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24
OPHTHALMIA NEONATORUM.
OPHTHALMIA NEONATORUM.
On June 9th, 1910, the Public Health Committee considered a letter from the Social Welfare
Association for London in which that Association urged the necessity of making this disease
notifiable. The letter was referred to the Medical Officer of Health for report. His report* was
submitted on the 20th of the following October, and the Committee resolved to recommend the
Council to make an Order under the Public Health (London) Act, 1891, requiring the disease to
be notified. The recommendation of the Committee was adopted on November 15th, but, in the
meantime, the Medical Officer of Health of the County had been instructed to report on the
subject. The County Council in February of last year made a similar Order to that adopted by
the Borough Council, which was duly confirmed by the Local Government Board, no action
being taken by the Board with respect to the Order made by the Borough Council. The Order
made by the County Council has this advantage over that made by the Borough Council, viz.,
that it is applicable to the whole County and not to a limited area thereof. The Order became
operative on March 14th of last year.
The Order is perfectly general and the disease is, therefore, now a " dangerous infectious
disease" to which all the provisions of the Public Health Act relating to compulsory removal to
hospital and disinfection, penalties for exposing an infected person in a public place, &c., &c.,
apply. It is somewhat remarkable that the Order should have been made so general. In the
case of measles, which is not, however, a notifiable disease, only certain of the preventive sections
(as to disinfection, &c.) have been made applicable. It would seem to be somewhat superfluous
to make the whole of the law dealing with "dangerous infectious diseases " apply to ophthalmia,
a disease which never kills, is contagious, not infectious, and for which notification was sought
solely with a view to seeing that the children attacked should receive proper treatment to obviate
that permanent loss of sight which so frequently ensues from neglect.
The disease is manifestly one which requires administrative procedure of a special character.
The inquiries and general supervision of the cases were delegated to the Women Inspectors, the
routine prescribed being set out in a Memorandum of which a copy is given in the Appendix B.
The Order was operative for a little more than nine months and during that time 21 cases †
were notified, 3 of the patients being in the charge of the Poor Law. The Ward distribution
of the remaining 18 cases was—
Queen's Park, 1; Harrow Road, 3 ; Maida Vale, 5 ; Westbourne, 2 ; Church, 5 ; and Hyde Park, 2.
Eight of the children were males and 13 females, their ages ranging from a few days to one
year, the elder children (aged 2, 4 and 12 months) being girls. The ages of the other 18 were—
Under 1 week, 8 (3 males, 5 females).
1— weeks, 6 (3 ,, 3 ,, ).
2 ,, 2(1 male, 1 female).
3— „ 1 (female).
4— ,,0.
5—6 „ 1 (male).
Seven of the children were illegitimate, the proportion (33*3 per cent.) contrasting badly with
the proportion of illegitimate to total births (0 7 per cent.).
The period of incubation (i.e., the interval between birth and onset of disease; is of some
interest, and the appended analysis of the records of last year suggests that there are two distinct
forms of infection—one acting very quickly, the other less so.
Intervals to Onset.
0 days
(day of birth)- 4
1 day — 0
2 days — 1
3 days — 8
4 „ - 1
5 „ — 0
6 days
7 „
8 „
9 „
1 each.
(In 3 cases the intervals were not recorded.,)
* The report forms part of the Minutes of the Council (vol. 1909-10, p. 737;.
†In the report of 1910, already referred to, estimates of '20 genuine cases and a possible maximum of 60 (of
all degrees of eye trouble) were made.