For the second, we require (a) sanitary precautions by guardians of public health; (b) observance of rules of personal hygiene by which good health can be maintained.
(1). Wherever possible a medical inspection should be made to prevent importation of the disease. This is, however, a very difficult matter, and one unforeseen difficulty was experienced at Sukkur, where it was found that people booked to stations short of Sukkur, and rebooked at stations on the other side. Still this measure is highly important, and should be carried out most rigorously as long as there is any chance of importation of plague into an unaffected country. It is needless to feel the pulse of the patient; his gait, temperature, and look would afford a great deal of information. Information should be obtained from where the patient is travelling. An examination should also be made of clothes. Dirty clothes, soiled linen and rags should not be allowed to pass through an inspection post.
(2). There should be a disinfecting or sterilizing room fitted with a steam sterilizer in all large railway stations, where all goods should be disinfected. Mail bags should also be subjected to this disinfection. Transmission of such goods as corpses, used clothes, rags, waste paper, fur, hide, feather, and fish should be entirely suspended.
(3). If quarantine is imposed, it should be for a period not less than ten days. Every arrangement, however, should be made for suitable accommodation and sanitation in quarantine camps. In a quarantine camp new arrivals should not be mixed up with those who are already in quarantine.
(4). Ships from infected ports should be carefully watched. If any infection is discovered, then isolation of the sick, disinfection of the ship and quarantine are required, but ships with clean bills of health, and if ten days have passed since its departure from the infected port, may be admitted after medical inspection. It must, however, be borne in mind that rats could easily carry infection from one port to another without any fear of detection. These facts show that medical inspection and quarantine may be useful, but they can never be perfect, and therefore the principal safeguard of a place lies in the improvement of its sanitation, and therefore greater attention and energy should be directed towards it.
Sanitary Measures that should be taken by Municipal and Railway authorities.
(1). All filth should be removed from the vicinity of towns and villages and burnt, and no filth of any kind should be allowed to remain within an inhabited area for any length of time.
(2). All private and public latrines and public urinals should be cleaned and disinfected daily. All receptacles used for night-soil either in the latrine or for transport should be daily disinfected.
(3). Latrine accommodation, according to the requirements of the population, should be provided.
(4). Drains should be well washed and flushed with a disinfectant solution. In towns where there is an underground sewer, it should be well flushed and ventilated, and a disinfectant solution used for cleaning it. A house-to-house examination should be made to ascertain that all house-connections are properly and efficiently trapped. Deposits in the sewer should be taken out and suitably disposed off after disinfection.