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pox, and german measles. It would not be practicable, nor is it necessary
to admit all those suffering from measles and whooping cough, though it
is most desirable that those suffering from these complaints who are very
young or are badly housed, or are suffering from the more serious of the
complications, should be admitted. Diphtheria and enteric fever are
two diseases which need skilled nursing, and all sufferers should be treated
in hospital. Although infection is considered to have only rarely been
spread by actual cases of poliomyelitis and cerebro-spinal fever, sufferers
from these diseases are treated more often in isolation than in general
hospitals. Particularly during an epidemic of influenza those suffering from
the complications of this complaint are, if possible, admitted to hospital.
With the very mild clinical type prevailing to-day, it is unnecessary for
those suffering from scarlet fever to be admitted to hospital. Most
of the patients admitted to an isolation hospital are accepted at the
Edgware Isolation Hoapital, 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.
Patients suffering from smallpox are 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. A similar arrangement obtains in the case
of those suspected to be suffering from typhus fever.
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.
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 wide-spread 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.
The period of exclusion of day-school contacts of those suffering from
scarlet fever is seven days after the removal of the patient to hospital
or to the beginning of his isolation at home. Contacts of diphtheria
are excluded for seven days after the removal of the patient to hospital,
or the beginning of his isolation at home; if there are any suspicious