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118 [1910
return was registered in 1891, when 728 cases were entered. At that time,
however, notification was in its infancy, and there has been only too much
reason to suspect that only a percentage of the cases, although a large one,
was made known to the Medical Officer of Health.
These 730 cases were equal to an attack-rate of 2.22 per 1,000 of the
population, as compared with a corrected average of 1,208 cases, and an attackrate
of 3.69 per 1,000 in the preceding 10 years. The reduction in the number of
cases notified during the last eight years was common to each of the Subregistration
Districts in the borough, thus for instance there were 83 cases
notified in Tufnell sub-district, as against an average of 120 in the preceding
10 years; 76 in Tollington as against 132; 91 in Lower Holloway as against
170; 114 in Highbury as against 217 ; 117 in Barnsbury as against 199, and
128 in Islington South-East as against 275. In Upper Holloway, however,
the number of cases notified was exactly equal to the average.
There has undoubtedly been a tendency for the notifications of this
disease to decrease, for it is found that in the 10 years, 1891-1900,16,014 cases
were notified, while in the succeeding 10 years, 1901-10, there were only 11,893,
or a decrease of 4,121. The movement of the disease as shown in quinquennia
is as follows:—
1891-1895 8,502 cases. 1901-1906 5,867 cases.
1896-1900 7,512 „ 1906-1910 6,026 „
It will be seen from these figures that during the last quinquennial period
the decrease was not maintained. Still, the return for that period contrasts
very favourably with those of the two first mentioned periods. It has been
pointed out in previous reports that the bacteriology of Scarlet Fever is
uncertain, and it is to be regretted that during the year which has just passed
no new light has been thrown on the subject. Bacteriologists differ as to the
specific germ, and until they are agreed it is unlikely that much advance will
be made in the prevention of the disease. It is very difficult at times to trace
the source of a case of Scarlet Fever, but there can be very little doubt that
it must frequently be conveyed from one person to another, particularly from
one child to another while in attendance at school. The aggregation of children
is in itself fraught with danger, but when to this is added the embraces and
kisses of these little ones, such danger is immensely increased. It is of course
well known that the germ of the disease may be conveyed by clothes. It
is evidently very tenacious of life, for every Medical Officer of Health is
aware that garments that have been put away for months, when again used,
have been the means of starting a fresh outbreak. It is generally recognised
I