Discussion on the modern control of infectious diseases / R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1926?]
Catalogue details

Licence: In copyright

Credit: Discussion on the modern control of infectious diseases / R.A. O'Brien. Source: Wellcome Collection.

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    Section of Medicine Table II.—Diphtheria Incidence amongst Nursing Staffs, Edinburgh and Aberdeen. Year Total nursin staff Total diphtheria Diphtheria admissions to T staff hospital (a) Edinburgh 1919 ... — — 17 J 5 1920 118 1,201 10 5 5 1921 146 1,111 14 5 > 1922 147 914 13 (September, 1922) 5 J 1923 137 854 51 J } 1924 128 821 41 5 9 1925 161 1,050? 41 All in Schick positive nurses shortly after admission or before immunization. (b) Aberdeen 1912 125 _ 6 5 J 1913 125 — 15 ) 5 1914 125 — 15 5 ? 1915 125 — 8 J J 1916 125 — 10 J J 1917 125 — 10 9 9 1918 125 — 7 9 9 1919 125 — 5 9 9 1920 125 — 18 9 9 1921 125 — 18 9 9 1922 125 — 2 January, 1922 2 9 9 1923 125 — 0 9 9 1924 125 — 3 9 9 1925 125 — 1 2 Active immunization commenced. With regard to “reactions,” local or general, amongst the nurses after testing and immunization where these measures are in operation, the general reports are “ reactions negligible ” and ” no nurse off duty,” or that, at the worst, they cause no administrative difficulty. It would appear, now that it is practicable greatly to reduce or to abolish diphtheria among nurses, that serious consideration throughout large fever hospitals in England should be given as to the advisability of attempting to prevent the occurrence of the annual 500 cases of diphtheria amongst nurses in fever hospitals. If diphtheria could be abolished a considerable amount of dislocation of hospital routine, time and money would be saved, to say nothing of the personal inconvenience and risk to which the affected nurses are subjected. Scarlet Fever. Incidence.—In 1913 in the Metropolitan Asylums Board hospitals 117 cases of scarlet fever occurred amongst the staff, 15,010 cases were admitted, i.e., one staff case per 130 admissions; for 1914 the figures were 236, 22,000 = 1 per 93. The figures for two large cities from 1920-5 were 1 per 160 and 220. I have therefore assumed that one staff infection occurs for each 200 scarlet fever patients admitted. The average notification for the past four years in Britain has been 103,000; presumably 500 cases occurred amongst ward staffs. In the scarlet fever wards of one hospital, amongst 429 nurses employed during nine years forty-seven caught scarlet fever, i.e., 9 per cent. From our very meagre English experience we cannot yet say that Dick testing and active immunization have proved their ability to abolish scarlet fever from the ward staffs, but American experience seems to enable one to predict with some confidence that these measures will lie successful in greatly diminishing or abolishing the occurrence of scarlet fever. Though a negative response to the Dick test as at present carried out does not apparently indicate the practically complete immunity to scarlet fever that a negative response to the Schick test does in connexion with diphtheria, it is reasonable to conclude on the evidence available that a negative Dick response does indicate a