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21
intelligent supervision of the Sanitary Staff, and
outbreaks of infectious disease have been very materially
limited.
Unrecognised cases as in previous years have been
the origin of most outbreaks, and such unrecognised
cases are always likely to exist in all diseases especially
if the attack is a very mild type, so mild indeed are some
of these cases that the advice of a medical man is, by the
parents of the patients considered superfluous. These,
unfortunately, are the cases which prove the nuclei of
almost every epidemic. This has been particularly the
case in the outbreaks of Scarlet Fever in Mitcham,
Coulsdon and Woodmansterne, and Typhoid Fever in
Mitcham and Merton.
Immediately on notification being received of the
existence of cases of Scarlet Fever, Diphtheria, Typhoid
Fever, and Small Pox, it is the custom to offer hospital
treatment, and if the offer is accepted the patient is at
once removed to the Hospital; in no case should longer
than two hours elapse after receiving the intimation of
the existence of infectious disease in any house before
the patient, if for removal is in the Hospital, unless the
ambulance is in use removing another case, when
removal may be delayed considerably. This delay is to
be deprecated in all cases of diphtheria.
In all cases of Typhoid Fever which are not
admitted to the Hospital, sanitary pails, of a special
character, furnished with air-tight screw lids, are left at
the infected houses for the reception of all excreta and
other waste products of the sick room. These pails are
collected daily, and their contents are dealt with in the
destructor at the Hospital.