Contact Carriers in Meningitis

Abstract

IT is generally conceded that cerebrospinal fever (epidemic or meningococcic meningitis) is spread largely by healthy carriers. The control of the disease therefore depends upon the control of carriers. Measures leading to this end have been instituted under military conditions at various times in this country, in England, and in France. No attempt seems to have been made to control the movements of meningococcic carriers in a civilian population over any considerable period of time. The number of cases of epidemic meningitis reported to the Department of Health in Detroit during the autumn of 1928 was unusually large.t In January, 1929, 66 cases (with 35 deaths) were reported as compared to an average of 3 for January of the 5 previous years. It appeared certain that an epidemic was in progress. Accordingly, the Commissioner of Health issued an order effective February 1, 1929, requiring the isolation of home contacts for a period of 14 days only, or until two consecutive nasopharyngeal cultures, taken lot less than 24 hours apart, were found to be free from meningococci. Persons actually living in the apartment or house at the time the case was diagnosed as epidemic meningitis were considered contacts. In a few instances intimate or casual friends, who had been with the individual just before the illness began, have voluntarily requested that cultures be taken; but such persons when proved to be carriers were not officially isolated. This report summarizes the experience in Detroit during the 6 months ending July 31, 1929. Most of the cultures were taken by Department of Health nurses who were assigned to this work and carefully instructed. Some contacts came to the laboratory, but such a procedure was discouraged, particularly when street cars were used as means of transit. The cultures were taken from the nasopharynx with a swab on the end of a bent aluminum wire. The swab was then inserted in a sterile tube and placed in a towel between two warm water bags. Several calls