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29
[1926
HOSPITAL ISOLATION.
Secondary Infections.—An effort has been made as far as practicable
when a case of infection occurs in a household after the return of a case from
hospital, and presumably the discharged case is the infecting cause of the new
case, to communicate with the hospital from which the first case was discharged.
This gives the Medical Superintendent of the particular hospital the knowledge
that such an event has happened, otherwise he may be ignorant of it, for very
frequently the second case may be sent to another hospital altogether. In our
work in this connection, and also from enquiries by parents regarding. the long"
detention of some children inj hospital, it was discovered that when a child took a
fresh infection in hospital — for instance, Scarlet Fever case contracting
Diphtheria; a Diphtheria case contracting Scarlet Fever—it was not the practice
of some hospitals to notify the Medical Officer of Health. Thus a child going
into hospital as Scarlet Fever might contract Diphtheria in hospital, there was no
knowledge that it had had Diphtheria, and yet such a child when sent home might
be the cause of a case of Diphtheria arising in the household, having. previously
gone to hospital with Scarlet Fever, the connecting. link might not be thought of.
Upon enquiry into the matter it was found that in onel at least of the Metropolitan
Asylums Board's hospitals, outside the London Area, the Superintendent held
that according. to the Infectious Diseases (Notification) Act, 1889, which is the
Act in force outside the metropolitan area, he was exempted from notifying a
case which occurred within the hospital.
The matter having been brought before the Public Health Committee, the
following communication was addressed to the Metropolitan Asylums Board :—
" The Public Health Committee have recently had1 under consideration
in the monthly report of the borough Medical Officer of Health cases of
infectious disease classified1 as ' probable return cases.' It transpired that
cases of secondary infection in the hospitals of the Metropolitan Asylums
Board' were, as a rule, duly intimated: to the Medical Officer of Health, and
thus he had knowledge thereof, and was in a position to notice ' return
cases ' due to a particular secondary infection, but this applied' when the
Board's hospital was within the London Area.
" Where the Board's hospital is without the London area, section 3 of
the Infectious Disease (Notification) Act, 1889, exempts notification of
infectious disease occurring within the hospital, and consequently intimation
may not be given.
" The Committee think it is exceedingly desirable, and even necessary,
that intimation of all cases of infection occurring in Islington patients should
be sent to the borough Medical Officer of Health by the Medical Officers of
Hospitals under the control of the Board, whether within the London Area
or not, and I am accordingly requested to ask whether the Board can see
their way to arrange for this to be done."
On the 18th February, 1926, the Clerk to the Metropolitan Asylums Board
replied' as follows :—
"1 am directed to inform you that the question raised' in your letter
of the 31st December with regard to the notification of cases of secondary
infection which occur in the Board's infectious hospitals outside the
metropolitan area has been carefully considered by the committee concerned',
and that, as a result, instructions are being issued that the procedure which
is followed at the hospitals in the metropolitan area shall be put in force at
those outside that area."