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CHAPTER 111.
INFECTIOUS DISEASES.
1. SERVICES PROVIDED, Notification, investigation,
pamphlets issued on the various infectious diseases, exclusion
from school of patients and contacts, advice re milk handlers—
Disinfection — Hospitalisation generally at Hendon Isolation
Hospital or Neasden Hospital, re puerperal pyrexia and ophthalmia
neonatorum, Emergency Bed Service, re poliomyelitis at Royal
National Orthopaedic Hospital, re smallpox at Joyce G-reen
Hospital, Dartford — Notification of tuberculosis—Compilation of
tuberculosis register—Weekly and quarterly returns to Ministry of
Health and County Medical Officer—Authentication of travellers'
inoculation state—Food poisoning notification and investigation—
Scabies, arrangements with Royal Borough of Kensington—Complete
bacteriological service available at Central Public Health
Laboratory, Colindale, outfits distributed from Public Health
Department—anti-toxin available, diphtheria.
2. SMALLPOX. During the year we were unfortunate
enough to have one case of Smallpox in the area, which was of the
virulent Eastern type, and resulted in a very rapid death of the
sufferer.
It is of interest to record that the patient (an Australian
lady) was in contact with Smallpox at sea round about the 24th
March and landed in England from the S.S. Mooltan on the 3rd
April. She was vaccinated before leaving the ship but, unfortunately,
too long after the moment of contact with the virus to be
of any avail. On landing in this country she was notified to the
Department by the Port Health Authority, London, and placed
under surveillance for a period of fourteen days. Naturally, her
movements during this time were uncontrolled and before developing
the disease she was in direct and indirect contact with many
hundreds of persons in Wembley and in London. When the first
evidence of illness became apparent it was thought that she could
be suffering from the results of vaccinia and, indeed, this opinion
persisted for some twenty-four hours, but an increase in the
severity of her symptoms suggested that further precautions must
be taken and the Smallpox consultant of the Regional Hospital
Board was called to see the case, A diagnosis of Smallpox in its
very early stages was made and within three hours the patient
removed to isolation hospital where, I understand, she died before
the typical focal rash had appeared. Scientific investigation of
the condition was undertaken before removal and the Smallpox
virus was cultured on the developing membranes of an incubated
egg. Needless to say the notification necessitated the vaccination
of many hundreds of contacts and their surveillance for the
appropriate period, but one is happy to record that no secondary
cases occurred as a result of contact with this individual patient,
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