INFECTIOUS DISEASES.

Ashburton Guardian, Volume XXXVIII, Issue 9263, 8 April 1918, Page 8

INFECTIOUS DISEASES.

DH. M,, GiHSSSON EXPLAINS.

At.the ucsji-ital Board meeting to-day the following tatter was read from Dr. li. Oliess.son," in.strict Health Officer, in regard 10 infectious diseases :— •'Jour lotfcyr "of March 5 to hand, together with newspaper cutting ref tor ting the meeting of your, board. Alihougn jour accommodation is no uoubt taxed to. its utmost with the i:.<\v cases that have occurred in your cistrict, i foar tlmt you have take.n a

somewhat exaggerated view of the poaition. I'ou reier to the spread of iuifction in tiro district, attributing the blame to inability to remove cases to che nuspiui.l; isut l. must point out that :i you will- OKiimine the.' 1 returns you will note thafc the cases, both of scartet foyer and diphtheria, are well disoribu ted over tlie district, except in. the cases ai. Carew, which come, all from one family, and from Willowby, •:a which the name condition exists. One naturally expects that when a case occurs in a iaraily there is great possibility of another case, or cases, arising owing to .tho dose contact before- the ftrst case diagnosed, it cannot be said, therefore, .^ii'iki there is any evidence ■that the di.ses.ss:- is being spread in the district thro.ugh-lack■■'of isolation. : In the , newspaper cutting reference is .caade by the chairman as to the unsatisfactory : way the Public;-Health Act was. carried out. . 1 must point out that

your board i.s the local authority responsible for the carrying out of the Act. it ■is-'Viu- that you have referred co me one. or two cases in which iti -.ras Kiurgeste-:i' that- prosecution might be unuertttk-.M;', but in perusing the Wkience •J'cor.id see that there would Jiav" been' hufc prospect of gaining ;-; rour ease h-;2f- your board considers, ihat it wan Viufficienfc evidence to take

& prose.outioo in any of these cases there is' nothing to prevent the board doing so.--• iWuui? to the limited ac<.'onuuoa:.tio!i Which you' have at: piJer.ent, it ijj advisable only to remove

:hose cases wrueh cannot be sat)slac-| loriiv isolated at home, but those cases j .vhich cm he isolated in their own homes should be left, and strict super, vision uarriuti out, which would entail, <>£ course, miw.iy' visits fror/i the inspec--:or. 1 will k-idit your institution on -;he-first opportunity, and will be glad .•<) confi'i 1 with your chairman with regard to matters."

In a furfch-i 1?: letter, to the board on March 11, t><\ )Uhesson wrote:— "It miisf, be understood that al•thougji undoiifj^;4ly desirable that all eases of sc««t4 levoi- should be removed to fciici jsoia.tion hospital, we r.onid hartH;/ tx- justified- in insisting ujKm this if Mutation (»uld be satisfacvorilv carr'ed c-ttt. at. the patients' '.lomo, and it \*rt..-i' the wLsh of the par...■nis tlui-t tLn 1-' rase be nursed at home, v'ndei' such' emninifiunices one coukl jot very" w"^"; «u«^'-- upon the removal jnlcris we fo^su! that they did not oarry'o.it H»'« n^Lrictions imposed by the ' J^-partiii-^iil' on your board. One xHiul. thore-f-iH't'-, i<;asonably assume ihac permntv-rsf. ivnd full accommnda;.ion i'or frora 50 U> 12 cases should be ample i'or- U:^ requirements of the disirici, t'sp; v<i.'>.ll'i i ii some provision wass ai;ul.'' on t-ii-:- verandah tor atri.;)mn;rjdaciiui fo-i- jv.c or two beds td take casd-s wliich hsd arrived f.t a convalescent .stago. It is generally ac< ■■•■ n mild oa-hoh, or cases of moderate -'nten.sity,- &;<■>, tho first three wer-lv.-. -■ ;>ht? time ir: >vh.kh there is most da.nger of complioaturtjs. "' Tho. latter part oi the ! iiae is pi-a-ctic^lly .simply a ea.se of quaranbino.. Two small wards . of ro\u- ijedfi on-dt, one for male and tho otlier for f'etrtaJe, and say ' two. single rooms of ono bed each, which could be ised I'or rb.we and female, as occasion demaridedi <?r (w a suspect or complicated cas«.\ with good verandah aciommodatioM, rihould surely meet the i-equiromertfcs oi' the district., especially "if po desigKf<l as to permit of easy ■?xteri3ion.- The construction «hoiild, of ■course, h<e of. t-he very simplest.'" O" March. i:IC 'Uie clerk wrote-to s>r. '')!-■ •nson aa .follows: —

