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V.—Cases of Malaria, Dysentery (Amoebic and Bacillary), Pneumonia (Primary and
Influenzal), and Trench Fever are to be notified to the Medical Officer of Health by the Medical
Practitioners in due form.
VI.—Misdirected notifications received by the Medical Officer of Health are to be forwarded
to the Medical Officer of Health to whom they are proper.
VII.—On receipt of notification, or on becoming aware of a case, the Medical Officer of
Health shall investigate the source of infection and take steps for preventing spread and for
removing conditions favourable to infection, and if a Medical Practitioner is not in attendance
the Medical Officer of Health shall investigate the nature of the case.
VIII.—Trench Fever cases. Malaria (Indigenous cases) and Dysentery outbreak are to be
immediately notified, with names and addresses of patient, to the Local Government Board
and to the County Medical Officer of Health.
IX.—Treatment of these diseases is to be secured by the Medical Officer of Health in a
suitable hospital, unless treatment elsewhere is satisfactorily preventive of spread.
X.—Malaria.—If the Medical Officer of Health considers such action necessary he shall
take all practicable steps to ensure that every (1) case is supplied with mosquito netting, (2)
treatment with quinine, (3) receives instructions as to prevention of relapse and spread.
XI.—Two or more cases occurring in and contracted within a district may necessitate the
appointment of a medical man for the purpose of (1) a systematic search for cases in suspected
houses, (2) suitable treatment and handling of the cases and destruction of mosquitos. These
measures implying collection of material for miscroscopic examination.
XII. XV.—Dysentery and Enteric Fever.—A Medical Officer of Health may by written
notice require that a patient or a " carrier " of these diseases discontinue any occupation
connected with the preparation or handling of foods, and may specify measures which shall be
taken as to cleansing, disinfection, disposal of excreta, destruction of flies, and prevention of food
contamination.
XII.—He may* by written notice require clinical examination of a suspected " carrier " ; if
such examination prove positive he may require that the '' carrier '' shall no longer be employed
in preparation or handling of foods.
XIV.—Trench Fever.—In cases of Trench Fever a Medical Officer of Health may by
notice require destruction of lice throughout any building, and temporary segregation of inmates
or contacts for a period until their persons and clothing have been freed from lice.
XVI.—The same regulation applies to Typhus and Relapsing Fevers.
VII.—In these diseases the Medical Officer of Health shall notify the Local Government
Board and County Medical Officer of Health of the names and addresses of persons affected.
XVII.—Expenses incurred by the Medical Officer of Health shall be defrayed by the Local
Authority.
XVIII.—Institutions are exempt from these regulations except by consent of the Managers.
XIX.—Persons suffering from Malaria or Dysentery or Trench Fever who are on board ship
may, on certification by the Medical Officer of Health, be removed to hospital in the absence
of effective isolation against spread of the disease.
The Local Authority may provide medical assistance or hospital accommodation in these
diseases.
Where a suitable hospital or place of reception is provided within the District of a Local
Authority, cases may be removed to such hospital or place on certificate of the Medical Officer
of Health, and with consent of the superintending body of such hospital or place, at the cost
of the Local Authority.
The scope for effective work of the Port Sanitary Authority is considerably
enlarged by the above regulations.
Your Medical Officer anticipates that the hospital at Denton will be more continuously
in use, and that this will be a factor tending to stability in that institution.
Work throughout the staff of the Authority will be increased to some extent in every
department, but more especially among the Medical Officers. The staff at present
authorised will, as far as can be foreseen, suffice.
In the presence of an epidemic of Influenzal Pneumonia, however, the accommodation
at Denton Hospital will obviously not suffice for the Port Sanitary District.
Some details of hospital equipment for microscopical diagnosis and for treatment
will be necessitated.
During the War the treatment of severe cases of Malaria has already been undertaken
in Denton Hospital
It is advisable that the third launch should be brought into commission as soon as
possible for this purpose; a deck hand and engineer are required to fill the places of
men who have fallen in the War Your Medical Officer recommends that these hands
be obtained.
INSPECTION OF VESSELS AT SOUTHEND.
As a matter of convenience to shipping, several vessels awaiting clearance at
Southend, owing to no berths being available either in the docks or in the river, were
visited by your Medical Officers there. This breach of the routine is deprecated as
being inconvenient and unsafe; arising out of a merely temporary phase in shipping
movements, it was not expected that the procedure would be necessary either in many
cases or over a long period.