Evening star., 1941-10-12

cases at Sibley Hospital last yeal
was begun by Health Department
physician but no formal report was
ever made.
How far the Health Department
can 60 in a new effort to strengthen
hospital regulations is a question
The Hospital Act OF 1908 provides
that the Commissioners have the
power to order regulations in the
public interest, but a Health De-
partment official informed The Star
that the hospitals would have to
agree to any requested changes.
Hospital officials were called to
the Health Department to work out
a set of regulations in 1888, but the
corporation counsel's office said at
the time that the results OF the con-
ference could only be considered
standards of care-not regulations.
Standards Tested.
Standards they worked out con-
cerning the transmission of COM
infections in the nursery
provide that such infections should
be minimized by:
81. Procedures which will provide
for the early recognition of infec-
tions through careful observation OF
the patients and accurate recording
of these observations.
-. Prompt reporting OF these OBJ
servations to designated authorities.
"3. The provision of facilities and
personnel for, and the immediate
isolation of all patients with sus-
pected communicable infections.
a. The prohibition of the admis-
sion of unexposed patients to wards
or nurseries in which communicable
or suspected communicable infec-
tions have developed until such time
as it is safe to do so. Suitable facil-
tiles and personnel shall be made
available for these unexposed
patients"
20 Die Since Early August.
Despite these standards, DR.. James
G. Cumming director of the Health
Department Bureau of Preventable
Diseases, reported yesterday that 81
infants had been stricken by the
disease since early August and 20
had died. AS late as last week, the
death toll was still going up.
According to his figures, 38 in
fants born at Sibley Hospital were
stricken and II died; Sc infants
born at Gallinger were stricken and
eight died The other cases were
scattered and not connected with
what he termed outbreaks at the
two hospitals.
DR.. Cumming dates his figures
from the day after the Health De-
partment became aware that the
disease had been running through
the nursery of Sibley Hospital for
some time previously.
Although doctors and hospitals
have been required to report cases
of diarrhea of the newborn for over
a year and although the lists OF the
Bureau of Vital Statistics show a
number of deaths resulting from
diarrheal disorders earlier this
wear and last year, the first entry
in the Health Department case re-
port books was not until August
%, 1941.
Statistics Inadequate.
Similarly inadequate as basis OF
analyzing the number of cases that
have occurred here in the past two
years are the records of the Bureau
of Vital Statistics. An official OF
the bureau remarked that the terml-
nology was "deceiving.
The White House Conference on
Child Health and Protection called
attention to the meaningless condl-
tions that are often listed as being
the cause of death of newborn in
fants and an official OF New YORK
Citv's Bureau of Preventable Dis
eases, writing in the Journal OF
Pediatrics, commented that a num-
Der of deaths resulting primarily
from diarrheal disorders are listed
in other categories.
To get around that vagueness OF
diagnosis, New York's Health De-
partment not only requires report
ing of diarrhea of the newborn but
traces every infant death, regard
less of the given cause OF death,
back to the institution OF birth TO
check on the accuracy OF the dag
noSis.
Partially accounting for varia-
tions of diagnosis are the baf1llng
qualities of the disease itself. Most
doctors agree that epidemic diar-
rhea of the newborn, sepsls OF the
newborn or infectious diarrhea or
whatever they choose to call 1t IS a
definite clinical entity, a disease OF
unknown origin, disorder that In
wolves only newborn infants during
the first four weeks of life.
Proof of Cause Elusive.
Though they have made bacteri-
and pathological tests, put
ting everything that might come
into contact with infants under a
they have found no con-
elusive proof of the cause OF the
disease.
The variable nature of the disease
complicates the problem. In some
outbreaks, the disease is relatively
mild and supportive treatment is all
that is indicated. In others, the
infection is very severe and drastic
treatment must be instituted early
to prevent a high mortality.
Some cases develop two days after
birth, others as late as the 21st
or even the 30th day OF life. Death
sometimes comes in "a hours, at
other times a week after the disease
strikes.
The disease shows no seasonal
trend, no relationship between the
baby's state of nutrition or type of
feeding, nothing that would show a
difference between sexes or races.
1t is difficult to prove Just how