Page:Acute Poliomyelitis.djvu/132

 CHAPTER IX

Prophylaxis and Therapy

As a logical consequence of the doctrine of the infectivity of Heine-Medin's disease physicians and public authorities should enforce the same regulations for the prevention of this as for the prevention of other acute infectiouFmaTadies ; e. g., isolation of the patient, disinfection, etc. Isolation is almost insuperably difficult to attain. Not only the paralytic, but also the abortive cases, and the healthy virus agents need to be segregated. To the last two categories we possess no guides comparable with those we can utilize, for instance, in diphtheria, cerebrospinal meningitis and other contagious diseases. Hence, effective isola- tion practically cannot be accomplished. Under such circum- stances we can only warn those suspected of being either abortive cases or virus carriers of the menace they may be to the com- munity. Schools ought to be closed for several weeks. Isolation of the patient seems not to be essential, for experience has taught us that infection is seldom direct. The patient may, however, become a source of virus carriers and to guard against this possi- bility isolation is desirable. Isolation hospitals are the best means of segregating such cases, but the present custom of admitting fresh cases among others seems to me to be bad. We have no exact information yet concerning the isolation time necessary. According to Ed. Miiller it Is eight weeks. Most physicians in the Swedish epidemic were content with three weeks. At present we cannot, however, make any positive pronouncement on this point. Obviously an attempt must be made to destroy the in- fecting germs, even although we are still in the dark concerning them. Experimental poliomyelitis in monkeys has shown that we may deem the intestinal and nasal mucosae and the salivary glands as excretory channels for the virus. It is therefore advisable at least in the early stages to disinfect the intestinal and nasal discharges. Flexner and Lewis found that one per cent, solution of hydrogen peroxide destroys the virus; such a solution may be