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9
Puerperal Pyrexia
One hundred and ninety notifications of puerperal pyrexia were received during 1966. All the
cases occurred in hospital, 80 of the patients being persons normally resident in Westminster.
Puerperal pyrexia is defined as any febrile condition occurring in a woman in whom a temperature
of 100.4°F. or more has occurred within fourteen days after childbirth or miscarriage. Table 6, page
66, shows an analysis of the causes of pyrexia in the cases notified in 1966.
Typhoid Fever
The two cases of typhoid fever notified during the year were both instances of isolated infection
occurring in persons from abroad who were admitted to hospital shortly after arrival in this country.
No secondary cases developed.
INTERNATIONAL CERTIFICATES OF VACCINATION AND INOCULATION
Arrangements continued during the year for the authentication by the Medical Officer of Health of
International Certificates of Vaccination and Inoculation completed by medical practitioners in
Westminster. These certificates are required by persons proceeding abroad from this country,
and the purpose of the authentication is to provide proof to those health authorities overseas who
desire it that the signature of the person issuing the certificate is that of a registered medical practitioner.
After normal office hours, at weekends and on public holidays, certificates can be authenticated
upon application to the Duty Officer at City Hall.
Thirty-three thousand three hundred and ninety-four such certificates were authenticated in 1966
compared with 12,740 in 1965, the unusually heavy demand during 1966 being due to the outbreak
of smallpox in the West Midlands.
The Medical Officer of Health also issues, on request and in appropriate circumstances, certificates
to the effect that no cases of smallpox have occurred in the district during the preceding two weeks.
These certificates, some 40 of which were issued during 1966, are sought mainly by persons
proceeding to the United States of America who do not wish to submit to vaccination. It is understood
that the United States immigration authorities reserve the right to place such persons under
surveillance notwithstanding the production of a certificate of this kind.
AFTER HOURS EMERGENCY TELEPHONE SERVICE
This service has continued to prove its value as a simple and effective means of providing comprehensive
coverage of health, welfare, medical and similar emergencies arising outside normal office
hours. It is administered by the City of Westminster Health Department and financed jointly with the
Royal Borough of Kensington and Chelsea to cope with any such problems arising within the areas
of the two Authorities.
The control centre is at City Hall, Westminster, and it is manned by four Duty Officers working on a
rota system. Each Duty Officer has at hand files of general and specialised data relating to all
available services, and the telephone numbers of senior officers and other staff on standby duty
for the respective Health, Welfare and Children's Departments together with details of parallel
emergency telephone services in the other London Boroughs and elsewhere. He is thus able to
refer any given emergency directly to the appropriate officer or service, and to supply information,
advise generally, or pass the less pressing matters to the appropriate day staff for attention.
The officers always available on call for Westminster and for Kensington and Chelsea include the
Medical Officers of Health or their Deputies, Senior Medical Officers, Mental Welfare Officers,
Children's Officers, Welfare Officers, Midwives and Public Health Inspectors. Senior officers in
other departments of the Council and other officials such as Coroner's Officers, District Surveyors,
can also be contacted through the control centre if necessary.
The Duty Officers have a working knowledge of the services with which each of the various departments
deals and this, together with information from the files, and their experience of the types of
problems likely to arise, enables them to advise on many matters which require no immediate
specific action.
Further advantages of the system are that officers called to a particular case are enabled to report
back periodically to the centre to receive additional messages, seek the advice or assistance of
colleagues, pass reports for subsequent action by day staff, or instruct the Duty Officer to make
telephone calls on their behalf with a consequent saving of time. The Duty Officers are also available
to authenticate International Certificates of Vaccination where early departure prevents this
being done during normal office hours, to receive bacteriological specimens and transmit them to the
laboratories for examination, to issue vaccines to medical practitioners, to summon police or