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Scarlatina. During the summer months the district was remarkably free from
this disease, only 7 cases being notified from the middle of April to the
middle of September. In the closing months there was a small outbreak
entirely among children of school age, but the patients were so widely
scattered that the source of infection could not be traced to any particular
school. 7 cases were clearly due to contact with earlier cases from the
same houses( one particular family supplied 4 patients), and 4 cases were imported
into the District, in some instances causing the infection of other
members of the family.
No setter how exhaustive enouiries are made it is often impossible
owing to the fact that the district is to such a large extent a dormitory for
workers elsewhere, to trace conclusively the source of infection.
33 of the cases were treated at the Isolation Hospital and 2 at home.
Diphtheria. In January, the Council, acting under the powers conferred upon
them by Sec. 67 of the Public Health Acts Amendment Act 1907, provided nursing
attendance at home for two cases of Diphtheria where the patients were unfit
for removal to the Isolation Hospital. One of these cases proved fatal and
the other made a good recovery. There was a second fatal case in .February
1913.
Three of the cases notified were clearly imported, one of them,who
had been in attendance at the London Hospital as a Clerk, having contracted
the disease on his eye.
7 of the patients were treated at home, and 5 were removed to the
Isolation Hospital.
A child from this District on a visit to friends in the Metropolitan
Borough of Woolwich was taken ill with diphtheria, and as a precautionary
measure the house waff disinfected.
The question of period of isolation of cases of Scarlatina and
Diphtheria is interesting.
Many hospitals keep patients suffering from scarlet fever under
treatment for two or three months or even longer. In the Council's hospital
a patient is seldom detained longer than five weeks and I think four weeks
will eventually be found long enough.
In cases of diphtheria it is in my opinion often impossible to obtain
negative swabs until the patient has left the Hospital. As a rule I
dismiss the patient in three weeks with instructions to abstain from close
contact with other persons for a further period of a week.
Prom a Blue Book issued by the Medical Officer of the Local Government
Board it appears that the incidence of scarlet fever and diphtheria per
1,000 of the population in Bexley and the neighbouring Districts during the
year 1913 was as follows:- Scarlet Sever. Diphtheria.
BEXLEY UR3AST DISTRICT. 2.2 .6
Dartford Urban District. 3.0 .78
Erith Urban District. 4.2 1.4
Foots Cray Urban District. 3.3 2.3
Dartford Rural District. 2.7 1.7
Woolwich Borough. 5.3 3.3
Rules somewhat similar to those adopted here have been in operation
at Southampton and Leicester for some years, without resulting in any increase
of infections. In those places patients are discharged without regard
to whether desquamation or peeling is complete.
Shortening of time mates a great difference the amount of
accomnodation required, and in the cost of maintenance.
Measles. Owing to the prevalence of measles among the scholars, the
Upland Council Schools (Infants Department) were closed from January 23rd to
February 14th inclusive; the Bexley heath Church of England Schools (infants
Department) from February 7th to 28th; and the Bexley Church of England
Schools (infants Department) from Larch 17th to April 6th., with a view to
preventing the spread of disease.
This disease is not notifiable in the District, nor do I consider it
necessary that it should be notifiable.
There is in operation an arrangement with the head-masters of the
Public Elementary Schools whereby cases of suspected illness among their
scholars aer reported to me.
Infectious Disease Frevention Act 1890, Ho orders for the cleansing and
disinfacting of pvemitses under the provisions of Section 5 of the above Act
3vve been required or issued during the year.
Seven Orders for the cleansing and whitewashing of premises under
Sec. 46 of the Public Health Act 1875 were made, and all but two (which were
made in December) were complied with at the end of the year. A notice outstanding
at the end of December 1912 was also complied with during the year.