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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108
Appendix IV.
A comparison between the period of isolation of cases treated at home and that at hospital shows a very marked difference in their duration, as is seen by the following statement:—
| Scarlet Fever. | Diphtheria. | |||||||
|---|---|---|---|---|---|---|---|---|
| Hospital. | Home. | Hospital. | Home. | |||||
| No. | Percentage. | No. | Percentage. | No. | Percentage. | No. | Percentage. | |
| "Under 2 weeks | 2 | 0.0 | 22 | 4.5 | 14 | 0.5 | 153 | 37.6 |
| 2 weeks and under 4 weeks | 11 | 0.3 | 17 | 16.5 | 95 | 3.9 | 181 | 44.8 |
| 4 „ ,,6 „ | 102 | 3.0 | 169 | 36.4 | 543 | 20.5 | 51 | 12.6 |
| 6 ,, .,8 „ | 680 | 20.3 | 157 | 33.7 | 835 | 35.3 | 12 | 2.9 |
| 8 „ „ 10 „ | 989 | 29.6 | 35 | 7.5 | 479 | 18.1 | 5 | 1.2 |
| 10 „ „ 12 „ | 691 | 20.3 | 5 | 10 | 307 | 11.6 | 2 | 0.4 |
| 12 „ „ 15 „ | 625 | 18.9 | 0 | 0.0 | 253 | 9.5 | 0 | 0.0 |
| 15 ,, and over | 236 | 7.0 | 0 | 00 | 122 | 3.9 | 0 | 0.0 |
| 3,334 | — | 465 | — | 2,648 | — | 404 | — | |
Note.—The period of isolation at home, being determined as that period between the notification of the illness
and the date of disinfection of the house after the recovery of the patient, does not possess the same exact accuracy as
the period of isolation in hospital. The error, however, is after all very small, and the figures show a very striking
contrast, the importance of which is only slightly lessened by the comparatively small numbers dealt with in the home
figures.
(It is very probable, and acknowledged by some, that cases in all respects identical with
"return cases" occur in connection with home treatment, but no such cases have been recorded by
Prof. Simpson, and none have been known of in Paddington during the last seven years at least.)
Without formulating definite recommendations on the subject, Prof. Simpson suggests
(a) that a classification of cases with special isolation and treatment of those patients who are
affected with certain affections of throat, nose, &c., should be tried, and he thinks that the duration
of detention might in general be shortened; (b) that parents should be cautioned not to allow
discharged patients to sleep with others immediately on their return home; and (c) that the medical
officer of.health of the district to which the patient is discharged should be notified of such
discharge.
The Report was forwarded by the Asylums Board to the Royal College of Physicians, and
the College was asked to express an opinion "as to whether, and if so, under what conditions, the
present period of detention in hospital could consistently with public safety be shortened."
In their Report the Committee of the College say:
" That there is not sufficient evidence at present before them to enable them to lay
down any definite period of time as necessary for the detention of patients recovering from
scarlet fever. With the object of obtaining further evidence the Committee recommend—
"(i.) That in each hospital a couple of wards identical in respect to cubic space per bed, &c.,
should be set aside and administered on a different principle, the sex of the children
being the same, and the age as far as possible; that in one ward the cases subject to