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46
Arrangements were made meanwhile for the admission of
patients to other Institutions, St. James's Hospital and the Clapham
Maternity Hospital taking most of the cases. Permission was also
given to any applicant accepted for admission to the Borough
Maternity Hospital to make other arrangements if desired while
the Hospital was closed, but in very few instances was this permission
availed of.
There were 22 cases in the Hospital on the date of closing,
and these were gradually evacuated to the Isolation Hospital or
discharged to their own homes. The Hospital was entirely cleared
of patients by the 23rd February. The staff were medically examined
and, with the exception of a nucleus to work the Hospital,
were sent away for a holiday, and not allowed to return until after
further medical inspection and the bacteriological examination of
swabs.
During the period the Hospital was closed the closest investigations
were made into the causes responsible for the outbreak.
Swabs were taken from the throats and noses of the medical and
nursing staff, and in some instances the presence of organisms of
a haemolytic streptococcal strain was disclosed on bacteriological
examinations. In no case was there any clinical evidence of infection,
but as a precautionary measure those showing positive results
present were sent away for a time and not permitted to return
to duty until found on consecutive bacteriological tests to be
negative.
One of the nursing staff, a pupil midwife, had contracted
tonsillitis about the middle of November, 1929. She was isolated
at the top of the administrative side of the Hospital (Elmhurst).
She declined to be removed to a general hospital and as her home
was in the north of England, her condition at the time did not
permit of her being sent home. Precautions were taken to keep
her isolated, but although there does not appear to have been any
strong evidence connecting this case with the subsequent serious
outbreak of Sepsis in January and February, it would have been
better, as is the invariable rule of the Hospital, to have sent this
case to an appropriate institution.
Some of the nurses and pupil midwives developed sore fingers
and in one or two instances styes on the eyelids. Several infants
also developed sore fingers during the latter part of January and the
beginning of February. It is probable that these minor infections
among the nursing staff were not disclosed early enough, probably
as being too trivial in the early stages to be reported to the Matron
and Doctor. This, there is reason to believe from my investigation
in at least one instance, may have been the probable source of infection,
especially as the type of infection was not (excluding these two
fatal cases, in one of which death was inevitable in any case)
virulent. Apart from these two cases the majority of the patients
were not severely attacked, and all these, including the cases