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74
Kensington District Nursing Association.
The Kensington District Nurses under Miss Eales continue to show great enthusiasm in their
work. They attended 39 notified cases and 47 cases of diarrhoea and vomiting, which had not been
notified, making a total of 86 cases in all. They paid 617 visits. Two cases were admitted to hospital,
of which one proved fatal. One death occurred in the home whilst the nurses were attending. There
have, therefore, been only two deaths amongst the 86 cases attended by the nurses.
Deaths from Diarrhoea.
There were 34 deaths of children under one year of age from diarrhoea or enteritis during the year.
Thirty-two deaths occurred amongst cases which were not notified or not attended by the nurses. Only
two deaths occurred in cases which were notified and attended by the nurses.
It will thus be seen that 32 deaths occurred amongst children who had not received routine treatment
in their own homes or prior to removal to hospital.
St. Mary Abbots Hospital.
With regard to the treatment of cases in hospital, there is nothing further to be said than that which
was described in last year's report. No cases of paratyphoid or Flexner bacillus were found amongst
the children treated. Most of the cases which proved fatal were extremely ill on admission, suffering
from dehydration and collapse.
Thirty-one cases of diarrhoea and vomiting were admitted to the hospital during the year, and
there were 13 deaths.
I attended most of the post-mortem examinations, and my observations only confirm the findings
in my report of last year.
RONALD CARTER.
Dysentery.—Two sisters in the St. Charles ward were infected with the Sonne organism and a
girl of six in the Pembridge ward suffered from the Flexner variety of the disease. No evidence
as to how the disease was contracted could be obtained.
Acute Rheumatism.—Under the Kensington (Acute Rheumatism) Regulations, 1927, acute
rheumatism, as defined in these regulations, was made a notifiable disease for three years from
1st October, 1927. The regulations define acute rheumatism as denoting the following conditions,
occurring separately or together in a child under the age of sixteen years.
(a) Rheumatic pains and arthritis, if accompanied by a rise of temperature;
(b) Rheumatic chorea;
(c) Rheumatic carditis.
Before sanctioning these regulations, the Ministry of Health required to be satisfied that:—
(1) Efficient machinery existed for investigating the cases notified.
(2) There was accommodation for institutional treatment.
(3) The local authority was well organised in regard to health administration and
had good housing records.
The first of these conditions was provided by setting up a Rheumatism Supervisory Centre and
by arranging that on the receipt of a notification a health visitor should visit the home of the
rheumatic child to make certain enquiries and observations. The second was complied with by
making special arrangements with the Poor Law Authorities of Kensington, whereby in-patient
accommodation was set aside at St. Mary Abbots Hospital, and by making a grant towards the
provision of convalescent treatment. The third condition was already satisfied.
In September, 1930, the Minister of Health issued the Kensington (Acute Rheumatism)
Regulations, 1930, thereby continuing to make acute rheumatism, in children under 16 years of age
a notifiable infectious disease for a further period of three years from 1st October, 1930.
During the year under review, 99 cases of this disease were notified, 47 of which were removed to
hospital for treatment.
The Third Annual Report on the working of the Rheumatism Scheme during the period
1st October, 1929, to 30th September, 1930, prepared by the physician in charge of the Centre and
the Medical officer of Health, appears as Appendix I to this Report.
Other Notifiable Diseases.—With the exception of tuberculosis, which is dealt with in a
separate section, no notifiable infectious diseases, other than those to which reference has been
made, were notified during the year.
Non-Notifiable Diseases.
Measles.—There were thirty-nine deaths from measles in Kensington during the year. The
women health officers paid 1,511 visits to measles patients; two hundred and five cases were
removed to the Metropolitan Asylums Board and London County Council hospitals.
With the object of reducing the mortality and mitigating the complications associated with
measles epidemics by the prompt removal of cases to hospital, the London County Council, in
conjunction with the several metropolitan borough councils, have drawn up the following scheme
to operate during epidemic periods.