A PUBLIC HEALTH RIDDLE

BY OUR MEDICAL CORRESPONDENT.

It is one of the most disconcerting features of some common ailments that, although for years on end they may have assumed only unimportant proportions, suddenly they appear as dangerous diseases. Just now we have to face an exaggerated virulence of that very familiar trouble, nasal catarrh. The common cold is one of those minor disorders of health that are always with us and, although everyone knows that it is possible to catch a bad cold from someone else, no one under ordinary circumstances bothers much about it or takes special precautions to avoid an attack. Lately, however, catarrhal conditions of the nose have once again become so virulent and the precursor of such serious complications that their prevention is now a matter of real importance. They are taking the form of that specially severe type of “cold” with which we associate the name influenza. Even in the best of winters a certain number of people suffer from such violent catarrhs that we say they have “influenzal colds” as a way of indicating the acuteness of the short and sharp illness in question; but we reserve the term influenza – for all that in some it may be nothing but a severe bout of coughing and sneezing – for a much more disturbing malady. To-day the occurrence and nature of epidemic nasal catarrh offers to our public health authorities a pressing problem for solution, and it may be said that the science of bacteriology has given us much valuable information about this which is being found of great value as regards prevention and treatment. But no one has yet found the answer to the riddle of why a “cold” is sometimes a trifling ailment, at others quite a sharp illness, with debilitating after-effects, and sometimes a most serious illness, leading to very fatal complications. Still, we have to make the best of the position as we find it.

METHODS OF PREVENTION

It seems very probable that the regular use of mild disinfectants has lessened the influence of influenza in various institutions and localities during the present winter. Solutions suitable for gargling the throat or rinsing out the nose once or twice daily may be readily obtained from the nearest chemist, and when prepared by responsible hands are safe enough. On the other hand, it will be seen that everything should be done to prevent the spread of germs from one person to another. Here is room for both common sense and the application of simple mechanical principles. Avoidance of closely-crowded places by healthy persons, and the keeping away from too close contact with their fellows as a matter of duty by those who are infected, are obvious measures, although, indeed, not always acted upon. Yet again the keeping of the mouth closed so far as possible in public places, or the use of a simple gauze mask covering nose and mouth, are methods of prevention that may well be practised. A more drastic preventive process is that of injection with vaccine, the general use of which, and the interesting questions centred round this process, deserve special consideration.

TOLL OF THE EPIDEMIC

In Reading five deaths from influenza are reported in one house. A woman who died last Saturday week will be buried to-day – ten days after death – the undertakers, though working night and day, being unable to cope with orders. All the elementary schools in Leeds will be closed this week in consequence of influenza. Owing to influenza and pneumonia, fifty-eight deaths have taken place in South Wales. Influenza continues to increase in Newcastle. Up to Saturday there were 141 deaths from influenza and 26 from pneumonia, the figures for the preceding week having been respectively 94 and 35. The death-rate is increasing every day in Durham county, and all the elementary schools are closed for three weeks. In many cases whole families are down with influenza in the South Durham district. Epidemic of influenza is very severe in Aberdeen, and is causing great concern to the authorities. It has been decided to close all secondary and elementary schools for a fortnight. Picture houses must close for an hour for ventilation and children under fourteen will not be admitted. In Edinburgh during the past week the deaths totalled exactly the same as the preceding week, viz. 316, equal to 48.8 per 1,000, which is the highest figure ever reached. Ninety-five deaths were due to pneumonia and influenza, while in fortyfive other cases influenza was the contributing cause. Twelve deaths were due wholly to influenza, against thirteen the previous week. Mr. F. N. Charrington, hon. superintendent of the Tower Hamlets Mission, draws attention to what he regards as the worst centre of infection – the cinema theatre. Many of these, he says, are not only ill-ventilated, but a large number are utterly unventilated. “These places,” proceeds Mr. Charrington, “are not only open every night during the week, but in London we now have them opened on Sundays as well. This also happens to be the most crowded night of all, and is surely an unnecessary public danger, as I presume no medical man would deny the fact that they are the greatest centres of infection.”