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54
Throughout the greater part of the year it has been necessary
to exercise some measure of selection in regard to the cases admitted
to the Isolation Hospital and to arrange, whenever possible, that
patients suffering from the disease in a mild form should be nursed
at home. For this purpose it has been essential for every case
to be visited by the Sanitary Inspector prior to arranging for
admission to the hospital so that full information regarding the
home circumstances could be available to determine the necessity
for removal.
Despite this limitation of admissions the accommodation at
the Isolation Hospital for cases of scarlet fever was severely taxed
throughout the whole year and on several occasions every bed was
occupied and urgent cases had to be refused admission. Fortunately
the Willesden Isolation Hospital was able to admit ten cases of
scarlet fever whose treatment in hospital was urgently necessary.
To encourage the home-nursing of cases as far as possible
the following letter was issued to all medical practitioners in the
Borough of Ealing :—
Prevalence of Scarlet Fever.
14th December, 1933.
Dear Sir,
Owing to the prevalence of scarlet fever in the Borough and the
accommodation at the Isolation Hospital being overtaxed it is not
possible to remove to hospital all cases of scarlet fever. It is now
generally recognised that it is not necessary to treat all cases in hospital
and as far as practicable cases should be nursed at home. Whenever
the condition of the patient or the home circumstances or both call
for the removal of the patient to hospital every effort will be made
to effect removal. Sometimes if removal is not immediately practicable
it may be in the course of a day or two.
To make sure that all cases are treated on their merits an enquiry
is made regarding all of them before removal and while the recommendation
of the medical practitioner will receive every consideration
it must be clearly understood that my decision, as Medical Officer
of Health and Medical Superintendent of the Hospital, is the one
that must be accepted in all cases.
Yours faithfully,
THOMAS ORR,
Medical Officer."
Enteric Fever.—Four cases of enteric fever were notified
during the year. Particulars regarding these cases are as follows :—
(1) Male, 36 years of age ; a farmer staying at an hotel
in Ealing. There was a history of relations in the country
also suffering from a similar illness. This led to the discovery
of other cases.