View report page

which made it advisable to exclude him from work. The Medical
Officer of Health should accordingly be prepared to issue such a
certificate where he thinks it proper to do so in order that the person
concerned may send it to the local office of the Ministry of National
Insurance in support of his claim for sickness benefit. The certificate
should be given in writing, preferably on official notepaper."
It is only exceptionally that exclusion of an adult is necessary. The
only certificate issued under these arrangements in respect of one in
this district was to a student nurse at a hospital. She was a contact of a
case of german measles. She had not had the disease, so she was
excluded for the period she would have been infective had she been going
to contract the illness.
Because of the special features in the spread of poliomyelitis, more
stringent precautions are advised for the contacts of those suffering from
this complaint than from others. (See page 127.)
The practice of excluding from school child contacts of infection
has been markedly relaxed in recent years. Not only is exclusion
required 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 from 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
eachers 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
1ll