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accepted at the Edgware Isolation Hospital, which was the Hendon
Isolation Hospital, Goldsmith Avenue, Hendon—Medical Superintendent,
Dr. Livingstone. Tel. No. Colindale 8182. For those patients who
cannot be accepted here, but who are considered to be in need of
admission to hospital, application for their admission elsewhere is made
to the Emergency Bed Service.
Smallpox is one of the notifiable diseases which is treated in a hospital
quite apart from those taking in other infections. Before such patients
are removed to hospital, it is now customary for the diagnosis to be
confirmed by a consultant attached to one of the larger isolation hospitals.
This is arranged through the Emergency Bed Service, which also decides
which hospital the patient is to be admitted to. A similar arrangement
obtains in the case of those suspected to be suffering from typhus fever.
There are special institutions too, for the treatment of those suffering
from tuberculosis, many of the pulmonary cases being admitted to sanatoria,
while those suffering from the non-pulmonary disease who are
mostly children are, in general, admitted to separate institutions. The
arrangements for the admission to hospital of those suffering from
tuberculosis are made by the physicians at the chest clinics.
The school child who has suffered from scarlet fever is usually
excluded from school for seven days after his discharge from hospital
or from home isolation. This period is extended should he develop a
cold in the head, a discharge from the nose or ear, a sore throat or septic
spots. The period of exclusion of those who have suffered from diphtheria
is determined usually by the child's clinical condition. After
recovery, it is usual to obtain negative nose and throat swabs. A sufferer
from measles is excluded for 14 days from the appearance of the rash;
from german measles for seven days from the appearance of the rash;
from whooping cough for 28 days from the beginning of the characteristic
cough; from mumps for 14 days from the onset of the disease, or seven
days from the subsidence of the swelling; and from chicken pox for 14
days from the date of the appearance of the rash.
Exclusion of Contacts.
Because a contact of a sufferer from an infectious disease might be
a carrier either contact or incubationary, it was at one time customary to
insist on the exclusion of contacts from work. The stringency of this
practice has been greatly relaxed so that to-day most authorities exclude
only those contacts whose work brings them into association with those
of susceptible ages or which renders them possible instruments of widespread
outbreaks through their handling of milk or some other medium.
Even where exclusion is required, it is imposed only in the case of the more
severe of the infectious diseases. In regard to children attending day
schools the practice in this district is that recommended in the addendum
issued in 1942 to the memorandum on the Closure of and Exclusion from
Schools which had at an earlier date been issued by the Ministry of Health
and The Board of Education. The period of exclusion of contacts of patients
suffering from scarlet fever is seven days after the removal of the patient
to hospital or the beginning of his isolation at home. Contacts of diphtheria
are excluded for seven days after the removal of the patient to