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110
PEMPHIGUS NEONATORUM.
In March, 1933, the Medical Officer of Health submitted to
the Maternity and Child Welfare Committee the following observations
:—
Pemphigus Neonatorum is a rare but highly contagious disease of the
skin occurring in the new-born, usually between the 4th and the 14th day
after birth. Although the infection is often of mild type, serious outbreaks
have been reported in which cases terminate fatally. In October last I
reported to this Authority and to the Ministry of Health regarding a series
of five cases which occurred in the practice of a midwife in this area; and
during the past month two further cases have been dealt with.
The cause of Pemphigus Neonatorum is not known accurately, but
the infection seems to cling to clothing, medical appliances and equipment,
etc.; and we do know that the midwife or medical attendant may be the
source of infection and the means of spread.
According to the rules of the Central Midwives Board a midwife must
summon medical aid and notify the Local Supervising Authority at once in
the case of any serious rash in a new-born child attended with the formation
of watery blisters. She is also bound to undergo disinfection to the satisfaction
of the Local Supervising Authority.
There is, however, no obligation on medical practitioners to notify
such cases, as Pemphigus Neonatorum is not one of the diseases scheduled
as compulsorily notifiable in the Infectious Disease (Notification) Act.
Inasmuch as it calls for more energetic public health action than most contagious
diseases, I suggest that this Committee submit to the Public Health
Committee a recommendation that steps be taken to extend the list of diseases
notifiable under the Infectious Disease (Notification) Act to include Pemphigus
Neonatorum.
In April the Council made an Order extending the application
of the Infectious Diseases (Notification) Act to include Pemphigus
Neonatorum subject to the approval of the Minister of Health,
who formally approved the Order during the following month.
Cases during Year (Report by Dr. Menzies).
Four definite cases of Pemphigus Neonatorum occurred during 1933.
One case was notified on discharge from Queen Mary's Hospital, and the
remaining three cases occurred at intervals of two months (from February
to June) in the practice of different private midwives. There was no
apparent connection between any of the cases.
The first case, notified from hospital, had developed on the 6t,h day
after birth, and when the child was visited six days later the remains of
nine superficial bullæ were found. No further lesions developed.