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

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Walthamstow 1909

[Report of the Medical Officer of Health for Walthamstow]

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Being unable to deal with all the cases, a further difficulty was
experienced in determining whether the removal of all new cases
as they arose and before infection from them could be conveyed to
others, should be undertaken, or admit those who were in different
stages of convalescence, but clamouring for removal.
In giving preference to the new cases, unfortunately, a child, already
ill for 14 days and believed to be efficiently isolated, caused others to
contract the disease, and one of them died.
This led to a complaint to the Local Government Board, who
advised early provision of further Isolation Hospital accommodation.
The Public Health Committee seriously considered this request, but
in view of the facts placed before them, decided that whatever provision
they might make, short of extravagance, it would at times prove
inadequate, and that for all the legitimate needs of the district the
Hospital had a sufficient number of beds.
As stated, 76 per cent. of all the notified cases in 1909 were treated
in Hospitals, and considering that a capital expenditure of £41,000 has
already been incurred for the Sanatorium, that the cost of maintenance
and upkeep yearly exceeds £7,000, and that the County Medical
Officer of Health reported in 1905 that to provide for all cases of
Scarlet Fever would be waste of public money, the decision of your
Authority was justified.
Scarlet Fever is a disease very difficult to control, and impossible to
eradicate by isolation in Hospital, owing to the uncertainty of the period
of infectivity of those treated there, and to the number of missed and
doubtful cases constantly turning up in the general community. Our
knowledge of Scarlatina! infection is so limited, and the circumstances
of season and locality determining its spread so little understood, that
before the Hospital is enlarged we ought to know why a child, suffering
from Scarlet Fever for three weeks and daily in attendance at school,
does not convey the infection to other school children, but does to his
neighbours; and yet another child, with fewer signs of his illness, will
infect one after another of his classmates and others with whom he is
brought in contact; or why a child after eight weeks' isolation in
hospital, and who is apparently perfectly well, upon his returning home
will infect one or two of his brothers and sisters and not the remainder.
Why we should have an increased incidence yearly under similar
circumstances in certain months and not in others, or why a child
treated in a General Hospital for scalds should contract Scarlatina
while all the other children of the Ward escape, are problems that want

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