The diagnostics and treatment of tropical diseases

by E. R. Stitt

Prognosis

There is the greatest variation in the mortality in different epidemics as is true of most other epidemic diseases. At any rate 50% may be considered an average mortality.

Young children and old people give a very high mortality rate as is also true of alcoholics and those with kidney disease.

Prophylaxis and Treatment

Prophylaxis.—Of all the quarantinable diseases cholera is the one in which personal prophylaxis is apparently of greatest influence in protection from infection.

In the presence of cholera one should not only drink recently boiled water, which has been protected from the contaminating influence of flies, but all forms of uncooked food should be avoided. In the first rank of prohibited foods should be raw shell fish and uncooked salads. Such articles as lettuce and celery are particularly dangerous on account of the moisture retained. Fruits such as bananas and oranges can be made safe by covering them with boiling water for two or three minutes and subsequently peeling. Care must be taken that native servants do not put fish, which may have been contaminated with cholera-infected water, on the ice in an ice box and through such a source to have the butter, etc., infected. The most scrupulous attention should be given the matter of the care of the ice-box in the tropics.

If conditions are such that boiled water cannot be obtained the water may be treated with good quality chlorinated soda. As a stock solution we use 1 teaspoonful of chlorinated soda to 1 pint of water and of this 1 teaspoonful to 2 gallons of the water to be disinfected. Pottevin recommends six hours contact with hypochlorite of soda, 1 mg. per liter.

Besides care of the food and water ingested particular attention should be paid to the washing of the hands before eating and if in contact with cholera cases careful disinfection of the hands.

Experience in cholera epidemics has shown the importance of avoiding anything which might lower resistance. In particular are fatigue, excesses in alcohol or the taking of any kind of indigestible foods to be avoided. It must be remembered that the use of purgatives may set up cholera in a cholera carrier so that this possibility should be thought of.