Home Quarantine by Kate Lindsay, M. D.

Review and Herald Publishing Association · Washington, D. C. · May 19, 1910

Home Quarantine

By Kate Lindsay, M. D.

KATE LINDSAY, M. D.

THE prevention of the spread of infectious diseases by separation of the sick from the uninfected, is practised more or less everywhere except in the homes of the land. Yet the home is just where isolation would be most effective as a life-saving and disease-preventing measure. If every home were provided with a room fitted up for caring for any member of the family in case of illness, so constructed as to have an outside entrance, and so located that it could be closed up from direct communication with other rooms in the house, the expenditures of money and loss of time due to illness would be greatly reduced and the death-rate notably decreased.

The infectious disorders are especially dangerous among children. Measles, whooping-cough, scarlet fever, and diphtheria are often fatal during the first five years of life, most of the fatal cases occurring under this age. Whooping-cough and measles are especially deadly from six months to two years. In cases of scarlet fever and diphtheria the mortality decreases after ten years of age, and these diseases are seldom contracted in a severe form after twenty. The epidemics of children's diseases are most common in the cold season of the year. With the shutting up of the homes of the nation, by closing doors and windows, and the greater crowding together of the family members within four walls, comes a foul domestic air-supply and closer personal contact, with much less outdoor exercise. The women and children living most of the time in the unhealthful, shut-in environment, are the greater sufferers. The schools also begin to open with the advent of September, and the infection of one home by any contagious disease endangers the health of other households. Thus the whooping-cough, measles, scarlet fever, or diphtheria, of the isolated farmhouse, carried to the district school on the clothing or person of some student, may spread over the entire neighborhood, and infect other distant country homes.

Epidemics are often more difficult to control and stamp out in the country than in the city, where the contagion hospital is handy, and the board of health is better organized. The absence of the contagion hospital indicates the need for the farmhouse quarantine room, and the more or less imperfect rural board of health system indicates the need of every family having its own sanitary regulations. Many healthy country children of school age have measles, scarlet fever, whooping-cough, or other children's diseases in a mild form. They are in no serious danger of either death or damage to health from these disorders.

Young Children Most Liable to Infection

But at home are the infant members of the family, not yet of school age, who are liable to infection from their older brothers and sisters, and likely to have these diseases in a severe and speedily fatal form, or else their health may be permanently injured and death result a few years later from tuberculosis or some other chronic disorder. The writer once had such a case with which to deal. A sturdy youth of eighteen had a mild attack of scarlet fever. He came home, and was warned not to mingle with the younger members of the family, which consisted of eighteen-months-old twins, his half brother and sister. The young man, being away from home at the time of their birth, and not having seen the children, was very anxious to have them brought to his room, as he arrived late the night before and did not see them, fortunately, at the time of his arrival. The physician called early the next morning to diagnose his case, positively forbade any communication between the youth and the babies, prescribed the needful treatment of the case, reported it to the health officer, and went on her way. She was satisfied in mind that no member of the family was likely to suffer from the spread of the infection, as the parents had both had the disorder, and the little ones were to be sent to their grandparents, half a mile distant, at once. Calling next day to see her patient, you may well imagine her chagrin to find the young man sitting up in bed playing with the innocent little ones.

The health officer had tacked up a scarlet-fever sign on the gate-post to save the children outside from infection. It did not protect the babies in that home. Some wise old lady had diagnosed the young man's disorder as scarlet rash, which she assured them it was better for them to get through with while young. Four days later the little sister awoke feverish and with sore throat, vomiting, strawberry tongue, and all the symptoms of scarlet fever. Next day the little brother was ill too. The tenth day both the children died of malignant scarlet fever. The youth and his thoughtless parents were left at home to meditate on the folly and fatality likely to attend the voluntary exposure of tender infants to contagious, infectious disorders.

The Wisdom of Precaution

If a wise system of home sanitary regulations were established by the head of all homes, such sad bereavements would be much lessened in number. When a member of the family would complain of feeling ill and having a sore throat, rash, or any other symptoms of contagious disorder, he could be retired to the quarantine room at once, where he could be put to bed and made comfortable until the arrival of a physician. If it should prove some simple disorder and not dangerous to the life of others, no harm is done to any one. Should it prove to be a case of contagion, who can tell the good done to the other members of the family and the community? Also, consider the saving, even from a money standpoint. It is cheaper to care for only one case of family illness, rather than to have the whole household sick. In most homes now constructed, no provision has been made for a home quarantine room, therefore a selection must be made of the one most suitable for this purpose, well ventilated, and with an outside door, also in communication with another room where water can be heated and disinfecting done; or the room, if large, may be divided with a curtain or screen; all carpets, heavy curtains, and upholstered furniture, or anything likely to hold infection, should be removed. The bed, a few plain chairs, cheap rugs, two or three tables, a number of cheap, bright pictures on the walls, and vases for flowers, with a screen or two, are all that are needed. A closet or wardrobe is handy if it has shelves and drawers, but should never be used to hold soiled clothes or unemptied slop-pails. Only medicine bottles, clean linen, and the needed sick-room utensils, after a thorough cleansing, should be put into these useful receptacles for stowing away things out of sight.

Before the Doctor Comes

The family needs, for diagnosing illness, a thermometer and carefully cultivated powers of observation. When the temperature is above normal two or three degrees, it may indicate some serious disorder, or only a cold, overeating, overexercising, or some trivial disorder, or it may mean the onset of some serious illness. In any case the management is the same until the doctor arrives. Undress the patient and put him to bed, stopping all food, and giving him plenty of water to drink. A warm bath is useful and needful in most cases, also an enema to free the bowels. If there is sore throat, a gargle of peroxid of hydrogen and water, one part to four of the water, is good; also hot fomentations. Pain in the bowels is often relieved by hot applications; sickness of the stomach, by free tepid water drinking or a lavage to free the digestive organs from fermenting food. A chill can be relieved by a hot foot-bath, hot water drinking, and keeping quiet in bed. A warm bath will often hasten the rash in eruptive disorders, and cool sponging or a cool bath is very soothing in cases of fever. A little care at the outset of any infectious disorder may make the whole course of disease light. When the doctor comes, he will have charge of the case, but there must be some one who has undercharge, and who will carry out his orders, look after the disinfecting of all discharges from the body, and see to the cleansing and sterilizing of clothing, bedding, and all utensils about the sick-room. The discharges from the body in case of contagious disease, should never be emptied into the water-closet, or other closet used by the family. They had best be burned. If they are not burned, disinfect with five-per-cent carbolic acid solution or with chlorid of lime, and bury in quicklime.

Boulder, Colo.