(13). If plague breaks out, then isolation of cases is a great necessity. When practicable, such isolation may be done in the house of the patient. The patient should be kept in a separate room apart from those where other inmates of the house live. A temporary room could be put up on the roof of a house or in the compound, if there is any, or a tent may be pitched. Where possible, all healthy inmates of the house should at once remove themselves in camp leaving only such near relatives who must attend and nurse the patient. For patients living in lodging houses, or, where there is no means of such isolation as stated above, segregation in special isolation hospitals should at once be done. The isolation hospitals should be separate for each of the following classes—(a) for lower class people; (b) for middle class people; (c) for such people of the middle or upper class who may chose to pay for their expenses. It is needless to say that there should be special hospitals for women, where only female attendants and nurses should be employed. Hospitals should be provided with means for free ventilation, both for the sake of patients as well as attendants. No other disease requires more careful nursing than the plague, therefore ample nursing staff should be provided. The hospitals should have a separate observation ward and a separate convalescent ward, and by no means doubtful cases should be mixed up with confirmed cases. Disinfecting apparatus, sterilizers, good water supply and special laundry are other adjuncts essentially necessary for a plague hospital. Greatest care is required in the management of such a hospital, and only trained men should be employed.
Suitable means for ambulance should be provided, and should be had ready within convenient distances. They should be thoroughly disinfected after the conveyance of any case. Ambulance carts or doolies should be comfortable, for physical exertion and exhaustion, attending a long journey in the early stage, greatly compromise chance of recovery.
Burial within inhabited areas of a town or village should be stopped. Dead bodies should be removed under strict precautions for disinfection and disposed off quickly. Bodies should be buried deeply—4 to 6 feet.
PRIVATE HYGIENE.
I. Houses and compounds, stables, kitchen and outhouses should be thoroughly cleaned, and they should be whitewashed with lime. Air-tight dustbins should be kept in the house.
II. Rooms, specially bed-rooms, should be well ventilated, attention should be paid to the condition of the floor, which should not be damp, and care should be taken that rats may not infest the house and spaces under the floor. If dead rats are found in the house, they should be removed and burnt, and the place thoroughly disinfected.
III. House drains should be cleaned and well flushed with a disinfectant solution.
IV. Nowhere in the house or compound should any kind of organic refuse be allowed to accumulate. Better not use any organic manure in the kitchen garden or house garden during an epidemic.
V. Articles of food should not be allowed to remain uncovered on the table or elsewhere, for there is chance of their infection by flies, mice, or rats.
VI. Clothes received from the dhoby’s house should be again boiled in water, dried, and then used.