Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 9 (7).djvu/14

 as long as six months ; this problem is still without a satisfactory solution.

TECHNIQUE OF PASSING THE NASO-PHARYNGEAL SWABS.

Two matters are of prime importance in this connection : — 1. The swab should be as free as possible of contamination with saliva. 2. As the meningococcus readily dies on the swab, it is desirable to make the cultures as quickly as possible, and for these cultures to be got into the incubator as quickly as possible.

With a view to avoidance of contamination by saliva, a special covered swab such as that introduced by West is suitable. The man is seated facing the light. His mouth is opened as wide as possible, and the tongue depressed with a spatula. During phonation the covering tube containing the swab is passed behind the soft palate, and the swab extruded so as to come in contact with the naso-pharynx. The swab is then drawn back into the covering tube and the instrument removed.

PUBLIC HEALTH PRECAUTIONS.

Prevention. — The meningococcus is spread by being carried in the nose and throat of normal individuals, convalescent patients, and patients actually suffering fioin the disease, and is imparted to other individuals by direct contagion.

Such contagion takes place either by actual contact, such as kissing, or by s])raying of the discharges of the throat and nose, as in coughing, speaking, singings and sneezing. The question of preventive measures, therefore, resolves itself into the isolation and treatment of such persons. The average period of time during which a person may carry the active infection in his naso-pharynx is twenty-one days; a fairly trustworthy result should be available in four or five days ; this is a very important result as regards military efficiency, as it means a saving of seventeen days for each contact who has been found positive.

There is also a possibility that the organism might be spread by the contamination of articles of clothing, or of walls and floors by such proceedings as spitting, but the extreme susceptibility of the meningococcus to drying renders such method of spread at least very unlikely. The