Epidemic and infection control measures in charitable institutions for children in the 19th — early 20th century (based on the materials from Saint-Petersburg)

Based on the documents stored in archives, here we present the analysis of the evolution of forms of the epidemic and infection control measures in charitable institutions for children in Saint-Petersburg with the deve-lopment of medicine, the introduction of sanitary and hygienic standards, and guidelines based on the acquired experience. The causes of mass infection of the pupils have been identified, which were associated with the lack of well-established daily hygienic practices for pupils, their close contact within the institution, and the presence of visiting caregivers in orphanages who had extensive contacts outside. At the state level, until the end of the 19th century, there were no uniform sanitary norms and rules, as well as specialized schemes for their identification and con-trol. As the analysis shows, this resulted in the fact that the trustee boards of orphanages and doctors assigned to them were forced, sometimes with the help of police, to independently introduce restrictive measures at the ad-ministrative level, determine treatment methods and manage all emerging issues aimed at preserving health of the pupils, while often not having sufficient professional knowledge and experience for this. The documents sug-gest that due to the lack of established diagnostic system, the treatment methods practically did not differ for vari-ous infectious diseases, and the recommendations of doctors for a long time mainly consisted of changing the diet, purifying the air, isolating patients, and burning possessions of sick children. Considering religious education in all charitable institutions, lents and fast days were supposed to be observed, which required the approval of the clergy, who, although as a rule did not create serious obstacles, but granted individual and limited permits. In the beginning of the 19th century, smallpox vaccination began, and such practices gradually expanded thanks to the state and benefactors, but due to the lack of support from church, as well as conservatism and superstition of a significant proportion of parents, they did not become widespread and routine.