SCARLET FEVER CASES.

New Zealand Herald, Volume LXVII, Issue 20537, 11 April 1930, Page 12

SCARLET FEVER CASES.

SIX WEEKS' ISOLATION.

CRITICISM OF PRACTICE.

HEALTH OFFICER'S REPLY

Ths opinion that ovrr-stringent measures are taken by " le health authorities in isolating scarlet fever cases was expressed this week by an Auckland medical man. Dr. T. J- Hughes, medical officer of health for Auckland, when asked about the matter, upheld his department's policy as fully justified by past experience and the practice in other countries.

The view taken by the private practitioner was that the really infectious stage of the disease was the first ten days. The old belief that peelings from the skin in the later stages carried infection had been abandoned, he said, but the Health Department still insisted on isolation for six weeks. In the latter part of this period there was no real risk that tho patient would infect others. There was also some ground for criticising tho practice in dealing with contacts. This seemed to lack uniformity. When a patient was treated at home, the other inmates of the house, except tho nurse, were sometimes allowed to come and go provided they did riot enter the sick room. In other cases the entire household was isolated, causing inoonvenjencn.

" Our regulations are quite definite in requiring six weeks isolation for scarlet fever cases," said Dr. Hughes. " Formerly patients could be released at the end of four weeks if there were no further discharges from the mouth, nose or ears, but the rule is now stricter. To my own knowledge, infection has been conveyed by patients who were allowed to go after four weeks, when the discharges had ceased. Now we are taking no risks.

Dr. Hughes referred to a memorandum issued by the British Ministry of Health in 1027, and read a passage, which stated that scarlet -fever cases were usually treated in isolation hospitals and detained for a period of six weeks. In New Zealand, he said, patients were sometimes allowed to leave hospital and return home after four weeks, if the discharges had ceased, provided that they remained in isolation for a further fortnight. This was done only when the conditions in the home were such that isolation could be carried out satisfactorily. If the house was small, or the family included children, or its members could not be trusted to observe proper precautions, the patient was not allowed to go home before six weeks had expired. With regard to contacts, the practice varied. Persons such as school teachers, whose work brought them into association with children, were usually isolated for seven days. The same was done with persons who handled food, especially milk. In general, contacts were treated according to the circumstances of the case, and this would account for any apparent inconsistency. The same conditions applied when a patient was treated at home. This was seldom allowed except when beds were not available in the isolation hospital. The number of scarlet fever cases occurring in Auckland was not abnormal at present, Dr. Hughes stated. From 10 to 15 had been notified weekly in the. past, month. The cases were well distributed. and there had been no outbreak connected with any school or other institution.