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18
Cross Infection : 26 patients suffered from chicken pox while in-patients
in the scarlet fever wards, three of these apparently being in the incubation
stage at the time of their admission. In addition, there was one case
each of measles, German measles and whooping cough. In the absence
of cubicle accommodation the introduction of any cross infection cases
creates administrative difficulties.
Return Cases : Return cases were notified from 12 households to which
patients treated in hospital after scarlet fever returned during the year.
Period of Stay : 60 per cent. of the patients were discharged within
24 days from the onset of their illness, the commonest interval from onset
to discharge being 20 days; 4 per cent. went home on the 18th day and
the following percentages on the succeeding days, 8, 16, 12.5, 11.5, and 9.
Just over 20 per cent. were in until the 30th day or longer. Most of
these were held up because of some minor condition which might be
infective, e.g., moisture of the nose or a crack at the angle of the mouth,
the nose or the ear, some because of some associated minor condition such
as pustular eruption, while some were retained in hospital for longer
than the usual period because of some cardiac condition from which they
were suffering when admitted.
Diphtheria.
Number admitted on a diagnosis of diphtheria 63
Number of cases clinically diphtheria 45
Number of carriers 2
Of the 16 cases in which the diagnosis was not confirmed the revised
diagnosis was tonsillitis, including quinsy, in 10 cases ; laryngitis or
croup in 4 ; and scarlet fever and influenza one each.
Of the 45 cases clinically diphtheria, 43 were faucial, one nasal and
one laryngeal. Both the carriers were nasal.
Deaths:
Number of deaths from diphtheria amongst those admitted during
the year, one.
Case mortality : 2.5 per cent.
This fatal case was that of a boy of 4 admitted on the 3rd day of illness
with an attack of faucial and nasal diphtheria, who died on the 7th day
after admission. Another child admitted in 1941 died on January 1st;
this case was mentioned in last year's report. Another fatality occurred
in a child admitted suffering from croup with oedema of the larynx,
tracheotomy being performed very shortly after admission.
Complications : Apart from evidence of involvement of the heart muscle
in a number of patients, the only complications occurred in one patient who
developed slight paresis of the palate, and three who had albuminuria
of varying degrees.
7 per cent. of those to whom serum was administered reacted by the
production of a serum rash.