Books, etc. - When the Patient is Free from Infection in Various Illnesses - Special Rules for Scarlet
When nursing a case of whooping-cough, every precaution must be taken against infection, as it is one of the most infectious of all ailments.
Unfortunately, even when a case is isolated, the infection is sometimes communicated to children in other parts of the house. • Plenty of fresh air will dilute the poison and help to prevent the spread of infection. This is one of the illnesses in which the carbolic spray should be freely used in the room, as the poison seems to exist rather in the atmosphere than in the clothing of the patient.
Children under seven years are specially susceptible to whooping-cough, and it is rather serious when infants and young babies contract it, especially if they are weakly and rickety, when complications such as bronchitis and pneumonia are liable to occur.
Infection after this ailment lasts as long as the "whoop" is present, which is, unfortunately, a somewhat vague statement, as this often persists for many weeks. In most cases the child ought to be free from infection about four weeks after the commencement of the illness.
At the end of an infectious illness, when the patient is to be allowed to mix once more with the general community, the doctor will require that he should be thoroughly disinfected, and the room, with all its contents, fumigated. The patient must be bathed in a warm bath and liberally washed with a disinfectant soap. He should then be dressed in clean clothes and taken to another room, which has been previously warmed and prepared for his reception. The hair, of course, requires to be thoroughly washed, and the mouth should be rinsed once or twice daily for some time with warm water to which a little Condy's Fluid is added.
In the next place, all bed-clothing, garments, etc., should be sent to a disinfecting chamber, as well as the clothing worn by the patient just before he was taken ill, so that it can be disinfected by thorough baking. The carpet ought to have been taken up, as was mentioned in the beginning of this series of infectious ailments, and if the mattress is not of the expensive order, it is best to burn it. Otherwise these things will have to be sent to a disinfecting chamber to be baked or steamed.
All toys, books, and magazines used in the sickroom will have to be destroyed, as it is almost impossible to disinfect them, and the risk of carrying infection to others is very great. Before the nurse mixes with other people, she must disinfect herself in the same way.
It is extremely useful to know the time from which people can be said to be free from infection, after, of course, proper disinfection.
In typhoid fever the patient is free from infection when he reaches convalescence.
Scarlet fever is infectious for at least six weeks, until, in fact, all trace of peeling has ceased.
A case of chicken-pox must be kept in quarantine until a week after the last crust or scab has disappeared.
In German measles a fortnight after the rash has gone.
In the ordinary, uncomplicated case of measles the child should be isolated for about a month, and not allowed to mix with others until there is no trace of cough or discharge from the nose, etc.
Disinfecting: a Room
In some ailments, such as measles, after disinfection is not enforced; but the time is not far distant when this will be a notifiable disease, and careful disinfection afterwards will then be compulsory. With chicken-pox, measles, and mumps a certain amount of disinfection is certainly desirable. Whenever possible, all bed-clothing and garments should be baked, the furniture washed with carbolic solution, and the room thoroughly scrubbed, whilst thorough exposure of the room to fresh air and sunlight provides a natural disinfectant which is exceedingly useful.
With regard to scarlet fever and diphtheria, however, such precautions are not sufficient, and the room will have to be disinfected as follows:
First, bed-clothing, garments and woollen materials, mattress and pillows, must be removed to be sent to a disinfecting chamber. The wallpaper should be well soaked by means of a brush with a long handle, with some disinfecting solution such as carbolic, and left until the following day, or for a few hours at least, after which it can be scraped off and burnt. The drawers should be removed from the toilet-table and chests and stood on end on the floor. Any cupboard or wardrobe doors must be left open, whilst toilet-basin, etc., can be disinfected in a proper solution, and then removed from the room, to be afterwards treated with boiling water. The crevices of the window and chimney should be closed. Small crevices can be stopped up by covering with lard or other grease. A zinc bath containing water may then be placed in the middle of the room, and an old tray or shovel, or the lid of a saucepan, laid on it. On this a pound of sulphur should be laid, or two or three sulphur candles placed on end. If the ordinary sulphur is used, hot coals will need to be added, or, if preferred, spirits of wine. Then the person lights the sulphur, leaves the room, locking the door and pasting brown paper over the keyhole and the bottom of the door so that the room is airtight. The room should be left for twenty-four hours in order that the sulphur fumes may penetrate to every part.
The next day the windows can be opened, the sulphur appliances removed from the room, the ceilings and wall whitewashed, the floor thoroughly scrubbed, the paintwork cleaned or renewed, and the walls repapered. After the chimney has been swept a fire should be kept alight for two or three days with the windows open. The furniture must also be washed. Then the room should be left empty for some little time and thoroughly ventilated each day. By the time the bed-clothing, etc., return, the room is usually ready for occupation.