Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council.

  • Wheaton, S. W.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council. Source: Wellcome Collection.

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    to their homes without changing their clothes or taking a disin- fecting bath. There is no accommodation at the sanitary offices for this purpose. The drains of infected premises are flushed with chloros solution. The ashbin, or ashpit, is not emptied, or the contents disinfected, but left for the usual weekly collection of refuse. Blank forms are provided for the medical attendant to certify when the patient is free from infection in the case of patients treated at home. The medical attendant often sends a swab from the throat for examination to the medical officer of health in diphtheria cases, and does not fill up this certificate until the throat has been pronounced to be free from the diphtheria bacillus by the latter. The council have two ambulances. One has been retained for use in diphtheria only. They are kept at the council offices so that they can be despatched at very short notice. There is a drawback, however, to this arrangement, because no nurse accompanies the ambulance. The work of removal, and any necessary care the patient requires, is left to the attendant or the driver. The ambu- lance attendant also assists in supervising the ^scavenging. A form is filled up at the patient’s house by the inspector or ambulance man and is sent to the hospital with the patient. This form states the ]>atient’s name and address and the date of onset of various symptoms, such as headache, sore throat, rash, vomiting, the family history and patient’s history. It is also stated if the patient had a discharge from ear or nose previously, whether there were vermin on the head or body, or sores, how many children there were in the family, and how many had not had the illness from which the patient was certified to be suffei’ing. On October 10th, 1908, the district council decided to supply diphtheria antitoxin free of charge to all medical practitioners asking for it. The inspector of nuisances was furnished with a supply at his office, and the medical officer of health also had a supply, so that it covdd be obtained on application to either of them. Antitoxin has been used since this date to a considerable extent both with a curative and prophylactic object. The medical officer of health has made a bacteriological examination of swabs from the throat in all cases where requested, and if diphtheria bacilli have been found he has informed the medical attendant forwarding the swab. The school medical officer has also taken swabs from the throats of many suspicious cases attending the schools and sent them to the medical officer of health. In this way some cases of diphtheria have been detected and removed to hospital, others having only slight symptoms of illness but with diphtheria bacilli present have been excluded from school and isolated at home as far as possible under the circumstances. During 1908 the medical officer of health has examined 306 swabs from the throat, 128 of which gave positive results. A large proportion of swabs which were taken fi-om the throats of children attending school who were contacts, and who in some instances presented signs of sore throat, gave negative results. The school medical officer and the medical officer of health have co-operated throughout the epidemic. When any increased incidence was noted in any particular school the school medical officer of health has visited it and examined the