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76
mally would have gone home. To some extent this is offset by the admission of
cases suffering from the primary disease for which the ward is open, and who also
have satisfactory evidence of immunity to the secondary infection, e.g., cases of
scarlet fever showing definite chickenpox scars can be safely admitted to a scarlet
fever ward in quarantine for chickenpox, but this has a small effect in reducing the
wastage. The following figures are, however, set forth in the hope that they may
give some indication of the minimum percentage of loss that we may reckon on
meeting with in a two-yearly period. Since this loss is greatly influenced in London
by the regular appearance of a measles epidemic every two years, any period of
years not a multiple of two would be unsatisfactory for the purpose.
Disease.
1933.
1934.
Total in
bed-days.
Chickenpox 1,649 996 2,645
Scarlet fever 705 660 1,365
Measles 459 2,062 2,521
Chickenpox and measles 293 236 529
Measles and scarlet fever 112 43 155
Chickenpox and scarlet fever — 176 176
Mumps — 211 211
Total 3,218 4,384 7,602
From the above table it is evident that chickenpox, measles, scarlet fever, and
combinations of these are almost entirely responsible for the loss of bed-days
resulting from quarantine. The minimum total loss works out at 7,602 bed-days
in two years, i.e., 5.07 per cent, of the available bed-days in the hospital. Expressed
in another way, and allowing 38 bed-days per case of scarlet fever, this means that
during the two years in question, but for the necessity for quarantine, accommodation
could have been found for 200 more cases of scarlet fever. As might be expected
the loss shows a definite seasonal variation which may be noted from the following
table:—
Month. 1933. 1934. Total.
January 513 519 1,032
February 365 540 905
March 289 1,016 1,305
1st quarter, 3,242,
or 8.7 per cent.
April 523 844 1,367
May 379 334 713
June 491 263 754
2nd quarter, 2,834,
or 7.6 per cent.
July 97 346 443
August 242 152 394
September 60 69 129
3rd quarter, 966,
or 2 • 5 per cent.
October 73 52 125
November 43 37 80
December 143 212 355
4th quarter, 560,
or 1 • 4 per cent.
Total 3,218 4,384 7,602
From the above it is obvious that the seasonal loss operates to the disadvantage
of the hospital in that it occurs at the time of maximum pressure on the
accommodation.
Acute poliomyelitis.
Of the 24 cases of acute poliomyelitis under treatment during the year at the
Western hospital, where there is a special unit for this disease, 3 were discharged
cured, 13 were transferred to Queen Mary's hospital for children, Carshalton, 1 was
transferred to St. Mary Abbots hospital, and 7 were still under treatment on 31st
December, 1934. During the year 20 cases of poliomyelitis were admitted, but