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II.—NOTIFICATION OF INFECTIOUS DISEASE.
In Table III. of Appendix will be found particulars of infectious diseases notified during
the year under report.
The number of cases notified was 943, compared with 746 in 1910, and 810 in 1909.
The diseases which show a decrease on the numbers for the previous year are scarlet fever (56),
small-pox (1), enteric fever (6), cerebro-spinal meningitis (4), while those showing an increase are
diphtheria (53), puerperal fever (7), post-basic meningitis (1), ophthalmia neonatorum (36), chickenpox
(142), acute polio-myelitis or acute polio-encephalitis (3). The number of cases notified in the
registration sub-districts was 655 in Bermondsey against 501 in 1910, 242 in Rotherhithe against
192, and 46 in St. Olave against 53 in 1910.
The attack-rate per thousand inhabitants was 7.5, the rate for the sub-districts being 8.0
for Bermondsey, 6.9 for Rotherhithe, and 5.3 for St. Olave. The corresponding rates in the
previous year were 5.9 for the Borough, 6.l for Bermondsey, 5.0 for Rotherhithe, and 7.3 for St.
Olave.
47 cases were returned from hospital as not suffering from the disease for which they
were notified, but if allowance is made for mild unreported cases, the recorded notifications would,
if anything, understate the actual number of cases.
Small-pox.
No cases were notified during the year under report.
Typhus Fever.
No cases of typhus fever were notified during the year under report.
Diphtheria.
There were 260 cases of diphtheria notified in 1911, of which 184 occurred in Bermondsey,
60 in Rotherhithe, and 16 in St. Olave. This is an increase on 1910, for which the figures were:—
Borough, 207; Bermondsey, 131; Rotherhithe, 61, and St. Olave, 15. From the following table it
will be seen that a general increase has taken place throughout London.
Cases of Diphtheria Notified.
Year.
London.
Bermondsey.
1892
161
1893
367
8,368
13,712
1894
11,204
446
11,231
281
1895
425
1896
13,825
1897
13,217
393
326
1898
11,883
1899
13,711
734
1900
471
12,023
1901
12,156
329
1902
277
10,731
172
1903
7,738
1904
7,219
191
1905
165
6,482
1906
8,041
327
1907
8,779
311
251
1908
8,001
191
1909
6,679
1910
5,494
207
1911
260
7,385
9,894
315
Average
The attack-rate per thousand inhabitants was 2.1, against 1.6 in 1910. The case
mortality was 5.0 per cent., against 8.7 per cent, in 1910 and 6.3 per cent, in 1909. 12 cases
were returned as not suffering from this disease.
176 specimens were sent in by medical practitioners for bacteriological examination, against
122 in 1910 and 134 in 1909. Of these 33 were found to contain diphtheria bacilli, all of
which were notified.
In 13 cases of diphtheria the source of infection was attributed to previous cases in the house
or family.
Diphtheria is a disease caused by a characteristic bacillus known as the Klebs-Loeffler
Bacillus, which occurs in the throats of persons attacked by the disease. It seems to be conveyed
from person to person by direct contact, and there is no virulent disease which will spread more
rapidly under certain circumstances than this will among school children. It is more or less directly
conveyed from throat to throat by children passing sweets, slate pencils, and other articles which
they are liable to put in their mouths, from one child to another. Kissing an affected person on
the mouth will also frequently give rise to the disease, and an infected child coughing in the
neighbourhood of non-infected ones will also often transmit the disease to them. Sometimes the
bacilli will exist in the throat for a long time without producing any symptoms, but such children,
while not suffering themselves, will be liable to convey the infection to others.
For this reason they have been called " carrier " cases, and, as expressed in previous reports,
my belief is that a large part of the spread of the disease is due to such cases. Since 1902 an
B