London's Pulse: Medical Officer of Health reports 1848-1972

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West Ham 1934

[Report of the Medical Officer of Health for West Ham]

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During the year many of the patients were late in coming into
hospital owing to the lack of accommodation. Even those recommended
for admission had frequently to be kept at home for some
days waiting for vacant beds. Only 29 per cent. of the admissions
were brought into hospital during the first three days of illness.
The average duration of illness of all the cases on admission was
5.64 days. Less than 50 per cent. of them had a rash on the day
of admission. A feature of the present mild type of the disease
is that desquamation is frequently imperceptible; it had not been
detected in 24 per cent. of the cases discharged. A relapse
occurred during the 3rd week of illness in 8 cases in which the
diagnosis was confirmed by the presence of rash and desquamation.
Seven cases in which the diagnosis was doubtful on admission
contracted the disease in the wards.
Scarlet fever antitoxin was administered intramuscularly to
69 of the more severe cases which came under treatment during
the first 3 days of illness. The dosage varied from 10 to 40 c.c.'s.
Complications occurred in 21 per cent. of these cases.
Corrected diagnosis:— The 37 cases in which the diagnosis
was revised after admission were found to be suffering from the
following complaints:— Measles 6, rubella 9, tonsillitis 5, nephritis
1, chicken-pox 1, whooping cough 1, impetigo 1, toxic rash
1, erythema 2, constipation 1, dentition rash 1, debility 1, negative
Eleven cases admitted as diphtheria proved to be scarlet
Fatality rate:—Of the 798 cases admitted during the year, 9
proved fatal. Four of these were complicated by broncho-pneumonia
on admission. Three were suffering from septic scarlet
fever; one case had whooping cough and the other had nephritis.
I he fatality rate was 1.13 per cent. of the admissions.
In 24 cases the patient was found after admission to be
suffering from a second infection as follows
Scarlet fever with faucial diphtheria 7 cases
„ „ „ nasal diphtheria 9 „
„ „ „ measles 3 „
„ „ „ chicken-pox 3 „
„ „ „ whooping cough 2 „

Of the 817 cases which were discharged, 273, or 33.41 per cent., suffered from complications as follows:—

Adenitis69 cases or 8.45 per cent.
Albuminuria57„ „ 6.98 „ „
Arthritis16„ „ „ 1.96 „ „
Nephritis17„ „ 2.08 „ „
Otorrhoea41„ „ 5.02 „ „
Rhinitis71„ „ 8.69 „ „
Vaginitis2„ „ 0.24 „ „
The average duration of residence of all the cases was 37.04 days.