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17
ANTI-TOXIN IN DIPHTHERIA.
Although the administration of anti-toxin to practically every recognised case of diphtheria
has resulted in a great reduction in the mortality from that disease, it was apparent
that there was need for authoritative advice as to dosage. The London County Council
appointed a committee of experts to consider this question, and their valuable report has
been circulated to all medical practitioners in the City and also to St. Bartholomew's Hospital.
PUBLIC HEALTH OPHTHALMIA NEONATORUM (AMENDMENT) REGULATIONS, 1937.
Ophthalmia Neonatorum is a purulent discharge from the eyes of an infant, commencing
within 21 days from the date of its birth. It is usually a gonorrhœal affection, and if not
treated promptly and efficiently, is very likely to result in blindness. Regulations for the
notification of this disease were first made in 1914, when notification had to be sent to the
Medical Officer of Health of the district in which the parents or guardians of the child were
living by either the certified midwife or the medical practitioner in attendance. This dual
notification by midwife or doctor led to confusion and in some cases to failure to notify at
all. Therefore new regulations were introduced in 1926, placing the obligation to notify
on the medical practitioner only. Notification had, however, to be sent to the Medical
Officer of Health of the district in which the parents or guardians of the child were living,
and the local medical officer of health was required to send a copy of the notification to the
county medical officer of health within 24 hours. In 1928, amendment regulations were
issued requiring that notification should be to the medical officer of health of the district in
which the doctor was attending the child. In the administrative County of London cases
occurring in Hospital must be notified to the medical officer of health of the district from
which the child or mother was brought to the hospital.
It has now been agreed that it is essential that notification should be received at the
earliest possible moment by the maternity and child welfare authorities, who are in a position
to give assistance by home visiting and nursing or by hospital treatment.
Further amendment regulations, styled the Public Health (Ophthalmia Neonatorum)
Regulations, 1937, have therefore been issued, and came into operation on the 1st April, 1937.
These require that notification shall be direct to the Medical Officer of Health of the local
authority for the purposes of the Notification of Births Acts, which is in all districts the
Maternity and Child Welfare Authority. The Regulations also provide that the medical
officer of health for the district which is not a maternity and child welfare authority will
receive a notification of any case of Ophthalmia Neonatorum occurring in his district from
the County Medical Officer of Health, and that the County Medical Officer of Health will
receive prompt information of all cases occurring in the County. Thus notification will
be direct to the authorities able to act on the information for the benefit of the patient,
but provision is made for copies of the notifications to be sent promptly to authorities
indirectly concerned.
LEPTOSPIRAL JAUNDICE.
Leptospiral Jaundice is an uncommon disease in this country and is difficult to diagnose,
particularly in mild cases. I have therefore made arrangements for blood tests to be taken
of all suspected cases amongst City sewer workers, and have also arranged that, in the case
of any of these men who are away from duty suffering from any ailment which even remotely
suggests the possibility of leptospiral infection, a letter be sent to the medical practitioner
in attendance, reminding him that this disease is an occupational risk amongst sewer workers
and informing him of the facilities for diagnosis.
SCABIES AND IMPETIGO.
In consequence of the increase during recent years in the number of cases of Scabies
and Impetigo reported by head teachers of the London County Council day schools, as well
as in the number attending the bathing centre provided by the Council, the London County
Council prepared a circular letter for distribution to medical practitioners, indicating the
facilities available for the treatment of Scabies and Impetigo, and at the request of that
Authority I have circulated this letter to the medical men practising within the City area.
See Appendix F.