A fever hospital or isolation hospital is a hospital for infectious diseases such as Scarlet fever, Tuberculosis, Lassa fever and Smallpox. Their purpose is to treat affected people while isolating them from the general population. Early examples included the Liverpool Fever Hospital (1801) and the London Fever Hospital (1802). [1] : 13 Other examples occurred elsewhere in the British Isles and India.
The hospitals became common in England when laws were passed at the end of the 19th century, requiring notification of infectious diseases so that public health officers could ensure that the patients were isolated. During the 20th century, immunisation and antibiotics reduced the impact of these diseases. [2] After the introduction of the National Health Service in 1948, the hospitals were wound down so that, by 1968, there were few left. [1] : 27
As a result of the COVID-19 pandemic a number of temporary isolation wards within existing hospitals were established as well as several temporary hospitals, [3] such as the nightingale hospitals in England which were little used in many countries with the notable exception of China. [4]
It has been suggested that creating modern isolation hospitals might be an effective way of managing highly infectious diseases as was shown in China during the COVID-19 pandemic. [4] however the lack of staff to operate these facilities, the large costs for no ongoing direct patient benefit and the inability to use other hospital facilities to provide care for patients have been cited as the key reasons why fever hospitals are not appropriate in modern healthcare. [5]
The first hospital specifically for smallpox was the London Smallpox Hospital, founded in 1741. The first specialist hospital for other infectious diseases was the Liverpool Fever Hospital which was founded in 1801. Fever hospitals or "houses of recovery" were then established in other major cities – Chester, Hull, London, Manchester, Newcastle upon Tyne and Norwich. These were mainly for the treatment of typhus which was common. [6] By 1879, isolation hospitals of some sort were established in 296 local authorities, out of a total of 1,593 – about 18.5%. As the germ theory of disease and nature of infection became established, more fever hospitals were established so that, by 1914, they were the most common sort of hospital. [1] : 20 The numbers and sizes of the different sort of institutions at that time were [1] : 20
Institution | Average size (beds) | Number in England and Wales |
---|---|---|
Fever hospital | 41 | 755 |
Poor Law infirmary | 134 | 700 |
General hospital | 53 | 594 |
Smallpox hospital | 22 | 363 |
Specialist hospital | 62 | 222 |
After the London Fever Hospital was established in 1802, six more hospitals were established in London by the Metropolitan Asylums Board. These were designed with two separate buildings – one for smallpox patients and one for sufferers from other infectious diseases: cholera, diphtheria, dysentery, measles, scarlet fever, typhoid fever, typhus and whooping cough. [7] : 23
In London, there were protests and legal action against fever hospitals by residents who were concerned about the risk of infection. Precautions were taken, such as disinfection of ambulances, but it was found that the incidence of smallpox increased near smallpox hospitals. Siting of the hospitals next to rivers, so that transport of patients could be limited to ambulance steamers was found to reduce this. Ships, moored on the Thames at Long Reach, were also used as isolation hospitals. [8]
The UK Infectious Disease (Notification) Act 1889 (52 & 53 Vict. c. 72) required that local authorities be notified of the occurrence of such infectious diseases. The medical officer of health was then empowered to isolate the patients to prevent spreading. Well-to-do patients could be isolated at home but poorer people lacked the facilities and space for this. The requirement for isolation thus drove the need for provision of hospitals for this purpose. These measures were compulsory in the London area and were made compulsory in the rest of the country by a similar act of 1899. [9]
Cross-infection was a significant issue because patients with different diseases might be put in the same ward and share facilities such as towels. Isolation hospitals were then criticised as places "where a person goes in with one infectious disease and catches all the rest." [9] : 4 Patients returning from such hospitals might then spread the acquired infections to members of their families. These were called return cases and they could result in complaints and lawsuits. A major difficulty was a lack of understanding of scarlet fever, which was the most common disease at that time. The nature of the disease and how it was transmitted was uncertain. To prevent return cases, hospitals tried extending the period of isolation and giving patients disinfectant washes with formalin or Lysol when discharging them. [9]
A quarantine is a restriction on the movement of people, animals, and goods which is intended to prevent the spread of disease or pests. It is often used in connection to disease and illness, preventing the movement of those who may have been exposed to a communicable disease, yet do not have a confirmed medical diagnosis. It is distinct from medical isolation, in which those confirmed to be infected with a communicable disease are isolated from the healthy population.
The UK statutory notification system for infectious diseases is a system whereby doctors are required to notify a "proper officer" of the local authority if they are presented with a case of a serious infectious disease such as diphtheria or measles. The proper officer then sends a report to the Centre for Infections of the Health Protection Agency (HPA) in Colindale, north London.
Murine typhus, also known as endemic typhus or flea-borne typhus, is a form of typhus transmitted by fleas, usually on rats, in contrast to epidemic typhus which is usually transmitted by lice. Murine typhus is an under-recognized entity, as it is often confused with viral illnesses. Most people who are infected do not realize that they have been bitten by fleas. Historically the term "hunger-typhus" was used in accounts by British POWs in Germany at the end of World War I when they described conditions in Germany.
Highlands Hospital was a hospital in Winchmore Hill, in the London Borough of Enfield which closed in 1993. The site was redeveloped for residential accommodation, although many of the original buildings remain. The site is designated a conservation area and the former ambulance station is a grade II listed building.
