View report page

16
SCARLET FEVER.
A report was submitted to the Public Health Committee setting out the machinery
necessary to give effect to the Order, but the Committee resolved to take no action for the
present.
Of the value of the serum as a curative agent there is no room for doubt. As to its
use as a prophylactic there is, however, considerable difference of opinion. Evidence has been
recently adduced of the dangers arising from such use.* Persons subject to asthma appear to
be quite unfit for prophylactic doses. A curious condition of hypersensitiveness has been
observed in persons who, after a prophylactic dose, contract the disease, and a subsequent
curative dose of the serum may prove to be ineffective and dangerous.
SCARLET FEVER.
Last year 260 persons were reported to have this disease, but in two cases the diagnosis
was subsequently amended to one of enteric fever, and the cases were accordingly transferred
to that heading, leaving 258 cases for consideration here.
Up to the end of 1909 the smallest (uncorrected) number of cases recorded in any year
since 1901 was 277 (the total for 1905), from which figure the cases increased to 715 in 1906,
570 in 1907, 681 in 1908 and 629 in 1909. Last year's total shows, therefore, a great decrease
(practically 59 per cent.) from that of the previous year. It is also the smallest total for the
ten years 1901-10. The morbidity rate for last year (1.69) was less than half the mean rate
(3.83) for the five years 1905-09 (Table 4). It will be seen from the figures given in Table 7
that the disease was markedly less prevalent in the Metropolis and in the districts circumjacent
to the Borough. The local rate for the past year (1.70) was higher than those of the
circumjacent districts, except Willesden, (1.89) but a good deal less than that for the whole
Metropolis (2.16).
The uncorrected numbers of cases reported from each of the Wards of the Borough during
the past two years are compared in Table 6. The figures for Queen's Park, Maida Vale and
Lancaster Gate, West, Wards show the smallest changes. The numbers recorded in each
quarter of the year are given in Table 12. The largest number of cases (79) was recorded in
the second quarter, and the smallest (51) in the fourth, the usual autumnal increase in the
disease being replaced by a distinct fall. The chart (facing page 8) clearly shows the
variation in the prevalence curve of the disease during the year from the normal.
The 258 cases reported last year included 29 subsequently found to have been erroneously
diagnosed, while of the 229 genuine cases, 14 were believed to have been due to infection
contracted outside the Borough, including 3 cases contracted in out-lying institutions, and 15
to the return home of patients from hospital ("return cases"). The errors of diagnosis constituted
11.2 per cent, of the total reported, as compared with 6.3 in 1909 and an average of
5.2 per cent, during the five years 1905-9.
Two patients were reported during the year with second attacks of the disease, the
diagnosis being confirmed on both occasions in each case. The particulars of the cases
were—
W. J. C., m., æt 3, first attack 10.xi.'08, second 14.v.'10.
W. K., f., æt 7, first attack 28.i.'07, second 10.vi.'10
The 258 notifications came from 240 houses, the secondary notifications (54) forming 20.9
per cent. of the whole, the corresponding proportion for the previous year having been 20.2.
The house distribution of the notifications during the past six years, is given on the opposite page.
* See Public Health, vol. xxiv., p. 132 (January, 1911).