xii, B, 2 Proceedings of the Manila Medical Society. HI 



though generally severe. In general the mortality is low — 4 to 

 10 per cent — but in New York last year it was over 25 per cent. 



To prevent the spread of the disease, all cases and suspects 

 should be reported to the proper health authorities. Immediate 

 hospitalization of all cases should be enforced; if hospitalization 

 cannot be enforced, it should be at least encouraged. The ac- 

 tivity of children should be limited, to guard against the spread 

 of disease through association and contact. If schools have been 

 closed, their reopening should proceed with caution, it being 

 better to begin with those of higher age groups. Cases and 

 persons residing on the premises should be quarantined for at 

 least six weeks from the date of onset; however, individuals 

 over 16 years of age may be moved with proper authorization 

 to other quarters after thorough disinfection of person and cloth- 

 ing, and children may similarly be removed to places where 

 there are no children, provided they are quarantined on the new 

 premises for two weeks and kept under close observation. Under 

 exceptional circumstances wage earners may be released from 

 the above restrictions provided there is no association or contact, 

 direct or indirect, with the cases. Children should be excluded 

 from school for two weeks after the raising of quarantine. 

 Patients should be isolated in screened and bare quarters, and 

 clothing, linen, utensils, and other articles disinfected or burned 

 on removal from the sick room. After removal of the patients 

 the quarters and furniture should be scrubbed and gone over 

 with some disinfectant solution, and carpets, mattresses, and 

 similar articles should be disinfected or, at least, thoroughly 

 exposed to the sun. Animals should be excluded or, if present, 

 be given a disinfecting bath before removal. All faecal and 

 nasopharyngeal discharges should be thoroughly disinfected. 

 Frequent cleansing of the nasopharynx with a weak antiseptic so- 

 lution, such as hydrogen peroxide, is recommended for patients 

 and contacts. Contact between attendants and outsiders should 

 be limited to essentials. Attendants should not handle food- 

 stuffs for others than the patients, and the distribution of 

 milk or foodstuffs from infected premises should be prohibited. 

 A more or less strict control of travel, especially of children 

 under 16 years of age, by regulations governing inspection, 

 quarantine, and certification is advisable. 



The greatest needs to control the spread of poliomyelitis, at 

 least from the sanitarian's viewpoint, are a ready means of 

 diagnosis for all classes of cases and healthy carriers as well 

 and a more exact knowledge of the manner of transmission of 



