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of the contacts of a much smaller number of diseases but the period of
exclusion asked for at all is shorter. It was once usual where exclusion
was thought to be necessary, to require the child to remain away from
school for a few days longer than the longest limit of the period of
incubation of that disease. To-day, on the other hand, the time is a day
or two longer than the common period of incubation. Another relaxation
is that when a patient is nursed at home, the period of exclusion of the
contact is for a period from the time the patient is satisfactorily isolated,
whereas before that the period ran from the date the patient was declared
to be free from infection. It is not felt that these relaxations have resulted
in infections having spread any more than they would have under the
more rigid restrictions previously imposed.
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 signs, the child is excluded further until pronounced by a
medical practitioner to be free from infection. Infant contacts of measles
who have not had the disease are excluded for 14 days from the appearance
of the rash in the last case in the house; other contacts are allowed
to attend school. Infant contacts of whooping cough who have not had
the disease are excluded for 21 days from the onset of the disease in the
last case in the house. It is not now the practice to exclude for any time
contacts of those suffering from a number of infections, e.g. german
measles, mumps or chickenpox.
The County Council has recently revised their regulations as to the
exclusion of contacts of infectious diseases which are a guide to head
teachers where no intimation has been received from the Medical Officer
of Health or no certificate has been received from a private medical
practitioner. Under these regulations, contacts of those suffering from
enteric fever, erysipelas, german measles, dysentery, whooping cough,
chickenpox, mumps or cerebro-spinal fever, need not be excluded; nor
need the contact of a patient suffering from measles unless that contact
suffers from a cold, chill, or red eyes. It is quite probable that it will
ultimately be found that even further relaxation can be permitted in the
rules as to exclusion of contacts of infection without this practice being
found to result in the spread of infection.
Disinfection.
Except after cases of smallpox, typhoid fever, tuberculosis and
scabies, and in any exceptional cases approved by the Medical Officer of
Health, where disinfection cannot be carried out in the home, terminal
fumigation and removal of bedding and other articles for stoving after
the commoner notifiable infections is not carried out by the Council, the
household being instructed as to the precautionary measures to be taken.
Where householders still request that fumigation or stoving be carried out,
a charge is made. 7s. 6d. for fumigating the room, and 10s. for the
stoving of the first load, and 5s. for any subsequent load.
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