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This, of course, would involve a most exacting nursing
regime, embracing as it would immediate sterilisation, not
only of all utensils, but the hands and forearms of doctors
and nurses after each patient has been dealt with. It would
mean the wearing of a separate gown for those in attendance
on each patient, the employment of dust allaying methods,
and it would mean that each patient would be a unit within
his own barrier, both within the ward and outside during
his exercise. This may seem a spartan mode of treatment
but it can be said without equivocation that if patients are
to be nursed in common in multi-bedded wards, it is the only
method likely to achieve the avoidance of crossed infection
by the different strains of streptococci in the common ward.
This method is being operated with success in a number of
Isolation Hospitals and has even been introduced to the ear,
nose and throat wards of general hospitals, and it would be
no more spartan—even less so—than is the cubicle system.
Now that different types of this organism are recognisable
it would be possible to identify the infecting type of organism
at the time of the patient's admission and the rigid confinement
of each affected person within the confines of his barrier
could be relaxed, at least during his exercise in the open air.
In other words, types could be segregated in common.
Another method of avoidance of complications particularly
those complications which arise from the patient's own
original type of streptococcus—for as already said no form of
isolation will obviate this cause of complications—suggests
itself by the employment of the new drug, Prontosil album,
which has proved so effective in treatment of streptococcal
infection following childbirth.
(Note :—As a result of a subsequent report upon this subject
to the Public Health and Medical Services Committee,
all the necessary equipment has been approved in
order to carry out this system.)
Return Cases.
There were 7 return cases of Scarlet Fever during the year
as compared with 16 during 1935.