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Annual Report of the MedicalOffier Health-1892. 33
??? om hailed from this district. The conditions were just such as were best
???culated to spread the communicabie diseases.
with a view of lessening the chances of infection through a child returning
school after treatment at home, from an infected house, and with infected body
??? d clothing, I have gone further than the mere requirements of the law, and the
??? stay have, on my advice, adopted three separate forms (for copies see
??? pendix A) for use in this Parish.
Form A directed to the head teacher, recommends that he should prevent
??? y member who is an inmate of the same house as the patient from attending
???, until lie is furnished with a certificate of the final disinfecti
??? mises, &c., having been effected.
Form B, given to the occupier or other person in charge of infected premises,
quests that the signature of the Medical Attendant should be obtained to a certifi???
te appended and certifying that the premises, bedding, 4c., are now read- for
??? al disinfection, the case of sickness having terminated.
Form C. is a certificate stating that the premises, bedding, &c. have been
sinfected, which when signed by the Medical Officer of Health, is intend to be
livered to the head teacher prior to his re-admitting any child from the recently
fected house.
The London School Board have lately issued a circular letter advising all
etropolitan Sanitary Authorities to adopt the precautionary method described.
I regret to say—that so far—very few applications for certificates of final
sinfection have been applied for.
The Notification of Infectious Diseases.
Notification of certain infectious diseases has been compulsory in London
??? ce October, 1889. Its beneficial effect has been particularly exemplified during
??? e latter months of the past year, when 436 cases of small-pox were notified, and
??? e further spread of the disease, chiefly checked through the prompt removal of the
??? tients, by the excellent ambulance service of the Asylums Board, to the wellanaged
floating hospitals on the Thames at Long Reach, Dartford, and Grove Farm
mall-pox Hospital at Darenth.
Notification of first cases—affording concerted action between Medical
??? ractitioners, Medical Officer of Health, and the officials of the Asylums Board, is
??? valuable in the prevention of costly epidemics.
Its neglect entails delay which is apt to cause greater mischief than can be
??? epaired by any subsequent effort.
I would take this, the earliest opportunity, of tendering to the Medical Practi???
oners of the district my thanks for the cordial co-operation they have uniformly
??? iven me in the discharge of my duty as regards the Notification Act.
108 cases of erysipelas have been notified during 1892. Although this
??? mmunicable disease, which is liable to be spread to those having open wounds???cluding
the recently vaccinated—and to lying-in women, by means of a well-known
??? nd specific microbe, is only imperfectly isolatable, owing to its inadmissibility into
??? he wards of the Asylums Board Hospitals, and difficulty of entry within the general
??? ospitals, yet good has, I believe, been derived by its nature and dangers having
??? een explained in every case notified to me, and followed-on the termination of
he case—by disinfection of all infected articles. Ineffcient drains and drain-traps,
??? oreover, on the premises of many of those suffering with erysipelas, have been
??? emedied. I have been powerless, however, under the existing law to remove several
??? f the patients from damp, dark and unventilatabel underground basements, not
??? ented "separately," and a few of them habit to reflux of sewage in time of heavy
ainfall. Phthisis or consumption, although an infectious disease, which kills about
??? ne-tenth of the total number of those dying, is not yet notifiable in England.