In health care facilities, isolation represents one of several measures that can be taken to implement in infection control: the prevention of communicable diseases from being transmitted from a patient to other patients, health care workers, and visitors, or from outsiders to a particular patient. Various forms of isolation exist, in some of which contact procedures are modified, and others in which the patient is kept away from all other people. In a system devised, and periodically revised, by the U.S. Centers for Disease Control and Prevention (CDC), various levels of patient isolation comprise application of one or more formally described "precaution".
The Cork Street Fever Hospital, also known as the House of Recovery, was a hospital located in Cork Street in Dublin, Ireland.
Lodge Moor Hospital is a former isolation hospital on Redmires Road in the Lodge Moor area of the City of Sheffield, England. The hospital which opened in 1888 and closed in 1994 initially treated Smallpox but soon broadened its treatment to other infectious diseases and in its latter years expanded to provide more general nursing, notably spinal injuries and chest medicine. At the time of closure, the hospital was operated by the Central Sheffield University Hospitals NHS Trust.
King's Cross Hospital, often shortened to King's Cross is a hospital in Dundee, Scotland. It is managed by NHS Tayside.
Diseases and epidemics of the 19th century included long-standing epidemic threats such as smallpox, typhus, yellow fever, and scarlet fever. In addition, cholera emerged as an epidemic threat and spread worldwide in six pandemics in the nineteenth century.
Joyce Green Hospital was a hospital near Dartford, Kent, England. It opened in 1903 as an isolation hospital. In later years it was a training hospital. The hospital was closed in 2000 and the buildings were demolished. The greenspace where the hospital used to stand is known as Joyce Green.
Catherine-de-Barnes Isolation Hospital was a specialist isolation hospital for infection control in Catherine-de-Barnes, a village within the Metropolitan Borough of Solihull in the English county of West Midlands.
The Infectious Disease (Notification) Act 1889 first appeared on the UK national statute books in 1889. It was compulsory in London and optional in the rest of the country. It later became a mandatory law with the Infectious Disease (Notification) Extension Act 1899. These acts required householders and/or general practitioners to report cases of infectious disease to the local sanitary authority. The following diseases were covered by the acts: smallpox, cholera, diphtheria, membranous croup. erysipelas, scarlatina or scarlet fever, typhus fever, typhoid fever, enteric fever, relapsing fever, continued fever and puerperal fever. Householders or general practitioners who failed to notify a case of one of these diseases was liable to a fine of up to forty shillings.
Monsall Hospital was a hospital in North Manchester, England.
Hazard controls for COVID-19 in workplaces are the application of occupational safety and health methodologies for hazard controls to the prevention of COVID-19. Multiple layers of controls are recommended, including measures such as remote work and flextime, personal protective equipment (PPE) and face coverings, social distancing, and enhanced cleaning programs. Recently, engineering controls have been emphasized, particularly stressing the importance of HVAC systems meeting a minimum of 5 air changes per hour with ventilation or MERV-13 filters, as well as the installation of UVGI systems in public areas.
Shiranee Sriskandan is a British academic who is Professor of Infectious Diseases at Imperial College London and Honorary Consultant at Hammersmith Hospital. Her research considers how Gram-positive bacteria cause disease, with a particular focus on the bacteria Streptococcus pyogenes.
Convalescent plasma is the blood plasma collected from a survivor of an infectious disease. This plasma contains antibodies specific to a pathogen and can be used therapeutically by providing passive immunity when transfusing it to a newly infected patient with the same condition. Convalescent plasma can be transfused as it has been collected or become the source material for hyperimmune serum or anti-pathogen monoclonal antibodies; the latter consists exclusively of IgG, while convalescent plasma also includes IgA and IgM. Collection is typically achieved by apheresis, but in low-to-middle income countries, the treatment can be administered as convalescent whole blood.
An isolation pod is a capsule which is used to provide medical isolation for a patient. Examples include the Norwegian EpiShuttle and the USAF's Transport Isolation System (TIS) or Portable Bio-Containment Module (PBCM), which are used to provide isolation when transporting patients by air.
The Edinburgh City Hospital was a hospital in Colinton, Edinburgh, opened in 1903 for the treatment of infectious diseases. As the pattern of infectious disease changed, the need for in-patients facilities to treat them diminished. While still remaining the regional centre for infectious disease, in the latter half of the 20th century the hospital facilities diversified with specialist units established for respiratory disease, ear, nose and throat surgery, maxillo-facial surgery, care of the elderly and latterly HIV/AIDS. The hospital closed in 1999 and was redeveloped as residential housing, known as Greenbank Village.
COVID-19 hospital is a general name given to clinical institutions that provide medical treatment to Coronavirus Disease 2019 (COVID-19) infected patients. According to the World Health Organisation (WHO)'s COVID-19 regulations, it is critical to distribute COVID-19 patients to different medical institutions based on their severity of symptoms and the medical resource availability in different geographical regions. It is recommended by the WHO to distribute patients with the most severe symptoms to the most equipped, COVID-19 focused hospitals, then patients with less severe symptoms to local institutions and lastly, patients with light symptoms to temporary COVID-19 establishments for appropriate isolation and monitoring of disease progression. Countries, like China, Germany, Russia, the United Kingdom and the United States have established their distinctive COVID-19 clinical set-ups based on the general WHO guidelines. Future pandemic protocols have also been adapted based on handling COVID-19 on a national and global scale.
Mary Wardell was a British philanthropist whose establishment for the treatment of Scarlet Fever reduced the prevalence of the infection in London.