for(;e on smallpox. 183 



once to await fuither developments. Even if the ex[)osure was seven or 

 eight (lays previous, the ])ei'son should be vaccinated, as it may yet 

 modify, if it does not ])revent tlie disease. Jf ihe exposed persons will not 

 be vaccinated then they should be is-olated lor at least sixteen days from 

 the dal(i of last exposure, and then if there are no symptoms or signs of 

 the disease, they may be released after taking a balh and disinfecting 

 llu'ir i)ersons and clothing. 



The attendants on the sick, llio licaKli olliccr and (lie attending physi- 

 cian, should be immediately vaccinated, if n(»t recently successfully vac- 

 cinated. After visiting a smallpox ])ntient, the health officer or physician 

 should have a tlioi-ough change of clothing before seeing any person. The- 

 clothing should be disinfected by fumes of burning sulphur, or by formal- 

 dehyde gas, in a tight room or box, burning sulphur at the rate of three 

 pounds, or using eiglit ounces of a forty per cent solution of formaldehyde, 

 to each ].(I00 cubic feet of air Kj>ace, the exposure to be at least for Three 

 hours. When clianging the clothing, the physician or health officer should 

 have a thorough bath; and disinfect his hands, hair, and beard if any, 

 for which purpose physicians sometimes use a solution of mercuric chlor^ 

 ide, one part to om* thousand of water or cologne. The hands of nurses 

 may perhaps be disinfected by washing in a solution of chlorinated soda. 

 The nose and throat are most liable to harbor the si)ecitic cause of small- 

 pox, and should, as far as possible, be cleaned, gargled and disinfected.. 

 Every used hr.ndkerchief should be carefully guarded until disinfected. 



Disinfection hy the Health Officer. 



The law requires the health officer to disinfect rooms, clothing and 

 premises, and all articles likely to be infected, before allowing their use 

 by persons other than those in isolation. The disinfection should be 

 done with fumes of burning sulphur, or with formalhehyde gas, burning 

 at least three pounds of sulphur, or vaporizing at least eight ounces of a 

 forty per cent solution of formaldehyde for each one thousand cubic feet 

 of air space. This subject is treated at length in the Bulletin on the 

 Kestriction of Smallpox. 



Vaccination and Revaccination. 



The State Board of Health recommends and urges that every local 

 board of health in Michigan should, whenever smallpox is present or 

 threatening, meet promptly and publicly recommend general vaccination 

 and revaccination of all persons not successfully vaccinated within the 

 last five years, and offer free vaccination with bovine virus to all who 

 are not able to pay for the same. It has long been known that smallpox 

 can be prevented or modified by vaccination, and a widespread epidemic 

 can be attributed only to an equally widespread ignorance or willfulness 

 concerning smallpox and its prevention by vaccination. This subject is 

 treated very fully and at length in the document on "Vaccination and 

 Revaccination,— The Prevention of Smallpox," which document is being 

 widely distributed throughout the State. 



Where to Obtain Fresh and Pure Bovine Virus. 



Whenever smallpox is present to any extent, a large number of com- 

 munications are received, asking if the State Board of Health supplies 



