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55
The disease about which most discussion has taken place about the
desirability of its continuing to be notifiable, is scarlet fever. The reason
is that the rash from which the condition takes its name, is only one of
the reactions of the body to the invasion by the organism and, many
persons attacked by the organism do not develop the rash, though they
may be just as infective as the person suffering from a typical attack of
scarlet fever and can, in just the same way, hand on that organism which
may cause a typical attack of scarlet fever in the recipient. When so
many patients suffering from scarlet fever were admitted to the fever
hospitals almost automatically because they had scarlet fever, not to
treat seriously the other infectious person just because he had not
developed a rash, seemed illogical. To-day however, when, largely
because of the mild character of to-day's scarlet fever, it is becoming
more common for scarlet fever patients to be nursed at home, the position
is more rational, and would be still more so if the test of the need for the
patient to be admitted to hospital was not so much his possible infectiousness
as the severity of his illness and his need for skilled medical and
nursing attention.
The other notifiable condition which is discussed, is erysipelas, at
one time the dread of hospital wards. To-day, this condition is usually
mild and in any event, responds well to treatment. The organism responsible
for this can cause trouble to specially susceptible persons such as
recently confined mothers. To-day, this is about the limit of the public
health significance of erysipelas.
Aids to Diagnosis.
(1) Laboratory service (see page 27).
(2) Services of a consultant—
(a) Ordinary infections: Dr. Livingstone, of the Hendon
Isolation Hospital (Tel. No. Colindale 8182).
(b) Smallpox and typhus fever: The patient's doctor can be
put into touch with one of the Ministry of Health's
panel of consultants by means of the Public Health
Office, or the Hendon Isolation Hospital.
(c) Tuberculosis: Physicians at the Chest Clinics.
Isolation in Hospital.
(a) The usual infectious diseases: Most patients removed to hospital
are admitted to the Hendon Isolation Hospital, Goldsmith Avenue,
Hendon. When there is no accommodation here patients may be
admitted to one of a number of isolation hospitals around London,
arangements being made either by the staff of the Hendon Isolation
Hospital or by the patient's doctor applying to the Emergency Bed
Service.
(b) Smallpox or Typhus Fever: Patients suffering or suspected to
be suffering from these complaints are admitted to special hospitals.
(c) Tuberculosis: Arrangements for admission are made by the
staff of the Tuberculosis Service, mostly to special but sometimes to
general hospitals.