PROPHYLACTIC IMMUNIZATION OR VACCINATION 647 



perfect camp sanitation, and the results in 1911 leave no doubt as to the 

 value of antityphoid vaccination. 



Excellent results have been reported by Spooner, Hachtel and Stoner, 

 and others as to the prophylactic value of typhoid immunization in 

 hospital-training schools for nurses, insane asylums, and other public 

 institutions. 



Recommendations. In view of the satisfactory results obtained in 

 the army, typhoid vaccination is now obligatory on all members of the 

 army and navy corps. Protection of the individual by immunization 

 is the only measure of protection independent of surroundings and 

 effective under all conditions. 



Typhoid inoculation in civilian practice cannot be as wide-spread 

 or as readily performed as vaccination against smallpox, as the prophy- 

 lactic must be administered subcutaneously and more than one dose is 

 necessary. 



1. Our various State and city boards of health should endeavor to 

 educate the laity, and, if necessary, offer the prophylactic free of charge 

 in order to build up a vaccinated community as far as this is possible. 



2. Persons coming in intimate contact with typhoid patients, such 

 as physicians, nurses, and attendants in hospitals, should be immunized. 

 Hospital authorities are justified in making typhoid vaccination ob- 

 ligatory on all applicants for admission to training schools. 



3. All inmates of asylums, homes, and other public institutions 

 under forty-five years of age should be immunized and the State should 

 be ready, if necessary, to furnish the vaccine. 



4. The physician and nurse should urge vaccination upon all the 

 members of a family when there is a typhoid patient among them. 



5. The physician should especially advise immunization of those 

 about to leave their homes for a vacation in some neighboring seashore 

 or mountain resort. 



6. In times of epidemics of typhoid fever the physician should urge 

 vaccination of all over whom he has influence. Thorough vaccination 

 with proper sanitary conditions offers the best hope of eradicating this 

 dreaded disease. 



PLAGUE 



In view of the frightful infectiousness and mortality of plague, 

 prophylactic measures are highly desirable. Extermination of rats and 

 ground squirrels, especially of the former, about the wharves of seaport 

 cities and towns is highly essential, as the disease is transmitted by the 



