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One of the cases of Typhoid Fever was of some clinical interest from the fact that the patient
failed to develop a positive Widal Reaction. The case was admitted to Hospital towards the end of
the second week of the illness, and he had had several intestinal haemorrhages previous to admission.
The symptoms all pointed to Typhoid Fever, and a blood count showed a leucopenia. A Widal
Reaction done on the 21st day of the illness proved negative to the Bacillus Typhosus, and the Bacillus
Paratyphosus A and B. The patient had never been inoculated against Typhoid Fever. Several
further haemorrhages occurred and the patient died on the 24th day of his illness. A post-mortem
examination revealed typhoid ulceration of the ileum.
Duration of Stay in Hospital.
The following figures show the average stay in days for certain diseases :—
Scarlet Fever, 47.2; Diphtheria, 54.1; and Other Diseases, 29.0.
Sick Staff.
The number of nurses who were off duty from sickness for 24 hours or more was 44, as compared
with 38 in 1925. The number of days they were off duty was 726, 145 days more than the previous
year. Nine nurses contracted Diphtheria, 1 Scarlet Fever and 1 Chicken Pox—all recovered.
Amongst the Domestic Staff, 29 maids were off duty for a total of 492 days. In 1925 there
were 17 members off duty for 256 days. One maid contracted Diphtheria.
Schick Test and Active Immunisation against Diphtheria.
Up to this year the Schick Test and the active immunisation against Diphtheria had not been
carried out at this Hospital. The incidence of Diphtheria amongst the nursing staff has been high,
and this is accounted for by the fact that Diphtheria of a virulent type was epidemic during the spring,
and, as a consequence, the acute diphtheria ward was overcrowded.
Early in the year the large majority of the nursing staff was Schick-tested and those giving a
positive reaction were immunised. Later in the year a considerable number of the staff attached
to the Municipal Clinics were similarly treated. After an interval of six months, the first batch
of nurses who had been immunised were again Schick-tested and those giving a positive reaction had
another course of toxin-antitoxin injections. Another batch will be due shortly to be re-Schicktested.
In one case only has there been a moderately severe general reaction after the toxinantitoxin
injection, and this only lasted for one day. Since the commencement of testing and
immunisation nine cases of sore throats have occurred in Schick negative or in immunised nurses
and these have all proved to be non-diphtheritic.
Number of persons Schick-Tested 61
Number of persons giving a positive reaction 32
Percentage of persons giving a positive reaction 52.4%
Number of persons re-Schick-Tested 11
Number of persons re-Schick-Tested giving a positive reaction 7
Percentage of persons re-Schick-Tested giving a positive reaction 63.6%
All new nurses are now immunised before going on duty in the diphtheria wards.
Dick Test.
This test has been employed on a few occasions in which a case of Scarlet Fever has arisen in
the Hospital. The patients in the affected ward have all been Dick-Tested and those giving a positive
reaction have had a prophylactic dose of Scarlet Fever antitoxin administered. By this means it
has been found that a complete control over the disease can be maintained.