Moreover, the child with an unclean mouth not only infects and reinfects himself but scatters germs in the air whenever he sneezes or coughs. In a cold apartment where there is no appreciable current of air a person can scatter germs for a distance of more than twenty-two feet. Germs are also scattered through the air by means of salivary or mucous droplets. It is this fact that makes colds so dangerous.

Table VIII

City of Manchester Education Committee

Infectious Or Contagious Diseases In Schools Information For Teachers

Four columns are omitted: (1) Interval between Exposure to Infection and the First Signs of the Disease; (2) Day from Onset of Illness on which Rash appears; (3) Period of Exclusion from School after Exposure to Infection; (4) Period of Exclusion from School of Person suffering from the Disease

DISEASEPRINCIPAL SIGNS AND SYMPTOMSMethod of InfectionREMARKS
MeaslesBegins like cold in the head, with feverishness, running nose, inflamed and watery eyes, and sneezing; small crescentic groups of mulberry-tinted spots appear about the third day; rash first seen on forehead and face. The rash varies with heat; may almost disappear if the air is cold, and come out again with warmth.Breath and discharges from nose and mouth.After effects often severe. Period of greatest risk of infection first three or four days, before the rash appears. May have repeated attacks. Great variation in type of disease.
German MeaslesIllness usually slight. Onset sudden. Rash often first thing noticed; no cold in head. Usually have feverishness and sore throat, and the eyes may be inflamed. Rash something between Measles and Scarlet Fever, variable.Breath and discharges from nose and mouthAfter effects slight.
Chicken PoxSometimes begins with feverishness, but is usually very mild and without sign of fever. Rash appears on second day as small pimples, which in about a day become filled with clear fluid. This fluid then becomes matter, and then the spot dries upand the crust falls off. May have successive crops of of rash until tenth day.Breath and crust of spots.When children return, examine head for overlooked spots. All spots should have disappeared before child returns. A mild disease and seldom any after effects.
Whooping CoughBegins like cold in the head, with bronchitis and sore throat, and a cough which is worse at night. Symptoms may at first be very mild. Characteristic "whooping" cough develops in about a fortnight, and the spasm of coughing often ends with vomiting.Breath and discharges from nose and mouth.After effects often very severe and the disease causes great debility. Relapses are apt to occur. Second attack rare. Specially infectious for first week or two. If a child is sick after a bout of coughing, it is most probably suffering from whooping cough. Great variation in type of disease.
MumpsOnset may be sudden, beginning with sickness and fever, and pain about the angle of the jaw. The glands become swollen and tender, and the jaws stiff, and the saliva sticky.Breath and discharges from nose and mouth.Seldom leaves after effects. Very infectious.
Scarlet Fever or ScarlatinaThe onset is usually sudden, with headache, languor, feverishness, sore throat, and often the child is sick. Usually within twenty-four hours the rash appears, and is finely spotted, evenly diffused, and bright red. The rash is seen first on the neck and upper part of chest, and lasts three to ten days, when it fades and the skin peels in scales, flakes, or even large pieces. The tongue becomes whitish, with bright red spots. The eyes are not watery or congested.Breath, discharges from nose and mouth, particles of skin, and discharges from suppuratory glands or ears. Milk specially apt to convey infection.Dangerous both during attack and from after effects. Great variation in type of disease. Slight attacks as infectious as severe ones. Many mild cases not diagnosed and many concealed. The peeling may last six to eight weeks. A second attack is rare. When scarlet fever is occurring in a school, all cases of sore throat should be sent home.
DiphtheriaOnset insidious, may be rapid or gradual. Typically sore throat, great weakness, and swelling of glands in the neck, about the angle of the jaw. The back of the throat, tonsils, or palate may show patches like pieces of yellowish-white kid. The most pronounced symptom is great debility and lassitude, and there may be little else noticeable. There may be hardly any symptoms at all.Breath and discharges from nose, mouth, and ears.Very dangerous both during attack and from after effects. When diphtheria is occurring in a school all children suffering from sore throat should be excluded. There is great variation of type, and mild cases are often not recognized but are as infectious as severe cases. There is no immunity from further attacks. Fact of existence of disease sometimes concealed.
InfluenzaBegins with feverishness, pain in head, back, and limbs, and usually cold in the head.Breath and discharges from nose and mouth.Excessively infectious. After effects often very serious and accompanied with great prostration and nervous debility.
SmallpoxThe illness is usually well marked and the onset rather sudden, with feverishness, severe backache, and sickness. About third day a red rash of shotlike pimples, felt below the skin, and seen first about the face and wrists. Spots develop in two days, then form little blisters, and in other two days become yellowish and filled with matter. Scabs then form, and these fall off about the fourteenth day.Breath, all discharges, and particles of skin or scabs.Peculiarly infectious. When smallpox occurs in connection with a school or with any of the children's homes, an endeavor should be made to have all persons over seven years of age revaccinated. Cases of modified smallpox—in vaccinated persons—may be, and often are, so slight as to escape detection. Fact of existence of disease may be concealed. Mild or modified infectious as severe type.