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isolating in hospital individuals suffering from streptococcal sore
throat associated with a rash, whilst ignoring those with a similar
sore throat and no rash. To do so does not protect the community,
but it is impracticable to remove to hospital all those suffering
from streptococcal sore throat and it follows that the needs of the
particular patient should decide whether or no he should be given
hospital accommodation.
Cross infection, which is largely responsible for the complications
of ' scarlet fever,' does not occur if the patient is nursed
at home and this is one of the main reasons for advocating home
treatment of this disease wherever possible. Although the
welfare of the patient is the first consideration, other aspects of
the problem cannot be ignored, and one of these is the possibility
of the spread of infection by milk or foods which are consumed
uncooked, whilst another is the risk of infecting a woman in the
later stages of pregnancy. Where, therefore, a case of ' scarlet
fever ' occurs in a household, a member of which is a food handler,
or where there is a woman approaching confinement, it would be
inadvisable to have the patient nursed at home. It is, therefore,
recommended that admission (of cases of ' scarlet fever') to
hospital should be determined by:—
(1) the severity of the disease;
(2) the home nursing facilities;
(3) the employment of another member of the household in
the preparation or distribution of food for public
consumption;
(4) the approaching confinement, say within one month, of
any female in the patient's home.
It is highly desirable that the public should be informed of
the altered view now taken by the medical profession of ' scarlet
fever,' and it is felt that this can best be done by the family
doctor."
Members of the Council will recall that occasions have arisen in
the past when the methods of the control of Scarlet Fever have been
challenged. It is hoped that now the position has been clarified, the
confidence of the public will be won.
DIPHTHERIA
IMMUNISATION.
A steady flow of children to the Diphtheria
Immunisation Clinics has been maintained
during the year, and an increasing number of
children under five years of age has attended the Infant Welfare
Centres for this purpose. Owing to removals from and into the
Borough, it is not possible to give with any accuracy, the percentage
of children in the Borough who may be regarded as successfully
immunised, but the low incidence of Diphtheria may be taken as an
index of the immunity of the population.