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19
ENCEPHALITIS LETHARGICA.
In January, 1919, Encephalitis Lethargica was added to the list of notifiable
infectious diseases, because of the considerable incidence of this disease since the
year 1917.
In the early part of the present year the Ministry of Health, in view of the
necessity of co-operation between Officers of the Ministry, Medical Practitioners
and Medical Officers of Health, issued a memorandum which was doubtless of
considerable assistance in disseminating information as to diagnosis, treatment,
infectivity, etc., of cases. It also clearly stated what action was to be taken by
Medical Officers of Health on receipt of notifications. The following suggested
precautions against infection are I think of sufficient importance to warrant their
inclusion in this report :—
" The other occupants of a house in which a case of encephalitis has occurred or is being
" treated may be assured that the disease is one of low infectivity, and that very slight risk
" is run by association with the patient. At the same time it is desirable that such
" association should be limited to what is necessary for proper care and nursing, and the
" patient should be well isolated in a separate room.
" School children in the affected household may be kept from school as a precautionary
" measure, for three weeks after the isolation of the patient.
" There is no necessity to place restrictions on the movements of other occupants pro"
vided they are frequently examined and remain well. Those in contact with the case,
" however, should be advised to use antiseptic nasal syringes or douches and to gargle the
" throat with solutions such as those advised for Influenza.
" For example any of the following :—
(1) " One per cent. solution peroxide of hydrogen.
(2) " Two per cent. solution of permanganate of potash, 1 in 5,000 in 0.8 per cent.
" solution of chloride of sodium (common salt).
(3) "Liquor sodæ chlorinate 0.5 per cent.
" The solutions can be used as ordinary throat gargles or snuffed up through the nostril
" or applied by an efficient spray.
" Any person in the infected household who suffers from sore throat or other symptoms
" suggesting an abortive attack should be treated from this point of view and isolated so
" far as possible until they have recovered.
" The sick room should be thoroughly cleansed and disinfected at the end of the illness."
Some years ago the Court of Common Council approved the expenditure of
£25 per annum for providing nursing assistance in complicated cases of measles.
It has never been necessary to use any part of this grant and the Court therefore
authorised the use of so much of it as was necessary for nursing cases of
Encephalitis Lethargica.
PREVENTION OF EPIDEMIC DIARRHOEA.
Having regard to the possibility of an increase in the death rate from infantile
Diarrhoea which might arise from the hot summer which was experienced in 1921,
the Ministry of Health in July issued a Circular Letter to Local Authorities carrying
out Maternity and Child Welfare work in England and Wales, suggesting that
preparations should be made immediately for dealing with an epidemic of Diarrhoea
should it occur.
Mortality from Diarrhoea is almost entirely confined to children under the age
of five years, and the fact that young children, who are most quickly and acutely
influenced by the condition of the home are those affected by Diarrhoea emphasises
the importance of home cleanliness as a primary factor in determining the occurrence
of the disease. Not only is it important to insist upon domestic cleanliness, but
also to ensure that all accumulations of dust, refuse and filth about dwelling houses
are removed at short intervals.
The Corporation, by means of a Circular Letter which was widely distributed
throughout the City, directed attention to the necessity of observing such a
precaution.
The special precautions suggested by the Ministry in the event of Diarrhoea
threatening to become seriously epidemic are briefly summarised below :—
(a) The attention of mothers of young children should be directed to the importance of
breast feeding during the hot weather, the methods of preserving and storing milk and other
food, and protecting it from flies, and the detection of early symptoms of illness and the
desirability of medical advice.