Читать книгу American Red Cross Text-Book on Home Hygiene and Care of the Sick - American National Red Cross - Страница 22

Table of Contents

Well persons who carry in their bodies pathogenic germs but who themselves have no symptoms of disease are called carriers. Thus typhoid carriers have typhoid bacilli in the intestinal tract, while they themselves show no symptoms of typhoid fever; diphtheria carriers have bacilli of diphtheria in the throat or nose, but have themselves no symptoms of diphtheria, and so on. It has now been proved that many patients harbor bacteria for weeks, months, or even years following an infection, and are dangerous distributors of disease; also, some healthy individuals without a history of illness harbor living bacteria which may infect susceptible persons in the usual ways. Transmission by healthy carriers goes far to explain the occurrence of diseases among persons who have apparently not been exposed. This explanation has greatly clarified the whole problem of the spread of communicable diseases. Carriers, unfortunately, exist in large numbers, and render the ultimate control of disease exceedingly difficult. They can usually be identified by bacteriological tests. To some extent they can be supervised; food handlers at least should be legally obliged to submit to physical examinations, and should be licensed only when proved free from communicable disease.

Diseases are also spread by persons suffering from them in a form so mild or so unusual that they pass unrecognized. These persons are known as "missed" cases. Carriers of disease and "missed" cases go freely about the community, handling food, using common drinking cups, travelling in crowded street cars, standing in crowded shops; in various ways coming into close contact with other people, coughing and sneezing and kissing their friends no less often than normal individuals. It is consequently clear that the bodily discharges of supposedly normal persons may be hardly less a menace than those of persons known to be infected.

Diseases that depend for transmission upon milk, water, food, and insects may be controlled by public action, that is, by specific measures taken by a large group of people in order to protect the individual. Such action constitutes public sanitation. There is, however, a large group of diseases, chiefly sputum-borne, that cannot be controlled except by individual action. Such individual action constitutes a large part of personal hygiene.

The whole problem of controlling infections sounds simple, depending as it does for the most part upon unpolluted water, milk, and food, extermination of certain insects, and cleanliness in personal behaviour. In practice the problem is not so easy. Public sanitation has performed miracles in the past, and will do much in the future; behaviour, however, will continue to be influenced by many factors, social and economic as well as personal. Ignorance of the laws of health is an obstacle to progress, but in modern conditions even the instructed may be unable to control their ways of living and working. Indeed, such control is at present limited to the privileged few. On the ignorant and the poor, those least able to bear it, society loads the heaviest burden of sickness. Only when ignorance and poverty are abolished, as one day they will be, can the final stage be reached in the fight for public health.