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16
NURSING PROVISION.
Measles, etc.—The Corporation has approved of the expenditure of £25 per annum in
respect of the nursing of complicated cases of Measles, Encephalitis Lethargica and Cerebrospinal
Fever, and have also agreed to expend the sum of £30 on provision of medical assistance
and nursing attendance in necessitous cases of Influenza. No action was necessary under
this heading during 1928.
TEMPORARY ISOLATION ACCOMMODATION,
29, MIDDLESEX STREET,
Suitable accommodation for isolation and observation of Small-pox Contacts is provided
by the Corporation at 29, Middlesex Street, but it has not been found necessary to use the
accommodation during the year.
NOTIFICATION OF ACUTE RHEUMATISM.
In view of the crippling and ultimately deadly results of acute rheumatism in children
and the desirability of obtaining the fullest information as to its incidence and prevalence,
I am in complete accord with the endeavour which is being made by the Metropolitan
Boards Standing Joint Committee to secure the notification of acute rheumatism in children
under 16 years of age and of the establishment of supervisory centres in London.
THE INFECTIOUS DISEASES (LONDON) REGULATIONS, 1927.
The above-mentioned regulations, which came into operation on the 1st January, 1928,
revoke the Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1919, which
were issued to make provision against the number of infectious diseases, such as Dysentery,
Malaria, and Trench-Fever, which, it was feared, might be introduced into this country
by soldiers returning to London from overseas, and the precautions possible under the regulations
doubtless contributed to the low incidence of these diseases. Their provisions, after
review and amendment, have been issued as a fresh set of regulations under the title of
"Infectious Diseases (London) Regulations, 1927." One of the most apparent alterations
is the removal of Trench-Fever from the list of diseases which are notifiable. An important
addition has been made with regard to Malaria. There had previously been no legal obligation
to report cases of Malaria induced in an Institution as a method of treatment for other
conditions, and although such cases are still not required to be notified, the practitioner
in charge of the case, if of the opinion that the patient is liable to relapses of Malaria, shall
notify the Medical Officer of Health of the district in which the patient proposes to reside
at least four days before his discharge from the Institution. Upon receipt of a notification,
the Medical Officer of Health is required, amongst other things, to take such steps as are
necessary or desirable to investigate the source of infection, for preventing its spread by
removing conditions favourable to infection, and if no medical practitioner is in attendance
on the patient, shall take such steps as are necessary or desirable for ascertaining the nature
of the case. In Malaria endeavours are to be made to obtain material for microscopic
examination, and also to ensure that the patient is supplied with the necessary quinine, etc.
In Typhus and Relapsing Fever provision is made for the destruction of lice.
In Enteric Fever and Dysentery steps must be taken to protect food against contamination
by the patient or by a carrier of the infection who may be concerned with the preparation
or handling of food or drink for human consumption. In this connection the affected person
may be prevented from following his occupation, and provision is made for appropriate
compensation. All medical practitioners resident or practising within the City area were
made aware of the operation of the new regulations and were supplied with a copy. The
number of notifications received by me during 1928, in accordance with the requirements
of the regulation, were 5.
BAKER'S DERMATITIS.
Some consideration was given during the year to a suggestion made by one of the Metropolitan
Borough Councils that powers should be sought to enable a Medical Officer of Health
to enter a bakehouse and examine the staff employed, with a view to detecting the existence
of skin diseases such as Baker's Dermatitis (Baker's Itch). Other cases are due to direct
irritation of skins which are sensitive to some constituent of flour. These come into the
category of idiosyncracies homologous with nettle rashes occurring on ingestion of certain
food by certain individuals. This affection is an Eczema, particularly of the hands and
arms, due to the lodgment of a mite. The irritation induced causes scratching and a consequent
exematous inflammation of the hands and arms, which is protracted by the contact
of glutinous matter such as flour.