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Of the primary cases 242 occurred in Estate houses, and
36 in other houses, the incidence in the two types being
roughly proportional to the susceptible populations.
Owing to lack of accommodation at the Isolation Hospital,
in the course of the year about two thirds of the patients had
to be treated at home, the proportion it was possible to remove
varying, of course, at different times of the year, the greatest
proportion having to stay at home at the time of maximum
incidence of Diphtheria, when one of the wards, originally
allocated to Scarlet Fever, had to be used for the reception
of cases of this disease.
In spite of the many cases which have been home treated,
it has always been possible to admit to hospital all for whom
admission is required on clinical grounds.
At those times when beds were available, removal was not
insisted upon where home circumstances seemed favourable
and the parents expressed a desire to retain the patient at
home. It seemed illogical in these cases to stress the danger of
spread of infection in July, when few cases prevailed and
attempt to obtain removal, and then in November to have to
refuse admission to cases in which the possible spread of
infection appeared to be much greater.
In the first three months of the year accommodation was
limited, and during that period 40 cases were treated at home
to 17 removed. For six weeks beds were more free and during
this time only 12 were home treated against 17 in hospital
For the next month again admissions were restricted, 19
cases being treated at home, and 8 in hospital.
During July beds were free, only 16 patients staying at home,
31 being removed. In August and September, beds were again
getting short, and for these months there were 27 home against
28 hospital treated cases. For the last three months of the
year 93 patients remained at home to 29 admitted. The totals
for the year were:—home treated 216, hospital treated 124.
The greatest number of actual cases at home at any one time
was 46. When beds are scarce cases are admitted only in
special circumstances as reported last year, the last cases
admitted during the year being sent in for the following
reasons:—
1. Clinical grounds
2. Difficulty in nursing—
(a) adult patients 5
(b) absolute poverty in the home 3
(c) other reasons 6
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3. Wage earner would be excluded from work 3
4. Crowded homes with much risk of spread of
infection10