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The 25 deaths recorded in 1920 included 2 "Transfers" and may, therefore, be ignored for
the moment. Of the remaining 23, 12 occurred after (or simultaneously with) notification as
cases of influenzal pneumonia—a fact which suggests that notification was very incomplete.
Six of the deaths took place at the Infirmary (all notified cases) and 3 in nursing homes
(2 notified).
Primary Pneumonia.—During 1919, 83 cases (48 males and 35 females) were reported, and
during 1920, 96 (males 56, females 40). Of the cases notified during 1919, 5 were subsequently
marked "errors," as also were 2 of those reported during 1920. In 2 instances there was clear
history of the disease being contracted outside the Borough.
Of the total 179 cases reported during the two years 37 received treatment in hospitals,
31 in infirmaries and 2 in nursing homes, the total of those cases (70) forming 39.1 per cent,
of all cases reported. Institutional treatment was given in 1919 to 36.0 (30 cases) of the cases
and to 39.5 per cent. (38 cases) in 1920. The District Nurses were called in by the
Department to 19 cases, 9 in 1919 and 10 in 1920.
There were 25 deaths (males 12, females 13) among the 83 cases reported in 1919, and 32
(males 19, females 13) among the 96 reported in 1920. Those figures would give fatality rates
of 30T and 33'3 per cent, respectively, but such rates by no means represent the truth.
Some of the fatal cases were certified to have been due to diseases other than pneumonia, and
a good many deaths certified due to "pneumonias"—excluding broncho-pneumonia—were not
notified. The notification of the "pneumonias" is at present incomplete. Moreover, as in 30
instances death ante-dated notification, there appears to have been some delay in reporting
cases. Notification was better in 1920 than in 1919, as the proportion of cases in which death
occurred before notification decreased from 72 per cent, in 1919 to 37.6 in 1920.
The deaths from the pneumonias*—excluding broncho-pneumonia—numbered 96 in 1919
(48 of each sex) and 54 (33 males, 21 females) in 1920). The Index Numbers (total) are:—
1919, 110; and 1920, 62—the annual average 1909-13 (=100) being the standard. In 1919
37.5 per cent. of the deaths occurred in institutions, the proportion falling to 29.6 per cent,
in 1920.
Respiratory Diseases.—The deaths from all forms of these diseases numbered 391 in
1919 and 284 in 1920—as compared with annual averages of 346 and 351 in 1909-13 and
1914-18. Taking the average of 1909-13 as the basis (= 100), the Index Numbers are:—
1914-18, 101; 1919, 114; and 1920, 82. The very small increase noted in 1914-18 is
remarkable, having regard to the fact that 1918 was the year of the influenza epidemic
(358 deaths beiug due that single disease). In that year the total deaths numbered 239, with
an Index Number of 69 only.
Dysentery.—This disease was made notifiable in January, 1919. During that year
3 cases—all ex-service men—were reported to have the disease, in each instance contracted
abroad. During 1920 only one case—an ex-service man— was notified.
In April, 1920, there were 10 cases of dysentery at the Children's Hospital, Paddington
Green. In four instances bacteriological tests were applied to the fasces, the Flexner bacillus
being found in three. Enquiry failed to connect the outbreak with any ex-service man or to
throw any light on its origin. None of the cases were notified.
Trench Fever.—This disease was made notifiable in January, 1919. Only one case has
been notified since that date. The patient had his first attack in France during 1917. There
were no signs of vermin in the man's home, and no spread of the disease.
* When a death is certified as due to one of the pneumonias following epidemic influenza, such death is
classified under epidemic influenza.