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16 SCARLET FEVER.
SCARLET FEVER.
Of all the diseases scheduled for notification scarlet fever alone presented any points
worthy of minute study during the past year. The circumstances of its prevalence were
somewhat unusual, and it has been thought desirable to reserve a discussion of it for a special
report. Only a few figures in continuation of those presented in previous years are given in
this part of the Report.
The notified cases of scarlet fever numbered 715 in 1906, the highest number on record
for any year, fell to 579 in 1907, and rose to 681 last year. The morbidity rate last year was
4*43 per 1,000 persons, as compared with rates of 4'81 in 1906, and 3*87 in 1907, and a mean
rate of 3*17 for the five years 1903-07. The prevalence of the disease was generally above
the average in the Metropolis (rate, 1908, 4*51; mean, 3'89) and in the districts adjacent to
the Borough. The greatest prevalence was recorded in Willesden, where last year's rate was
4*76 as compared with a mean rate of 3'59. (See Table 5.)
Although the number of cases in the Borough as a whole was larger than that recorded
in 1907, yet fewer cases were recorded in Maida Vale, Lancaster Gate, East, and Hyde Park
Wards. (See Table 7.) The most marked increases occurred in Harrow Road and Church
Wards. It will be seen from Table 6 that more than half of the recorded cases occurred in
children aged from 5 to 13 years.
The certified cases included 38 erroneously diagnosed (equal to 5*5 per cent, of the total,
average 1903-07,3*8), 50 "return" and 31 "imported." There were definite outbreaks in
connection with certain schools and institutions in the Borough.
The 681 cases reported during the year included no fewer than 217 secondary cases,
equal to 31*8 per cent, of the total, as compared with 28'5 in 1907. This proportion
represents cases secondary to the primary attacks of the year. There were in addition a
small number of attacks secondary to cases occurring in the previous year. The distribution
of multiple attacks in each of the past five years is given below:—

Of the total of 681 reported cases 646 were removed to hospital, equal to 94"8 per cent., just
on 5 per cent, above the average. (See Table 14.) The percentages of cases removed from
the different Wards varied from 66'6 in Lancaster Gate, East, to 100 in Church Ward. (See
Table 13).
The fatality of the disease was singularly low, being only 1*7 per cent, of all cases, after
allowing for those erroneously diagnosed, as compared with an average of 2'3 per cent, for
the preceding five years. (Table 14.) This low fatality doubtless accounted for the very
small increase in the mortality, viz., from a mean (1903-07) of 0'07 per 1,000 persons, to a
rate of 0'08 during the past year. According to the Registrar-General's figures (Table 10)
the local rate was 0'09 last year, which rate was exceeded only by those of the Metropolis
(O'll) and Marylebone (0*10). Last year's rate was above the mean in all cases except
Marylebone, where it equalled it.