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39
The low incidence of the first quarter of the year, when only
31 cases were notified, was followed by a still lighter rate in the
second quarter, the number of cases notified being only 21. Though
in no week of the third quarter were more than seven cases notified,
the general prevalence throughout this period resulted in the total
notifications for the quarter being 46. A heavier average weekly
incidence, in the last quarter, though again with no week having
recorded more than 14 cases, made a total of 106 notifications
received for this period.
Place of Treatment.
Of the 217 cases notified, including those in whom the notifications
were later withdrawn, 54 were treated at home at the election
of the parents. 160 were admitted to the local isolation hospital,
and three to the isolation hospitals of other local authorities.
Of those admitted to hospitals, in 27 per cent. of cases there
appeared to be no real reason that the child should not have been
treated at home, a figure within the range of 25 to 35 per cent.
for the years 1936 to 1940. Air raids have apparently had little
influence on the question as to whether removal to hospital would
be requested or not. Probably there are those who, though
ordinarily they would nurse the child patients at home, are
influenced to send them to hospital because of the particular
difficulties in providing isolation of the patient and protection of
other members of the family, or because they feel that more adequate
protection can be afforded to the patient in hospital. There was
more than one patient whose parents began to treat them at home
but whose admission to hospital was actually requested because
of the air raids. On the other hand, there will be those parents
who would wish at all costs to avoid parting with their children,
so that the possibility of raiding will have the result of keeping
some at home who ordinarily would have been sent to hospital.
The fact that there is little change on previous practice is probably
to be accounted as a final result of two opposing factors. In
point of fact, the ratio of the number kept at home to those
admitted to hospital in the first quarter was 1 to 4, and in the
second quarter, 1 to 3. The slight fall of 1 to 2.5 in the third
quarter was followed by a return in the last quarter to a ratio 1
to 3. In rather more cases this year was the reason for admission
the fact that the patient was an adult, the percentage being 18 as
against 10 for last year. The figure of 15 per cent. where the
reason was the presence of younger children at home and a similar
figure where it was because there was no bedroom in which the
patient could be nursed by himself are much the same as the
figures for last year. Only in 5 cases was a request for admission
on the grounds that there was no one to nurse the patient, and
in only one case was admission requested because of the clinical
condition of the patient, this sole instance being a patient suffering
from mastoid involvement.