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question constantly comes up of whether there is any point in continuing
to have some of these diseases notifiable, or whether it might not
be more profitable to remove some of them from the list to which can
then be added other conditions about whose incidence there is no certain
indication.
G.R.O. Circular (M.O.H.) No. 1/1958 of 1st January, 1958 deals
with the steps to be taken to avoid duplicate notifications. There are
special provisions for London.
Isolation. By contrast with the position when the isolation hospitals
were first erected and all the beds were occupied by patients suffering
from scarlet fever, diphtheria or enteric fever and at which time a very
high proportion of those suffering from these infections would be
admitted to hospitals, today these infections account for only a small
proportion of the admissions to isolation hospitals. Today there are not
those numbers of cases of diphtheria and enteric fever to be admitted. In
the case of scarlet fever, the reduction is due to the fall in the number of
severe cases because whether the disease is highly or only slightly
prevalent, only very few of the patients are seriously ill. Today then those
admitted to the isolation hospitals are mostly those suffering from the
conditions which have become notifiable by regulation, and in general far
fewer beds are occupied by the infectious sick than was the case before the
war.
While the mild case of scarlet fever does not need to be admitted to
hospital to enable him to receive any special medical or nursing care, it is
still necessary that he should be isolated. These days it would seem that
many are losing their fear of scarlet fever, and for that reason perhaps fail
to appreciate the need to prevent the spread of infection to others in the
family. The result is that patients often enough are allowed to be up after
too short a period, something which is not in their own interests or in
those with whom they are permitted to come into contact.
Exclusion of Contacts. At one time quite stringent precautions
were taken to control the spread of infection from persons suffering from
the various infections By degrees these rules have been relaxed first in
the case of adults and more recently in the case of children, so that now
it is quite exceptional for an adult contact to have to refrain from going
to work, and the school child who is a contact of those suffering from
various infections is allowed in most cases to go to school.
Disinfection. At one time carried out as a routine practice after a
number of infections, it has largely been abandoned as routine measure
and is carried out only after certain infections. In this district it is limited
virutally to the fumigation of rooms and the steam treatment of the bedding
and Nothing of those suffering from smallpox, the bedding of typhoid
Patients and the rooms occupied by those suffering from open tuberculosis.
No progress could be made during the year about the erection of the
new disinfecting plant, although towards the end of the year it was learned
that it might not be very long before sanction to proceed was received.
In addition to these measures of course, there is the active immunisation
which can be carried out to ward off a growing number of diseases.