Return cases of scarlet fever and diphtheria : reports and papers relative to the Board's inquiries / Metropolitan Asylums Board.

  • Metropolitan Asylums Board (London, England)
Date:
1901
Catalogue details

Licence: In copyright

Credit: Return cases of scarlet fever and diphtheria : reports and papers relative to the Board's inquiries / Metropolitan Asylums Board. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    A comparison between the period of isolation of cases treated at home and that at hospital shows a very marked difference in their duration, as is seen by the following statement :r— Scarlet Fever. Diphtheria. Hospital. Home. Hospital. Home. Under 2 weeks o-o 4-7 0-5 37-6 ‘2 weeks and under 4 weeks... 0-2 16-5 5-2 44-8 4 ,, 6 n 2’8 33*5 11-2 12-6 0 „ ,, 8 19-2 . 314 32’4 2-9 8 „ „ 10 24 9 7‘5 18-9 04 10 „ „ 12 )) * 19’3 1-0 12-2 o-o 12 „ „ 15 ' > 5 is • • 17-9 o-o 10-0 o-o 15 weeks and over 6-7 o-o 4-9 o-o The statement shows that, while 91 per cent, of the scarlet fever cases treated at home are isolated less than eight weeks, only 22 per cent, of those treated in hospital are discharged by this period, and 71 per cent, are detained for eight weeks and longer, extending to over 12 and 15 weeks, which apparently does not exist in home isolation; and that while 82 per cent, of the diphtheria cases treated at home are isolated less than four weeks, only 5 per cent, of those treated in hospital are discharged by this period, and 94 per cent, are detained four weeks and longer. The extremes are shown in the table, and I think there can be little doubt that, while 37 per cent, of the home isolation of diphtheria is under two weeks, and 57 per cent, of the scarlet fever cases is under six weeks, there is no lack of infectious material abroad to keep up the supplies of these diseases when seasons favour their prevalence. In diphtheria the percentage is probably somewhat higher than actually represents the facts, owing to its including a few fatal cases. Period of isolation at home too short. On the other hand, from the point of view of infection, the isolation detention in Board’s infectious hospitals appears to be of unnecessary length Metropolitan in both diseases. ]Mo rigid rule can be lived for all cases, for the Asylums’ presence of albuminuria and other complications will not permit of XlOSpiLcLLS -r i • i • • • too long. this; but I think it is a question for careful consideration whether there is anything gained by detaining the patient longer than is the general practice in infectious hospitals in other parts of the country, such as Aberdeen, Glasgow, Edinburgh, and Liverpool, in which the average duration of stay in hospital is at least a fortnight, and sometimes three weeks, less than in the Metropolitan Asylums Board’s infectious hospitals. Summary. (i.) In conclusion, I shall briefly summarise the results of the inquiry as stated in this report:— That before investigation into causes the return cases were 339, giving a percentage of 3’4 on the total discharges from hospital, 3’S per cent, being scarlet fever and 2’3 per cent, being diphtheria.