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1928]
34
Over 600 persons were re-vaccinated by Dr. Evans; some 211 domicilliary
visits were paid to "contacts" by the Sanitary Inspectors of my department alone,
many of these visits having to be paid after usual working hours, as the persons were
engaged at their usual vocations during our office hours. Arrangements were made
for the Steward of the Hospital to immediately notify my department whenever
the employees of the hospital residing outside the Institution failed to report for
duty, and these absentees were visited at their homes to fully ascertain the cause
of absence. This visitation had to be carried out on Sundays as well as weekdays.
A large amount of correspondence was necessary in connection with the contacts
living outside the Borough. As far as possible these were telephoned and confirmed
by writing afterwards. One hundred and eighty-five mattresses, over 200 pillows,
and an equal amount of bedding have been stoved, in addition to a vast amount of
clothing. Books, papers and articles which could not be effectively disinfected have
been burned. One interesting item in the disinfection was the disinfection of 100
grampohone records, which had to be separately washed with disinfectant. This
gramophone had been in common use in the wards, and was a possible source of
infection from one ward to the other.
I feel that the Hospital Committee of the Guardians (this is a joint hospital
for Holborn and Finsbury) have shown great foresight, and have met the requirements
most sympathetically. They have taken the opportunity after the disinfection
of the four large wards to have them thoroughly cleansed and renovated. The redecoration
of these wards, although an expensive matter, is money well spent,
and after an outbreak like this, the time was most opportune for it being undertaken.
The Medical Superintendent, Dr. Thomas Evans, has had a most anxious time,
but the success which has followed his painstaking and arduous work must be regarded
as in a large part due to the rapidity with which he carried out the initial vaccination
and re-vaccination of such a large number of people at the hospital, and to the very
thorough supervision which he exercised in having all our requirements carried out.
Mr. Bicknell, the District Sanitary Inspector, had for the second time recently
a very onerous and exacting task. The Royal Northern Hospital, where we had an
outbreak before, also fell to him, but this institution was a task of even greater
magnitude, as naturally a hospital of this class has a different clientele, and the
supervision more difficult.
Diphtheria was responsible for 760 cases of illness, which were (170) below
the average (930) of the preceding ten years. The attack rate was equal to 2.34
per 1,000 of the civil population annually, and was 0.48 below the mean rate (2.82)
of the decennial period.
In London the attack-rate was 2.77 per 1,000, and the Encircling Boroughs
2.77.
DIPHTHERIA ANTI-TOXIN.
Under the Special Order of 15th August, 1910, the then Local Government
Board sanctioned the provision by the Sanitary Authority, in pursuance of section
77 of the Public Health (London) Act, 1891, of a temporary supply of
Diphtheria Anti-toxin "for the poorer inhabitants of the district, subject to the
following conditions, that is to say, the arrangements with respect to the keeping,
distribution and use of the Diphtheria Anti-toxin shall be made in accordance
with the advice of the Medical Officer of Health."