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Annual Report of the Medical Officer of Health—1898.
23
This amount, paid in the first instance by your Vestry, is recouped by the
Asylums Board, and charged to the Metropolitan Common Poor Fund. 75.6 per
cent. of the total number of cases notified in the parish during 1898 were removed to
the Asylums Board and other hospitals.
It is important to bear in mind that prompt isolation alone can obviate the
danger resulting from the detention of infectious patients in so poor and densely
packed a district as St. George's.
Typhus Fever.
On the 12th April, a case of typhus fever was notified to me, in the parish, and
at once removed to the South Eastern Hospital. The patient was a woman who had
been exposed to the disease in Kensington, where she had attended a family in which
typhus fever had recently existed. The case was thus an imported one, and no
further case arising from it was notified in the parish—a fact which may be fairly
attributed to prompt removal of exposed persons to the reception house, and to
thorough subsequent disinfection. In Kensington, on the contrary, where there is no
reception house, there were many cases and several deaths. Another case of typhus
fever was notified on the 22nd October, six months later. It was that of a young
man who was found to have the disease upon presenting himself as an out-patient at
Guy's Hospital. The source of infection could not be ascertained, but up to the end
of the year no further attack was notified. Full details of this and of the preceding
case will be found in the Special Reports (pages 27 and 30).
Room Disinfection.
It will be within the memory of your Vestry, that, during the year 1896, a
considerable amount of attention was given to the subject of room disinfection.
As a result of my personal experience and investigation I expressed the conclusion
that the system of administration as then practised was imperfect. Among the
chief causes of such imperfection the following were mentioned (page 24 of my
Annual Report for 1896):—
(a) Want of a refuge house.
(b) Want of a larger staff of disinfectors.
(c) Want of a special inspector to deal with infectious diseases.
(d) Want of promptitude of the Asylums Board in the removal of cases.
With regard to the foregoing, it may be stated that a Refuge House has been
established and is in working order; that in 1896 an addition was made in the staff of
disinfectors in the person of a Superintending Disinfector who, with his wife, lives in
the Reception House ; and that the question of the special inspector is still in abeyance.
Since I made the suggestion for the appointment of the latter in my Annual Report
for 1896, the duties of the District Inspectors have been considerably increased with
regard to the investigation and supervision of infectious cases. In this way their
work is to some extent curtailed in other directions, and the desirability of appointing
a special Fever Inspector is thereby emphasised.
Lastly, considerable improvement has taken place in the adequacy of the hospital
accommodation provided by the Metropolitan Asylums Board.
Reception House.
This link in the preventive handling of infectious diseases is no less necessary
than the allied measures of notification, isolation and disinfection. In a poor and