London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Paddington 1900
[Report of the Medical Officer of Health for Paddington, Metropolitan Borough of]
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104
Appendix IY.
deserves. For some months past it has been made a rule to fully examine the sanitary condition
of the houses in which these "return cases" occur. The results have been as follows :—
Of the 13 houses re-infected by the discharged patients, at 5 the drains were so bad as to
require complete re-construction; at 4 the drainage system had been recently overhauled and
was satisfactory when specially examined; at 2 the drainage was found good; at one the
W.C.s were found choked, but no report on the general state of the house was made ; and
the twelfth house was not reported on at all.
The attitude of the Asylums Board with reference to the allegations of cases following the
return of patients from the Board's hospitals has been somewhat striking. The allegations were at
first emphatically repudiated, the possibility of their being well founded was then hesitatingly
admitted, and lastly accepted and investigations authorized. In the Annual Report for 1898 it
was recorded that Prof. Simpson, late Medical Officer of Health of Calcutta, had been appointed
for a period of six months, to investigate the circumstances attending "return cases." His report
to the Metropolitan Asylums Board, dated June 5th, 1899, was issued at the commencement of the
current year (1901). The conclusions which he arrived at are worthy of record here, as they will
form a basis for future investigations.
The 339 return cases were therefore equal to a percentage of 2.4 on the total notifications, or 2*8 per cent, of all notified cases of scarlet fever, and 1.9 per cent. of all notified cases of diphtheria.
| Disease. | Total Number discharged from Hospitals. | Number of Homes re-infected. | Number of "Return Cases." | Percentage of Homes re-infected to Total Discharges. | Percentage of "Return Cases" to Total Discharges. |
|---|---|---|---|---|---|
| Scarlet Fever | 6,507 | 193 | 253 | 2.9 | 3.8 |
| Diphtheria | 3,275 | 64 | 86 | 1.9 | 2.3 |
| Total | 9,782 | 257 | 339 | 2.6 | 3.4 |
As regards the frequency of return cases in the various sanitary areas, no complete statement isgiven,
but Prof. Simpson says:—
"The incidence of the secondary cases varied much in the 52 districts of London, or 51
districts if the Port of London be excluded, and the variations corresponded in some measure
with the prevalence of the disease in the district'.
"The greatest incidence was in Battersea, in which there were 56 secondary cases,
representing 8 per cent. of the notified scarlet fever cases and 5 per cent. of the notifieddiphtheria
cases in that district; and over 16 per cent. of the 339 cases in London arising in
houses to which primary cases discharged from hospital had been sent."
Proceeding to examine the 339 return cases, Prof. Simpson found that certain of them required
to be excluded as being "in no way connected with the return of primary cases from hospital."
The cases thus excluded were:—
(a) Cases where the secondary attack oommenced prior to the arrival home of thedischarged
patient. 7 cases.