"I am. iastructed by the chairman to iijform you that since February 1 the board Ivvt had already to deal witl'2s scarlet, fever cases. The cbfuvm-n <.••>; ivi-^sses a-dmibt if the board V7JJI appreciato the responsibility °f disc;.!inatirig botwwn cases' which ought aivi ■m^ht'no'-, fcq'-''be isolated. He himself is of the- o|»inir>n that it is ' neither •desirable aw in the- best interest of phe admiaLsfcration of the Act that infectious ojwos uliould be aJlowed to iye treated a); the patients' home ■■'■- far as this health district is concerned; This board. oniM' not possibly exercise ss'jpervision of these

in ans'.vcv fe> the chairmaji's letteiDr. v'it-.-sson. ivroto: — " I quite agree with your chairman that it in moftv satisfactory t& have Micii oases m'Mwj hospital. It is practicaily imposHJ^le to provide siich permanent acco-taraodation as will deal with all cases bhafc'may possibly arise in the .-.venz of an epidemic, and as far as the Hospital dipnoi is. concerned your board would bo guided as regards individual cases to si.large* extent by the inspector's report. Sn other parts'of my district case^ are. quite satisfactorily treated in Weic own homes when the uonuv tu-o . hirfcc enough and well enough conducted for this purpose, and as you have- fui inspector resident in the ■li-;^o it should not be very difficult :o ensure proper isolation being carried oui. in selected cases."

Commenting on the above, the chairman said he. maintained that the isolation should be carried out as far as yr.K.:-■:'Jo-al Mu> hospital. As soon as the inspe-eWs back was turned proper ■station was not observed in many 'nomes, aud oUier people from outside Ayr.-- stllowcni to Bee the patients, thus ll'.f outbreak. After Dr. Ohesson had, visited the hospital find .seen for hmiscll' tho conditions, he actujilly reported to the Minister of rL::i!h' thy.t the accommodation was aot overtaxed.

Mr C. Reid said a reply should bo sent to Dr. Chesson pointing out that it \v:i.s the iiepartraent's own fault that fch-p nocomnioUation was not available at thf hospital. Tho board should place :h'. 1 blame oh the proper shoulders. T: ':■■■■ chairman said the question for the board bo decide was whether sufficient accommodation was available. If not, tho board should go on with tho rev or ward.

Mr Dixskie maintained that there- was not sufficient accommodation. A postDon^inent might mean a serious epidemic in the. district. Ho move? — ''■That, in tin-- opinion of this bourn, oxtra n.cconirrioda.tio'n was TKHjo^ary for infectious diseases at the hospital, and that tho board take steps to ,?>\'x't tlic new fev«>r ward," T'!;? 1 r.ha.inniiM said if the dc^:-ri;me'it had not. inlyrtV.rod with t?'r- Ix>;-i-(.'{ th" !ic""' •'.•,'■/;'! -vould have been "wric-'. U-.::^ l ji.p'o, a.n(l &A> hnli the co;-"''.. !'e .vl-! /is^fi th- h"%v>\ i.v I)iiild t l-.- > ,•■■ •.•,T.vf!| US '■'imrily ;'--, n*i>sib!:v Mr I)if:kk>'ri iiiotion was :■■; <-<;ii''c<j l>y Mr C. Rnid, anil carried iffmuiffloryiy. |