should be given 20 c. c. of anti-plague serum imme-
diately, and should be simultaneously injected with plague vaccine,
a second dose being given 10 days later. All cuts and wounds
should be carefully protected.

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