London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1900
[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]
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106
Appendix IV.
An analysis showing the frequency of the various pathological conditions noted in the primary —i.e., re-infecting—cases of each disease is given below:—
| Disease. | Discharge from Nose. | Sore Nose. | Discharge from Nose and Ears. | Desquamation of Skin and Eczema-tous Eruption. | Unhealthy Throat and Swollen Glands. | Colds in Head. | Colds in Chest. | Relapse. | Healthy. | Other Causes. |
|---|---|---|---|---|---|---|---|---|---|---|
| Scarlet Fever (90) | 36 | 5 | 13 | 3 | 7 | 15 | 5 | 0 | 3 | 3 |
| Diphtheria (21) | 6 | 0 | 1 | 0 | 3 | 4 | 2 | 3 | 0 | 2 |
| Total | 42 | 5 | 14 | 3 | 10 | 19 | 7 | 3 | 3 | 5 |
| Percentage | 37.9 | 4.5 | 12.0 | 2.7 | 9.0 | 17.1 | 6.3 | 2.7 | 2.7 | 4.5 |
At the present time the bacillus of scarlet fever has not been identified, and the bacteriological
examinations of the secretions from the cases examined threw no light on the question.* With
regard to diphtheria, the results obtained required to be received with caution; firstly, because it is
known that the B. diphtheria has not infrequently been found to persist for a long time in the
throats, &c., of convalescent patients; and, secondly, because at the date of examination, after the
recurrence of one or more cases of diphtheria, it was possible that re-infection of the home-coming
patient might have occurred. In 5 out of 6 re-infecting patients examined who had discharge
from the nose, the bacillus was found in 4; in 3 out of 4 with "colds in the head," the bacillus was
also found ; but in 2 with " colds on the chest," the bacillus was not detected.
Prof. Simpson observes that the bath given before discharge not only failed to remove infection
in the cases referred to, but in certain cases, by causing "colds" to be taken, appeared to favour the
infection of other patients. He appears to think that the "cold" may awaken the infectivity of
the micro-organism, which would otherwise give rise to no accidents. In one ease quoted a " cold "
apparently caused a relapse in a patient just discharged from hospital after diphtheria.
After relating certain cases of extreme detention in hospital, for 8 months in one case, in
which the returned patient infected others, he concludes that mere detention in hospital is no
guarantee of freedom from infection.
The discharges from the mucous surfaces he regarded as the carri- rs of infection, not the active
agents of infection. The infection which impregnates such discharges does not apparently persist
for any long time. The fact that furniture, books, &c., in a hospital ward are infected by the
* During 1900 5 return cases (scarlet fever) were examined bacteriologically for the Department. The results
obtained were:—
(1) Report mislaid.
(2) Secretion from nose: "Micrococci (probably M. jiyogenes aureus) and other cocci (probably Sarcina)
present."
(3) Swab from throat: "A few streptococci present."
Swab from nose: "Some Klebs-Loffler bacilli (B. dipththeriee); a few pseudo-diphtheria bacilli,
and large number of streptococci present."'
(4) Swab from throat: "Pure culture of Klebs-Loffler bacillus obtained ; nothing else."
Swab from nose: "A few Klebs-Liiffler bacilli; some staphylococci and diplococci present."
(5) Swab from nose: "The pseudo-diphtheria bacillus has been recognized, together with a variety of
streptococci."