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THE FOLLOWING REPORT IS REPRODUCED BY COURTESY OF DR. W. H. KELLEHER
PHYSICIAN SUPERINTENDENT, WESTERN HOSPITAL, SEAGRAVE ROAD, S. W. 6.
"POLIOMYELITIS IN THE western HOSPITAL DURING 1955"
The number of cases of poliomyelitis occurring throughout the country during 1955 has
shown a considerable increase over the preceding year and this has been reflected in the
admissions to the special unit at the Western Hospital. It may not be generally known,
however, that this unit receives cases not alone from local districts but from areas much
further afield, such as the South coast towns and even from abroad . This has largely arisen
from the designation at the Western Hospital of a unit for the treatment of the dangerous
respiratory complications, which is planned to serve a large part of the South West Metropolitan
Regional Hospital Board area, The impact of the disease on the local Boroughs has
fortunately been relatively slight, although many cases of suspected poliomyelitis have been
admitted for observation and diagnosis.
The fear and anxiety exhibited by the public reaction to illness which may simulate
poliomyelitis is well reflected in the rate of medical certification of patients in whom
poliomyelitis is diagnosed or suspected. This suspect group forms a substantial proportion
of admissions and, where accommodation allows, there is much to be said in favour of such
admissions where, with separate room isolation, an expert eye can be kept on the development
of an illness and steps taken to initiate specialized treatment at the very earliest stage.
The use to which these facilities have been allowed may be gauged by the figures of
admissions of suspected or diagnosed cases of poliomyelitis to the Western Hospital, which
amounted to 424 during 1955, Less than one half (189) of the 424 admissions could be confirmed
as suffering from the disease, to the great relief no doubt of the patients and their
relatives where the illness finally diagnosed was of a less serious character, At the same
time almost exactly one third of the diagnosed cases of poliomyelitis were in the category
"non-paralytic" and were restored to full health in a few weeks. There were were 123 cases with
paralysis, some slight but indeed many with considerable damage.
Danger to life in poliomyelitis is almost invariably connected with complications
created through the failure of the muscles concerned with breathing and swallowing, and in
certain classes and age groups, especially in the past, the mortality has been very considerable,
especially where a combination of defects has occurred: indeed some hospitals on
the continent have recorded a death rate as high as 80-90 per cent in the severely affected
groups.
The selection of the complicated case for admission to the Western Hospital has
resulted in a disproportionately high percentage of admissions with respiratory paralysis,
This is reflected in the figure of 66 patients (forming more than half of the paralytic
cases), requiring specialised treatment in "iron lungs" or other equipment devised for
correction of the suffocative disorders complicating the attack.
The impact of such selection has called for special organisation, one element of which
has been the equipping of an ambulance containing all the necessary instruments with which
an expert team travels to the place (hospital or home) from which the case is to be
collected. The team has to be prepared to provide the necessary help to sustain the
patient's breathing during the journey This has indeed provided an invaluable adjunct to
the organisation and has been very successfully used. In addition, a good deal of expensive
equipment has had to be provided for the special ward.
The care and maintenance of equipment is a most responsible and time consuming task for
the hospital engineer and his staff and is indeed fraught with no inconsiderable anxiety to
these technicians who must occasionally show their worth in acute emergencies where
mechanical defects supervene.
The nursing and medical staffing of the unit calls for considerable augmentation. A
cubicle has had to be provided in the ward annexe as sleeping accommodation for the doctor