BACTERIUM DIPHTHERIA 99 



Diphtheria is contracted by receiving, on a susceptible 

 surface, some of the bacteria themselves. They usually 

 come from an active case. However, after recovery from the 

 attack, at a time when no symptoms exist, fully virulent 

 bacteria may remain in the throat for many days. People 

 with such a condition are called ''carriers," and strict 

 hygienic measures are being taken now by all health authori- 

 ties to prevent spread of the disease by such means. Cough- 

 ing or sneezing dislodges particles containing diphtheria 

 bacilli and spread the disease. Infection has been known 

 to travel by milk, where the dairyman had a case on his 

 farm. The milk had become infected by those handling it. 

 Nurses and doctors contract the disease frequently by their 

 close association with the patient. They can protect them- 

 selves while inspecting a throat by placing a piece of glass 

 before the patient's mouth, so that if he cough the organisms 

 will not get into the examiner's face. The absolute isolation 

 of patient and nurse is now demanded by health authorities. 

 A case of diphtheria remains infectious while there are 

 virulent bacilli on the inflamed surface; in the throat this is 

 nearly always two weeks or longer. Isolation and disinfec- 

 tion must therefore be kept up for this period at least and 

 when possible until two cultures twenty-four hours apart 

 fail to show the presence of organisms. 



All materials that can be so treated should be burned. 

 Utensils and fabrics should be soaked in carbolic acid solu- 

 tion and then boiled. Great care must be used by the nurse 

 with her hands, face, nose, throat, hair, and clothes. The 

 lodgment of diphtheria bacilli in the hair is of special danger, 

 since they remain active for a long time. To prevent the 

 settling of the bacilli in the hair it is advisable to wear a cap 

 that will completely cover the head. Thorough washing 

 with soap and water and drying in the sun are advisable 

 when the nurse leaves the patient. Since the bacilli spread 

 through the air, sheets wetted with disinfectants should be 

 hung about, particularly at doors. 



