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43
had recovered from an attack; several of these were above or below
school age; no medical man had been consulted in 8 of the cases. One
child had been sent to a convalescent home and was there found to be
peeling, a doctor had seen the child some days after the eruption, and
had certified her to be convalescent from influenza; but the child was
not taken to the home until 7 days after the certificate was signed, so
that by that time peeling had set in. No information had been sent in
from the school that the child had been excluded. In another instance,
a girl employed as a tailoress had a mild attack which was not
recognised at the onset, and she was not seen by a medical man until
3 weeks after, when she attended the out-patient department of the
Middlesex Hospital and was found to have her skin peeling off.
I regard the out-patient departments of hospitals as a distinct source
of danger in regard to the spreading of infectious disease. Persons
in a weak state of health are exposed in the waiting rooms to the risk
of infection from others suffering from scarlet fever, diphtheria, measles,
whooping cough, and other maladies of like nature.
Not only so, but the medical and nursing staff, and sometimes the
in-patients, become infected. During last year seven cases of scarlet
fever and two of diphtheria occurred among the staff of one hospital,
and instances occur from time to time. It is not an unusual practice,
when infectious disease occurs in the family of foreign tailors, for the
person to be taken off to a general hospital, partly in the hope that a
second opinion will prove the illness not to be infectious, and partly to
prevent disinfection and interference with work, as the patient would
be sent off to the isolation hospital direct from the general hospital
instead of from the home. Where it can be proved that a medical man
has already informed those responsible that the illness is an infectious
one, legal proceedings should be taken.
In 46 instances, 2 cases occurred during the year in the same house;
in 15 instances, 3 cases; and in 5 instances, 4 cases.
A few cases of scarlet fever appeared to be due to patients returning
from hospital in which they had been inmates while still in an infective
condition; thus, a child, who had been over seven weeks in hospital,
returned home having a nasal discharge; shortly after, his mother
developed scarlet fever, and the child was notified as still suffering, and
re-admitted to hospital. In other instances, infection seems to revive in a
patient- discharged apparently well, after being at home for a week or so.
Diphtheria.—Cases of this disease in Westminster were rather more
than in 1907, although in London, as a whole, there was a decrease.
From the subjoined table it will be seen that the cases of Diphtheria
in Westminster were fairly spread over the twelve months. Table XV
shows that Victoria, St. Margaret and St. John Wards suffered chiefly.