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72
Public Health (Smallpox Prevention) Regulations, 1917.
No vaccinations were performed by the Medical Officer of
Health under the Public Health (Smallpox Prevention) Regulations,
1917.
Diphtheria.
" The incidence of diphtheria had been slowly and steadily
increasing from 1921 to 1930, when the number of cases notified
was 957 and the incidence or attack rate per one thousand population
was 3.25. In 1931 the notifications fell to 469, with an
incidence of 1.58. In 1932 the corresponding numbers were 440
and 1.50. Sudden drops in the incidence of epidemic diseases
are usually followed by a considerable increase both in the
incidence and the virulence. In other words, more cases are to be
expected, which will be more severe in character and the mortality
per 100 cases greater."
This forecast extracted from the Annual Report of last year is
being justified. There were 116 more cases notified in 1933 than
in the previous year and although the number of deaths was less
the incidence and the mortality are now both rising. In the first
quarter of 1933 there were 94 cases, only four of which were fatal,
while in the first quarter of 1934 there were 188 cases of which 15
were fatal, i.e., double the number of cases, but practically four
times the number of deaths. It would seem that the " mitis "
type of the disease is being supplanted by the " gravis."
The immunisation carried out at the Council's two diphtheria
clinics continue to remove the possibility of diphtheria from a
considerable number of individual children, but the numbers
immunised are still so small compared with the population exposed
to the risk that no reduction of the incidence of the disease can
be expected from this source. The disease, however, continues to be
conspicuous by its entire absence from the residential institutions
in the Borough in which all entrants are immunised and the standard
of immunity maintained at 100 per cent.