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2. Precautions after reception home.
(a) Modified isolation from rest of family who are presumed to be susceptible—
chiefly the younger members—thus, sleeping apart, avoidance of kissing, fondling
and playing in common; the use of separate utensils.
This would be almost impossible in our district in the majority of cases.
(b) The issue of a special warning card on the day of the patient's dismissal
from hospital, advising the parents to consult a medical man on the appearance of
sore nose, rhinorrhea, otorrhea, coryza, bronchitis, etc., within a certain time after
return home.
(c) Notification of dismissal from hospital of all cases to be sent to the Sanitary
Authorities. (This has lately been done by the Asylums Board.)
3. Patients convalescent from Diphtheria to be discharged "culture free."
4. Patients recovering from Scarlet Fever should not be sent home if they have
discharge from the nose, throat, etc., or are peeling.
5. Isolation within isolation.
In this method each case is removed to hospital, and there isolated, so that
the hospital is in reality a large aggregation of isolation rooms containing
single beds. A modification of this method is already being carried out in France
with admirable results. (Article on "Measles" in "Twentieth Century Practice of
Medicine.")
6. In the absence of the measure last indicated, the treatment in wards of the
"clean" cases alone; the "unclean" being isolated and detained in hospital in
single-bedded isolation rooms. The chief objection to 5 and 6 is that of expense.
7. The re-notification and re-admission of the primary case as soon as one case
is notified.
The need for inquiry is emphasised by the fact that "return cases" occur
frequently in all the other Metropolitan Districts. They are the cause of a great
deal of anxiety and expense.