Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Harrow]
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107
(3) In London Administrative County, notification of certain
diseases diagnosed in hospital is required to be made to the
Medical Officer of Health of the district from which the patient
was admitted and should be counted in the returns of that
district. The diseases concerned are:—Smallpox, cholera, diphtheria,
membranous croup, erysipelas, scarlatina or scarlet fever,
typhus, typhoid, enteric fever, relapsing fever, plague, measles,
whooping cough.
Cases of other diseases diagnosed in hospital in London should be
notified to the Medical Officer of Health of the district in which the hospital
is situated, as is required by paragraph 1 above and should be counted
in the returns for that district.
Enquiries
Following receipt of the notification, a visit is made to the home.
Up to recent years, this was carried out by the sanitary inspector, because
so many of the infections were considered to have their origin in some
defect in the drainage or in the structure or ventilation of the house.
To-day, with an appreciation of the individual as the source of infection,
in most cases the visit is made by the health visitor. It is felt, too, that
she might be the more suitable person to give advice about isolation
and concurrent disinfection, which is considered to-day to be in most
cases of more importance than terminal disinfection. Nevertheless, in
certain conditions, such as food poisoning or the enteric or the dysenteric
infections, or smallpox, the sanitary inspector visits. The enquiries are
directed to two ends. The first is to determine, if possible, the source
of the infection, with the object of taking whatever steps might be
practicable to avoid others being infected from that source. It is for
this reason that enquiries are made as to the source of the water or milk,
or about the school or other buildings, at which the child has been. The
second line of enquiry is to enable such steps to be taken as will minimise
the spread of infection by the infected person. It is for this reason
questions are asked about his place of occupation and lists obtained of
the contacts and their places of work.
Aid to Diagnosis
The earlier the diagnosis, the greater the likelihood that preventive
measures will limit the spread of infection. In some diseases, the
laboratory is of help. (See Laboratory Service, page 44.)
Where a patient is suffering from some clinical condition which is
suspected as being infectious, and in which the help of the laboratory is
sought, it is usually advisable, pending the confirmatory diagnosis, for
ne same precautionary steps to be taken as if the patient were known to
suffering from the infectious condition.
The other assistance a practitioner can obtain in the making of a
'agnosis is having a second opinion. Because of his training and
jcause, too, he was so often associated with an isolation hospital, the
, ed'cal Officer of Health usually had more experience in infectious
iseases than his colleagues in general practice. It was quite usual then
0r him to see cases about which the general practitioner was in doubt.