View report page

13
In 1890-91 the effects of compulsory notification began to manifest themselves,
and since 1892 scarlet fever and diphtheria have been prevalent in the Metropolis.
The growing disposition on the part of the public to avail themselves of the
advantages of the means of isolation afforded by the hospitals of the Board is well
illustrated by the figures given by their Clerk with regard to the number of cases
yearly treated in their hospitals during the past six years. In 1890 42.64 per cent.
of the cases notified as scarlet fever were treated in the hospitals of the Board, in
1891 the percentage increased to 4616, in 1892 it was 48.32, in 1893* it was 48'31,
in 1894 it increased to 62.89, and in 1895* there was a further increase to 64.81.
There is no doubt that the increasing disposition on the part of the people to
obtain the removal of their infectious sick to isolation hospitals has contributed in no
small degree to the difficulties experienced by the Managers of the Board with regard
to the accommodation at their disposal.
During the past year nine instances of recurrence of scarlet fever in families,
following the return of patients recently suffering from that disease from hospitals of
the Board, came under my observation. In my Annual Report for 1893 I drew attention
to the occurrence of such cases, and stated as the result of my investigations
that it was difficult to eliminate the possibility of infection being introduced a second
time into the same family from other outside sources. Doubtless, a small number of
such recurrences may be due to the discharge of patients whilst still infectious, but
in the great majority of the instances which have come under my own observation
the circumstances are such as to render it impossible to decide that such is the case.
This question of the alleged premature discharge of patients from the Managers'
hospitals came under the consideration of the Metropolitan Asylums Board, and the
conclusions arrived at by a sub-committee of the General Purposes Committee of the
Board, contained in the report submitted to the Managers in October, are as follows:—
(a) "That there is no evidence to shew that any appreciable number of
patients admitted to the Board's hospitals during the past two years
have contracted infection from patients previously discharged therefrom.
That there is reason to believe that of the so-called 'return' cases some
have been due to the re-introduction of infection into households owing
to the disturbance of insufficiently disinfected clothes, etc., left at home
and stored away during the patient's stay in the hospital."
(b) "That it is desirable that those Sanitary Authorities in the Metropolitan
District who have not yet provided themselves with steam disinfectors
should be urged to do so with the least possible delay; and further,
that the Authorities who still entrust the work of disinfection to contractors
should be advised to discontinue the practice, and to have the
work carried out by responsible officials."
*The percentages for these years are only with reference to the periods when it was unnecessary
to refuse admission.