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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.
Cases of smallpox from all parts of Middlesex are admitted to the
Joyce Green Hospital, Dartford, Kent. Although the removal of these
patients is made by the ambulances of the London County Council, the
approach for the removal is made to the Middlesex County Council
ambulance service.
The schoolchild who has suffered from scarlet fever is usually excluded
from school for seven days after his discharge from hospital or
from home isolation. This period is extended should he develop a cold in
the head, a discharge from the nose or ear, a sore throat or septic spots.
The period of exclusion of those who have suffered from diphtheria is
determined usually by the Child's clinical condition; after recovery, it is usual
to obtain negative nose and throat swabs. A sufferer from measles is excluded
for fourteen days from the appearance of the rash; from german measles
for seven days from the appearance of the rash; from whooping cough for
twenty-eight days from the beginning of the characteristic cough; from
mumps for fourteen days from the onset of the disease, or seven days
from the subsidence of the swelling; and from chickenpox for fourteen
days from the date of the appearance of the rash.
Exclusion of Contacts
Today it is very rarely felt necessary to prohibit persons carrying on
employment with a view to limiting the spread of infection. The practice
as regards children attending day schools follows the recommendations
set out in the Memorandum on the Closure of Schools and Exclusion
from School on account of Infectious Illness issued jointly by the Ministry
of Education and the Ministry of Health. School contacts of those
suffering from scarlet fever, german measles, mumps and chicken pox are
not excluded. The apparently well contacts of cases of measles can continue
to attend school, though contacts under five years of age or contacts