View report page

48
Of the 67 (?) infecting cases 25 were found to have rhinitis in varying degrees (two of
these had also otorrhœa, one conjunctivitis and impetigo, three enlarged glands in the neck with
enlarged tonsils, one other enlarged tonsils, one epistaxis, one jaundice, and one psoriasis);
6 had enlarged glands in the neck (of which 3 had enlarged tonsils); one had enlarged tonsils;
two had sore throat; and one each had epistaxis and rheumatism, a sore on the face, and vaginitis.
The remaining 30 had no signs of infectiousness, though 4 of them had slight enlargement of the
tonsils and 3 palpable glands in the neck, but not greatly enlarged. In 10 of the cases of rhinitis
swabs were taken from the nose and bacilli indistinguishable morphologically from diphtheria
bacilli were found in 4 cases, and negative results in 6. The four " positives " were readmitted
to hospital.

Scarlet fever after diphtheria.—There were also 4 instances in which cases of scarlet fever
developed within 28 days of the return from hospital to the same house of a previous case of
diphtheria. In each of two of these there was one further case of scarlet fever after the return
case, and in one other there were two further cases. In all 4 houses the return cases of scarlet
fever were in the same family as the previous case of diphtheria. In three instances the previous
case of diphtheria was found to be suffering from rhinitis, and the one other showed no signs of
infectiousness. The intervals between the return of the case of diphtheria and the onset of
the case of scarlet fever were 6, 11, 22 and 26 days.
/fter-care.—A proportion of the children who have been discharged from hospital after
scarlet fever have been visited to ascertain their condition and to secure treatment for sequelae
if necessary. 329 such children have been visited in 1921, of whom 275 are reported to have
recovered satisfactorily and 54 to have required treatment. The conditions needing treatment
were as follows : Debility 15, nose and throat 15, ears 3, enlarged glands 5, rheumatism 4,
kidney 3, eyes 2, heart 2, cough or "chest trouble" 2, other conditions 3. Sixteen of the cases
were treated at the St. Pancras Dispensary, 22 at hospitals, 2 at the School Clinics, and 14 by
private doctors.
DIPHTHERIA.
723 patients were notified in 1921 as suffering from diphtheria or membranous croup.
Of these, 66 were afterwards found not to be suffering from the disease by Medical Superintendents
of the Metropolitan Asylums Board.
The corrected number of diphtheria cases notified was therefore 657, equal to an
incidence rate of 3.1 per 1,000 population.
The number of deaths from diphtheria certified during the year was 51, equal to a deathrate
of 0.24 per 1,000 population and a case mortality of 7.8 per cent. of cases notified.