592
The examination of merchandise should never be neglected, if there is any suspicion of plague. There is the possibility of its infection through plague infect- ed rats to be borne in mind. Cases of such have been reported during the past few years. According to KoSSEL and NOCHT, in Hamburg merchant ships arrived from plague infected ports. No cases of plague in man had occurred on board. The cargoes were discharged and with them were found numerous dead rats which had died of plague. In such cases contact of the ship's rats with those on shore must be avoided, and those engaged in discharging the cargo, ought to be placed under medical supervision.
The measures against rats on board are now universally adopted. The destruction of rats on board ship is a matter of great difficulty. The use accord- ing to the fire extinguishing and disinfecting system of an apparatus like Clayton's is not always satisfactory.
In summing up, therefore, the principles involved in general prophylactic measures against plague, one must strongly advocate, the following:-
(1.) The limitation as far as possible of actual quarantine.
(2.) The extension of the system of revision.
(3.) Strong measures against rats.
(4.) The evidence of all unnecessary dogmatic rules and standing orders. (5.) The individual treatment of each case according to its merits. (6.) The employment of competent ship doctors.
Other-
(7.) The employment of skilled port officers well versed in quarantine
matters. These officers, in order to overcome the many duties of their office, must devote the whole of their time to this work. wise the measures at their disposal mas be carried out in a desultory fashion.
WILLIAM HUNTER.
The Principles of Special Prophylaxis.
Viewed from an epidemiological point of view plague is found to occupy a place amongst infectious diseases peculiar to itself, this is evidenced by the fact that there exists for the spread of the disease two great avenues of infection. Indeed approaching the question from a strictly public health standpoint, there exist two entirely different types of plague epidemics, namely:-
(1.) Epidemics caused by plague infected rats.
(2.) Epidemics caused by plague infected individuals.
The first is what we commonly meet with in Hongkong, namely, septicemic plague with bubonic and pneumonic manifestations.
The second is rarely found in Hongkong. It is what is known as primary pneumonic plague. This form was frequently the cause of enormous epidemics during past centuries, It would appear to be less frequently met with now-a-days It is the most dreaded form of plague.
Septicemic plague in its various forms depends upon a rat epizootic which is now generally known as "Rat Plague Man becomes infected either by direct contact with infected rats or by indirect contact, the virus being conveyed to him through the agency of infected habitations, ships, goods, etc., upon which rats scatter their secretions and excretious. Infection by direct contact would appear to be rare. Infection by indirect contact is, in my opinion, the usual mode of conveyance of the B. pestis from the rat to man.
At the same time the conveyance of plague infection from man to man or from man to rat by way of infected secretions and excretions must not be lost sight of.
The transference of infection by way of suctorial insects would appear to be of no practical significance. Bubonic plague is held by many people to be of no importance in regard to the spread of infection. From my researches, however, his appears to be only partially true. The discharges from the buboes may be regarded as not dangerous to public health as the plague bacilli originally present
No comments yet.
Private notes are available after approval.