e. In the Military. The almost total absence of cholera in American troops
during World War II is attributed to the combined effects of two factors, natural host
resistance and good sanitation; however, the potential danger of our troops or advisors
stationed in endemic areas should not be taken lightly. Besides the control measures
discussed in section II, following preventive and treatment measures are indicated.
(1) Strict isolation of patients and carriers is not necessary; however, the
patient's clothing, bedding, and eating utensils should be disinfected by boiling or
autoclaving. Woolen blankets need not be boiled; they may be decontaminated by
laundering, drying, and exposing both surfaces to the sun for several days.
(2) Particular care should be taken to avoid pollution of water supplies in the
disposal of excreta and vomitus and all articles, which are contaminated by them.
(3) Attendants should thoroughly wash their hands with soap and water and
disinfect them with an antiseptic solution immediately after handling patients or any
article contaminated by them.
(4) Contacts should be under medical surveillance for at least 5 days from
last exposure, or longer if their feces contain the cholera bacilli.
(5) Unreported cases and foci of infection, such as water sources and
foodstuffs, should be sought.
(6) Artificial immunization is of variable effectiveness and duration. It is
required upon assignment to endemic areas and every 6 months while in such areas.
BACILLARY DYSENTERY (SHIGELLOSIS)
a. Identification. Bacillary dysentery is an acute inflammatory disease of the
colon caused by members of the genus Shigella. These organisms are easily killed by
direct sunlight, but they survive for considerable periods in water, ice, and the fecal
discharges of active cases.
b. Location. Shigellosis occurs worldwide, being especially common in
subtropical and tropical regions of the Orient.
c. Transmission. Transmission is by direct or indirect fecal-oral route. Those
who do not clean their hands thoroughly including under their fingernails may spread
the infection by touching others or by contaminating food.
d. Signs/Symptoms. When uncontrolled, it is a potent cause of disability.
Typically, after an incubation period of a few days, the onset of the disease is abrupt
and accompanied by fever, which may reach I04 F.