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. 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. The numbers and sizes of the different sort of institutions at that time were 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. 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.
Notification 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 the
Infectious Disease (Notification) Extension Act 1899 (
62 & 63 Vict. c. 8).
Cross infection 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." 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. ==List of hospitals==