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Any members of the infected household who appear to have
a cold should remain isolated and be seen immediately by the
family doctor.
This disease is infectious, and while many are infected, few
actually succumb to the invasion. The carrier condition is much
more responsible for the spread of infection than is a patient
himself while too it must be realised that the presence of these
carriers helps in the formation of a protective immunity amongst
the general population. There is no justification for alarmist
action on the outbreak of a case in a district. While it be possible
that the occurrence of one or two cases may be the beginning
of an explosive epidemic, the probability in England is
against it. But, of course, on the occurrence of the very first
case, reasonable action requires to be taken by the Medical
Officer of Health, and his action will be very similar regarding
the first case to that which will be taken regarding individual
cases which may be proved later to form part of an epidemic,
Cerebro-Spinal Fever.
One case of cerebro-spinal fever was notified in a female
aged 10 years. The patient had been admitted to Redhill County
Hospital where she died.
Lymphocytic Meningitis.
The following case is recorded in some detail, as both its
occurrence and the action called for show the necessity for a
continual lookout for the unusual case as well as of contact
with other Health Departments throughout the country, even
beyond this country on occasion.
The medical officer of health was asked by a medical colleague
to see a woman, aged 20, who had just arrived from
Ireland. She was very ill, the doctor suspecting cerebro-spinal
meningitis. There was present, however, a very arresting rash
which had a dusky look immediately suggesting typhus fever,
now a rare disease in this country.
The advice of the Ministry of Health was sought and a
medical officer visited the case. The differential diagnosis was
decided to be typhus fever, cerebro-spinal fever or poliomyelitis,
and the girl was admitted to an isolation hospital of the London
County Council. Regarding cerebro-spinal fever, in due course
the cerebro-spinal fluid did not indicate such a diagnosis, and,
for a day or two, on clinical grounds the case was thought to
be typhus fever. Again, however, the Weil Felix reaction (a
reaction generally associated with typhus fever) was negative
on repeated trial. The less usual virus infections were then
considered. In a few days the information was obtained from
a hospital in Surrey that another girl, who had been in Ireland
with the Wembley patient, was ill with paralysis of both legs.
Intensive examination of this latter patient revealed the disease
to be "benign lymphocytic meningitis."
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