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Although the actual condition was extremely mild,
one had to consider the possibility of the spread of infection
and that further cases might have become more
virulent than the earlier ones. Bearing in mind the
history of outbreaks occurring in other institutions from
time to time, which proved extremely difficult to overcome,
it was decided to take a serious view of the matter.
I, therefore, communicated with the Ministry of Health
on the 4th May and Dr Manson one of the Medical
Officers of the Ministry, came down on the 5th May to
assist us in the investigation. Dr. Manson, in fact,
spent the whole day at the Maternity Home with the
Matron and myself and, after a very full examination of
the position, it was decided to suspend admissions for
the time being.
The following action was also taken.
1. Nasal swabs were taken from all members of the staff.
2. Swabs were taken from a baby's spots.
3. As many mothers and babies were sent home as early
as was conducive to safety.
4. Attendance at the homes of discharged babies by
midwives from the Maternity Home was arranged
where necessary.
5. All cases were followed up by Health Visitors.
6 Walls and floors at the Maternity Home were washed
and re-sterilisation of cots, mattresses and equipment
was carried out.
7. Arrangements were made for the provision of alternative
accommodation for all booked cases.
The results of the swabs showed that several members
of the staff were nasal carriers of the particular
germ which was capable of causing this condition. By
an arrangement with the Central Public Health Laboratory
at Colindale, special typing of the organism was
carried out which showed that, in the case of one member
of the staff, the organism taken from her nose was identical
with that isolated from the baby's spot and, as there
was a prima facie case that this might have been the
origin of the trouble, the nurse in question was taken off
duty.
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