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130
PUERPERAL INFECTION
The state which is notifiable under the 1951 regulations is any
febrile condition occurring in a woman in whom a temperature of 100.4°F.
or more has occurred within fourteen days after childbirth or miscarriage.
This raised temperature may be the result of some state such as an
infection following the confinement or miscarriage, or it may be due to
a cause which may affect any person and be entirely unrelated to the
pregnancy. Many of the notified patients are removed to the isolation
hospitals for treatment. This is especially necessary if the febrile patient
is in a nursing home and some innocent cause of the pyrexia has not
been found. Because of the risk of transmission of infection to other
patients, the midwife who attends other confinements is relieved of her
duties of attending the febrile patient who is at home and who is thereafter
attended by the home nurses who do not nurse women at their
confinements.
The notification under these regulations is sent to the Medical Officer
of Health who sends a copy to the Local Health Authority. If a woman
living in one area is confined in a hospital in another area and develops
puerperal pyrexia, the notification is sent to the Local Health Authority of
the district in which the hospital lies and appears in the returns of that
district. At one time this was not the case in regard to London hospitals
as notifications of patients suffering from pyrexia in those hospitals
were sent to the areas in which the homes of the patients were.
There were four cases of puerperal pyrexia amongst those who
were confined in their own homes in this district. In one the raised
temperature followed an incomplete abortion, in another the fever was
due to an inflamed breast. The cause of the rise in temperature in the other
two patients was not detected.
OPHTHALMIA NEONATORUM
Ophthalmia neonatorum is an inflammation of the eyes ot the
new-born. At one time it was responsible for much blindness. To-day,
probably mainly as the result of preventive treatment carried out at the
time of the birth of the infant, the position is much more satisfactory
Infection of the eye, however, can so readily lead to blindness that lot
many years local authorities have made special arrangements for tie
treatment in hospital of the more severe cases or the treatment by skills
nurses of those infants remaining at home. If the infant has to be
admitted to hospital, it is as well for the mother to be admitted too.
During 1954 three notifications were received of infants who had
been born in this district suffering from ophthalmia neonatorum,
cases were mild and recovered without any injury to the eye.
PEMPHIGUS NEONATORUM
This is a disease of the skin which in the new-born can cause extreme
illness, or even death. Outbreaks have occurred in which the spread
seemed to be associated with the practice of a particular midwife, thongh
the exact mode of transmission is unknown.