ACUTE POLIOMYELITIS. 309 



the appearance of paresis and one from the blood of a paralyzed child. 

 Only in one case (from a monkey) did the infection succeed. This, of course, 

 argues against the possibility of infection by any blood-sucking insect. 



Because of the gastro-intestinal symptoms the possibility of it being car- 

 ried by foodstuffs and milk is apparent. No outbreak of Poliomyelitis has 

 been associated with milk, water, or any article of diet. Landsteiner and 

 Levaditi have shown that milk and water which were inoculated with the 

 virus remained infective for a month. Kling and Levaditi could not, how- 

 ever demonstrate the presence of the virus in milk or water used by families 

 that were suffering from the disease. Breast nursed children aiso suffer from 

 Poliomyelitis. 



Infantile paralysis is considered by some to be a dust-borne disease and 

 this is very probable when we recall the fact that the virus is resistent to 

 drying. The best evidences of this are the very interesting experiments of 

 NeustJider and Thro Avho succeeded in infecting monkeys by means of 

 filtered extracts of dust collected from rooms in which patients had poliomye- 

 litis. This experiment demonstrates the presence of the virus in the dust 

 of the sick-room. 



It was also suggested that poliomyelitis may be spread by some of the 

 lower animals for it was noticed that domestic animals (horses, dogs, pigs, 

 chickens) suffer from nervous diseases during poliomyelitis epidemics. In 

 the eases reported we are not sure that rabies was excluded. In as much 

 that the lower animals except the monkey and certain species of rabbits 

 cannot be infected with the virus it is strong evidence against the theory 

 of transmission by such animals. Flexnor, Lewis, Clark and Richardson 

 could not by experimental methods transmit the affection suffered by the 

 domestic animals and in all probability there is no connection between these 

 diseases. 



The manner in which the disease makes its appearance seems rather 

 uncertain. Consequently specific methods of prophylaxis are difficult. In 

 the present state of our knowledge the only thing that can be done is to fight 

 the disease from every possible avenue of infection. 



The patient should be isolated and other members of the family should 

 be kept under quarantine for four to eight weeks. Above all children from 

 such famihes must not be allowed to go to school. It may be advisable to 

 close the latter and other places of assembly for children during epidemics. 



Persons who have been directly exposed to poliomyelitis should be kept 

 under observation for a period of two weeks. 



Traveling in or out of infected areas especially children should not be 

 permitted and unnecessary contact with persons known to have come from 

 infected regions should be avoided. 



Secretions and excretions of the nose and intestines of patients should be 

 carefully disinfected. Local application of disinfectants may be applied 

 to the nose and mouth regents. 



