—"The cleansing and disinfection of the person includes washing the entire body and the hair with soap and water; thorough brushing of the teeth; rinsing the mouth; gargling the throat, and douching and spraying the nose with an antiseptic solution; and finally, a complete change of clothing (or a change of underwear) and a thorough shaking and brushing of the outer garments out-of-doors before these are put on again."—(New York State Department of Health.)
Termination of Quarantine.
—After the patient has recovered, he and the attendant should, if the doctor thinks it necessary, disinfect themselves as directed above before they mingle again with other people. The exact time when it is safe for a person to come out of quarantine and resume ordinary life varies in different diseases. Moreover, opinion differs in regard to quarantine periods for the same diseases, so that the regulations of Boards of Health in different cities show wide variations. It is of course impossible to say at just what moment every patient, or even the majority of patients, will stop expelling
germs. Quarantine periods are intended to protect the community as completely as possible without causing unnecessary hardship to individuals. In any given case, the local regulations should be strictly observed but release from quarantine is not a guarantee that the patient is not still discharging germs, and extreme care should still be taken to prevent the spread of saliva and other discharges.
Terminal Disinfection.
—A room that has been occupied by a patient with a communicable disease should be thoroughly cleaned at the termination of the illness. Dishes, utensils, bed linen, etc. should be cared for in the ways already described. The floor, bedstead, and other furniture should be washed with hot water, soap, and washing soda. The walls, windows, etc., should be wiped with a cloth wrung out of hot water, soap suds, and soda. The mattress, unless badly soiled with discharges, should be scrubbed with the same solution and a stiff brush, and left out-of-doors in the sunshine for a day or two, or until dry. If badly soiled, it is best to destroy the mattress unless the Board of Health has facilities for steam sterilization. Ordinary washing is all that is generally required for blankets, but if badly soiled they should be sterilized by steam or burned. The room should
then be thoroughly sunned and aired for a day or two, with the windows wide open both day and night. Sunning and airing are among the most important measures in disinfecting a room, and should not be slighted. If there has been gross pollution, as when a careless consumptive persists in spitting on the floor and walls, it may be necessary to remove the old paint and paper and have the room done over. The room may safely be occupied after all these measures have been taken.
Fumigation.
—Many Boards of Health have abandoned fumigation after communicable diseases, except after those which like typhus and yellow fever, are carried by vermin or insects. Dry formaldehyde gas, which was formerly used for fumigation, has a violent effect on mucous membranes, but its power to kill bacteria, even on surfaces, appears to be weak, while its penetrating power is not sufficient to disinfect bedding, carpets, upholstered furniture, and other fabrics. Since fumigation is costly, troublesome, and ineffectual there seems to be no good reason for using it. Moreover, its use gives a false sense of security, so that really effective measures like sunning, airing, and scrubbing are likely to be neglected.
Theory and practice of disinfection, it is clear,