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34
RETURN CASES OF SCARLET FEVER AND DIPHTHERIA.
By the term "return case" is implied the cases where the return
of a former patient from a fever hospital is responsible for the
infection appearing in another member of the household. From a
recent enquiry into the cause of these return cases by Prof. Simpson,
it seems that of the former sufferers from Diphtheria and Scarlet
Fever discharged from the Metropolitan Asylum's Board's Hospitals,
under 2 per cent. convey the infection home with them, and that of
these the large majority do so on account of discharges from the nose,
ears, etc., and not because they have been prematurely discharged
while still suffering from the actual disease.
Dr. Turner, the Medical Superintendent of the South-Eastern
Hospital, in his observations on Professor Simpson's report, suggests
that the managers should try the experiment of isolating cases before
discharge in a separate house, one patient in each room. Professor
Simpson supports this suggestion, and recommends that in cases of
oral and nasal discharge the patients should be thus isolated,
the discharges treated antiseptically, and the patient sent out after
isolation for a fortnight.
As I have advocated elsewhere, two or three years ago, a printed
notice should be issued by the Metropolitan Asylum's Board, and
given to every parent or guardian whenever a patient is discharged
from hospital, advising them to make arrangements, if possible, for
the individual discharged to keep from other children and to sleep in
a separate bedroom or bed for one week subsequent to his return
home. I believe if parents and guardians would and could carry out
this practice instead of the present general practice of putting a child
straight from a fever ward to sleep in the same bed with other
children, we should hear far less of "return cases." Professor
Simpson, in his report, makes a similar recommendation.