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Many cases are of so mild a type that medical advice is
not sought by the parents, and the nature of the disease is not
recognised. The mild cases are, however, infectious, and play
an important part in the spread of the disease.
The number of cases removed to hospital was 376 or 83.9
per cent. of the cases notified. In 1902 87.7 per cent., and
in 1901 80.6 per cent, of the cases notified were removed to
hospital. In the sub-districts the percentage of cases
removed to total cases was as follows : —East Battersea, 85.3 ;
North-West Battersea, 86.5 ; South-West Battersea, 78.2.
The high percentage of removals is an indication of the popular
confidence in the Metropolitan Asylums Board's hospitals, for
in no case was it found necessary to exercise compulsion to
effect a removal.
In 84 cases a history of direct personal contact with a
previous case in the district was obtained, and 12 other cases
were infected outside Battersea. In 24 cases the patients
were infected within one month of the return of an inmate
of the same house who had been discharged from an isolation
hospital after an attack of scarlet fever or diphtheria. In
some of these " return " cases the infection was probably
derived from the primary case. Of the 376 cases of scarlet
fever removed to hospital, 8, or 2.12 per cent., developed
diphtheria in hospital, but not one of these cases was fatal.
Post-scarlatinal diphtheria was formerly a most fatal disease,
but since the introduction of the anti-toxin treatment the
mortality has fallen very low.
In 27 of the cases notified as suffering from scarlet fever,
the diagnosis was found to be erroneous and the patients sent
back from hospital.
Diphtheria and Membranous Croup.
The case-rate, death-rate and case-mortality from
Diphtheria and Membranous Croup since 1891 are set out
below : —