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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    of health visits the house, and in the case of diphtheria he may make a preparation from the throat oi any suspicious case for diagnostic purposes. Where a medical man is in attendance his notice is drawn to the illness and his opinion asked for. In consequence of the diphtheria prevailing almost entirely among the poorer classes the medical attendant usually does not make a second visit after the case which he has notified has been removed to hospital. It follows that except for this visit of the inspector the occurrence of secondary cases might not be brought to light except by the parents noticing the illness and calling in the medical attendant. Unfortunately in many instances parents have not called in medical advice until the disease has been well established. Thus antitoxin has not been administered at the most favourable time, i.e., quite early in the disease, and also opportunity of infection of other members of the family has been afforded. There would be great advantage if arrangements could be made for visits to households of this class by a medical man after the notification and removal of the first case to hospital. This visit would often be the means of detecting the subsequent cases at the earliest moment, it would also ensure the detection of cases that might otherwise have been overlooked, their isolation and the prevention of the spread of the disease to the rest of the family. The notification of one case of diphtheria has frequently led to the discovery of others in the household or family, the onset of whose illness had preceded that of the notified patient, and who, although apparently well, were in an infective condition. Medical practitioners do not always consider the great desirability of examining the rest of the family or household after notifying the diphtheria in the case of the patient whom they have been called to see, thinking that such work is the duty of the officers of the sanitary authority, who can be remunerated for it. Similar visits are also desirable after the return of the patientffrom hospital to home, unless the medical attendant undertakes this duty. These are necessary to ascertain the condition of the patient when he arrives home from hospital and the condition of the rest of the family. They also give the opportunity to caution the parents as to the possible need of partial isolation of the patient for a further time as far as possible, as to the necessity of early notifica- tion of any suspicious illness occurring subsequently among the members of the family, and to see that the sanitary condition of the premises is, or has been placed, in a satisfactory state. In Enfield when a patient is discharged from the isolation hospital the inspector of nuisances is informed by telephone. The inspector then visits the house or sends his assistant to caution the parents as to the need for isolation of the patient for some time as far as possible and to further examine the condition of the premises. When a patient is removed to hospital no printed instructions are given to householders prescribing the precautions to be taken to avoid dissemination of infection, the period for which other children of the family are to be kept from attendance at school, inmates of the house from their work, &c. Such instructions are given verbally only. If the patient be nursed at home printed instructions are given to the parents prescribing the measures to be taken for isolation of the