View report page

SMALL-POX.
The general incidence of Small-pox throughout London and its vicinity during 1929
made a very heavy demand upon the services of the staff, and in order to deal adequately
with the control of the many contacts working in the City, it was necessary to make some
temporary readjustment of duties, and matters which might be regarded as of a somewhat
routine character have been allowed to remain in abeyance in order to avoid the necessity
of engaging additional assistance. This rearrangement has, I feel, affected to some extent
the figures reported under the Factories and Workshops Section of this Report.
In all, 176 cases of Small-pox, either resident, working, or otherwise associated with the
City, were notified. Of these, four only actually resided within the one square mile, and ten
other cases, not resident, were diagnosed on City premises. It is not these cases, however,
which call for special effort in the City, but the 162 other cases, who reside outside but were
engaged within the City during the day time. These cases have almost invariably been
in contact with a number of fellow-workers, and there were in all 8,370 persons ascertained
as being contacts with City cases. It is the supervision of this large number which has
necessitated the readjustment referred to above.
Every effort is made to encourage immediate vaccination of each of these contacts,
as it is recognised that this is the first and greatest public health measure in Small-pox
control. The Corporation, during the year, expressed the opinion that this should be enforcible
by law, and have also determined to make Chicken-pox, which is liable to be
mistaken for the present mild type of Small-pox, temporarily notifiable in the City for
a period of six months. A voluntary system of notification has been in force for some years,
and has resulted in the notification of many cases, but, of course, not to the extent which
would result from a Statutory obligation.
RECEPTION AND TREATMENT OF MEASLES.
During the course of every Measles Epidemic in London a time almost invariably arrives
when the demand for hospital accommodation is greater than that which is available, and
cases are then only accepted for admission on the recommendation of the appropriate medical
officer of health, who bases his recommendation on—
(1) The type of house and facilities therein available for the proper care of the
patient;
(2) The fact that the patient is under the age of two years when the case mortality
is high; and
(3) Whether broncho-pneumonia co-exists with the measles.
By reason of the fact that measles is not a notifiable disease, medical practitioners are
often not aware that hospital accommodation is available or the conditions under which
patients are admitted, and I have therefore addressed an appropriate communication to
members of the profession practising within the City, and inviting them to communicate
with me in cases where hospital treatment is desired.
NURSING PROVISIONS.
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 1929.
INFLUENZA.
In the early part of the year the very rapid spread of Influenza in the United States
of America and Canada suggested the desirability of precautionary measures being instituted
in this country, in order to minimise the incidence of the illness should it become epidemic.
Leaflets and posters setting out the precautions which should be adopted were prepared
and issued to the larger employers of labour, such as the Banks, Insurance Companies,
Railway Companies, Shipowners, Stock Exchange, etc. They were also circulated to City
residents and exhibited at the Police Stations and other places in the City.
A communication was also forwarded to medical practitioners in the City, enclosing a
copy of the Ministry of Health's memorandum on the malady, and offering nursing assistance
in such cases as came before their notice where difficulty was experienced in this direction.
Copies of this pamphlet and posters are included in the Appendix to this Report.
14