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78
As compared with the figures for 1896, the numbers of cases of the several
diseases notified are less, with the exception of diphtheria, which shows a slight
increase. The number of cases of smallpox remains the same as last year. The
deaths from notifiable infectious diseases numbered 136, as compared with 135 in
1896, 117 in 1896, and 123 in 1894.
The deaths from notifiable infectious diseases were at the rate of 1.1 per 1,000
inhabitants in Shoreditch; the deaths from the principal zymotic diseases which are
not notifiable wore at the rate of 3.1 per 1,000 inhabitants. The deaths due to scarlet
fever show a decrease, these due to diphtheria, enteric fever and erysipelas an increase.
Nino instances came under my observation in which, following upon the return of
persons, who had been suffering from scarlet fever, from the hospitals of the
Metropolitan Asylum Board, recurrences of the disease took place in the families to
which they belonged. The circumstances pointed in nearly all the cases to the
recurrence being in some way connected with the return of the patients. There was
no conclusive evidence that any of the patients were in an infectious condition when
discharged from hospital, but two or three were open to very considerable suspicion.
ISOLATION OF CASUS OF DANGEROUS INFECTIOUS DISEASE.
In the vast majority of cases of dangerous infectious disease in Shoreditch, the
only means of isolation in the strict sense of the term, is removal to a hospital for
infectious disease. As a rule but little difficulty through objections on the part of
parents and others is now experienced in obtaining such removals. Occasionally,
however, objection is raised, in cases where isolation at home is quite impossible, and
delay in the removal, attended by danger to the inmates of the house and others, arises
in consequence. Should such delay occur in connection with a dangerous infectious
disease like smallpox, it is hardly necessary to point out how grave would be the risks
to the public health. It appears to bo open to question whether in the Metropolis
there is any statutory power given for enforcing the removal to hospital of persons
suffering from dangerous infectious disease who are improperly isolated. The sixtysixth
section of the Public Health (London) Act, 1891, empowers a justice on a
certificate signed by a legally qualified medical practitioner to order to be removed to a
hospital, with the consent of the superintending body of such hospital, any person
suffering from dangerous infectious disease who is without proper lodging or
accommodation, or is lodged in a tent or van, or is on board a vessel. It is,
however, possible that a person suffering from dangerous infectious disease may have
proper lodging or accommodation so far as he himself is concerned, and yet be so
lodged and accommodated as to be a danger to others.
The sixty-seventh section gives a justice power to direct that a person suffering
from dangerous infectious disease who is in a hospital to be detained in the hospital
if he "would not on leaving the hospital bo provided with lodging or accommodation,
in which proper precautions could be taken to prevent the spreading of the disease