Investigating, etc., of infectious disease.

Appx. XIX.

     49. Preventive measures.— Disinfection will be carried out as indi-
cated in para. 554. Must be based principally on the early diagnosis
and segregation of cases of consumption.

     General preventive measures include the cleansing of barrack-
rooms in such a manner as to obviate the raising of dust, and the
prohibition of dry-scrubbing, attention to over-crowding or defective
ventilation, especially in tents. Cases of coughs, debility or loss of
weight, especially among Indian troops should be investigated.

TYPHOID AND PARATYPHOID FEVERS.

     50. Spread.— Infection may be carried in a number of ways, either
in food or water infected with the specific micro-organism by acute
or chronic " carriers " or through the medium of flies. Sudden and,
explosive epidemics may be due to water which has been fouled by
sewage containing the specific bacilli; smaller outbreaks and those
developing slowly are more commonly due to contamination of food
or milk.

     About 1.5 per cent. of cases of these fevers continue to excrete
the germ for years after recovering from the disease and while in
apparently perfect health. Many outbreaks have been traced to such
chronic carriers. Cases of these diseases also occur of so mild a nature
that the persons attacked do not report sick. Such cases are potent
factors for infection as they may distribute the specific germs broad-
cast.

     51. Preventive measures.— Disinfection will be carried out as indi-
cated in para. 554. The chief preventive measures consist in protective.
inoculation and in the discovery and isolation of the carrier and the.
undetected case. With this object in view all cooks, water-carriers,
dairy men and bakers will have their stools bacteriologically exam-
ined before enlistment. Dates of examination of all cooks and
cookmates will be available for inspection in cookhouses, etc.

     No one who has suffered from typhoid or paratyphoid fever or who
is proved to be a " carrier " will be employed in the preparation or
handling of food or drink.

     Food which is stored before issue should be adequately protected
from flies and dust; milk and butter must be especially safeguarded,
the former being a favourable medium for the growth of germs. The
safe disposal or destruction of excreta is of particular importance.

     52. Classification.—(a) The classification of the Enteric group of
fevers is as follows:—

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