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64
Patients suffering from smallpox are admitted to special hospitals,
and for many years those from Middlesex have been admitted to one of
the London County Council special hospitals. Before admission to a
hospital can be arranged, it is now necessary that the opinion of a consultant
shall have been given confirming the diagnosis. The Regional
Hospital Board has arranged that consultants might be available through
the machinery of the Emergency Bed Service. The actual arrangements
for removal of the patient and his admission to hospital are made by the
same body.
TYPHUS FEVER.
Typhus fever, a louse-borne infection, is not ordinarily present
in this country, but is liable to be imported, particularly during wars.
Air travel increases the risk of importation, so many visits have to be
paid to the homes of those about whom information is received that they
have recently arrived by air from a suspected area.
If a case is suspected the opinion of a consultant can be obtained
just as in the case of smallpox. Patients suffering from typhus fever
are not admitted to the ordinary isolation hospitals. Because of the
manner in which it is conveyed, special precautions have to be taken by
all those who come into contact with what may prove to be a case of
this infection, every member wearing special garments which will reduce
the risk of louse infestation. For this reason the suspect is removed
to hospital not by the ambulance which is used for the removal of those
suffering from the commoner infections, the arrangements for the removal
of the patient are made by the authorities of the hospitals to which these
patients are admitted.
MALARIA.
Although at one time endemic in large areas of this country, to-day
malaria is endemic only in limited localities, and in general the greatest
risk of infection is the return home of those large numbers of members
of the services who have been in malarial-infested countries. Notifications
are occasionally received, though in fact not one was in 1948.
All of those in this area have referred to persons who had contracted the
infection abroad and were suffering from relapses.
ENTERIC FEVER.
Each year a small number of notifications is received amongst those
living in this district. Very rarely the disease is typhoid fever, the
vast majority of the cases being of paratyphoid fever, the organism
nearly always being the para B type. Although clinically similar—though
again the paratyphoid illness is in general more mild in character than
the typhoid infection—epidemologically the diseases are very different in
that typhoid fever is almost always related in its incidence to water, while
paratyphoid infections are more commonly food borne. The ultimate
origin of the organism is human.