Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street.

  • Power, W. H.
Date:
1880
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Licence: Public Domain Mark

Credit: Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    Mr. W. H. Power’s Report to the Local Government Board on Diphtheria at the Hospital for Sick Children, Great Ormond Street. Geokge Buchanan, Medical Department, November 15, 1880. This inquiry, ordered by tbe Board at tbe instance of the Medical Com- mittee of the Hospital for Sick Children, has sought a cause for diphtheria occurring in that institution during March of this year. The outbreak in question is without parallel in the history of the hospital. In-patients have heretofore rarely been attacked by diphtheria; and when this has happened it has been under circumstances consistent with extension of the disease from antecedent cases under treatment in particular wards. On the present occasion, in-patients of four out of the five general wards of the hospital were almost simultaneously attacked by diphtheria or scarlatina, and this under circumstances that seemed to exclude, at least in the majority of cases, antecedent human infection. Preliminary inquiry by a sub-com- mittee of the medical staff of the hospital, led, in view of the above and of other evidence, to suspicion that the outbreak had been related to dust which had permeated the hospital during demolition of buildings in its neighbour- hood. In the end it will be seen that much doubt attached to this view, although the suspicion could not wholly be set aside. The inquiry that I have made has not succeeded in demonstrating a cause of the diphtheria. Its failure in that sense has been chiefly due to the complexity of the conditions inquired about. Invasion of the hospital by diphtheria could not, of course, be considered apart from a nearly simultaneous invasion of certain of the wards by scarlatina; nor could the fact be over- looked that among the after occurrences of illness, there were—besides diphtheria, scarlatina, and sore throats of an anomalous sort—cases also of whooping cough and measles apparently originating in the hospital. The mere enumeration of these circumstances will indicate something: of the difficulties which the inquiry had to encounter. The facts, as they soon presented themselves for examination, are summed up in the following tables :— Table I. (a.) Disease contracted in the Hospital. Date of Invasion. Patient in Hospital before Attack. Ward occupied by Patient before Attack. Name and Age of Patient. Malady for which Patient was admitted. Result of inter-current Illness. Scarlatina - 0th March 45 days Louise Ewens, 3 Abdominal abscess Recovered. Diphtheria 8th „ 26 „ Alexandra Thurston, 9^ Chorea - Died, 14th March. INasal diphtheria - 9th „ 19 „ Alice Ashford, ly^^^ Phthisis - Died, 11th April. Diphtheria 9th ,, 27 „ Do. Simpson, 4tAt Meningitis Died, 16th March. Diphtheria loth „ 6 ,, Do. Kirby, 5^ Rheumatism Recovered. Diphtheria 10th „ 13 „ Victoria Warner, 2y\- Pneumonia Died, 13th March. Scarlatina 10th „ Months Alexandra A nurse, adult - Recovered. Tonsillitis iOth „ 29 days Alice Rossiter, 5y^ Cerebral tumour - Do. Acute albuminuria 11th „ 44 „ Alexandra Martin, 5|^ Phthisis - Do. Whooping cough - 11th „ 23 „ Alice Jordan, 2^ Moule, 3p^ Empyema Do. Swollen tonsils 10th-14th „ 37 „ Do. Brain case Do. Swollen tonsils 10th-14th „ 55 „ Do. Blacknell, 3y^ Brain case Do. Q18S4. 100.—11/80. Wt.4442. E. & S. A