TYPHOID FEVER IN THE PHILIPPINE ISLANDS. 117 



PREVENTIVE MEASURES. 



Whenever typhoid fever does make its appearance in a com- 

 munity, steps should immediately be taken to prevent its spread, 

 and in this connection it should ho borne in m.ind that, although 

 a VVidal test should be carried out in all cases, precautionary 

 measures to prevent the spread of the disease should be taken as 

 soon as any case of illness presents symptoms suggestive of 

 typhoid fever. The disease is conveyed in much the same way 

 as cholera, and therefore the measures applicable in the case 

 of that disease may be employed also in combating typhoid. 

 It must be remembered, however, that the organism is not so 

 easily killed as the cholera vibrio and that in some instances 

 it is present for months, and even years, in the stools of persons 

 who have had the disease. The urine and faeces of typhoid 

 patients must be thoroughly disinfected by being placed in a 

 5 per cent solution of carbolic acid, or in a 1 per cent kreso 

 solution ; or, when that is not possible, they should be burned 

 or boiled. A simple method of disinfecting by heat is to put 

 the discharges and body washings into a kerosene tin covered 

 by a wet bag, and place the tin on a fire. The hands of all 

 persons who come in contact with the patient and particularly 

 of those who come in contact with his discharges, either indi- 

 rectly, through the means of his bed clothes, etc., or directly, 

 by handling the vessels in which the discharges are placed, must 

 be disinfected thoroughly after each contact of this kind and 

 always before touching food with the hands. A soapy cresol 

 preparation, such as liquor cresolis compositus, U. S. P., is most 

 suitable for this purpose. 



It has frequently happened that the milk supply of a town 

 has become infected on account of the milk, in its preparation, 

 being handled by someone who comes in contact with the dis- 

 charged matter of a person who excretes typhoid bacilli. The 

 possibility of milk infection should always be considered, and 

 inquiries made as to the source of the milk supply used by the 

 patient, and proper action should be taken when it is found or 

 suspected to be at fault, as the occurrence of several cases hav- 

 ing the same milk supply will at once lead to an investigation 

 of the sanitary conditions under which the milk is produced, 

 stored, or sold. 



Drinking water may become infected by discharges fmding 

 their way into the water supply. This has been reported to 

 have happened on a large scale where a case occurred upon 

 a watershed, the water from which is collected into a reservoir 



